bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient triage to specialist outpatient clinics—time to standardize terminology
Authors: Belostotsky Vladimir , Roy Madan , Mikrogianakis Angelo 
Published: May 2022

Abstract

Objectives
The objectives of this study were to evaluate existing nomenclature used for outpatient referrals triage and propose a system, which meets the needs of McMaster Children’s Hospital and can be modified for use in other hospitals.

Methods
We reviewed triage practices in the Department of Pediatrics, McMaster Children Hospital, Hamilton, Ontario and conducted a literature search to assess terminology used for outpatient referrals triage at other institutions.

Results
There is lack of unified terminology for triaging outpatient referrals. Existing systems are not widely accepted, lack uniformity, and often miss recording the true acuity of the referral. We developed a system that covers most outpatient triage scenarios, allocates either flexible or precise visit timelines to referrals and plans for logistics of the patient’s visit. Triage categories are iMMediate (MM), Acute (A) (1 to 14 days), Semi-Acute (S) (1 to 3 months), Timetabled (T) (next available appointment slot), Evaluated (E) (used for either forwarding to another provider or requesting additional information), and Rejected (R) categories—McMASTER triage system. Several numbered subcategories are used in each category to define precise timelines, if needed. Visit logistics categories are the following: Hub (H) (place to see the patient), How to notify patient and referring provider (HP) and (HD), need to Start with tests prior to appointment (S), and need to Complete (C) other relevant local processes—HHSC logistics system. Both these systems may be adapted for local use in other institutions.

Conclusion
This is the first publication that proposes terminology standardization in triaging outpatient referrals for specialist paediatric services.
Ustilaginoidea virens secretes a family of phosphatases that stabilize the negative immune regulator OsMPK6 and suppress plant immunity
Authors: Zheng Xinhang , Fang Anfei , Qiu Shanshan , Zhao Guosheng , Wang Jiyang , Wang Shanzhi , Wei Junjun , Gao Han , Yang Jiyun , Mou Baohui , Cui Fuhao , Zhang Jie , Liu Jun , Sun Wenxian 
Published: May 2022

Abstract
Rice false smut caused by Ustilaginoidea virens is emerging as a devastating disease of rice (Oryza sativa) worldwide; however, the molecular mechanisms underlying U. virens virulence and pathogenicity remain largely unknown. Here we demonstrate that the small cysteine-rich secreted protein SCRE6 in U. virens is translocated into host cells during infection as a virulence factor. Knockout of SCRE6 leads to attenuated U. virens virulence to rice. SCRE6 and its homologs in U. virens function as a novel family of mitogen-activated protein kinase phosphatases harboring no canonical phosphatase motif. SCRE6 interacts with and dephosphorylates the negative immune regulator OsMPK6 in rice, thus enhancing its stability and suppressing plant immunity. Ectopic expression of SCRE6 in transgenic rice promotes pathogen infection by suppressing the host immune responses. Our results reveal a previously unidentified fungal infection strategy in which the pathogen deploys a family of tyrosine phosphatases to stabilize a negative immune regulator in the host plant to facilitate its infection.
Ethylene augments root hypoxia tolerance via growth cessation and reactive oxygen species amelioration
Authors: Liu Zeguang , Hartman Sjon , van Veen Hans , Zhang Hongtao , Leeggangers Hendrika A C F , Martopawiro Shanice , Bosman Femke , de Deugd Florian , Su Peng , Hummel Maureen , Rankenberg Tom , Hassall Kirsty L , Bailey-Serres Julia , Theodoulou Frederica L , Voesenek Laurentius A C J , Sasidharan Rashmi 
Published: May 2022

AbstractFlooded plants experience impaired gas diffusion underwater, leading to oxygen deprivation (hypoxia). The volatile plant hormone ethylene is rapidly trapped in submerged plant cells and is instrumental for enhanced hypoxia acclimation. However, the precise mechanisms underpinning ethylene-enhanced hypoxia survival remain unclear. We studied the effect of ethylene pretreatment on hypoxia survival of Arabidopsis (Arabidopsis thaliana) primary root tips. Both hypoxia itself and re-oxygenation following hypoxia are highly damaging to root tip cells, and ethylene pretreatments reduced this damage. Ethylene pretreatment alone altered the abundance of transcripts and proteins involved in hypoxia responses, root growth, translation, and reactive oxygen species (ROS) homeostasis. Through imaging and manipulating ROS abundance in planta, we demonstrated that ethylene limited excessive ROS formation during hypoxia and subsequent re-oxygenation and improved oxidative stress survival in a PHYTOGLOBIN1-dependent manner. In addition, we showed that root growth cessation via ethylene and auxin occurred rapidly and that this quiescence behavior contributed to enhanced hypoxia tolerance. Collectively, our results show that the early flooding signal ethylene modulates a variety of processes that all contribute to hypoxia survival.
Auxin-driven ecophysiological diversification of leaves in domesticated tomato
Authors: Moreira Juliene d R , Rosa Bruno L , Lira Bruno S , Lima Joni E , Correia Ludmila N F , Otoni Wagner C , Figueira Antonio , Freschi Luciano , Sakamoto Tetsu , Peres Lázaro E P , Rossi Magdalena , Zsögön Agustin 
Published: May 2022

Abstract
Heterobaric leaves have bundle sheath extensions (BSEs) that compartmentalize the parenchyma, whereas homobaric leaves do not. The presence of BSEs affects leaf hydraulics and photosynthetic rate. The tomato (Solanum lycopersicum) obscuravenosa (obv) mutant lacks BSEs. Here, we identify the obv gene and the causative mutation, a nonsynonymous amino acid change that disrupts a C2H2 zinc finger motif in a putative transcription factor. This mutation exists as a polymorphism in the natural range of wild tomatoes but has increased in frequency in domesticated tomatoes, suggesting that the latter diversified into heterobaric and homobaric leaf types. The obv mutant displays reduced vein density, leaf hydraulic conductance and photosynthetic assimilation rate. We show that these and other pleiotropic effects on plant development, including changes in leaf insertion angle, leaf margin serration, minor vein density, and fruit shape, are controlled by OBV via changes in auxin signaling. Loss of function of the transcriptional regulator AUXIN RESPONSE FACTOR 4 (ARF4) also results in defective BSE development, revealing an additional component of a genetic module controlling aspects of leaf development important for ecological adaptation and subject to breeding selection.
0002 Go to bed! A systematic review and meta-analysis of bedtime procrastination determinants and sleep outcomes
Authors: Hill Vanessa , Ferguson Sally , Rebar Amanda , Shriane Alexandra , Vincent Grace 
Published: May 2022

Abstract

Introduction
Bedtime procrastination, the volitional delay of going to bed without any external circumstances causing the delay, is associated with poor sleep outcomes. Alleviating bedtime procrastination is an important target for interventions to promote adequate sleep, yet the social cognitive, biological, and behavioural determinants of bedtime procrastination are poorly understood. The present study aimed to conduct a systematic review, narrative synthesis, and meta-analysis of (1) the underlying determinants of bedtime procrastination, and (2) the strength and direction of the relationship between bedtime procrastination and sleep outcomes.

Methods
A database search was conducted through CINAHL, EMBASE, PsychINFO, PubMed, Scopus and Web of Science, using keywords related to procrastination, delay, bedtime and sleep.

Results
A total of 2087 records were identified, and 38 publications met the inclusion criteria. Random-effects meta-analysis for bedtime procrastination and sleep outcomes is ongoing. Preliminary findings suggest self-regulation, self-control and chronotype are the most prominent determinants.

Conclusion
Future research should expand focus to identify a broader range of determinants. Given that there are multiple benefits to a theory-based approach to behaviour change interventions, further research exploring determinants will be able to guide the development of interventions targeting bedtime procrastination.
Support (If Any):
0003 On the Same Wavelength? Quantifying the Associations between Eating Timing and Rest-Activity Rhythms in Free-Living Adults
Authors: Hoopes Elissa , D'Agata Michele , Brookstein-Burke Talia , Robson Shannon , Witman Melissa , Malone Susan , Patterson Freda 
Published: May 2022

Abstract

Introduction
Misalignment between the central circadian clock and daily behaviors increases cardiometabolic morbidity and mortality risk, likely due to internal misalignment between central and peripheral circadian rhythms. Experimental studies suggest food intake may act as a time cue (‘zeitgeber’) for resetting circadian rhythms, representing a potential behavioral target to ameliorate circadian misalignment and associated health consequences. However, the extent to which eating timing relates to circadian rhythms in free-living adults is unclear. Therefore, we tested the associations between eating timing with 24-h rest-activity-rhythms (RAR), a free-living proxy for endogenous circadian rhythms, in non-shift-working adults.

Methods
Adults without chronic health conditions or sleep disorders completed 14 days of 24/7 wrist accelerometry to evaluate RAR variables of interdaily stability (IS; day-to-day stability in RAR), intradaily variability (IV; within-day fragmentation of RAR), relative amplitude (RA; difference between peak vs. trough activity), L5 onset time (5-h period with lowest activity), and M10 onset time (10-h period with highest activity). Concurrently, time-stamped image-assisted diet records were obtained to generate average eating timing variables, including daily eating onset (time of first caloric intake after awakening), offset (last caloric intake time), duration (time elapsed between eating onset and offset), and caloric midpoint (time at which 50% of daily kcals were consumed), and variables illustrating irregularity in eating timing (standard deviation of eating timing variables). Pearson’s correlations quantified the associations between RAR and eating timing variables.

Results
Participants (N=30) were 28.0±6.6 years, 57% female, with a BMI of 23.8±2.5 kg/m2. Higher IS was correlated with lower irregularity in both eating onset (r=-0.55, p&lt;0.01) and duration (r=-0.51, p&lt;0.01). Higher RA correlated with earlier eating onset (r=-0.47, p&lt;0.01), longer eating duration (r=0.53, p&lt;0.01), and lower eating onset irregularity (r=-0.37, p&lt;0.05). Later L5 correlated with later eating onset (r=0.67, p&lt;0.001), offset (r=0.58, p&lt;0.001), caloric midpoint (r=0.56, p&lt;0.01), and greater eating offset irregularity (r=0.53, p&lt;0.01). Later M10 correlated with later eating offset (r=0.40, p&lt;0.05).

Conclusion
Preliminary findings indicate that eating timing and RAR are moderately correlated in free-living adults. Earlier eating timing, increased eating regularity, and longer daily eating duration may represent behavioral targets for improving circadian rhythms and subsequent cardiometabolic outcomes.
Support (If Any): Support provided by the American Heart Association (#831488) and a University of Delaware Research Fund-Strategic Initiative Award.
0004 Sleep, Team and Social Processes, and Health, Performance, and Safety in Naval Operational Environments
Authors: Roma Peter , Jameson Jason , Kubala Andrew , Markwald Rachel , Russell Dale 
Published: May 2022

Abstract

Introduction
Sleep disruption and teamwork are inherent features of 24/7 operational environments, yet little is known about how sleep and team/social processes interact to affect crew readiness and endurance.

Methods
We analyzed data of 3,434 active duty US sailors (80% male) from the Afloat Safety Climate Assessment Survey. Using structural equation modeling, we specified latent factors of Sleep Health (typical hours of sleep per day and sleep disturbances in shipboard environment); crew team and social factors of Team Transition Processes, Team Action Processes, Team Interpersonal Processes, Unit Cohesion, Psychological Safety, and Social Support; and operational outcome risks of Physical Health (no. days in previous 30 with physical illness or injury), Mental Health (no. days with stress, depression, or emotional problems), Performance (frequency of fatigue-induced functional impairments on duty), and Safety (individual and crew noncompliance, and rate of observed near misses).

Results
Higher Sleep Health reduced impairments in Physical Health, Mental Health, Performance, and Safety (standardized βs = −0.096 to −0.542, ps &lt; 0.0001, CFI/TLI &gt; 0.980, RMSEA = 0.033). Higher Sleep Health improved Team Transition, Action, and Interpersonal Processes, Unit Cohesion, Psychological Safety, and Social Support (βs = 0.178 to 0.380, ps &lt; 0.0001, CFI/TLI &gt; 0.982, RMSEA = 0.029). Social Support reduced risks to Physical Health, Mental Health, and Performance; Team Interpersonal Processes reduced Metal Health risk; Psychological Safety reduced Performance and Safety risks; Unit Cohesion reduced Safety risk (βs = −0.053 to −0.709, ps &lt; 0.05, CFI/TLI &gt; 0.979, RMSEA = 0.027). Mediation models indicated good Sleep Health enhances Social Support’s beneficial impact on Physical Health, Mental Health, and Performance; Psychological Safety’s impact on Performance and Safety; Team Interpersonal Processes’ impact on Physical Health; and Unit Cohesion’s impact on Safety (indirect effect βs = −0.032 to −0.127, ps &lt; 0.0001, CFI/TLI &gt; 0.967, RMSEAs &lt; 0.051).

Conclusion
Sleep health improves team/social functioning, which serves an additive protective function and enhancement to crew operational health, performance, and safety. Future work should closely examine these interrelationships to identify mechanisms as targets for policy and procedures to help optimize crew readiness and endurance.

Support (If Any)
Military Operational Medicine Research Program under work unit N2010.
0006 An At-Home Evaluation of a Light Intervention to Mitigate Sleep Inertia Symptoms
Authors: Hilditch Cassie , Costedoat Gregory , Pradhan Sean , Bathurst Nicholas , Glaros Zachary , Gregory Kevin , Feick Nathan , Shattuck Nita , Flynn-Evans Erin 
Published: May 2022

Abstract

Introduction
Sleep inertia symptoms typically occur after waking from nocturnal sleep. Under laboratory settings, light exposure upon waking has been shown to improve alertness, mood, and vigilant attention. We investigated whether a field-deployable light-emitting device would help to improve alertness and working memory in a real-world setting.

Methods
Thirty-five participants (18 female; 26.4 ± 6.0 y) completed an at-home, within-subject, randomized crossover study. Participants wore actiwatches during their normal sleep-wake schedule for five nights ahead of the adaptation and experimental nights. On the experimental night, participants performed baseline testing before their self-selected bedtime. Forty-five minutes after bedtime, participants received a phone call and were instructed to perform test bouts while wearing light-emitting glasses with the light either on (light condition) or off (control). A 3-minute descending subtraction task (DST) and the Karolinska Sleepiness Scale (KSS) were performed at +7, +17, +27, and +37 minutes after the call. Participants were then instructed to go back to sleep and were called 45 minutes after lights out to repeat the test bouts in the opposite condition. A series of mixed-effects models were performed with fixed effects of condition, test bout, and their interaction, and a random effect of participant. Condition order, sex, and baseline were included as covariates.

Results
There was a significant effect of test bout for DST total responses (χ2 [3] = 17.42; p &lt; .001) and total correct (χ2 [3] = 21.29; p &lt; .001) with improved performance at +27 and +37 minutes compared to +7 minutes. Sex was a significant predictor for KSS (F1,30 = 10.26; p = .003), with females (8.20 ± 0.23) rating higher sleepiness than males (7.10 ± 0.25). There were no other significant effects for DST or KSS outcomes (p &gt; .05).

Conclusion
These results suggest that the intervention was not able to improve working memory or alertness under naturalistic at-home settings. Further analysis is needed to determine whether these results are applicable to other cognitive performance domains.

Support (If Any)
Funded by the Naval Postgraduate School, via the Naval Medical Research Center's Naval Advanced Medical Development Department (MIPR N3239820WXHN007), with support from the NASA Airspace Operations and Safety Program, System-Wide Safety.
0009 Interindividual variation and extended wakefulness in sleepiness after acute and chronic sleep deprivation
Authors: Fernandes Guilherme , Araujo Paula , Tufik Sergio , Andersen Monica 
Published: May 2022

Abstract

Introduction
Sleepiness is a behavioural consequence of sleep pressure and is associated with negative outcomes with interindividual variation, possibly related to central sleep mechanisms. However, there is a lack of evidence linking progressive sleep need and sleepiness with factors of individual variability, which could be tested by total acute and chronic sleep deprivation. Thus, the objective of the study was to investigate the development of sleepiness in sleep deprived mice.

Methods
Male C57BL/6J mice were distributed in sleep deprivation, sleep rebound and control groups. Animals underwent acute sleep deprivation for 3, 6, 9 or 12 hours or chronic sleep deprivation for 6 hours for 5 consecutive days. Sleep rebound groups had a sleep opportunity for 1, 2, 3, or 4 hours after acute sleep deprivation or 24 hours after chronic sleep deprivation. During the protocols, sleep attempts were counted to calculate a sleepiness index. After euthanasia, blood was collected for corticosterone assessment.

Results
Using the average of group sleep attempts, it was possible to differentiate between sleepy (mean&gt;group average) and resistant animals (mean&lt;group average). Resistant mice were more frequent in all settings. Individual variation accounted for 52% of sleepiness variance during chronic sleep deprivation and extended wakefulness explained 68% of sleepiness variance during acute sleep deprivation. A normal corticosterone peak was observed at the start of the dark phase, independent of sleep deprivation.

Conclusion
Different profiles of sleepiness emerged in sleep deprived mice. Sleep deprivation was the main factor for sleepiness during acute sleep deprivation whereas in chronic deprivation individual variation was more relevant.

Support (If Any)
Our studies are supported by the following funding agencies: AFIP (Associação Fundo de Incentivo à Pesquisa), São Paulo Research Foundation (FAPESP #2017/18455-5 to GLF), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES - Finance Code 001 to GLF), and CNPq (fellowships to MLA and ST; #169040/2017-8, and #141445/2021-1 to GLF). This study received indirect funding from AFIP and CNPq, which support the department in which the project was conducted.
0020 Investigation of Seasonal Changes in Self-Reported Sleep Quality and Psychomotor Vigilance Task Outcomes: Results From the Ultra Long-Term Sleep (ULTS) Study
Authors: Ahrens Esben , Hemmsen Martin Christian , Duun-Henriksen Jonas , Kjær Troels Wesenberg , Allen Luke , Cormack Francesca , Taptiklis Nick 
Published: May 2022

Abstract

Introduction
Although sleep is fundamental for human well-being, factors that contribute to an individual’s experience and report of sleep quality remain poorly understood. Utilizing that sleepiness is known to impact vigilance performance, this study sets out to explore how self-reported sleep quality changes with behavioral performance and how this variation is affected by seasonal changes.

Methods
This work is an interim analysis of self-reported sleep quality and behavioral performance data collected in the Ultra Long-term Sleep (ULTS) study (ClinicalTrials.gov Identifier: NCT04513743). In the study 20 healthy participants (average 33±13 years of age) were enrolled for 365 continuous days to observe the seasonal variation in sleep and cognitive performance. The outcome from the daily psychomotor vigilance task (PVT) and sleep questionnaire is analyzed and reported. The sleep questionnaire is a composite of questions from the Sleep Satisfaction Tool, the Karolinska Sleep Diary, questions regarding feelings of pain and outside disturbances, easiness of waking up, and the Karolinska Sleepiness Scale (KSS). The PVT was designed for self-administered high-frequency testing and has a short 3-minute test period. Monthly changes were examined from June to November. This period was chosen since all subjects were active.

Results
The first eight participants have now completed the study. Repeated measures correlations between KSS and mean PVT reaction time showed moderate but highly robust associations between the two measures over time (r=0.2; 95% CI 0.18-0.23). From the data collected thus far from the entire population, fastest PVT mean reaction times were found on Saturdays and slowest on Tuesdays. Similarly, KSS had best scores in weekends. There was an overall increase in mean PVT reaction time during the investigated period from June to November. This was also observed in KSS.

Conclusion
Our findings show a moderate correlation between the mean PVT reaction time and Karolinska Sleepiness Scale with up to 365 datapoints per subject with weekly and seasonal trends observed.

Support (If Any)
This research is supported by Innovation Fund Denmark.