bluuebunny/crossref_metadata_2025_split huggingface dataset:
0792 Exploring Symptomatic Relief of Patients with Central Sleep Apnea when using CPAP or BiPAP Therapy
Authors: Kachechian Talar , Jamil Saad Bin , Armache Maria , Fast Zhanna 
Published: May 2022

Abstract

Introduction
About 0.9% of peoples over the age of 40 in the United States have Central Sleep Apnea (CSA). The key to treating CSA is to address any underlying health issues causing the condition as there are no clear, established treatment guidelines. For example, approaches will be made to mitigrate congestive heart failure. Often, patients may require the use of CPAP or BiPAP device to decrease cessations in respiration during sleep.

Methods
We investigated those patients diagnosed with CSA who use CPAP or BiPAP therapy and it's potential therapeutic effects through a retrospective chart review over a three-year period. We excluded those who were diagnosed with treatment emergent CSA and those using ASV. Data was collected from each patient's chart about patient demographics, modality of PAP therapy, and information pertaining to symptomatic relief.

Results
42 patients were identified who had a diagnosis of CSA. 25 of 42 (59.5%) were excluded as they were using alternative therapies. Of the 17 patients, 14 (82.4%) were male with an average age of 70.7 and 3 (17.6%) were females with an average age of 50. 15 of the 17 (88.2%) used CPAP therapy and the 2 (11.8%) patients used BiPAP.Prior to PAP therapy, the average Epworth Sleepiness Scale was 8.08 which improved to 3.79 post therapy. 9 out of the 17 (52.9%) patients reported improvement in nocturnal gasping while 2 (11.8%) did not report relief and 6 (35.3%) patients we were unable to determine through chart review. 9 out of 17 (52.9%) patients reported unrefreshed sleep and later 6 of the 9 (66.7%) patients reported refreshed sleep with initiation of PAP therapy while 1 patient reported no improvement and 2 (22%) we were unable to determine. 15 of the 17 (88.2%) patients complained of waking up multiple times throughout the night before PAP therapy. 5 (33.3%) patients had improvement of the frequency of nighttime awakenings while we were unable to determine the remaining 10 patients.

Conclusion
When central sleep apnea persists despite adequate treatment of the primary cause, CPAP or BiPAP may be used for symptomatic relief.

Support (If Any)
0799 Precipitation of Dream Enactment Behavior in the setting of β -Blocker therapy
Authors: Patel Jay , Moshtagh-Sisan Mahtab , Sarrami Kayvon , Avidan Alon 
Published: May 2022

Abstract

Introduction
REM sleep behavior disorder (RBD) is defined by dream enactment behavior (DEB) and REM sleep without muscle atonia (RWA). It is proposed that in both isolated and secondary RBD, the loss of REM sleep atonia is related to a failure of spinal motoneuron inhibition in the rostral pons. RBD is most commonly isolated, although it has been attributed to serotonergic antidepressant medication. This is the first report of metoprolol succinate (MS) provoking DEB in patients with RWA which helps shed more light on the mechanism of DEB in RBD.
Report of Cases: A 51-year-old male with a new diagnosis of atrial fibrillation (AF) was referred for evaluation of snoring and hypersomnolence. Polysomnography (PSG) revealed obstructive sleep apnea and RWA. DEB was not observed. Compliance with PAP therapy improved his symptoms. Persistent AF required the use of Metoprolol Succinate (MS), which precipitated aggressive DEB.
Discontinuation of MS resulted in clinical resolution of DEB.

Conclusion
The data sheds more light on the potential role of β- blockers, in general, and MS, in particular, in precipitating DEB in susceptible individuals with RWA. While MS is an uncommon cause of visual hallucinations, the data here indicates that it might increase susceptibility to DEB in those who are at risk (RWA). Potential mechanisms include the following: β-blockers bind to serotonin receptors and precipitate DEB in the setting of RWA. β-blockers may also precipitate DEB by suppressing melatonin release via specific inhibition of central beta-adrenoreceptors culminating in sleep instability and DEB as a consequence. This case illustrates a clinically important role of the β-blocker MS, in precipitating DEB, and the need to avoid these agents in the setting of injurious parasomnias. We recommend that clinicians keep a vigilant eye for the exacerbation of DEB in people with RBD who are prescribed β-blockers.

Support (If Any)
0817 Conquering Two Sleep Birds with One Iron stone: The Case of Resolved Restless Sleep Disorder and Parasomnia with Iron Therapy
Authors: Richens Zachary , Ibrahim Sally 
Published: May 2022

Abstract

Introduction
Restless Sleep Disorder (RSD) is characterized by frequent nocturnal movements of large muscle groups or a complaint of restless sleep by observers with associated daytime dysfunction.1 RSD, like other movement disorders of sleep, is associated with low iron stores.2 Children with RSD have increased NREM sleep instability and a propensity for parasomnia.2 No reports to date have demonstrated the use of iron therapy for parasomnia in patients with RSD. Furthermore, studies are limited in very young children with this disorder as they currently fall outside proposed diagnostic criteria.1
Report of Cases: A 2 year-old male presented to the sleep clinic with parental complaints of nightly sleep initiation and maintenance difficulty, mild snoring, restless sleep, episodes of sleepwalking and night terrors multiple times per week. Symptoms worsened over 6 months and were associated with daytime irritability and behavioral problems. Sleep quality measures assessed progress between visits: the PROMIS Sleep Disturbance (PROMIS SD) and Sleep Related Impairment (PROMIS SRI). Serum ferritin was initially 20ug/L. Polysmnogram demonstrated no significant sleep related breathing disorder, a large muscle group movement index of 14, periodic limb movement index of 3. Initial treatment included oral iron therapy, scheduled awakenings, and hypnotic dose melatonin. The sleep psychologist addressed limit setting and negative sleep associations with improved insomnia symptoms but parasomnia and restless sleep continued. The parent noted reduction in both movements and parasomnia frequency after one month of iron therapy. After a 3 month period on treatment, the parent reported complete cessation of the parasomnia, drastic reduction in restlessness, and near resolution of insomnia. Sleep quality measure PROMIS SD improved by 11, demonstrating reduced sleep disturbance. PROMIS SRI did not change. Ferritin level increased to 47ug/L.

Conclusion
RSD in a very young child with NREM parasomnia responded to oral iron therapy improving overall sleep quality. This case demonstrates the relationship between relative iron deficiency, RSD and associated parasomnia.

Support (If Any)
1. DelRosso LM, Ferri R, Allen RP, et al. Consensus diagnostic criteria for a newly defined pediatric sleep disorder: restless sleep disorder(RSD).SleepMed.2020;75:335-340. 2. Leung W, Singh I, McWilliams S, Stockler S, Ipsiroglu OS. Iron deficiency and sleep - A scoping review. SleepMedRev.2020;51:101274
The association between race- and ethnicity-related stressors and sleep: the role of rumination and anxiety sensitivity
Authors: Otto Michael W , Lubin Rebecca E , Rosenfield David , Taylor Daniel J , Birk Jeffrey L , Espie Colin A , Shechter Ari , Edmondson Donald , Shepherd Justin M , Zvolensky Michael J 
Published: May 2022

Abstract

Study Objectives
This study was designed to investigate the association between psychosocial factors and self-reported sleep duration and two indices of sleep quality in a racially and ethnically diverse sample of adults. We investigated the relations between both rumination and anxiety sensitivity with these self-reported sleep outcomes. We also examined rumination and anxiety sensitivity as moderators of three race- and ethnicity-related stressors: discrimination, acculturative stress, and socioeconomic status.

Methods
In a cross-sectional design, we assessed 1326 adults (ages 18–48 years) selected for self-reported racial and ethnic minority status. Regression analyses were used to examine the associations between demographic, social/environmental stressors, depression severity, rumination, and anxiety sensitivity and three sleep outcomes: sleep duration, sleep quality subscale, and global sleep quality.

Results
Our findings supported the hypothesized role of rumination as an amplification factor for the influence of race- and ethnicity-related stressors on sleep duration and quality. Rumination was associated with all three sleep outcomes (sleep duration, sleep quality subscale, and global sleep quality) and was a moderator of the associations between discrimination and all 3 sleep outcomes. Anxiety sensitivity was not consistently associated with these sleep outcomes. Depression symptoms did not account for these findings.

Conclusions
If confirmed in longitudinal study, our findings introduce a potentially important treatment target—rumination—for addressing sleep disparities in prevention or intervention models. Rumination appears to amplify the negative sleep consequences of race- and ethnicity-related stressors and is a modifiable treatment target.
Sleep from acute to chronic traumatic brain injury and cognitive outcomes
Authors: Sanchez Erlan , Blais Hélène , Duclos Catherine , Arbour Caroline , Van Der Maren Solenne , El-Khatib Héjar , Baril Andrée-Ann , Bernard Francis , Carrier Julie , Gosselin Nadia 
Published: May 2022

Abstract

Study Objectives
Traumatic brain injuries (TBIs) cause persistent cerebral damage and cognitive deficits. Because sleep may be a critical factor for brain recovery, we characterized the sleep of patients with TBI from early hospitalization to years post-injury and explored the hypothesis that better sleep during hospitalization predicts more favorable long-term cognitive outcomes.

Methods
We tested patients with moderate-to-severe TBI in the hospitalized (n = 11) and chronic (n = 43) stages using full-night polysomnography, with 82% of the hospitalized group being retested years post-injury. Hospitalized patients with severe orthopedic and/or spinal cord injury (n = 14) and healthy participants (n = 36) were tested as controls for the hospitalized and chronic TBI groups, respectively. Groups had similar age and sex and were compared for sleep characteristics, including slow waves and spindles. For patients with TBI, associations between sleep during hospitalization and long-term memory and executive function were assessed.

Results
Hospitalized patients with TBI or orthopedic injuries had lower sleep efficiency, higher wake after sleep onset, and lower spindle density than the chronic TBI and healthy control groups, but only hospitalized patients with brain injury had an increased proportion of slow-wave sleep. During hospitalization for TBI, less fragmented sleep, more slow-wave sleep, and higher spindle density were associated to more favorable cognitive outcomes years post-injury, while injury severity markers were not associated with these outcomes.

Conclusion
These findings highlight the importance of sleep following TBI, as it could be a strong predictor of neurological recovery, either as a promoter or an early marker of cognitive outcomes.
Gender differences in narcolepsy: What are recent findings telling us?
Authors: Schmidt Markus H , Bassetti Claudio L A 
Published: May 2022

Abstract
Three papers currently published in SLEEP using two different mouse models of narcolepsy, including either Hcrt-tTa;TetO diptheria toxin-A (DTA) or Hypocretin knock-out (Hcrt-KO) mice, suggest important gender differences in narcolepsy expression. Specifically, these recent data corroborate previous findings in mice demonstrating that females show more cataplexy events and more total cataplexy expression than males. Moreover, in the neurotoxic DTA mouse model, females show earlier onset of cataplexy expression than males during active Hcrt cell loss. Finally, females show a doubling of cataplexy during estrous compared to other phases of the estrous cycle. These findings are reviewed in the broader context of prior published literature, including reported gender differences in Hcrt expression and hormonal influences on sleep and wakefulness. Although similar findings have not been reported in humans, a systematic evaluation of gender differences in human narcolepsy has yet to be performed. Taken together, these animal data suggest that more research exploring gender differences in human narcolepsy is warranted.
Efforts to advance NIH-funded behavioral and social sciences research on structural racism and health
Authors: Blachman-Demner Dara R , Tyus Nadra C 
Published: May 2022

Abstract
This commentary provides background and context for the increasing attention to research designed to better understand and address the impact of structural racism on health, with particular attention to the role of the behavioral and social sciences. The manuscript describes the impetus provided to this work by recent public health crises of COVID-19 and the racial justice movement that emerged following the murder of George Floyd in the summer of 2020. A range of initiatives from the National Institutes of Health (NIH) focused on structural racism and health equity are discussed in this context and opportunities and gaps for future research are identified.
Early Drug-Induced Liver Injury Risk Screening: “Free,” as Good as It Gets
Authors: Martin Matthew T , Koza-Taylor Petra , Di Li , Watt Eric D , Keefer Christopher , Smaltz Daniel , Cook Jon , Jackson Jonathan P 
Published: May 2022

Abstract
For all the promise of and need for clinical drug-induced liver injury (DILI) risk screening systems, demonstrating the predictive value of these systems versus readily available physicochemical properties and inherent dosing information has not been thoroughly evaluated. Therefore, we utilized a systematic approach to evaluate the predictive value of in vitro safety assays including bile salt export pump transporter inhibition and cytotoxicity in HepG2 and transformed human liver epithelial along with physicochemical properties. We also evaluated the predictive value of in vitro ADME assays including hepatic partition coefficient (Kp) and its unbound counterpart because they provide insight on hepatic accumulation potential. The datasets comprised of 569 marketed drugs with FDA DILIrank annotation (most vs less/none), dose and physicochemical information, 384 drugs with Kp and plasma protein binding data, and 279 drugs with safety assay data. For each dataset and combination of input parameters, we developed random forest machine learning models and measured model performance using the receiver operator characteristic area under the curve (ROC AUC). The median ROC AUC across the various data and parameters sets ranged from 0.67 to 0.77 with little evidence of additive predictivity when including safety or ADME assay data. Subsequent machine learning models consistently demonstrated daily dose, fraction sp3 or ionization, and cLogP/D inputs produced the best, simplest model for predicting clinical DILI risk with an ROC AUC of 0.75. This systematic framework should be used for future assay predictive value assessments and highlights the need for continued improvements to clinical DILI risk annotation.
Gestational cholestasis induced intrauterine growth restriction through triggering IRE1α‐mediated apoptosis of placental trophoblast cells
Authors: Gao Xing‐Xing , Lin Shuai , Jiang Pei‐Ying , Ye Meng‐Ying , Chen Wei , Hu Chuan‐Xiang , Chen Yuan‐Hua 
Published: May 2022

AbstractEpidemiological and animal experimental studies suggest an association between gestational cholestasis and intrauterine growth restriction (IUGR). Here, we explored the mechanism through which gestational cholestasis induced IUGR. To establish gestational cholestasis model, pregnant mice were subcutaneously injected with 17α‐Ethynylestradiol (E2) on gestational day 13 (GD13)–GD17. Some pregnant mice were intraperitoneally injected with 4μ8C on GD13–GD17. The results found that the apoptosis of trophoblast cells was elevated in placentas of mice with gestational cholestasis and in deoxycholic acid (DCA)‐treated human trophoblast cell lines and primary mouse trophoblast cells. Correspondingly, the levels of placental cleaved caspase‐3 and Bax were increased, while placental Bcl2 level was decreased in mice with gestational cholestasis and in DCA‐treated trophoblast cells. Further analysis found that placental IRE1α pathway was activated in mice with gestational cholestasis and in DCA‐treated trophoblast cells. Interestingly, 4μ8C, an IRE1α RNase inhibitor, significantly inhibited caspase‐3 activity and apoptosis of trophoblast cells in vivo and in vitro. Importantly, 4μ8C rescued gestational cholestasis‐induced placental insufficiency and IUGR. Furthermore, a case–control study demonstrated that placental IRE1α and caspase‐3 pathways were activated in cholestasis cases. Our results provide evidence that gestational cholestasis induces placental insufficiency and IUGR may be via triggering IRE1α‐mediated apoptosis of placental trophoblast cells.
Interactions among key residues regulate mammalian odorant receptor trafficking
Authors: Xu Rui , Cong Xiaojing , Zheng Qian , Xu Lun , Ni Mengjue J. , de March Claire A. , Matsunami Hiroaki , Golebiowski Jérôme , Ma Minghong , Yu Yiqun 
Published: May 2022

AbstractOdorant receptors (ORs) expressed in mammalian olfactory sensory neurons are essential for the sense of smell. However, structure–function studies of many ORs are hampered by unsuccessful heterologous expression. To understand and eventually overcome this bottleneck, we performed heterologous expression and functional assays of over 80 OR variants and chimeras. Combined with literature data and machine learning, we found that the transmembrane domain 4 (TM4) and its interactions with neighbor residues are important for OR functional expression. The data highlight critical roles of T4.62 therein. ORs that fail to reach the cell membrane can be rescued by modifications in TM4. Consequently, such modifications in MOR256‐3 (Olfr124) also alter OR responses to odorants. T1614.62P causes the retention of MOR256‐3 in the endoplasmic reticulum (ER), while T1614.62P/T1484.49A reverses the retention and makes receptor trafficking to cell membrane. This study offers new clues toward wide‐range functional studies of mammalian ORs.
Is Methadone Safe for Patients With Opioid Use Disorder and Coronavirus Disease 2019 Infection?
Authors: Owiti John Arianda , Benson Molli , Maplanka Mandisa , Oluseye Lasekan , Carvalho Debora 
Published: May 2022

Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to not only increase in substance misuse, substance use disorder, and risk of overdose but also lack of access to treatment services. Due to lack of knowledge of the course and impact of COVID-19 and outcomes of it’s interactions with existing treatments, the Substance Misuse Service Team initiated a safety improvement project to review the safety of opioid substitution treatment, particularly the safety of methadone. This preliminary retrospective cross-sectional audit of safety improvement intiative underscores the importance of providing treatment services to those with opioid use disorders and that methadone is safe among this population with a high burden of comorbidity, most of which leads to negative outcomes from COVID-19. The outcomes show that patients who have COVID-19 should continue with opioid substitution treatment with methadone. Although treatment with methadone is safe, symptomatic patients should be monitored. In addition, patients who take methadone at home should be educated on the risk of overdose due to, and adverse outcomes from, COVID-19 infection. Patients should monitor themselves using pulse oximeter for any signs of hypoxia.
The Effect of Nutritional Support Based on the Dietary Anti-Inflammatory Index on Cancer-Related Fatigue in Lung Cancer Patients Undergoing Chemotherapy
Authors: Zhang Yanmei , Cui Guanjun , Xiu Yang , Zhao Mei 
Published: May 2022

Background
Cancer-related fatigue is one of the most common symptoms reported by cancer patients and is considered to be related to inflammation.

Objective
This study aimed to explore the effects of nutritional support based on the dietary anti-inflammatory index on cancer-related fatigue in lung cancer patients undergoing chemotherapy.

Methods
This was a randomized controlled trial with 106 lung cancer patients who were divided into either the anti-inflammatory diet group (n = 53) or the usual diet group (n = 53) for 3 months. The primary outcome was cancer-related fatigue. Secondary outcomes included high sensitivity C-reactive protein (hs-CRP) concentrations, nutritional status, and quality of life. Repeated-measures analysis of variance was used to examine the effectiveness of this intervention.

Results
The anti-inflammatory diet improved fatigue (−1.99 ± 1.78, P < .001), hs-CRP levels (−4.15 [−11.87, −0.58], P < .001), Patient-Generated Subjective Global Assessment (−2.53 ± 3.11, P = .030), and albumin concentrations (2.83 ± 0.59, P < .001) compared with the usual diet after 3 months. Simultaneously, in the repeated-measures analysis of variance, the differences in fatigue (F = 5.536, P < .001), hs-CRP levels (F = 6.918, P < .001), and albumin concentrations (F = 2.727, P = .048) were statistically significant for the group-by-time interaction.

Conclusion
The study provided evidence for the positive effect of nutritional support based on the dietary anti-inflammatory index on cancer-related fatigue, hs-CRP levels, nutritional status, and quality of life in lung cancer patients undergoing chemotherapy.

Implication for Practice
With an anti-inflammatory diet, nurses can help these patients improve their overall quality of life.
Symptom Profiles and Related Factors Among Breast Cancer Patients Undergoing Endocrine Therapy
Authors: Jing Feng , Zhu Zheng , Qiu Jiajia , Tang Lichen , Xu Lei , Xing Weijie 
Published: May 2022

Background
To provide person-centered symptom management, the interindividual variability in breast cancer patients merits further exploration. However, how sociodemographic and clinical characteristics influence symptom profile membership in endocrine therapy for breast cancer is still unknown.

Objectives
This study aimed to explore symptom profiles of breast cancer patients undergoing endocrine therapy and to identify sociodemographic and clinical characteristics among symptom subgroup members.

Methods
A cross-sectional study was conducted, and participants were invited to complete a general information questionnaire and Functional Assessment of Cancer Therapy-Endocrine Subscale. Latent profile analysis, univariate analysis, and multinomial logistic regression were performed to explore symptom profiles and identify interindividual variability.

Results
Three distinct subgroups were identified: “all high” (9.8%), “all moderate but high sexual symptoms” (25.4%), and “all low” (64.8%). Age, body mass index, main payment source for medical expenses, type of endocrine therapy, and history of breast cancer treatment were factors that determined membership in these 3 symptom subgroups.

Conclusion
Patients’ demographic and clinical characteristics were associated with their endocrine therapy–related symptom profiles. In general, those younger in age who pay out of pocket for medical expenses, use aromatase inhibitors, present a history of chemotherapy, and have a higher body mass index have a greater risk of symptom burden.

Implication for Practice
The findings of this study will contribute to implementing individual cancer care based on the characteristics and needs of patient subgroups, which may improve the allocation of medical resources and provide interventions tailored to patients’ unique needs.