bluuebunny/crossref_metadata_2025_split huggingface dataset:
0848 Two Are Better Than One: Treatment of Complex Sleep Apnea with Two Distinct Sleep Neurostimulators
Authors: BalbiCaruso Nicolas , Goss Deborah , Ashtyani Fariborz , Ashtyani Laura , Simons Grant 
Published: May 2022

Abstract

Introduction
Complex sleep apnea refers to the emergence of central apnea when obstructive apneas have been adequately treated. While a combination of medications and noninvasive positive airway pressure ventilation is frequently used in patients with this syndrome, the optimal treatment has not yet been fully elucidated. With the advent of nerve stimulation therapy, it is now possible to target specific physiologic mechanisms and provide precise and adjustable therapy. We present a case in which two distinct nerve stimulators were used to successfully treat a patient with complex sleep apnea.
Report of Cases: We present a case in which a ptient with complex slepe apnea was successfully treated by implantation of two distinct nerve stimulators: hypoglossal nerve stimulation therapy for obstructive sleep apnea and phrenic nerve stimulation therapy for concomitant central sleep apnea.

Conclusion
Complex sleep apnea was successfully treated in this patient with the combination of hypoglossal and phrenic nerve stimulation therapy as evidenced by a reduction in both the obstructive and central apnea hypopnea indices. This patient also had significant clinical improvement with decreased excessive daytime sleepiness and improved daytime functioning as evidenced by decreased Epworth Sleepiness Score, improved patient reported daytime activity, decreased apnea hypopnea index, and increased total sleep time. This case provides evidence for the efficacy and safety of the simultaneous use of hypoglossal and phrenic nerve stimulation for the treatment of complex sleep apnea. Is also highlights the importance of obtaining a laboratory polysomnographic evaluation in all patients prior to any sleep device implantation. Further study is needed, however, to establish the long-term efficacy of this approach to treatment.

Support (If Any)
I am seeking financial support and assistance for meeting attendance and travel for the June sleep meeting from Inspire Sleep Apnea and other travel assistance funds.
Cerebro-cerebellar interactions in nonhuman primates examined by optogenetic functional magnetic resonance imaging
Authors: Goda Naokazu , Hasegawa Taku , Koketsu Daisuke , Chiken Satomi , Kikuta Satomi , Sano Hiromi , Kobayashi Kenta , Nambu Atsushi , Sadato Norihiro , Fukunaga Masaki 
Published: May 2022

Abstract
Functional magnetic resonance imaging (fMRI) is a promising approach for the simultaneous and extensive scanning of whole-brain activities. Optogenetics is free from electrical and magnetic artifacts and is an ideal stimulation method for combined use with fMRI. However, the application of optogenetics in nonhuman primates (NHPs) remains limited. Recently, we developed an efficient optogenetic intracortical microstimulation method of the primary motor cortex (M1), which successfully induced forelimb movements in macaque monkeys. Here, we aimed to investigate how optogenetic M1 stimulation causes neural modulation in the local and remote brain regions in anesthetized monkeys using 7-tesla fMRI. We demonstrated that optogenetic stimulation of the M1 forelimb and hindlimb regions successfully evoked robust direct and remote fMRI activities. Prominent remote activities were detected in the anterior and posterior lobes in the contralateral cerebellum, which receive projections polysynaptically from the M1. We further demonstrated that the cerebro-cerebellar projections from these M1 regions were topographically organized, which is concordant with the somatotopic map in the cerebellar cortex previously reported in macaques and humans. The present study significantly enhances optogenetic fMRI in NHPs, resulting in profound understanding of the brain network, thereby accelerating the translation of findings from animal models to humans.
Limited accumulation of high-frequency somatic mutations in a 1700-year-old Osmanthus fragrans tree
Authors: Duan Yifan , Yan Jiping , Zhu Yue , Zhang Cheng , Tao Xiuhua , Ji Hongli , Zhang Min , Wang Xianrong , Wang Long 
Published: May 2022

Abstract
Lifespan varies greatly between and within species. Mutation accumulation is considered an important factor explaining this life-history trait. However, direct assessment of somatic mutations in long-lived species is still rare. In this study, we sequenced a 1700-year-old sweet olive tree and analysed the high-frequency somatic mutations accumulated in its six primary branches. We found the lowest per-year mutation accumulation rate in this oldest tree among those studied via the whole-genome sequencing approach. Investigation of mutation profiles suggests that this low rate of high-frequency mutation was unlikely to result from strong purifying selection. More intriguingly, on a per-branching scale, the high-frequency mutation accumulation rate was similar among the long-lived individuals such as oak, wild peach and sweet olive investigated here. We therefore suggest the possibility that the accumulation of high-frequency somatic mutations in very long-lived trees might have an upper boundary due to both the possible limited number of stem cell divisions and the early segregation of the stem cell lineage.
Differences in the metabolic and functional mechanisms used to tolerate flooding inGuazuma ulmifolia(Lam.) from flood-prone Amazonian and dry Cerrado savanna populations
Authors: Ribeiro Isadora M , Vinson Christina C , Coca Guilherme C , Ferreira Cristiane da S , Franco Augusto C , Williams Thomas C R 
Published: May 2022

AbstractFlood tolerance is crucial to the survival of tree species subject to long periods of flooding, such as those present in the Amazonian várzea. Tolerance can be mediated by adjustments of metabolism, physiology and morphology, reinforcing the need to investigate the physiological and biochemical mechanisms used by tropical tree species to survive this stress. Moreover, such mechanisms may vary between populations that are subjected to differences in the frequency of flooding events. Here, we aimed to identify the mechanisms used by two populations of the tropical tree Guazuma ulmifolia (Lam.) to tolerate flooding: an Amazonian population frequently exposed to flooding and a Cerrado population, adapted to a dry environment. Young plants were subjected to a flooding of the roots and lower stem for 32 days, followed by 17 days of recovery. Amazonian plants exhibited greater increases in shoot length and higher maximum photosynthetic rate (Amax) compared with non-flooded plants from 7 days of flooding onwards, whereas increased Amax occurred later in flooded Cerrado plants and was not accompanied by increased shoot length. Lactate accumulated in roots of Cerrado plants after 24 h flooding, together with transcripts coding for lactate dehydrogenase in roots of both Cerrado and Amazonian plants. After 7 days of flooding, lactate decreased and alcohol dehydrogenase activity increased transiently, together with concentrations of alanine, γ-aminobutyric acid and succinate, indicating activation of metabolic processes associated with low oxygen availability. Other amino acids also increased in flooded Cerrado plants, revealing more extensive metabolic changes than in Amazonian plants. Wetland and dryland populations of G. ulmifolia revealed the great capacity to tolerate flooding stress through a suite of alterations in photosynthetic gas exchange and metabolism. However, the integrated physiological, biochemical and molecular analyses realized here indicated that wetland plants acclimatized more efficiently with increased shoot elongation and more rapid restoration of normal metabolism.
The Feasibility of Accelerating to Practice™ for Senior Baccalaureate Nursing Students’ Capstone Experience
Authors: Patterson Barbara J. , Rogers Meagan R. , Forneris Susan Gross , Allard Patti 
Published: May 2022

Abstract
With the ongoing debate on transition-to-practice gaps and lack of readiness for practice by novice nurses, curricular enhancements and innovation are imperative. A feasibility study was undertaken to inform and assess the integration of an Accelerating to Practice (A2P) curriculum in an academic context. Data from senior capstone students, faculty, and clinical preceptors provide evidence of the usefulness and applicability of A2P to provide intentional learning outcomes targeted at new graduates’ areas of weakness. This experience was aimed at clinical decision-making with psychomotor skill-laden activities deemphasized. A2P scaffolding aided in deeper learning and resulted in improved student learning.
NAL-NL2 Prescriptive Targets for Bone Conduction Devices With an Adaptation to Device Constraints in the Low Frequencies
Authors: Toll Martijn , Dingemanse Gertjan 
Published: May 2022

Objectives:
To study the effectivity of a transformed NAL non-linear version 2 (NAL-NL2) gain prescription for percutaneous bone conduction devices (BCDs) and to investigate how to take into account output constraints for the lower frequencies.

Design:
The NAL-NL2 prescription was converted to a bone conduction prescription rule. Adaptations were needed, as this converted rule prescribes more output at low frequencies than the device delivers. Three adaptations with different audibility and compression were compared. Setting 1 (S1, “optimal audibility”) had most audibility due to adapted frequency-dependent compression, setting 2 (S2, “moderate audibility”) had moderate output reduction below 1 kHz, and setting 3 (S3, “reduced audibility, least distortion”) had most output reduction. Eighteen experienced BCD users rated their relative sound quality in paired comparisons for different sounds (own voice, mixed voices, traffic noise, and music). In addition speech intelligibility in quiet and noise were assessed.

Results:
The relative sound quality rating for the adapted prescriptions varied between the stimuli: more low-frequency sound was preferred for music (S1 over S3), and less low-frequency sound was preferred for the own voice (S2 and S3 over S1). No differences in quality rating were found for mixed voices or traffic noise. Speech intelligibility in quiet scores at 45 dB SPL was significantly lower for S3 than for S1. Speech intelligibility in noise was significantly reduced in all settings and S3 yielded significantly better speech intelligibility in noise than S1.

Conclusions:
With a moderate gain reduction for low frequencies to comply with device constraints the transformed NAL-NL2 prescription was found suitable for fitting BCDs. Perceived sound quality depended on the gain settings, but also on the sound spectra and how the sound was appreciated. A moderate gain reduction below 1 kHz seems to be the optimal adaptation as it has a neutral or positive relative sound quality for all stimuli without negative effects on Speech intelligibility. The NAL-NL2-BC prescribed a sufficient amount of gain, as indicated by the speech tests.
Effect of extracorporeal shockwave therapy on medial tibial stress syndrome: a systematic review
Authors: Forogh Bijan , Karimzad Yousef , Babaei-Ghazani Arash , Janbazi Lobaneh , Bagherzadeh Cham Masumeh , Abdolghaderi Siavash 
Published: May 2022

Introduction:
This systematic review evaluates the available evidence for extracorporeal shockwave therapy (ESWT) use in the treatment of medial tibial stress syndrome (MTSS).

Method:
PubMed, EMBASE, Scopus, ISI Web of Science, and Cochrane Central Register of Controlled Trials (Cochrane CENTRAL) database searches were performed without a time limit in August 2021. Two independent researchers performed the search, screening, and final eligibility of the articles. Data were extracted using a customized spreadsheet, which included detailed information on patient characteristics, interventions, and outcomes. The methodological quality of the included studies was independently assessed by two reviewers using the Physiotherapy Evidence Database scale (PEDro).

Results:
Three studies were identified that compared 23, 12, and 22 participants in the intervention group with 19, 12, and 20 participants in the control group, respectively. The mean age of participants in these studies was 26.51 yr, and the mean duration of symptoms in the two studies that reported this was 16.36 mo. All studies used focus shockwave therapy.

Conclusions:
Extracorporeal shockwaves reduced pain and time to recovery and increased patient satisfaction. No study reported adverse effects. Based on the limited studies, ESWT may reduce pain and shorten recovery duration in MTSS. Further randomized clinical trials with sham control may substantiate these findings in other patient populations.

Level of Evidence:
Level I.
Radon-222 Charcoal Canister Steady State Model Calibrations Performed in a Highly Controlled Environmental Chamber and a Natural Indoor Environment
Authors: Kennings Thomas W. , Noey Jordan D. , Mata Loren A. , Kearfott Kimberlee J. 
Published: May 2022

Abstract
Charcoal canisters are a common method of 222Rn screening. The calibrations of different batches of activated charcoal used in different canister designs are typically performed in large volume controlled environmental chambers with known and controlled radon concentration, temperature, and humidity. Radon screening could be facilitated in locations without ready access to environmental chambers if canisters could be accurately calibrated and undergo quality control in less controlled environments. This study compares charcoal canister calibrations from a highly controlled radon chamber with calibrations from a basement storage area experiencing temporally varying radon. In addition, the impacts of exposure time and spectral region of interest selection on calibration accuracy are investigated by comparing calibrations calculated using three different choices. Approximately 30 mo after calibrations were completed, groups of canisters were exposed for different durations of time to investigate measurement accuracy and calibration validity over an extended time. A digital simulation of charcoal canister kinetics was also performed to establish limits on how stable radon must be in a space for equilibrium-based calibration to be performed there. Overall, the accuracy of measurements using calibrations from each space differed by less than 10% after 2 d exposure time, showing that carefully controlled conditions are not necessary for the accurate calibration of charcoal canisters. Measurement accuracy differed by less than 2% for different spectral region selections. Accuracy improved slightly with canister exposure duration. Simulations suggest that radon instability is most tolerable near the beginning of canister calibration exposures, but this merits further experimental study.
Sex-specific brain microstructural reorganization in irritable bowel syndrome
Authors: Labus Jennifer S. , Wang Chencai , Mayer Emeran A. , Gupta Arpana , Oughourlian Talia , Kilpatrick Lisa , Tillisch Kirsten , Chang Lin , Naliboff Bruce , Ellingson Benjamin M. 
Published: May 2022

Abstract
Preliminary evidence suggests that there are sex differences in microstructural brain organization among individuals with irritable bowel syndrome (IBS). The aim of this study was to further investigate sex-dependent differences in brain microstructure and organization in a large sample of well-phenotyped participants with IBS compared with healthy controls. We hypothesized that female patients with IBS would show evidence for increased axonal strength and myelination within and between brain regions concerned with pain and sensory processing, when compared with males with IBS. We also hypothesized that female compared with male IBS subjects show greater levels of somatic awareness and sensory sensitivity consistent with multisystem sensory sensitivity. Diffusion tensor images and clinical assessments were obtained in 100 healthy controls (61 females) and 152 IBS (107 females) on a 3T Siemens Trio. Whole brain voxel-wise differences in fractional anisotropy, mean, radial and axial diffusivity, and track density as differences in somatic awareness and sensory sensitivity were assessed using the general linear model. Female compared with male IBS participants showed extensive microstructural alterations in sensorimotor, corticothalamic, and basal ganglia circuits involved in pain processing and integration of sensorimotor information. Together with the observed increases in symptom severity, somatic awareness, and sensory sensitivity, the findings support the hypotheses that the etiology and maintenance of symptoms in females with IBS may be driven by greater central sensitivity for multiple sensory stimuli.
Structured Interventions to Optimize Polypharmacy in Psychiatric Treatment and Nursing Homes
Authors: Stötzner Philip , Ferrebus Abate Rodolfo Enrique , Henssler Jonathan , Seethaler Magdalena , Just Sandra Anna , Brandl Eva Janina 
Published: May 2022

Abstract

Background
Polypharmacy is a common clinical issue. It increases in prevalence with older age and comorbidities of patients and has been recognized as a major cause for treatment complications. In psychiatry, polypharmacy is also commonly seen in younger patients and can lead to reduced treatment satisfaction and incompliance. A variety of structured polypharmacy interventions have been investigated. This systematic review provides a comprehensive overview of the field and identifies research gaps.

Methods
We conducted a systematic review on structured interventions aimed at optimizing polypharmacy of psychotropic and somatic medication in psychiatric inpatient and outpatient settings as well as nursing homes. A search protocol was registered with PROSPERO (CRD42020187304). Data were synthesized narratively.

Results
Fifty-eight studies with a total of 30,554 participants met the inclusion criteria. Interventions were most commonly guided by self-developed or national guidelines, drug assessment scores, and lists of potentially inappropriate medications. Tools to identify underprescribing were less commonly used. Most frequently reported outcomes were quantitative drug-related measures; clinical outcomes such as falls, hospital admission, cognitive status, and neuropsychiatric symptom severity were reported less commonly. Reduction of polypharmacy and improvement of medication appropriateness were shown by most studies.

Conclusions
Improvement of drug-related outcomes can be achieved by interventions such as individualized medication review and educational approaches in psychiatric settings and nursing homes. Changes in clinical outcomes, however, are often nonsubstantial and generally underreported. Patient selection and intervention procedures are highly heterogeneous. Future investigations should establish standards in intervention procedures, identify and assess patient-relevant outcome measures, and consider long-term follow-up assessments.
Effects of the Affordable Care Act Medicaid Expansion on the Compensation of New Primary Care Physicians
Authors: Ma Yanlei , Armstrong David , Forte Gaetano J. , Yu Hao 
Published: May 2022

Background:
It is well-documented that the Affordable Care Act Medicaid expansion increased health care utilization by low-income Americans. Emerging studies also found that the expansion changed the geographical distribution of new physicians. However, the effect of the expansion on physician compensation has not been studied.

Objectives:
We aimed to assess how the Medicaid expansion affected the compensation of new primary care physicians (PCPs) and whether the effect differed by specialty, gender, and geography.

Research Design:
We used a quasiexperimental difference-in-differences design to assess changes in compensation for new PCPs from before to after the Medicaid expansion in states that expanded Medicaid compared with states that did not expand.

Subjects:
Our study included 2003 new PCPs who responded to the Survey of Residents Completing Training in New York between 2009 and 2018.

Measures:
Our primary outcome was respondents’ self-reported starting salary for their first year of practice. Our secondary outcomes were respondents’ self-reported additional anticipated income and incentives they received for accepting the job offer.

Results:
We found that starting salaries for new PCPs, especially new general internists and family physicians, grew faster in expansion states than in nonexpansion states. In addition, we found that the expansion was associated with a statistically significant increase in receiving additional anticipated income as part of the compensation package for new PCPs practicing in rural areas.
How Can Framed Mammography Screening Messages Be Optimally Persuasive for Foreign-Born Chinese American Women?
Authors: Sun Yiyuan , Moyer Anne , White Jane H. 
Published: May 2022

Background
Foreign-born Chinese American women (FBCAW) have the lowest mammography rates compared with other racial groups despite the overwhelming evidence of the benefits of screening. Message framing based on the prospect theory has shown significant but inconsistent effects on mammogram screening among ethnic minority groups.

Objective
Using data from a randomized controlled trial, this secondary analysis aims to identify factors that interact with message framing to improve mammography screening in FBCAW.

Methods
In the parent study, participants were randomized to receive either a gain- or loss-framed brochure that encouraged mammography screening. Data were collected at baseline and 2 months using validated questionnaires. For this secondary analysis, ordinal logistic regression was performed to identify moderation effects using both per-protocol and intention-to-treat principles.

Results
Participants predominantly had low income, a low level of English proficiency, and no insurance. Lack of access to mammography services, knowledge of making a mammogram appointment, knowledge of insurance coverage for breast cancer treatment, education levels, and mammogram history were significant moderators of the framing effects. Overall, the moderation effects were larger when using per-protocol analysis. Some moderation results under intention-to-treat analysis were different from those using per-protocol analysis.

Conclusions
The persuasive effects of the loss- or gain-framed messages depend on the characteristics of FBCAW. Future studies can identify algorithms to select tailored messages that match individual FBCAW’s characteristics to optimize the effects of framed messages.

Implications for Practice
Findings of this study can guide healthcare providers, especially nurses, to choose different wording when communicating with their clients.