bluuebunny/crossref_metadata_2025_split huggingface dataset:
P068 Computational fluid dynamic study in Obstructive Sleep Apnea patients
Authors: Lee Y , Lim W , Jung S , Lee D 
Published: November 2022

Abstract

Introduction
Obstructive sleep apnea (OSA) is a common disorder which may need surgery to widen the airway. However, the success rate of surgery is variable. Thus, it is necessary to predict the outcome of the surgery preoperatively. The purpose of this study is to evaluate the mechanical parameter of upper airway airflow in OSA patients using computational fluid dynamics (CFD) method.

Method
We conducted a study on the patients with snoring, underwent the full night polysomnograpny (PSG) and paranasal sinus computed tomography(CT). The patients with past history of previous trauma or surgery were excluded. Three-demensional reconstructions of the upper airway were created in the medical imaging software Mimics 16.0 using paranasal CT. The reconstructions extended from nasopharynx to hypopharynx. Steady-state, turbulent, inspiratory airflow simulations were conducted in Fluent 17.0 with following boundary conditions The mechanical parameters (wall shear stress, pressure, plane velocity) were calculated in the three levels of nasopharynx, retropalatal, retrolingual area.

Results
The maximum wall shear stress values were shown at the retropalatal plane in all patients. There is a tendency for the wall shear stress value of the retropalatal area to increase as the AHI increases. The maximum velocity values were shown at the retropalatal plane in all patients. The maximum pressure values were shown at the nasopharynx plane in all patients.

Conclusion
the maximum wall shear stress values were shown at the retropalatal plane and the wall shear stress value of the retropalatal area increased as the AHI increased. Thus, the palatal surgery might help the OSA patients.
P078 Predicting initial AutoPAP pressures in children - how do we perform ?
Authors: Mihai R , Nisbet L , Ellis K , Davey M , Nixon G 
Published: November 2022

Abstract

Introduction
Auto-titrating positive airway pressure (APAP) with remote monitoring provides valuable information on pressure requirements during acclimatisation to APAP in children. However there are no reliable predictors of pressure requirements in children to help guide clinician prescribing upon commencement of APAP.

Methods
Retrospective review of children commencing outpatient APAP in tertiary hospital from 2017-2022. Initial APAP prescription was at treating physician discretion and changes over subsequent days were based on review of remote monitoring data.

Results
111 children commenced APAP (86 male; median 13.7y; range 3.7-19.3y). Initial minimum APAP pressure ranged from 4-6cmH2O (median 4cmH2O), and maximum pressure ranged from 6-16cmH2O (median 12cmH2O). 69 (62%) required no pressure changes; 42 (38%) required 1 or more changes. Children who required ≥1 change had a lower initial maximum pressure than those not requiring change (median 10cmH2O versus 12cmH2O, p&lt;0.01) and were younger (median 9.6y versus 14.8y, p&lt;0.01). There was no significant difference between the two groups for minimum initial pressure, OAHI on diagnostic PSG or BMI z-score. Median days from initiation to the first change was 4d (IQR 2,11). Pressure adjustments were typically conservative increases in APAP maximum (median +2cmH2O; range -4 to +5cmH2O). The main indication for change was remote monitoring data showing pressures frequently approaching APAP maximum pressure.

Discussion
This study shows that clinicians are more likely to under-prescribe initial maximum APAP pressure in young patients, leading to a higher number of adjustments required to reach satisfactory therapy. Further investigations will assess the impact of prescription changes on adherence.
P096 Objective Measures of Sleep Architecture in Adults and Older Adults with Depression: A Systematic Review and Meta-Analysis
Authors: Ricciardiello A , Teh J , Lam A , Marshall N , Naismith S , D'Rozario A 
Published: November 2022

Abstract
Depression is intrinsically linked to sleep, however, the exact nature of sleep disturbances has been poorly defined, especially for older adults over 50 years with depression. We examined published articles with overnight EEG recordings in adults with and without depression to determine if objective measures of sleep macro and micro architecture differ. We also examined differences in these outcomes in older adults.
2135 papers were identified through four databases. Two reviewers, using the PICO structure, removed 2062 papers at abstract review and 58 at full text review. Fifteen articles met inclusion criteria and reported macroarchitecture. Three reported microarchitectural outcomes but were not meta-analysed. RevMan 5.4 software was used to perform a random effects model meta-analysis. NICE case-control guidelines were used for risk of bias.
Fifteen studies were assessed (406 depressed and 432 control). Two papers examined older adults (31 depression and 31 controls). Within the total population, adults with depression had less total sleep time, lower sleep efficiency(SE), delayed sleep onset latency, higher wake after sleep onset, shorter rapid eye movement latency(ROL) and greater REM density than controls. No differences in stage 1(N1), stage 2(N2), stage 3(N3) or REM sleep were observed. In older adults, the depressed group had greater N1, less N2, shorter ROL, greater REM density and no difference in SE or in REM sleep duration.
REM latency and REM density outcomes were consistent across older and younger depressed groups, whereas younger adults with depression had worse sleep continuity. Differences in sleep phenotype may relate to underlying neuropathology.
P100 Different effect of sleep loss paradigms on various pain types in healthy subjects: A systematic review and meta-analysis
Authors: Rouhi S , Topcu J , Egorova Brumley N , Jordan A 
Published: November 2022

Abstract

Introduction
Sleep disturbances are comorbid with chronic pain, exacerbating pain conditions. Experimental studies have implemented different sleep loss paradigms combined with quantitative sensory testing to better understand the sleep-pain relationship. However, knowledge of which sleep loss paradigms are most detrimental regarding hyperalgesia is lacking. The current review aims to differentiate the effect of fragmented sleep from partial or total sleep deprivation and determine whether sleep-loss-related hyperalgesia is due to curtailed/deprived consolidated sleep or sleep continuity disruption.

Methods
We searched the databases, including EBSCO, MEDLINE, Psychological Information Database (Psych INFO), Science Direct, and Web of Science, to identify 36 experimental studies involving 928 participants. The studies implemented different sleep loss paradigms, such as total sleep deprivation, sleep restriction, and disrupted sleep continuity on heat, cold, pressure, and mechanical pain thresholds in the general population. In addition, we considered the sex-dependent effect of sleep loss on various pain types.

Results
Total sleep deprivation exerted the strongest (SMD = -1.721; CI95: -2.358, -1.073; P&lt;0.001), while fragmented sleep protocols induced the least (SMD = -0.294; CI95: -0.478, -0.110; P=0.007) hyperalgesic effect. The effect of sleep loss on heat pain was greatest, whereas on pressure pain was smallest. The sleep loss-related hyperalgesia on heat and pressure pain differed between men and women, while the cold pain threshold was sex-independent.

Conclusion
This meta-analysis confirms that depriving sleep entirely greatly affects pain perception while disrupted sleep continuity induces a small effect and requires two consecutive nights of disruptions.
P106 Where is the care in healthcare? Mother perspectives’ of caring for a child with narcolepsy
Authors: Schokman A , Cheung J , Klinner C , Milton A , Naehrig D , Thornton N , Bin Y , Kairaitis K , Glozier N 
Published: November 2022

Abstract

Introduction
When caring for a child with a chronic illness, primary caregivers become care coordinators, system navigators, and illness experts. There is limited research on the challenges faced by family/carers of a child with narcolepsy.

Methods
Twenty participants who self-identified as a family/carer of a child with narcolepsy were interviewed, all of whom were mothers. Prior thematic analysis of submissions made by family/carers to the parliamentary inquiry informed interview questions. Interviews were analysed using the framework approach by a team of six multidisciplinary researchers.

Results
Three themes were identified. ‘Adjustment, communication and coping’ encapsulates challenges associated with diagnosis, the mental health toll it has on the whole family, and the limited support available to mothers. ‘Healthcare journey of narcolepsy families’ described challenges faced in the healthcare system, with mothers speaking of dismissal of their concerns and experiences of a lack of equity when accessing quality healthcare services for their child. ‘Independence, support, and resources’ unveiled the challenges carers faced accessing disability and academic supports at school and the workplace, underscoring mothers’ concerns for the future independence of their child.

Discussion
Mothers felt they had limited control over the trajectory of their child’s healthcare journey and emphasized the adverse psychological effect narcolepsy had on the entire family. There was an expectation that clinicians should be providing more information and support than currently is provided, across areas that traditionally are not within the healthcare domain. This raises important questions around who is responsible for providing this information and where is sourced from.
P107 Cost, Control, Compromise: Exploring the lived experience of narcolepsy in Australia
Authors: Schokman A , Cheung J , Klinner C , Milton A , Naehrig D , Thornton N , Bin Y , Kairaitis K , Glozier N 
Published: November 2022

Abstract

Introduction
Persons with narcolepsy wrote of dissatisfaction with healthcare and unmet psychosocial needs in submissions made to the 2019 parliamentary inquiry on sleep. This study aimed to explore the needs, concerns, and barriers faced by Australians living with narcolepsy.

Methods
126 self-reported persons with narcolepsy were recruited from support groups, with one-on-one interviews randomly conducted until saturation (n=24). Interviews were transcribed and analyzed using the framework approach by a multidisciplinary team of five researchers.

Results
Preliminary analysis highlighted a large psychosocial burden that affected the daily life of those with narcolepsy. Participants described the pervasiveness of symptoms and daily unpredictability of not knowing when symptoms would occur. Subsequent behavioral changes related to self-preservation were identified, including avoidance and self-management of care to exert control. Self-perception and adjustment to living with narcolepsy were informed by external opinions (e.g. societal/workplace expectations, family/friend opinion). Management of narcolepsy involves daytime naps; however, participants feared being negatively judged and perceived as lazy/unproductive if they napped. This led to an unwillingness to disclose/seek accommodations post-diagnosis. Executive dysfunction was frequently described, including impaired ability to recall names, times/dates, and appointments that contributed to school/workplace disruption.

Discussion
Participants living with narcolepsy spoke of a complex and burdensome condition requiring multidisciplinary management. Significant functional/psychosocial impairment was described, yet participants were not able to access NDIS support. Despite being known for its sleep-related symptoms, participants highlighted cognitive impairment and the subsequent impact on daily function as a concern that many felt was inadequately addressed.
P111 Paediatric day-case adeno-tonsillectomy transfer to Hospital-in-the-Home: a new model of care
Authors: Simpson C , Holt M , Withers A , Smith A , Inglis E , Morrison S , Phillips D 
Published: November 2022

Abstract

Aims
Tonsillectomy and adenoidectomy (T&A) is one of the most common paediatric surgical procedures. Post-operatively, children are monitored in hospital for bleeding, SpO2 desaturation, pain and oral intake. We report a new model of care for low-risk children undergoing T&A to transfer to hospital-in-the-home (HITH) on the day of surgery, with the benefits of providing medically-supported recovery at home and reducing healthcare expenditure.

Methods
Children &gt;/= 5yr, with normal pre-operative overnight oximetry, without co-morbidities/post-operative upper airway obstruction/bleeding and tolerating oral intake were eligible for HITH, between 4-6hr post-T&A. Families were educated on administering adequate pain relief and oral intake. Overnight oximetry was monitored on the first night. Patients were reviewed at home day 1 then via telehealth day 2, before discharge.

Results
Sixteen patients with mean age 8.2yr (5-13yr) transferred to HITH post-day-case T&A. There were no episodes of desaturation, bleeding or readmission. One patient presented to Emergency day 1 with fever, pain and vomiting, received symptomatic treatment and transfer back to HITH, with discharge day 2. Two patients required one additional telehealth assessment of hydration (1) and pain control (1) on day 3, before discharge.

Conclusions
This new model of care provides a safe, cost-saving, supported management pathway for low risk paediatric post-T&A cohorts. Eligibility criteria will now expand as we increase virtual monitoring in the low risk cohort, freeing up HITH beds for younger and more complex post T&A patients, and hospital beds for higher risk patients, enabling greater throughput for overwhelmed surgical wait lists.
P112 Non-invasive ventilation in motor neurone disease, an audit of a tertiary centers practice
Authors: Slader S 
Published: November 2022

Abstract

Background
MND is a progressive neurodegenerative disorder with significant morbidity and mortality. The prevalence in Australasia is the second highest in the world with 12.9 cases per 100 000. Impairment of respiratory function contributes to and correlates with QOL. Respiratory complications are the most common causes of death.
NIV improves or maintains QOL in patients with MND and prolongs median survival by up to 205 days in patients with normal to moderately impaired bulbar function. NICE guidelines recommend considering a trial NIV in those with symptoms, signs or evidence of impaired respiratory muscle strength.

Methods
A single centre, retrospective database and chart review of all incident and prevalent cases with two clinical interactions at the Princess Alexandra Hospital MND service between 2013-2021 was conducted.
The primary aim was to determine the proportion of patients who trialed NIV. Secondary outcomes include: concordance with NICE Guidelines regarding NIV commencement, proportion of patients treated with riluzole and received PEG. Survival will be estimated by constructing Kaplan-Meier curves for those established on NIV compared with those that were not.

Progress to date
A total of 211 patients were included in analysis. 62.1% males, 37.9 % female, mean age at diagnosis 62.8 years. Limb phenotype was most common (52.5%) followed by bulbar phenotype (35.9%). 36.5% of the cohort trialed NIV. Further analysis to follow.

Intended outcome and impact
The outcomes will be compared with those published in the literature facilitating benchmarking of the service and identification of facets of patient care that can be improved.
P113 A detailed analysis of multicentric sleep staging inter-rater variabilities
Authors: Somaskandhan P , Terrill P , Korkalainen H , Kainulainen S , Leppänen T , Islind A , Grétarsdóttir H , Nikkonen S 
Published: November 2022

Abstract

Introduction
Correct identification of sleep stages is important in sleep disorder diagnosis; but is subject to high inter-scorer variability. Thus, we aimed to systematically analyse sleep staging agreements between ten scorers in a multicentric environment to better understand areas that possess high scoring variations.

Method
Polysomnographic recordings of 50 individuals (mean (±SD)

AHI
12.0±13.2) were independently scored by ten sleep technologists from seven sleep centres (

Europe
six,

Australia
one). The epoch-based majority sleep stage was identified from all scorings; then the mean scorer agreement with this majority score was calculated. We also investigated how sleep-state transitions affect the mean scorer agreement.

Results
In total, 48556 epochs were analysed. The mean (±SD) scorer agreement with majority score was 86.3±2.9% (Randolph’s kappa κ=0.74) overall; and 86.3±9.5% (κ=0.74), 65.6±13.5% (κ=0.39), 86.1±6.2% (κ=0.74), 88.8±11.2% (κ=0.78), and 91.7±4.5% (κ=0.83) for Wake, N1, N2, N3, and REM respectively. Across the ten scorers, 20.0% of epochs were unanimously scored as N2, and the most frequent disagreement was between N2 and N3 (19.7% of epochs). Only 0.3% of epochs were unanimously scored as N1. There was a negative association between the sleep stage transition frequency of the majority score and the mean scorer agreement (r=-0.61).

Discussion
High mean scorer agreements were obtained with the majority score except for N1. Surprisingly, considerable disparities were observed among scorers in distinguishing N2 and N3; this may reflect both the discrepancy associated with N2/N3 transitions and potentially different scoring perceptions. Greater scoring discrepancies were identified in individuals with more frequent sleep-state transitions.
P132 Self-reported indicators of sleep health in Australia: a cross-sectional population-based study
Authors: Way J , Cistulli P , Bin Y 
Published: November 2022

Abstract

Introduction
Poor sleep health is associated with adverse physical and mental health outcomes. This study aims to examine the indicators of sleep health in an Australian-based population and to analyse the relationship between sleep and sociodemographic characteristics and health conditions.

Method
We investigated a nationally representative sample of adults aged over 18 (n = 21,562) who participated in the 2011-2013 Australian Health Survey (AHS). Participants in the AHS were assigned to either the National Health Survey (NHS) or the National Nutrition and Physical Activity Survey (NNPAS). The NHS collected data on sleeping tablets taken for a mental health condition. Sleep duration was self-reported in the NNPAS which we categorised into three groups: short sleep (&lt; 7 hours), recommended sleep (7 to 9hours) and long sleep (&gt; 9 hours).

Progress to Date
Prevalence of sleeping tablets use among Australian adults who had a mental health condition was 9.5%. The majority used sleeping tablets for a duration of 6 months or more (73.9%) and many took it every night (42.0%). On a typical night, a majority self-reported having the recommended amount of sleep for adults (67.2%). The sociodemographic characteristics and health conditions are currently being analysed.

Intended Outcome and Impact
Adequately monitoring the domains of sleep health can potentially improve the overall health and wellbeing of a population. This study will highlight the current gap in the surveillance of sleep health in Australia. With limited Australian data available, there is a need to prioritise sleep-related indicators in future national health surveys.
Assessing Surgical Approaches for Acoustic Neuroma Resection: Do Patients Perceive a Difference in Quality-of-Life Outcomes?
Authors: North Monique , Weishaar Jeffrey , Nuru Mohammed , Anderson Douglas , Leonetti John P. 
Published: November 2022

Objective
The objective of this study is to further patient-physician discussion regarding postoperative quality of life expectations after surgical acoustic neuroma resection.

Study Design
This study is retrospective prospective. Qualifying patients were identified and administered Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale.

Setting
The setting was Loyola University Chicago Health System.

Patients
Three hundred twenty-six patients at our center with surgically resected acoustic neuroma between January 1990 and July 2021 completed the PANQOL.

Intervention(s)
During postresection follow-up visits, patients were administered the PANQOL survey.

Main Outcome Measure(s)
The total PANQOL is comprised of questions addressing quality of life in seven domains of hearing, balance, face, energy, pain, health, and anxiety. Univariate and multivariable analyses were performed to test for associations between surgical approach and/or patient characteristics.

Results
Patients who were treated with retrosigmoid approach reported slightly higher PANQOL pain scores when compared with translabyrinthine approach. No association was found between responses on hearing PANQOL and surgical approach. No association was found between approach and total PANQOL score. However, on average female patients reported lower total PANQOL compared with male patients.

Conclusion
The lack of association between patient response on hearing PANQOL and surgical approach illustrates the impact of preoperative patient counseling in appropriately setting patient expectations. The difference in pain PANQOL response may be due to a higher rate of occipital neuralgia due to incision placement and soft tissue retraction in the retrosigmoid patient group. Surgeons may consider alternative surgical incisions and soft tissue dissection to improve patient's quality of life with respect to postoperative pain.
Preoperative Reading Efficiency as a Predictor of Adult Cochlear Implant Outcomes
Authors: Moberly Aaron C. , Afreen Hajera , Schneider Kara J. , Tamati Terrin N. 
Published: November 2022

Hypotheses
1) Scores of reading efficiency (the Test of Word Reading Efficiency, second edition) obtained in adults before cochlear implant surgery will be predictive of speech recognition outcomes 6 months after surgery; and 2) Cochlear implantation will lead to improvements in language processing as measured through reading efficiency from preimplantation to postimplantation.

Background
Adult cochlear implant (CI) users display remarkable variability in speech recognition outcomes. “Top-down” processing—the use of cognitive resources to make sense of degraded speech—contributes to speech recognition abilities in CI users. One area that has received little attention is the efficiency of lexical and phonological processing. In this study, a visual measure of word and nonword reading efficiency—relying on lexical and phonological processing, respectively—was investigated for its ability to predict CI speech recognition outcomes, as well as to identify any improvements after implantation.

Methods
Twenty-four postlingually deaf adult CI candidates were tested on the Test of Word Reading Efficiency, Second Edition preoperatively and again 6 months post-CI. Six-month post-CI speech recognition measures were also assessed across a battery of word and sentence recognition.

Results
Preoperative nonword reading scores were moderately predictive of sentence recognition outcomes, but real word reading scores were not; word recognition scores were not predicted by either. No 6-month post-CI improvement was demonstrated in either word or nonword reading efficiency.

Conclusion
Phonological processing as measured by the Test of Word Reading Efficiency, Second Edition nonword reading predicts to a moderate degree 6-month sentence recognition outcomes in adult CI users. Reading efficiency did not improve after implantation, although this could be because of the relatively short duration of CI use.