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Zawada SJ, Ganjizadeh A, Conte GM, Demaerschalk BM, Erickson BJ. Accelerometer-Measured Behavior Patterns in Incident Cerebrovascular Disease: Insights for Preventative Monitoring From the UK Biobank. J Am Heart Assoc 2024; 13:e032965. [PMID: 38818948 DOI: 10.1161/jaha.123.032965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/03/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND The goal was to compare patterns of physical activity (PA) behaviors (sedentary behavior [SB], light PA, moderate-to-vigorous PA [MVPA], and sleep) measured via accelerometers for 7 days between patients with incident cerebrovascular disease (CeVD) (n=2141) and controls (n=73 938). METHODS AND RESULTS In multivariate models, cases spent 3.7% less time in MVPA (incidence rate ratio [IRR], 0.963 [95% CI, 0.929-0.998]) and 1.0% more time in SB (IRR, 1.010 [95% CI, 1.001-1.018]). Between 12 and 24 months before diagnosis, cases spent more time in SB (IRR, 1.028 [95% CI, 1.001-1.057]). Within the year before diagnosis, cases spent less time in MVPA (IRR, 0.861 [95% CI, 0.771-0.964]). Although SB time was not associated with CeVD risk, MVPA time, both total min/d (hazard ratio [HR], 0.998 [95% CI, 0.997-0.999]) and guideline threshold adherence (≥150 min/wk) (HR, 0.909 [95% CI, 0.827-0.998]), was associated with decreased CeVD risk. Comorbid burden had a significant partial mediation effect on the relationship between MVPA and CeVD. Cases slept more during 12:00 to 17:59 hours (IRR, 1.091 [95% CI, 1.002-1.191]) but less during 0:00 to 5:59 hours (IRR, 0.984 [95% CI, 0.977-0.992]). No between-group differences were significant at subgroup analysis. CONCLUSIONS Daily behavior patterns were significantly different in patients before CeVD. Although SB was not associated with CeVD risk, the association between MVPA and CeVD risk is partially mediated by comorbid burden. This study has implications for understanding observable behavior patterns in cerebrovascular dysfunction and may help in developing remote monitoring strategies to prevent or reduce cerebrovascular decline.
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Affiliation(s)
| | - Ali Ganjizadeh
- Mayo Clinic Artificial Intelligence Laboratory Rochester MN
| | | | - Bart M Demaerschalk
- Mayo Clinic College of Medicine and Science Phoenix AZ
- Mayo Clinic Division of Stroke and Cerebrovascular Diseases Department of Neurology Phoenix AZ
- Mayo Clinic Center for Digital Health Phoenix AZ
| | - Bradley J Erickson
- Mayo Clinic College of Medicine and Science Phoenix AZ
- Mayo Clinic Artificial Intelligence Laboratory Rochester MN
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Robbins R, Affouf M, Masiakos PT, Iyer JM, Griggs C, Klerman EB, Sacks CA. Estimating Community Disruption from Nighttime Gunshots in 6 U.S. Cities, 2015 to 2021. J Gen Intern Med 2024:10.1007/s11606-024-08707-9. [PMID: 38565768 DOI: 10.1007/s11606-024-08707-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Gunshots affect those directly involved in an incident and those in the surrounding community. The community-level impact of nighttime gunshots, which may be particularly disruptive to the sleep of nearby community members, is unknown. OBJECTIVE Our aim is to estimate the number of people potentially affected by nighttime gunshots and the relationship between nighttime gunshots and median household income in the USA. DESIGN We collected publicly available data on the timing and location of gunshots in six U.S. cities (Baltimore, MD; Boston, MA; Washington, D.C.; New York, NY; Philadelphia, PA; and Portland, OR) from 2015 to 2021. We then analyzed the data by computing rate ratios (RRs) to compare the frequency of gunshots during nighttime hours (6:00 pm to 5:59 am) versus daytime hours (6:00 am to 5:59 pm). Additionally, we used geospatial mapping to create choropleth maps to visualize the variation in nighttime gunshot density across cities. We estimated, using city-wide population, person-nights potentially impacted by the sound of gunshots within areas of 0.2- (low) and 0.5-mile (high) radius. Finally, for five of six cities where data on median household income were available by census tract, we built nonlinear regression models to estimate the relationship between the number of nighttime gunshots and median household income. KEY RESULTS We analyzed 72,236 gunshots. Gunshots were more common during the nighttime than daytime (overall RR = 2.5). Analyses demonstrated that the low estimates for the mean annual number of person-nights impacted by nighttime gunshots were 0.4 million in Baltimore and Portland, 1.3 million in Philadelphia, 1.6 million in Boston, 2.9 million in New York City, and 5.9 million in Washington. The number of nighttime gunshots was inversely related to median household income. CONCLUSIONS Nighttime gunshots are prevalent, particularly in low-income neighborhoods, and may have under-recognized effects on the surrounding community.
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Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
- Center for Gun Violence Prevention, Massachusetts General Hospital, Boston, MA, USA.
| | - Mahmoud Affouf
- Department of Mathematics, Kean University, Union, NJ, USA
| | - Peter T Masiakos
- Center for Gun Violence Prevention, Massachusetts General Hospital, Boston, MA, USA
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jay M Iyer
- Departments of Molecular and Cellular Biology and Statistics, Harvard University, Cambridge, MA, USA
| | - Cornelia Griggs
- Center for Gun Violence Prevention, Massachusetts General Hospital, Boston, MA, USA
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Chana A Sacks
- Center for Gun Violence Prevention, Massachusetts General Hospital, Boston, MA, USA
- Division of General Internal Medicine and Mongan Institute, Massachusetts General Hospital, Harvard Medical School Boston, Boston, MA, USA
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Dhanda Patil R, Suurna MV, Steffen A, Soose R, Coxe J, Chan T, Ishman SL. Relationship of Nocturnal Insomnia Symptoms and Outcomes After Hypoglossal Nerve Stimulation. OTO Open 2024; 8:e134. [PMID: 38646184 PMCID: PMC11032643 DOI: 10.1002/oto2.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/24/2024] [Indexed: 04/23/2024] Open
Abstract
Objective In patients undergoing hypoglossal nerve stimulation (HGNS), we examined the Insomnia Severity Index (ISI) to understand how baseline sleep onset insomnia (SOI), sleep maintenance insomnia (SMI), and early morning awakening (EMA) affected postsurgical outcomes. Study Design Observational. Setting Multicenter registry. Methods We included patients from the Adherence and Outcomes of Upper Airway Stimulation for Obstructive Sleep Apnea International Registry (ADHERE) with a baseline ISI from 2020 to 2023. Regression analysis examined the association of ISI question scores for SOI, SMI, and EMA and outcomes: Apnea-Hypopnea Index (AHI) reduction, device usage, changes in the Epworth Sleepiness Scale (ESS) and overall ISI score, final visit (FV) completion, and satisfaction. Results No relationship was noted between insomnia subtypes and AHI reduction or FV completion. In the subgroup of patients with baseline moderate/severe insomnia, patients with major impairment for SOI used their device 64 min/day longer than those with minimal impairment. Among all patients, those with baseline major impairment for SOI had a 2.3 points greater improvement in ISI from baseline to FV compared to patients with minimal impairment, while patients with baseline major impairment for SMI had a 2.0 and 3.5 points greater improvement in the ESS and ISI than those with minimal impairment. Patients with EMA and moderate/severe baseline insomnia had decreased odds of being satisfied after surgery. Conclusion In ADHERE, nocturnal symptoms of insomnia did not limit HGNS efficacy or therapy use. Conversely, those with worse insomnia subtype impairments at baseline had improved outcomes related to adherence, sleepiness, and insomnia at the FV.
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Affiliation(s)
- Reena Dhanda Patil
- Department of Otolaryngology–Head and Neck SurgeryUniversity of CincinnatiCincinnatiOhioUSA
- Surgical ServicesCincinnati Veterans Affairs Medical CenterCincinnatiOhioUSA
| | - Maria V. Suurna
- Department of Otolaryngology–Head and Neck SurgeryUniversity of MiamiMiamiFloridaUSA
| | - Armin Steffen
- Department of OtorhinolaryngologyUniversity of LubeckLubeckGermany
| | - Ryan Soose
- Department of OtolaryngologyUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - James Coxe
- Department of Otolaryngology–Head and Neck SurgeryUniversity of CincinnatiCincinnatiOhioUSA
| | - Teresa Chan
- Department of Otolaryngology–Head and Neck SurgeryUniversity of Texas‐Southwestern Medical CenterDallasTexasUSA
| | - Stacey L. Ishman
- Division of Otolaryngology–Head and Neck SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
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Wang Z, Zeng Z. Association between personality characteristics and sleep quality among Chinese middle-aged and older adults: evidence from China family panel studies. BMC Public Health 2023; 23:2427. [PMID: 38053067 PMCID: PMC10699122 DOI: 10.1186/s12889-023-17352-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Poor sleep quality will have adverse effects on physical and mental health, quality of life and other aspects of middle-aged and older adults. Sleep quality is affected by many factors. Whether the sleep quality measures of the participants had changed in the previous or subsequent time period is not easily taken into account. Moreover, there have been no studies on this topic in Chinese middle-aged and older adults. The objective of this study was to mitigate the bias of sleep quality assessment, and analyze the association between personality traits and sleep quality in Chinese middle-aged and older adults. METHODS The data came from the China Family Panel Studies (CFPS). A total of 6031 participants aged ≥ 45 years were included in this study. Personality characteristics were evaluated based on the scores of each dimension of Big Five personality traits. Sleep duration and sleep perception were used as indicators to measure sleep quality. Logistic models were used to analyze the relationship between personality traits and sleep duration or sleep perception, respectively. RESULTS 4.5% of the participants had abnormal sleep duration, and 14.4% had a pessimistic sleep perception. Conscientiousness was rated the highest among the personality traits (3.97 ± 0.6). Participants with higher scores for extraversion personality traits had more normal sleep duration (OR = 0.77, 95% CI: 0.64-0.93) and more optimistic sleep perception (OR = 0.86, 95% CI: 0.76-0.96). Using the Internet and feeling unwell in the past week have a moderating effect on the impact of conscientiousness personality characteristics on sleep duration or sleep perception, respectively (but not overall sleep quality). In addition, participants with a spouse or no recent physical discomfort tended to have a normal sleep duration and a more optimistic sleep perception. CONCLUSIONS The higher the score of extraversion personality traits, the better the overall sleep quality of middle-aged and older adults. Having a spouse and feeling unwell were the important factors affecting their sleep quality. Specific personality traits intervention should be carried out for middle-aged and older adults with poor sleep quality to make their personality traits are closer to extraversion. In addition, middle-aged and older adults without spouses should be encouraged to marry or remarry. We will strengthen health management and medical expenditures for middle-aged and older adults.
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Affiliation(s)
- Zhen Wang
- School of Public Health, Hubei University of Medicine, Hubei, China
| | - Zhi Zeng
- School of Public Health, Hubei University of Medicine, Hubei, China.
- Center of Health Administration and Development Studies, Hubei University of Medicine, Hubei, China.
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