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Gillen MM, Rosenbaum DL, Winter VR, Bloomer SA. Hormonal contraceptive use and women's well-being: links with body image, eating behavior, and sleep. PSYCHOL HEALTH MED 2024; 29:905-916. [PMID: 37220269 DOI: 10.1080/13548506.2023.2216468] [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: 08/19/2022] [Accepted: 05/16/2023] [Indexed: 05/25/2023]
Abstract
The goal of the current study was to examine associations between hormonal contraceptive use and indicators of well-being including body image, eating behavior, sleep and energy level. Drawing on a health protection framework, we expected that individuals who use hormonal contraceptives would be more attuned to health and report more positive health attitudes and behaviors on these dimensions. Undergraduate college women (N = 270; M = 19.39 years, SD = 2.43, range 18-39 years) from diverse racial/ethnic and sexual orientation groups completed a survey online. Measures included hormonal contraception use, body image, weight control behavior, breakfast consumption, sleep behavior, and daytime energy level. Nearly 1/3 (30.9%) of the sample reported current hormonal contraceptive use, with most users reporting use of birth control pills (74.7%). Women who used hormonal contraceptives reported significantly higher appearance orientation and body surveillance, lower average energy, more frequent night awakenings, and more naps. Longer duration of hormonal contraceptive use was significantly related to higher body surveillance, and engaging in more unhealthy weight control behavior. Hormonal contraceptive use is not related to indicators of greater well-being. Rather, hormonal contraceptive use is related to greater attention to appearance, lower daytime energy, and some indicators of poorer sleep quality. Clinicians who prescribe hormonal contraceptives should attend to body image, sleep and energy concerns among users.
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Affiliation(s)
- Meghan M Gillen
- Division of Social Sciences, The Pennsylvania State University, Abington, PA, USA
| | - Diane L Rosenbaum
- Division of Social Sciences, The Pennsylvania State University, Abington, PA, USA
| | | | - Steven A Bloomer
- Division of Science and Engineering, The Pennsylvania State University, Abington, PA, USA
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Goldberg C, Greenberg MR, Noveihed A, Agrawal L, Omene C, Toppmeyer D, George MA. Ovarian Suppression: Early Menopause, Late Effects. Curr Oncol Rep 2024; 26:427-438. [PMID: 38305992 DOI: 10.1007/s11912-023-01491-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE OF REVIEW Pre-menopausal women diagnosed with hormone receptor (HR) breast cancer are candidates for prolonged hypoestrogenism to improve cancer outcomes. However, the disease benefit eclipses the toxicities associated with ovarian function suppression (OFS), which are often under-reported. RECENT FINDINGS Increased risk of mortality from cardiovascular disease, bone disorders, and metabolic disorders is well reported in women with no history of cancer, after surgical oophorectomy or premature ovarian failure. Vasomotor symptoms, urogenital atrophy, weight gain, sexual dysfunction, cognitive decline, and sleep disturbances contribute to the increased non-compliance associated with OFS, especially in younger women. Balancing the toxicities of prolonged OFS with its benefits should be critically analyzed by providers when making recommendations for their patients. Supportive care to manage multi-system toxicities and to counteract the long-term impact on all-cause mortality should be emphasized by every cancer program. Future studies with OFS should incorporate patient outcomes and strategies for symptom management in addition to focusing on improving disease outcomes.
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Affiliation(s)
- Chaya Goldberg
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | | | | | | - Coral Omene
- Rutgers Cancer Institute of New Jersey, Rutgers, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Deborah Toppmeyer
- Rutgers Cancer Institute of New Jersey, Rutgers, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Mridula A George
- Rutgers Cancer Institute of New Jersey, Rutgers, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
- The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
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Moon CM, Heo SH, Yoon W, Baek BH, Shin SS, Kim SK, Lee YY. Altered Sexual Response-Related Functional Connectivity and Morphometric Changes Influenced by Sex Hormones across Menopausal Status. J Clin Med 2024; 13:387. [PMID: 38256520 PMCID: PMC10816754 DOI: 10.3390/jcm13020387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Our study retrospectively investigated differential patterns of the functional connectivity (FC) of core brain regions synchronous with morphometric changes associated with sexual dysfunction in menopausal women, and their correlations with sexual hormones. Twenty-three premenopausal women (mean age: 41.52 ± 7.38 years) and 21 menopausal women (mean age: 55.52 ± 2.80 years) underwent sex hormone level measurements with high-resolution T1 and functional magnetic resonance imaging (MRI) during rest, neutral, and sexual arousal conditions. Analysis of covariance adjusted for age was used to compare the FC and gray matter (GM) volume between the two groups. Menopausal women showed lower GM volumes in the superior frontal gyrus (SFG), superior temporal pole, parahippocampal gyrus (PHG), hippocampus (Hip), amygdala (Amg), and cerebellum (Cb) compared to premenopausal women (p < 0.05). In addition, compared to premenopausal women, menopausal women showed decreased FC of seed regions involved in the SFG, frontal eye fields, and Amg, as well as target regions involved in the PHG, Hip, inferior frontal gyrus, Cb, and vermis (p < 0.005). Furthermore, the FC between the right Amg and right Cb and between the left Amg and right Cb during sexual arousal in both groups was positively correlated with total estrogen and estradiol levels, respectively (p < 0.01). The GM volume values in the right Amg and right Cb were positively correlated with total estrogen and estradiol levels (p < 0.05). Our study demonstrated an association between menopause-related differential FC and GM volume variations and fluctuating sex hormones. Our findings highlight that overlapping brain regions with functional alterations and morphometric changes are closely linked with menopausal symptom-related decreases in sexual arousal and hormone levels.
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Affiliation(s)
- Chung Man Moon
- Research Institute of Medical Sciences, Chonnam National University, 264 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
| | - Suk Hee Heo
- Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Woong Yoon
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Byung Hyun Baek
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Sang Soo Shin
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Seul Kee Kim
- Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Yun Young Lee
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
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Heaton K, Kham-Ai P, Shattell M. Sleep, mental health, and access to health care of women truck drivers. J Am Assoc Nurse Pract 2024; 36:38-45. [PMID: 38038951 DOI: 10.1097/jxx.0000000000000970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/02/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND The numbers of women in trucking are growing steadily, yet because they represent a minority group, little is known about their health issues. Most studies of truck drivers have focused on the mental and physical health, sleep, and health care access of male truck drivers. PURPOSE The purpose of this study was to characterize chronic stress, sleep, and mental health service and overall access to care among women truck drivers. METHODOLOGY Twenty-five female truck drivers were a subsample of participants from a larger parent study of truck drivers. After approval from the institutional review board, participants completed a 59-item Qualtrics survey; data were transferred from Qualtrics to SPSS v. 24 for analysis. RESULTS No acute sleepiness or excess daytime sleepiness was observed, but participants only slept 6 hr per night, and all experienced poor sleep quality. Although 28% of participants met or exceeded the threshold score for posttraumatic stress disorder (PTSD), only 8% sought care for feelings of upset or distress. Also, 80% of the women had health insurance, yet there were those who did not seek care because of job-related conflicts. CONCLUSION/IMPLICATIONS Participants were sleep deprived and experienced poor-quality sleep. Mental health and other health services utilization was low. Implications for practice include consideration of telehealth services to improve health care access and screening and referral as needed to mental health care providers by Department of Transportation medical examiners. Future research should include younger women truck drivers to determine the potential contribution of perimenopause/menopause to some of the health issues experienced by this group of workers.
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Affiliation(s)
- Karen Heaton
- Faculty, Occupational Health Nursing, Deep South Center for Occupational Health and Safety, School of Nursing, Adult/Acute Health, Chronic Care and Foundations, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Prasert Kham-Ai
- The University of Alabama at Birmingham, Birmingham, Alabama
| | - Mona Shattell
- Department of Nursing Systems, Hugh F. and Jeannette G. McKean Endowed Chair, College of NursingAcademic Health Sciences Center University of Central Florida, Orlando, Florida
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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [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] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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Zhang J, Jiang B. Influence of Melatonin Treatment on Emotion, Sleep, and Life Quality in Perimenopausal Women: A Clinical Study. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:2198804. [PMID: 37854169 PMCID: PMC10581846 DOI: 10.1155/2023/2198804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 10/20/2023]
Abstract
Method 100 healthy perimenopausal women were recruited and randomly assigned to two groups, with 50 subjects in each group. In the control group, placebo was administrated daily for 3 cycles (4 weeks of treatment for 1 cycle and drug withdrawals for 1 week). The study group received 3 mg oral melatonin treatment daily in the same period of time. All subjects completed the study. We compared the uterine volume, endometrial thickness, LH (luteinizing hormone), FSH (follicle generating hormone), E2 (estradiol), and melatonin levels during daytime between the two groups before and after the study. Moreover, perimenopause syndrome, sleep, mood, and QoL were analyzed at the baseline and 3 cycles by the questionnaires of the Kupperman index, the Pittsburgh sleep quality index (PSQI), the Hamilton anxiety scale (HAMA), and the Hamilton depression scale (HAMD), as well as menopausal QoL (MENQOL), respectively. Any adverse reactions experienced by the subjects were also compared in the study. Finally, 91 participants (92%) completed the whole study, 47 and 44 in the study and control groups, respectively, and their data were considered in subsequent analyses. Results After therapy, the two groups were similar in the uterine volume and endometrial thickness. In contrast to the control group, the study group showed notably decreased LH and FSH levels. No notable difference was discovered in E2 and melatonin levels between the two groups in the study. Moreover, the study group exhibited a significantly lower score in the Kupperman index, PSQI, HAMA, HAMD, and MENQOL scale than the control group. Moreover, the two groups had no notable difference in adverse reactions. Conclusion Melatonin was a useful treatment to relieve climacteric symptoms and improve sleep, mood, and life quality in perimenopausal women without obvious adverse reactions.
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Affiliation(s)
- Jianfu Zhang
- Department of Pharmacy, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - Bengui Jiang
- Department of Gynecology, Ningbo Women and Children's Hospital, Ningbo 315012, China
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Carrasco-Nuñes N, Romano M, Cabeza M. Sex hormone dose escalation for treating abnormal sleep in ovariectomized rats: in vitro GABA synthesis in sleep-related brain areas. Can J Physiol Pharmacol 2023; 101:529-538. [PMID: 37364372 DOI: 10.1139/cjpp-2022-0524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
No data in the literature have evaluated sex hormone dose escalation for treating abnormal sleep of ovariectomized rats-nor studies on the role of sex hormones in GABA synthesis of rats' sleep-related areas. The main aim of this study was to determine the maximum tolerated dose (MTD) of estradiol (ET), progesterone (PT), and the mixture of both (EPT) to restore normal sleep in a model of menopause in rats. The second purpose was to describe the in vitro activity of glutamate decarboxylase (GAD) in sleep-related brain areas in the presence or absence of sex hormones. A weekly dose-escalation design of ET, PT, or EPT was implemented in ovariectomized rats (six per group). Dose escalation continued until the dose at which 100% of the rats exhibited a state of "complete somnolence." Doses that were not toxic or did not show side effects were considered. For in vitro experiments, sleep-related brain areas were separated and incubated with radiolabeled glutamate. Estradiol (17β-E2), progesterone (P), and pyridoxal phosphate (PLP) were added to this assay, and GAD activity was determined. Under the same conditions, a second test was carried out, but the P antagonist RU486 was added to assess the role of P in GAD activity. Ovariectomy increased periodic awakenings compared to those determined for the SHAM group. The EPT for ovariectomized rats was very effective by the fifth week in decreasing arousal and achieving a similar sleep behavior to the SHAM-control group. Rats tolerated the ET, PT, and EPT well to the maximum planned dose (0.66 mg/kg and 4.4 mg/kg, respectively). No lethal events occurred; the MTD was reached. The in vitro studies indicated that the presence of 17β-E2 plus P in the assay triggered the activity of isotype 65 GAD in all the studied brain areas. RU486 in the incubation medium blocked such activity; however, the action of isotype 67 GAD was not blocked by RU486. A dose-escalation model was determined; the MTD coincided with the maximum dose of ET and PT used. However, the EPT combination restored normal sleep in the menopause model compared to the SHAMs without toxic effects. The in vitro model demonstrated that 17β-E2 plus P presence in the assay increased the activity of GAD65 in the studied brain tissues.
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Affiliation(s)
- Nayely Carrasco-Nuñes
- Departamento de Sistemas Biológicos. Universidad Autónoma Metropolitana-Xochimilco. Calzada del Hueso 110, Colonia Villa Quietud, 04960 Ciudad de México, México
| | - Marta Romano
- CINVESTAV. Av Instituto Politécnico Nacional 2508, San Pedro Zacatenco, Gustavo A. Madero, 07360 Ciudad de México, México
| | - Marisa Cabeza
- Departamento de Sistemas Biológicos. Universidad Autónoma Metropolitana-Xochimilco. Calzada del Hueso 110, Colonia Villa Quietud, 04960 Ciudad de México, México
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Rugvedh P, Gundreddy P, Wandile B. The Menstrual Cycle's Influence on Sleep Duration and Cardiovascular Health: A Comprehensive Review. Cureus 2023; 15:e47292. [PMID: 38022155 PMCID: PMC10656370 DOI: 10.7759/cureus.47292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
The menstrual cycle, a fundamental biological process in women, extends its influence beyond reproduction, impacting sleep duration and cardiovascular health. This comprehensive review delves into the intricate connections that bind these three vital aspects of women's health. Beginning with thoroughly exploring the menstrual cycle, we uncover its phases and the dynamic hormonal fluctuations that underlie each stage. We pay special attention to estrogen and progesterone, the primary sex hormones orchestrating the menstrual cycle. With their rhythmic rise and fall, these hormones orchestrate events, affecting sleep duration, sleep patterns, and various indicators of cardiovascular well-being. The review examines how the menstrual cycle influences sleep patterns, exploring the nuanced changes in sleep duration observed throughout menstrual phases. We elucidate the contributing factors, encompassing hormonal fluctuations, the impact of pain and discomfort, and the significance of emotional and psychological factors. All of these elements collectively contribute to variations in sleep quality. Shifting our focus to the cardiovascular system, we investigate the bidirectional relationships between sleep disturbances and cardiovascular conditions, emphasizing the need to address sleep-related issues in the context of cardiovascular risk. The menstrual cycle is analyzed as a pivotal mediator in these intricate connections, exploring how hormonal fluctuations across menstrual phases can influence sleep patterns and cardiovascular health. This analysis provides valuable insights into the complex causality web. As clinical implications emerge, we emphasize the importance of tailoring healthcare strategies for individuals with irregular menstrual cycles. We explore potential interventions, from personalized care and hormone management to lifestyle adjustments, to improve sleep and cardiovascular well-being. In conclusion, this comprehensive review sheds light on the interplay between the menstrual cycle, sleep duration, and cardiovascular health. It underscores the urgent necessity for personalized healthcare approaches and preventive strategies, empowering women to navigate these intricate relationships. Ultimately, through a nuanced understanding of these interactions, we can work towards enhancing women's overall well-being and reducing cardiovascular risk within the context of menstrual cycle-related influences.
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Affiliation(s)
- Padigela Rugvedh
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ppavani Gundreddy
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bhushan Wandile
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Eglovitch M, Parlier-Ahmad AB, Legge C, Chithranjan S, Kolli S, Violante S, Dzierzewski JM, Huhn AS, Wilkerson A, Martin CE. Patient reported preferences for sleep interventions among women receiving buprenorphine for opioid use disorder. Front Psychiatry 2023; 14:1244156. [PMID: 37779614 PMCID: PMC10537926 DOI: 10.3389/fpsyt.2023.1244156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Aim Among individuals receiving medication for OUD (MOUD), insomnia is highly prevalent and increases the risk for negative OUD outcomes. However, little is known about MOUD patient-reported preferences for insomnia treatments among women with OUD. This mixed-methods study explored acceptability of and patient preferences for sleep interventions among women in OUD treatment. Methods This is an analysis from an ongoing cross-sectional survey and interview study investigating the relationship between sleep and OUD recovery. The parent study is actively enrolling non-pregnant women between 18-45 years stabilized on buprenorphine from an outpatient program. Participants complete measures including the Insomnia Severity Index (ISI), with scores of ≥10 identifying clinically significant insomnia symptoms. A sub-sample who met this threshold completed semi-structured interviews. Descriptive statistics were generated for survey responses, and applied thematic analysis was used for interview data. Results Participants selected for the qualitative interview (n = 11) highlighted prior positive and negative experiences with sleep treatments, challenges with employing non-pharmacological sleep strategies, and preferences for both medical and behavioral sleep interventions while in recovery. Women emphasized the need for flexibility of sleep therapy sessions to align with ongoing social determinants (e.g., caregiving responsibilities) as well as for sleep medications without sedating effects nor risk of dependency. Conclusions Many women receiving MOUD have concomitant insomnia symptoms, and desire availability of both pharmacologic and behavioral sleep interventions within the OUD treatment setting. Qualitative findings underscore the need for evidence-based sleep interventions that account for the unique socioenvironmental factors that may impact strategy implementation in this population.
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Affiliation(s)
- Michelle Eglovitch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | | | - Catherine Legge
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Sajanee Chithranjan
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Saisriya Kolli
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Stephanie Violante
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | | | | | - Allison Wilkerson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Caitlin Eileen Martin
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
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Raj A, Chakole S, Agrawal S, Gupta A, Khekade H, Prasad R, Lohakare T, Wanjari M. The Impact of Menopause on Cardiovascular Aging: A Comprehensive Review of Androgen Influences. Cureus 2023; 15:e43569. [PMID: 37719547 PMCID: PMC10503403 DOI: 10.7759/cureus.43569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
Menopause represents a critical life stage in women, characterized by hormonal changes that significantly impact cardiovascular health. While the decline in estrogen levels has long been recognized as a major contributor to cardiovascular aging in menopausal women, the role of androgens, particularly testosterone, has gained increasing attention in recent years. This comprehensive review aims to provide a thorough understanding of the impact of menopause on cardiovascular aging, with a specific focus on the influences of androgens. A literature search was conducted to gather relevant studies and clinical evidence exploring the relationship between menopause, androgens, and cardiovascular health. The review integrates findings from various studies to present a holistic view of the topic. The review outlines the changes in hormone levels during menopause and discusses the cardiovascular risk factors associated with this transition. Furthermore, it explores the impact of menopause on cardiovascular structure and function, elucidating the underlying mechanisms that contribute to cardiovascular aging. Androgens' significance in maintaining cardiovascular homeostasis is discussed, followed by exploring the effects of androgen decline during menopause on lipid profiles, insulin sensitivity, vascular function, and other cardiovascular parameters. The review delves into the mechanisms of androgen action on the cardiovascular system, emphasizing the role of androgen receptors and the intricate interplay between androgens, estrogens, and other hormones. Clinical evidence supporting the effects of androgens on cardiovascular aging is presented, including studies investigating the association between androgen levels and cardiovascular outcomes. Additionally, the impact of androgen replacement therapy (ART) on cardiovascular risk markers and events in menopausal women is examined, along with controversies and conflicting findings surrounding the use of androgen therapy in cardiovascular aging. This structured review provides a comprehensive understanding of the impact of menopause on cardiovascular aging, with a specific focus on the role of androgens. By highlighting the significance of androgens in cardiovascular health during menopause, this review aims to create an initial impression and interest among readers, inviting potential citations in the future. The findings underscore the need for further research and offer insights into managing cardiovascular aging in menopausal women, including lifestyle interventions, pharmacological approaches, and the potential role of personalized medicine and precision therapies.
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Affiliation(s)
- Aditya Raj
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suyash Agrawal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anannya Gupta
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshal Khekade
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Roshan Prasad
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejaswee Lohakare
- Pediatrics, Smt. Radhikabai Meghe Memorial College of Nursing, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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11
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Baker FC. Optimizing sleep across the menopausal transition. Climacteric 2023; 26:198-205. [PMID: 37011660 PMCID: PMC10416747 DOI: 10.1080/13697137.2023.2173569] [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: 12/29/2022] [Accepted: 01/19/2023] [Indexed: 04/05/2023]
Abstract
Women frequently experience sleep disturbances, particularly night-time awakenings, as they transition menopause and enter postmenopause. Sleep is essential for optimal functioning and health. Persistent and distressing sleep disturbances across menopause can negatively impact daytime functioning and productivity, and increase risk for mental and physical health conditions. While multiple factors can disturb sleep, two unique factors in the context of menopause are vasomotor symptoms and the changing reproductive hormone environment. Vasomotor symptoms are associated with sleep disturbances and contribute significantly to awakenings and amount of time spent awake during the night. Even after accounting for vasomotor and depressive symptoms, lower estradiol and higher follicle stimulating hormone levels, indicative of menopause, are associated with sleep disturbance, particularly awakenings, suggesting that the hormone environment may directly affect sleep. Management strategies for clinically significant menopausal sleep disturbances include cognitive behavioral therapy for insomnia, which is effective and durable in treating menopausal insomnia. Hormone therapy alleviates sleep disturbances, particularly in the presence of disruptive vasomotor symptoms. Sleep disturbances have a significant impact on women's functioning and health, and there is a need for further research of the underlying mechanisms to advance effective preventative and treatment strategies that ensure optimal health and well-being of midlife women.
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Affiliation(s)
- F C Baker
- Center for Health Sciences and Human Sleep Research Program, SRI International, Menlo Park, CA, USA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Han F, Liu X, Yang Y, Liu X. Sex-specific age-related changes in glymphatic function assessed by resting-state functional magnetic resonance imaging. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.02.535258. [PMID: 37034667 PMCID: PMC10081329 DOI: 10.1101/2023.04.02.535258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
The glymphatic system that clears out brain wastes, such as amyloid-β (Aβ) and tau, through cerebrospinal fluid (CSF) flow may play an important role in aging and dementias. However, a lack of non-invasive tools to assess the glymphatic function in humans hindered the understanding of the glymphatic changes in healthy aging. The global infra-slow (<0.1 Hz) brain activity measured by the global mean resting-state fMRI signal (gBOLD) was recently found to be coupled by large CSF movements. This coupling has been used to measure the glymphatic process and found to correlate with various pathologies of Alzheimer's disease (AD), including Aβ pathology. Using resting-state fMRI data from a large group of 719 healthy aging participants, we examined the sex-specific changes of the gBOLD-CSF coupling, as a measure of glymphatic function, over a wide age range between 36-100 years old. We found that this coupling index remains stable before around age 55 and then starts to decline afterward, particularly in females. Menopause may contribute to the accelerated decline in females.
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Affiliation(s)
- Feng Han
- Department of Biomedical Engineering, The Pennsylvania State University, PA, USA
| | - Xufu Liu
- Department of Biomedical Engineering, The Pennsylvania State University, PA, USA
| | - Yifan Yang
- Department of Biomedical Engineering, The Pennsylvania State University, PA, USA
| | - Xiao Liu
- Department of Biomedical Engineering, The Pennsylvania State University, PA, USA
- Institute for Computational and Data Sciences, The Pennsylvania State University, PA, USA
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13
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Ballard HK, Jackson TB, Hicks TH, Cox SJ, Symm A, Maldonado T, Bernard JA. Hormone-sleep interactions predict cerebellar connectivity and behavior in aging females. Psychoneuroendocrinology 2023; 150:106034. [PMID: 36709633 PMCID: PMC10149037 DOI: 10.1016/j.psyneuen.2023.106034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/16/2022] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
Sex hormones fluctuate over the course of the female lifespan and are associated with brain health and cognition. Thus, hormonal changes throughout female adulthood, and with menopause in particular, may contribute to sex differences in brain function and behavior. Further, sex hormones have been correlated with sleep patterns, which also exhibit sex-specific impacts on the brain and behavior. As such, the interplay between hormones and sleep may contribute to late-life brain and behavioral outcomes in females. Here, in a sample of healthy adult females (n = 79, ages 35-86), we evaluated the effect of hormone-sleep interactions on cognitive and motor performance as well as cerebellar-frontal network connectivity. Salivary samples were used to measure 17β-estradiol, progesterone, and testosterone levels while overnight actigraphy was used to quantify sleep patterns. Cognitive behavior was quantified using the composite average of standardized scores on memory, processing speed, and attentional tasks, and motor behavior was indexed with sequence learning, balance, and dexterity tasks. We analyzed resting-state connectivity correlations for two specific cerebellar-frontal networks: a Crus I to dorsolateral prefrontal cortex network and a Lobule V to primary motor cortex network. In sum, results indicate that sex hormones and sleep patterns interact to predict cerebellar-frontal connectivity and behavior in aging females. Together, the current findings further highlight the potential consequences of endocrine aging in females and suggest that the link between sex hormones and sleep patterns may contribute, in part, to divergent outcomes between sexes in advanced age.
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Affiliation(s)
- Hannah K Ballard
- Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, USA; Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA.
| | - T Bryan Jackson
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Tracey H Hicks
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Sydney J Cox
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Abigail Symm
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Ted Maldonado
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA; Department of Psychology, Indiana State University, Terre Haute, IN, USA
| | - Jessica A Bernard
- Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, USA; Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
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14
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Hicks TH, Magalhães TNC, Ballard HK, Jackson TB, Cox SJ, Bernard JA. Network segregation in aging females and evaluation of the impact of sex steroid hormones. Front Hum Neurosci 2023; 17:1059091. [PMID: 36816502 PMCID: PMC9929548 DOI: 10.3389/fnhum.2023.1059091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/13/2023] [Indexed: 02/04/2023] Open
Abstract
Males and females show differential patterns in connectivity in resting-state networks (RSNs) during normal aging, from early adulthood to late middle age. Age-related differences in network integration (effectiveness of specialized communication at the global network level) and segregation (functional specialization at the local level of specific brain regions) may also differ by sex. These differences may be due at least in part to endogenous hormonal fluctuation, such as that which occurs in females during midlife with the transition to menopause when levels of estrogens and progesterone drop markedly. A limited number of studies that have investigated sex differences in the action of steroid hormones in brain networks. Here we investigated how sex steroid hormones relate to age-network relationships in both males and females, with a focus on network segregation. Females displayed a significant quadratic relationship between age and network segregation for the cerebellar-basal ganglia and salience networks. In both cases, segregation was still increasing through adulthood, highest in midlife, and with a downturn thereafter. However, there were no significant relationships between sex steroid hormone levels and network segregation levels in females, and they did not exhibit significant associations between progesterone or 17β-estradiol and network segregation. Patterns of connectivity between the cerebellum and basal ganglia have been associated with cognitive performance and self-reported balance confidence in older adults. Together, these findings suggest that network segregation patterns with age in females vary by network, and that sex steroid hormones are not associated with this measure of connectivity in this cross-sectional analysis. Though this is a null effect, it remains critical for understanding the extent to which hormones relate to brain network architecture.
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Affiliation(s)
- Tracey H. Hicks
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States,Tracey H. Hicks,
| | - Thamires N. C. Magalhães
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States,*Correspondence: Thamires N. C. Magalhães,
| | - Hannah K. Ballard
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - T. Bryan Jackson
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Sydney J. Cox
- Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Jessica A. Bernard
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States,Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, United States
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15
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Isoflavone and Antioxidant of Instant Cream Soup Made from Pumpkin and Tempeh and Their Active Compound in Ovariohysterectomy Rat-Induced Alzheimer’s Disease. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2022; 2022:8051624. [DOI: 10.1155/2022/8051624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/29/2022]
Abstract
Menopause period associated with brain function disorders can caused by decreasing estradiol levels and increasing oxidative stress in the body. Antioxidant agents are required to balance oxidative stress in the body. Instant cream soup made from pumpkin and tempeh is a supplementary food containing isoflavone and antioxidant agents. This study is aimed at analyzing the content of antioxidant level and isoflavones (genistein and daidzein) in instant cream soup and their effect on ovariohysterectomy (OVx) rats. Instant pumpkin cream soup with and without tempeh were subjected to isoflavone content and antioxidant analysis. Serum estradiol was analyzed using enzyme-linked immunosorbent assay. Liver concentration of malondialdehyde (MDA) and activities of superoxide dismutase (SOD) were measured by spectrophotometric methods. The study showed that the isoflavone content (genistein 370.86 g/100 g, daidzein 185.61 g/100 g) was only present in the pumpkin instant cream soup with tempeh (IPTS). IPTS has higher antioxidant levels (134.25 mg AEAC/100 g) than instant pumpkin cream soup without tempeh (IPS). In vivo study, experimental rats showed that OVx increased malondialdehyde (MDA) levels up to 5.85-6.07 nmol mL-1 as compared to control (4.47 nmol mL-1). Moreover, instant pumpkin cream soup with tempeh treatments significantly increased serum estradiol levels (2.37–3.63 μg) and superoxide dismutase (SOD) levels of 497.49-558.89 U mL-1. This study concluded that instant pumpkin cream soup and tempeh contained isoflavone and antioxidant, and it increased estradiol serum and SOD level.
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Mary A, Bastin C, Lina JM, Rauchs G. Editorial: The impact of age-related changes in brain network organization and sleep on memory. Front Aging Neurosci 2022; 14:1049278. [PMID: 36268189 PMCID: PMC9577460 DOI: 10.3389/fnagi.2022.1049278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Alison Mary
- UR2NF—Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Center for Research in Cognition and Neurosciences and UNI—ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
- *Correspondence: Alison Mary
| | - Christine Bastin
- GIGA-Cyclotron Research Centre In Vivo Imaging & Psychology and Neuroscience of Cognition, University of Liège, Liège, Belgium
| | - Jean-Marc Lina
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
- Department of Electrical Engineering, École de Technologie Supérieure, Montreal, QC, Canada
- Centre de Recherches Mathématiques, Université de Montréal, Montreal, QC, Canada
| | - Géraldine Rauchs
- Normandie Univ, University of Caen, Institut national de la santé et de la recherche médicale, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), GIP Cyceron, Institut Blood and Brain @ Caen-Normandie, Caen, France
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17
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Lin J, Cheng S, Zhang J, Yuan S, Zhang L, Wu J, Chen J, Tang M, Zhao L, Yin Y. The Relationship Between Daily Dietary Intake of Fiber and Short Sleep Duration in the Presence of Di(2-Ethylhexyl) Phthalate: A Population-Based Study. Front Nutr 2022; 9:910892. [PMID: 35782937 PMCID: PMC9240702 DOI: 10.3389/fnut.2022.910892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/11/2022] [Indexed: 12/16/2022] Open
Abstract
Objective This study aimed to evaluate the relationship between daily dietary intake of fiber (DDIF) and short sleep duration (SSD) in the presence of di(2-ethylhexyl) phthalate. Methods Data of 13,634 participants in this study were collected from the National Health and Nutrition Examination Survey (NHANES). The sum of urinary mono-2-ethyl-5-carboxypentyl phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl)-hexyl phthalate, and mono-(2-ethyl-5-oxohexyl) phthalate was used to evaluate the level of di(2-ethylhexyl) phthalate (DEHP) exposure. The ln-transformed urinary creatinine-corrected DEHP [ln(DEHP/UCr)] level was used in the statistical models. DDIF was divided into tertiles (<5.77 g/1,000 kcal, 5.77–9.04 g/1,000 kcal, and ≥9.04 g/1,000 kcal). Results The 13,634 participants included in this study were classified into two groups according to sleep duration. The dose response analysis showed that higher ln(DEHP/UCr) was related to a higher risk of SSD (<7 h and <6 h). Participants in the highest vs. the lowest quartile of DEHP were found to be at increased risk of SSD (<7 h, <6 h, and <5 h). The result of risk of SSD <7 h was OR 1.57, 95% CI, 1.40–1.76; Ptrend <0.001, of SSD <6 h was OR 1.38, 95% CI, 1.18–1.61; Ptrend <0.001, and of SSD <5 h was OR 1.45, 95% CI, 1.13–1.86; Ptrend <0.001. DEHP exposure was found to be associated with SSD <7 h in a sex-specific manner (Pinteraction = 0.033). A significant interaction between ln(DEHP/UCr) and DDIF(tertiles1 vs. tertiles2) (Pinteraction = 0.02) was detected for SSD <7 h. Conclusion Our results showed that there was a harmful association between DEHP exposure and SSD (<7 h, <6 h, and <5 h). The ameliorative effects of median level of DDIF on SSD <7 h in the presence of DEHP exposure were observed in this study.
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Affiliation(s)
- Jilei Lin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Siying Cheng
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mingyu Tang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Liebin Zhao
- Shanghai Engineering Research Center of Intelligence Pediatrics, Shanghai, China
- *Correspondence: Liebin Zhao
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics, Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children's Medical Center, Shanghai, China
- Yong Yin
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18
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Abbaspoor Z, Siahposh A, Javadifar N, Faal Siahkal S, Mohaghegh Z, Sharifipour F. The Effect of Citrus Aurantium Aroma on the Sleep Quality in Postmenopausal Women: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2022; 10:86-95. [PMID: 35372632 PMCID: PMC8957651 DOI: 10.30476/ijcbnm.2021.90322.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022]
Abstract
Background One of the most common problems in menopausal women is sleep disturbance. Citrus aurantium has sedative, hypnotic, and anti-anxiety effects. The aim of this study was to investigate the effect of Citrus aurantium aroma on the sleep quality of postmenopausal women. Methods This was a double-blind randomized controlled trial that was conducted from Feb to Dec 2019 on 80 postmenopausal women who suffered from sleep disturbances. The participants were assigned into two groups randomly. Women in the intervention group were requested to use 2 drops of essential oil of Citrus aurantium, twice a day, for 4 consecutive days in a week, for 4 weeks as inhalation. The control group received almond oil in the same way. The quality of sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI) before the intervention and 4 weeks after the intervention started. The data were analyzed using the SPSS statistical software, version 21, and P<0.05 was considered statistically significant. Results After 4-weeks of intervention, the mean score of sleep quality was significantly lower in the Citrus aurantium group compared to the control group (5.75±1.33 vs 13±1.59, P<0.001). In the intervention group, all dimensions of PSQI were improved significantly (P<0.001). Conclusion The results of this study showed that the aroma of Citrus aurantium essence could significantly improve the sleep quality of postmenopausal women. Therefore, it is recommended that health care providers should inform the postmenopausal women and advise them to use this intervention for reduction of sleep disorders. Trial Registration Number IRCT20160427027633N7.
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Affiliation(s)
- Zahra Abbaspoor
- Department of Midwifery, Menopause Andropause Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amir Siahposh
- Department of Pharmacology, Medical Plants Research Center., School of Pharmacy, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Javadifar
- Department of Midwifery, Menopause Andropause Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahla Faal Siahkal
- Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zeynab Mohaghegh
- Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Foruzan Sharifipour
- Department of Midwifery, Menopause Andropause Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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19
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Tandon V, Sharma S, Mahajan A, Mahajan A, Tandon A. Menopause and sleep disorders. J Midlife Health 2022; 13:26-33. [PMID: 35707298 PMCID: PMC9190958 DOI: 10.4103/jmh.jmh_18_22] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 11/04/2022] Open
Abstract
Women are likely to suffer from sleep disorders more in comparison to men during menopause and with advancing age. The incidence of sleep disorders ranges from 16% to 47% at peri-menopause and 35%–60% at postmenopause. Insomnia with or without associated anxiety or low lying depression and Mood disorder is most common associated manifestations. Sleep disorders and insomnia largely remain a clinical diagnosis based on the subjective complaints of patients. Benzodiazepines remain the mainstay of the treatment in majority of the sleep disorders including chronic or acute insomnia. Treatment of associated anxiety, depression, or psychosis is most important. Tricyclic antidepressant, Selective Serotonin Reuptake Inhibitors (SSRI), Melatonin, Duloxetine, Fluoxetine, Imipramine, Nortriptyline or Amitriptyline and other drugs such as Eszopiclone, Escitalopram, Gabapentin, Quiteiapine, Citalopram, Mirtazapine followed by long-acting Melatonin and Ramelteon, also are very useful for the management of various sleep disorders. Hormone replacement therapy presently lacks concrete evidence to be used in menopausal women for sleep disorder. Sleep hygiene practices, self-hypnosis, meditation, and exercise play a very important role.
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20
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Martin CE, Dzierzewski JM, Keyser-Marcus L, Donovan EK, Ramey T, Svikis DS, Moeller FG. Sex Specific Sleep Parameters Among People With Substance Use Disorder. Front Psychiatry 2022; 13:905332. [PMID: 35722562 PMCID: PMC9199851 DOI: 10.3389/fpsyt.2022.905332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/05/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Sleep can have substantial impacts in substance use disorder (SUD) pathogenesis, treatment, and recovery. Sex differences exist in both sleep and SUD, but how sleep is uniquely associated with SUD by sex is not known. The study objective was to compare, within sex, sleep parameters between individuals with SUD and non-substance misusing controls. METHODS Secondary analyses of a parent cross-sectional study examining the feasibility and acceptability of a novel neurocognitive phenotyping assessment battery were completed. SUD and control subjects were recruited through local advertising and an established research registry. Subjects with SUD were also recruited through a university-based outpatient SUD treatment clinic. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Sex-stratified t-tests compared sleep between SUD and control subjects while Crosstab analyses explored group differences in the proportion of individuals reporting poor sleep (defined as PSQI ≥ 5). RESULTS Data from 162 males (44 controls, 118 SUD) and 146 females (64 controls, 82 SUD) were included in the present study. For females only, a significantly lower proportion of controls reported PSQI-defined poor sleep than individuals with any SUD or specifically with opioid use disorder. Male, but not female, controls reported shorter sleep latency, longer sleep duration, and less sleep disturbance than males with each SUD type. DISCUSSION/IMPLICATIONS Sleep holds promise as an avenue to address SUD within a biopsychosocial model. Future work at the intersection of SUD and sleep should prioritize investigations of their interplay with sex to identify targets for tailored SUD interventions.
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Affiliation(s)
- Caitlin E Martin
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States.,Division of Therapeutics and Medical Consequences, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
| | - Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Lori Keyser-Marcus
- Division of Therapeutics and Medical Consequences, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
| | - Emily K Donovan
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Tatiana Ramey
- Department of Psychiatry, National Institute on Drug Abuse, Bethesda, MD, United States
| | - Dace S Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - F Gerard Moeller
- Division of Therapeutics and Medical Consequences, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
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21
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Eggert T, Dorn H, Danker-Hopfe H. Nocturnal Brain Activity Differs with Age and Sex: Comparisons of Sleep EEG Power Spectra Between Young and Elderly Men, and Between 60-80-Year-Old Men and Women. Nat Sci Sleep 2021; 13:1611-1630. [PMID: 34584476 PMCID: PMC8464589 DOI: 10.2147/nss.s327221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/29/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Quantification of nocturnal EEG activity has emerged as a promising extension to the conventional sleep evaluation approach. To date, studies focusing on quantitative sleep EEG data in relation to age and sex have revealed considerable variation across lifespan and differences between men and women. However, sleep EEG power values from elderly individuals are still rare. The present secondary analysis aimed to fill this gap. PARTICIPANTS AND METHODS Sleep EEG data of 30 healthy elderly males (mean age ± SD: 69.1 ± 5.5 years), 30 healthy elderly females (67.8 ± 5.7 years), and of 30 healthy young males (25.6 ± 2.4 years) have been collected in three different studies with the same experimental design. Each individual contributed three polysomnographic recordings without any intervention to the analysis. Sleep recordings were performed and evaluated according to the standard of the American Academy of Sleep Medicine. Sleep EEG signals were derived from 19 electrode sites. Sleep-stage specific global and regional EEG power were compared between samples using a permutation-based statistic in combination with the threshold-free cluster enhancement method. RESULTS The present results showed pronounced differences in sleep EEG power between older men and women. The nocturnal EEG activity of older women was generally larger than that of older men, confirming previously reported variations with sex in younger individuals. Aging was reflected by differences in EEG power between young and elderly men for lower frequencies and for the sleep spindle frequency range, again consistent with prior studies. CONCLUSION The findings of this investigation complement those of earlier studies. They add to the understanding of nocturnal brain activity manifestation in senior adulthood and show how it differs with age in males. Unfortunately, the lack of information on young women prevents a similar insight for females.
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Affiliation(s)
- Torsten Eggert
- Charité – Universitätsmedizin Berlin, Competence Centre of Sleep Medicine, Berlin, Germany
| | - Hans Dorn
- Charité – Universitätsmedizin Berlin, Competence Centre of Sleep Medicine, Berlin, Germany
| | - Heidi Danker-Hopfe
- Charité – Universitätsmedizin Berlin, Competence Centre of Sleep Medicine, Berlin, Germany
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22
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Dib R, Gervais NJ, Mongrain V. A review of the current state of knowledge on sex differences in sleep and circadian phenotypes in rodents. Neurobiol Sleep Circadian Rhythms 2021; 11:100068. [PMID: 34195482 PMCID: PMC8240025 DOI: 10.1016/j.nbscr.2021.100068] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/25/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022] Open
Abstract
Sleep is a vital part of our lives as it is required to maintain health and optimal cognition. In humans, sex differences are relatively well-established for many sleep phenotypes. However, precise differences in sleep phenotypes between male and female rodents are less documented. The main goal of this article is to review sex differences in sleep architecture and electroencephalographic (EEG) activity during wakefulness and sleep in rodents. The effects of acute sleep deprivation on sleep duration and EEG activity in male and female rodents will also be covered, in addition to sex differences in specific circadian phenotypes. When possible, the contribution of the female estrous cycle to the observed differences between males and females will be described. In general, male rodents spend more time in non-rapid eye movement sleep (NREMS) in comparison to females, while other differences between sexes in sleep phenotypes are species- and estrous cycle phase-dependent. Altogether, the review illustrates the need for a sex-based perspective in basic sleep and circadian research, including the consideration of sex chromosomes and gonadal hormones in sleep and circadian phenotypes. In rodents, males spend less time awake, and more time in NREMS than females. The recovery from sleep deprivation is also dependent on biological sex. Gonadal hormones modulate sleep and circadian phenotypes in rodents. A more systematic comparison of sex in basic sleep/circadian research is needed.
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Affiliation(s)
- Rama Dib
- Department of Neuroscience, Université de Montréal, Montréal, QC, Canada.,Center for Advanced Research in Sleep Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montréal, QC, Canada
| | - Nicole J Gervais
- Rotman Research Institute - Baycrest Centre, North York, ON, Canada
| | - Valérie Mongrain
- Department of Neuroscience, Université de Montréal, Montréal, QC, Canada.,Center for Advanced Research in Sleep Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montréal, QC, Canada
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23
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Age and gender differences in objective sleep properties using large-scale body acceleration data in a Japanese population. Sci Rep 2021; 11:9970. [PMID: 33976280 PMCID: PMC8113448 DOI: 10.1038/s41598-021-89341-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/26/2021] [Indexed: 11/11/2022] Open
Abstract
Using large-scale objective sleep data derived from body acceleration signals of 68,604 Japanese residents ranging from adolescents to the elderly (10–89 years old), we found significant age- and gender-related differences in sleep properties (timing, duration, and quality) in real-life settings. Time-in-bed and total sleep time (TST) showed a U-shaped association with age, indicating their decrease in adulthood following their increase in the elderly. There was a remarkable shift in sleep phase toward earlier bedtime and earlier wake time with increasing age (> 20 years), together with worsening of sleep quality, which is estimated by sleep efficiency (SE) and wake time after sleep onset. Gender comparisons showed that TST was shorter in women than in similarly aged men, which is much evident after the age of 30 years. This was associated with later bedtimes and greater age-related deterioration of sleep quality in women. Compared to men in the same age group, women over age 50 demonstrated a greater reduction in SE with aging, due mainly to increasing durations of nighttime awakening. These differences can be attributed to several intricately intertwined causes, including biological aging as well as socio-cultural and socio-familial factors in Japan. In conclusion, our findings provide valuable insights on the characteristics of Japanese sleep habits.
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Imes CC, Bizhanova Z, Kline CE, Rockette-Wagner B, Chasens ER, Sereika SM, Burke LE. Bidirectional relationship between sleep and sedentary behavior in adults with overweight or obesity: A secondary analysis. ACTA ACUST UNITED AC 2021; 2:zpab004. [PMID: 33870194 PMCID: PMC8038645 DOI: 10.1093/sleepadvances/zpab004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/25/2021] [Indexed: 01/14/2023]
Abstract
Study Objectives The relationships between daytime sedentary behavior and that night’s sleep and sleep and next day’s sedentary behavior are unknown. The purpose of this analysis was to examine these potentially bidirectional associations. Methods This study was a secondary analysis of baseline data from an ecological momentary assessment study to determine the triggers for dietary lapses during a weight loss intervention. Sedentary behavior, physical activity, and sleep were objectively measured using accelerometers. Linear mixed modeling was used to examine the bidirectional multivariate associations between activity and sleep characteristics for each outcome examined separately. The models included sex, age, body mass index (BMI), education, and day of the week (weekday vs. weekend). Results Participants were predominantly white (81.5%) and female (88.9%) with a mean age of 51.2 ± 10.6 years. Longer previous night’s total sleep time (TST) (b = −0.320, standard error [SE] = 0.060; p < .001) and being a weekend (b = −63.845, SE = 9.406; p < .001) were associated with less sedentary time the next day. More daytime sedentary time was associated with less wake after sleep onset (b = −0.018, SE = 0.008; p = .016), fewer awakenings (b = −0.010, SE = 0.004; p = .016), and less TST (b = −0.060, SE = 0.028; p = .029) that night. Conclusions The bidirectional relationships between sedentary time and sleep characteristics are complex and may vary depending on participant characteristics and duration of sedentary and sleep time. Interventions to decrease sedentary behavior may benefit by targeting sleep duration and weekday activity.
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Affiliation(s)
| | - Zhadyra Bizhanova
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Christopher E Kline
- Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, PA
| | | | | | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, PA.,Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Lora E Burke
- School of Nursing, University of Pittsburgh, Pittsburgh, PA.,Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
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He L, Guo W, Qiu J, An X, Lu W. Altered Spontaneous Brain Activity in Women During Menopause Transition and Its Association With Cognitive Function and Serum Estradiol Level. Front Endocrinol (Lausanne) 2021; 12:652512. [PMID: 34046011 PMCID: PMC8146460 DOI: 10.3389/fendo.2021.652512] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/28/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Serum hormone deficiencies during menopause transition may affect spontaneous brain activity and global cognition. The purpose of this study was to explore the differences in spontaneous brain activity between premenopausal and perimenopausal women, and to investigate the associations between spontaneous brain activity, serum hormone levels and global cognition. METHODS Thirty-two premenopausal women (47.75 ± 1.55 years) and twenty-five perimenopausal women (51.60 ± 1.63 years) underwent resting-state functional MRI (fMRI) scan. Clinical information including Mini-Mental State Examination (MMSE), levels of estradiol (E2), free testosterone, progesterone, prolactin, follicle-stimulating hormone and luteinizing hormone were measured. Regional homogeneity (ReHo) was used to evaluate spontaneous brain activity alterations between perimenopausal and premenopausal women. Correlation analysis was used to investigate the associations between brain functional alterations and clinical measures in perimenopausal group. RESULTS The results demonstrated increased ReHo value in the right lingual gyrus (LG) and decreased ReHo value in the right superior frontal gyrus (SFG) in perimenopausal women compared with premenopausal women. In perimenopausal group, ReHo of the right LG showed a negative correlation with level of E2 (r = -0.586, p = 0.002), ReHo of the right SFG showed a positive correlation with level of E2 (r = 0.470, p = 0.018) and MMSE (r = 0.614, p = 0.001). CONCLUSIONS The results demonstrated that women approaching menopause suffered from altered functions in brain regions related to cognitive function, working memory, the results also revealed a direct association between levels of E2 and brain functions in perimenopausal women.
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Affiliation(s)
- Lemin He
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Wei Guo
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Xingwei An
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- *Correspondence: Xingwei An, ; Weizhao Lu,
| | - Weizhao Lu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- *Correspondence: Xingwei An, ; Weizhao Lu,
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