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Haghayegh S, Gao C, Sugg E, Zheng X, Yang HW, Saxena R, Rutter MK, Weedon M, Ibanez A, Bennett DA, Li P, Gao L, Hu K. Association of Rest-Activity Rhythm and Risk of Developing Dementia or Mild Cognitive Impairment in the Middle-Aged and Older Population: Prospective Cohort Study. JMIR Public Health Surveill 2024; 10:e55211. [PMID: 38713911 DOI: 10.2196/55211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/21/2024] [Accepted: 03/16/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND The relationship between 24-hour rest-activity rhythms (RARs) and risk for dementia or mild cognitive impairment (MCI) remains an area of growing interest. Previous studies were often limited by small sample sizes, short follow-ups, and older participants. More studies are required to fully explore the link between disrupted RARs and dementia or MCI in middle-aged and older adults. OBJECTIVE We leveraged the UK Biobank data to examine how RAR disturbances correlate with the risk of developing dementia and MCI in middle-aged and older adults. METHODS We analyzed the data of 91,517 UK Biobank participants aged between 43 and 79 years. Wrist actigraphy recordings were used to derive nonparametric RAR metrics, including the activity level of the most active 10-hour period (M10) and its midpoint, the activity level of the least active 5-hour period (L5) and its midpoint, relative amplitude (RA) of the 24-hour cycle [RA=(M10-L5)/(M10+L5)], interdaily stability, and intradaily variability, as well as the amplitude and acrophase of 24-hour rhythms (cosinor analysis). We used Cox proportional hazards models to examine the associations between baseline RAR and subsequent incidence of dementia or MCI, adjusting for demographic characteristics, comorbidities, lifestyle factors, shiftwork status, and genetic risk for Alzheimer's disease. RESULTS During the follow-up of up to 7.5 years, 555 participants developed MCI or dementia. The dementia or MCI risk increased for those with lower M10 activity (hazard ratio [HR] 1.28, 95% CI 1.14-1.44, per 1-SD decrease), higher L5 activity (HR 1.15, 95% CI 1.10-1.21, per 1-SD increase), lower RA (HR 1.23, 95% CI 1.16-1.29, per 1-SD decrease), lower amplitude (HR 1.32, 95% CI 1.17-1.49, per 1-SD decrease), and higher intradaily variability (HR 1.14, 95% CI 1.05-1.24, per 1-SD increase) as well as advanced L5 midpoint (HR 0.92, 95% CI 0.85-0.99, per 1-SD advance). These associations were similar in people aged <70 and >70 years, and in non-shift workers, and they were independent of genetic and cardiovascular risk factors. No significant associations were observed for M10 midpoint, interdaily stability, or acrophase. CONCLUSIONS Based on findings from a large sample of middle-to-older adults with objective RAR assessment and almost 8-years of follow-up, we suggest that suppressed and fragmented daily activity rhythms precede the onset of dementia or MCI and may serve as risk biomarkers for preclinical dementia in middle-aged and older adults.
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Affiliation(s)
- Shahab Haghayegh
- Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Broad Institute, Cambridge, MA, United States
- Brigham and Women's Hospital, Boston, MA, United States
| | - Chenlu Gao
- Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Broad Institute, Cambridge, MA, United States
- Brigham and Women's Hospital, Boston, MA, United States
| | - Elizabeth Sugg
- Massachusetts General Hospital, Boston, MA, United States
| | - Xi Zheng
- Brigham and Women's Hospital, Boston, MA, United States
| | - Hui-Wen Yang
- Brigham and Women's Hospital, Boston, MA, United States
| | - Richa Saxena
- Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Broad Institute, Cambridge, MA, United States
| | - Martin K Rutter
- Faculty of Medicine, Biology and Health, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom
| | | | | | | | - Peng Li
- Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Broad Institute, Cambridge, MA, United States
- Brigham and Women's Hospital, Boston, MA, United States
| | - Lei Gao
- Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Kun Hu
- Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Broad Institute, Cambridge, MA, United States
- Brigham and Women's Hospital, Boston, MA, United States
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Li P, Gao C, Yu L, Gao L, Cai R, Bennett DA, Schneider JA, Buchman AS, Hu K. Delineating cognitive resilience using fractal regulation: Cross-sectional and longitudinal evidence from the Rush Memory and Aging Project. Alzheimers Dement 2024; 20:3203-3210. [PMID: 38497429 DOI: 10.1002/alz.13747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Degradation of fractal patterns in actigraphy independently predicts dementia risk. Such observations motivated the study to understand the role of fractal regulation in the context of neuropathologies. METHODS We examined associations of fractal regulation with neuropathologies and longitudinal cognitive changes in 533 older participants who were followed annually with actigraphy and cognitive assessments until death with brain autopsy performed. Two measures for fractal patterns were extracted from actigraphy, namely, α1 (representing the fractal regulation at time scales of <90 min) and α2 (for time scales 2 to 10 h). RESULTS We found that larger α1 was associated with lower burdens of Lewy body disease or cerebrovascular disease pathologies; both α1 and α2 were associated with cognitive decline. They explained an additional significant portion of the variance in the rate of cognitive decline above and beyond neuropathologies. DISCUSSION Fractal patterns may be used as a biomarker for cognitive resilience against dementia-related neuropathologies.
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Affiliation(s)
- Peng Li
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Chenlu Gao
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Lei Gao
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Ruixue Cai
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Kun Hu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
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Gao C, Scullin MK. Objective and Subjective Intraindividual Variability in Sleep: Predisposing Factors and Health Consequences. Psychosom Med 2024; 86:298-306. [PMID: 38439637 DOI: 10.1097/psy.0000000000001301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
OBJECTIVE We investigated the factors that predispose or precipitate greater intraindividual variability (IIV) in sleep. We further examined the potential consequences of IIV on overall sleep quality and health outcomes, including whether these relationships were found in both self-reported and actigraphy-measured sleep IIV. METHODS In Study 1, 699 US adults completed a Sleep Intra-Individual Variability Questionnaire and self-reported psychosocial, sleep quality, and health outcomes. In Study 2, 100 university students wore actigraphy and completed psychosocial, sleep, and health surveys at multiple timepoints. RESULTS In cross-sectional analyses that controlled for mean sleep duration, predisposing/precipitating factors to greater IIV were being an underrepresented racial/ethnic minority (Study 1: F = 13.95, p < .001; Study 2: F = 7.03, p = .009), having greater stress (Study 2: r values ≥ 0.32, p values ≤ .002) or trait vulnerability to stress (Study 1: r values ≥ 0.15, p values < .001), and showing poorer time management (Study 1: r values ≤ -0.12, p values ≤ .004; Study 2: r values ≤ -0.23, p values ≤ .028). In addition, both studies showed that greater sleep IIV was associated with decreased overall sleep quality, independent of mean sleep duration (Study 1: r values ≥ 0.20, p values < .001; Study 2: r values ≥ 0.33, p values ≤ .001). Concordance across subjective and objective IIV measures was modest ( r values = 0.09-0.35) and similar to concordance observed for subjective-objective mean sleep duration measures. CONCLUSION Risk for irregular sleep patterns is increased in specific demographic groups and may be precipitated by, or contribute to, higher stress and time management inefficiencies. Irregular sleep may lead to poor sleep quality and adverse health outcomes, independent of mean sleep duration, underscoring the importance of addressing sleep consistency.
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Affiliation(s)
- Chenlu Gao
- From the Department of Psychology and Neuroscience (Gao, Scullin), Baylor University, Waco, Texas; Department of Anesthesia, Critical Care and Pain Medicine (Gao), Massachusetts General Hospital; Division of Sleep and Circadian Disorders (Gao), Brigham and Women's Hospital; and Division of Sleep Medicine (Gao), Harvard Medical School, Boston, Massachusetts
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Liang Y, Shi W, Shao Y, Liu XZ, Gong HM, Cao GH, Gao C, Xin NJ, Song GD. [Effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix in the treatment of children with deep burns]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2024; 40:348-357. [PMID: 38664029 DOI: 10.3760/cma.j.cn501225-20230720-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Objective: To explore the effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix (ADM), i.e., early surgery, in the treatment of children with deep burns. Methods: This study was a retrospective cohort study. From January 2017 to December 2022, 278 deep burned hospitalized children aged 1-7 years who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. According to the differences in treatment processes, 134 children who underwent early surgery+routine dressing change were enrolled in eschar removal+dressing change group (77 males and 57 females, aged 1 (1, 2) years), and 144 children who underwent only routine dressing change were enrolled in dressing change alone group (90 males and 54 females, aged 1 (1, 2) years). Fifty-one children without full-thickness burns in eschar removal+dressing change group were enrolled in eschar removal+dressing change group 1 (26 males and 25 females, aged 1 (1, 2) years), and 57 cases of the 83 children with full-thickness burns who did not undergo autologous skin grafting at the same time of early surgery (namely early skin grafting) in eschar removal+dressing change group were included in eschar removal+dressing change group 2 (37 males and 20 females, aged 1 (1, 2) years). Seventy-six children without full-thickness burns in dressing change alone group were included in dressing change alone group 1 (51 males and 25 females, aged 1 (1, 3) years), and 68 children with full-thickness burns in dressing change alone group were included in dressing change alone group 2 (39 males and 29 females, aged 1 (1, 2) years). For deep partial-thickness burn wounds and small full-thickness burn wounds in eschar removal+dressing change group, the eschar removal was performed on the basis of retaining a thin layer of denatured dermis so as to preserve the healthy tissue of the wound base, and ADM was applied to all wounds externally after eschar removal. For larger full-thickness burn wounds in this group, especially those located in the functional part of joints, eschar removal to the plane layer of viable tissue and early autologous skin grafting was needed. When the superficial wounds of children healed or tended to heal, the residual wounds were evaluated, and elective autologous skin grafting was performed if it was difficult to heal within 14 days. The healing time, intervention healing time, times of operation/dressing change, and times of intervention operation/dressing change in children with deep partial-thickness burn wounds of children in eschar removal+dressing change group, dressing change alone group, eschar removal+dressing change group 1, and dressing change alone group 1 were recorded. At the last follow-up (follow-up period was set to 7-12 months), the modified Vancouver scar scale (mVSS) scores of the most severe area of scar hyperplasia of healed deep partial-thickness burn wounds of 54 children in eschar removal+dressing change group and 48 children in dressing change alone group were recorded. The healing time and times of operation/dressing change of all burn wounds of children in eschar removal+dressing change group and dressing change alone group, and the healing time and times of operation/dressing change of full-thickness burn wounds of children in eschar removal+dressing change group 2 and dressing change alone group 2 were recorded. The incidences of wound infection, sepsis, fever, and fever after 5 days of burns in children of eschar removal+dressing change group and dressing change alone group during wound healing. Results: Compared with those in dressing change alone group, the healing time and intervention healing time were significantly shortened, and the times of operation/dressing change and times of intervention operation/dressing change were significantly reduced in children with deep partial-thickness burn wounds in eschar removal+dressing change group (with Z values of -11.00, -11.33, -12.64, and -11.65, respectively, P<0.05). Compared with those in dressing change alone group 1, the healing time and intervention healing time were significantly shortened, and the times of operation/dressing change and times of intervention operation/dressing change were significantly reduced in children with deep partial-thickness burn wounds in eschar removal+dressing change group 1 (with Z values of 6.57, 6.46, 8.04, and 6.57, respectively, P<0.05). At the last follow-up, the mVSS score of the most severe scar hyperplasia area of healed deep partial-thickness burn wounds of 54 children in eschar removal+dressing change group was 4.00 (3.00,5.00), which was significantly lower than 6.50 (5.00,7.00) of 48 children in dressing change alone group (Z =-4.67, P<0.05).Compared with those in dressing change alone group, the healing time was significantly shortened, and times of operation/dressing change was significantly reduced in all burn wounds in eschar removal+dressing change group (with Z values of -5.20 and -6.34, respectively, P<0.05). Compared with those in dressing change alone group 2, the healing time was significantly shortened, and times of operation/dressing change was significantly reduced in full-thickness burn wounds in eschar removal+dressing change group 2 (with Z values of -5.22 and -5.73, respectively, P<0.05). During wound healing, the probabilities of fever and fever after 5 days of burns in children of eschar removal+dressing change group were significantly lower than those in dressing change alone group (with χ2 values of 4.13 and 3.91, respectively, P<0.05); only 1 child in dressing change alone group developed sepsis, and there was no statistically significant difference in the wound infection rate of children in the two groups (P>0.05). Conclusions: For children with deep burns, early surgery, and early skin grafting or elective autologous skin grafting as needed, have better short-term and long-term effects than those without early surgery.
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Affiliation(s)
- Y Liang
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
| | - W Shi
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
| | - Y Shao
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
| | - X Z Liu
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
| | - H M Gong
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
| | - G H Cao
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
| | - C Gao
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
| | - N J Xin
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
| | - G D Song
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University (Jinan Central Hospital), Jinan 250013, China
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Sugg E, Gleeson E, Baker SN, Li P, Gao C, Mueller A, Deng H, Shen S, Franco-Garcia E, Saxena R, Musiek ES, Akeju O, Xie Z, Hu K, Gao L. Sleep and circadian biomarkers of postoperative delirium (SLEEP-POD): protocol for a prospective and observational cohort study. BMJ Open 2024; 14:e080796. [PMID: 38643014 PMCID: PMC11033637 DOI: 10.1136/bmjopen-2023-080796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/06/2024] [Indexed: 04/22/2024] Open
Abstract
INTRODUCTION Surgical patients over 70 experience postoperative delirium (POD) complications in up to 50% of procedures. Sleep/circadian disruption has emerged as a potential risk factor for POD in epidemiological studies. This protocol presents a single-site, prospective observational study designed to examine the relationship between sleep/circadian regulation and POD and how this association could be moderated or mediated by Alzheimer's disease (AD) pathology and genetic risk for AD. METHODS AND ANALYSIS Study staff members will screen for eligible patients (age ≥70) seeking joint replacement or spinal surgery at Massachusetts General Hospital (MGH). At the inclusion visit, patients will be asked a series of questionnaires related to sleep and cognition, conduct a four-lead ECG recording and be fitted for an actigraphy watch to wear for 7 days before surgery. Blood samples will be collected preoperatively and postoperatively and will be used to gather information about AD variant genes (APOE-ε4) and AD-related pathology (total and phosphorylated tau). Confusion Assessment Method-Scale and Montreal Cognitive Assessment will be completed twice daily for 3 days after surgery. Seven-day actigraphy assessments and Patient-Reported Outcomes Measurement Information System questionnaires will be performed 1, 3 and 12 months after surgery. Relevant patient clinical data will be monitored and recorded throughout the study. ETHICS AND DISSEMINATION This study is approved by the IRB at MGH, Boston, and it is registered with the US National Institutes of Health on ClinicalTrials.gov (NCT06052397). Plans for dissemination include conference presentations at a variety of scientific institutions. Results from this study are intended to be published in peer-reviewed journals. Relevant updates will be made available on ClinicalTrials.gov. TRIAL REGISTRATION NUMBER NCT06052397.
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Affiliation(s)
- Elizabeth Sugg
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Medical Biodynamics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Elizabeth Gleeson
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah N Baker
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Peng Li
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Medical Biodynamics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Chenlu Gao
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Medical Biodynamics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ariel Mueller
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Hao Deng
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shiqian Shen
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Esteban Franco-Garcia
- Department of Internal Medicine, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Richa Saxena
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Erik S Musiek
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri, USA
- Center on Biological Rhythms and Sleep (COBRAS), Washington University School of Medicine, St Louis, Missouri, USA
- Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Oluwaseun Akeju
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Zhongcong Xie
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kun Hu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Medical Biodynamics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lei Gao
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Medical Biodynamics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Toribio-Vázquez C, Gómez Rivas J, Amigo F, Carrión DM, Yebes Á, Alonso-Bartolomé M, Ayllon H, Aguilera A, Martinez-Piñeiro L, Antón-Juanilla M, Crespo-Atín V, Otaola-Arca H, Herranz-Yague JA, Munoz Rivero MV, MacKenzie KR, Shah TT, Gao C, Zimmermann E, Jefferies M, Nambiar A, Gallagher KM, Khadhouri S, Kasivisvanathan V. Prevalence of urinary tract cancer in the Spanish cohort of the IDENTIFY study. Actas Urol Esp 2024; 48:228-237. [PMID: 37574012 DOI: 10.1016/j.acuroe.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Malignant tumors of the urinary tract are associated with high morbidity and mortality, and their prevalence can vary worldwide. Recently, the IDENTIFY study has published results on the prevalence of urinary tract cancer at a global level. This study evaluates the prevalence of cancer within the Spanish cohort of the IDENTIFY study to determine whether the published results can be extrapolated to our population. PATIENTS AND METHODS An analysis of the data from the Spanish cohort of patients in the IDENTIFY study was performed. This is a prospective cohort of patients referred to secondary care with suspected cancer, predominantly due to hematuria. Patients were recruited between December 2017 and December 2018. RESULTS A total of 706 patients from 9 Spanish centers were analyzed. Of these, 277 (39.2%) were diagnosed with cancer: 259 (36.7%) bladder cancer, 10 (1.4%) upper tract urothelial carcinoma, 9 (1.2%) renal cancer and 5 (0.7%) prostate cancer. Increasing age (OR 1.05 (95% CI 1.03-1.06; P < 0.001)), visible hematuria (VH) OR 2.19 (95% CI 1.13-4.24; P = 0.02)) and smoking (ex-smokers: OR 2.11(95% CI 1.30-3.40; P = 0.002); smokers: OR 2.36 (95% CI 1.40-3.95; P = 0.001)) were associated with higher probability of bladder cancer. CONCLUSION This study highlights the risk of bladder cancer in patients with VH and smoking habits. Bladder cancer presented the highest prevalence; higher than the prevalence reported in previous series and presented in the IDENTIFY study. Future work should evaluate other associated factors that allow us to create cancer prediction models to improve the detection of cancer in our patients.
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Affiliation(s)
- C Toribio-Vázquez
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain.
| | - J Gómez Rivas
- Servicio de Urología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - F Amigo
- Institut Hospital del Mar d''Investigacions Mèdiques, Barcelona, Spain
| | - D M Carrión
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | - Á Yebes
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | | | - H Ayllon
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | - A Aguilera
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain
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Gaba A, Li P, Zheng X, Gao C, Cai R, Hu K, Gao L. Associations Between Depression Symptom Burden and Delirium Risk: A Prospective Cohort Study. Innov Aging 2024; 8:igae029. [PMID: 38660114 PMCID: PMC11041407 DOI: 10.1093/geroni/igae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Indexed: 04/26/2024] Open
Abstract
Background and Objectives Delirium and depression are prevalent in aging. There is considerable clinical overlap, including shared symptoms and comorbid conditions, including Alzheimer's disease, functional decline, and mortality. Despite this, the long-term relationship between depression and delirium remains unclear. This study assessed the associations of depression symptom burden and its trajectory with delirium risk in a 12-year prospective study of older hospitalized individuals. Research Design and Methods A total of 319 141 UK Biobank participants between 2006 and 2010 (mean age 58 years [range 37-74, SD = 8], 54% women) reported frequency (0-3) of 4 depressive symptoms (mood, disinterest, tenseness, or lethargy) in the preceding 2 weeks prior to initial assessment visit and aggregated into a depressive symptom burden score (0-12). New-onset delirium was obtained from hospitalization records during 12 years of median follow-up. 40 451 (mean age 57 ± 8; range 40-74 years) had repeat assessment on average 8 years after their first visit. Cox proportional hazard models examined whether depression symptom burden and trajectory predicted incident delirium. Results A total of 5 753 (15 per 1 000) newly developed delirium during follow-up. Increased risk for delirium was seen for mild (aggregated scores 1-2, hazards ratio, HR = 1.16, [95% confidence interval (CI): 1.08-1.25], p < .001), modest (scores 3-5, 1.30 [CI: 1.19-1.43], p < .001), and severe (scores ≥ 5, 1.38 [CI: 1.24-1.55], p < .001) depressive symptoms, versus none in the fully adjusted model. These findings were independent of the number of hospitalizations and consistent across settings (eg, surgical, medical, or critical care) and specialty (eg, neuropsychiatric, cardiorespiratory, or other). Worsening depression symptoms (≥1 point increase), compared to no change/improved score, were associated with an additional 39% increased risk (1.39 [1.03-1.88], p = .03) independent of baseline depression burden. The association was strongest in those over 65 years at baseline (p for interaction <.001). Discussion and Implications Depression symptom burden and worsening trajectory predicted delirium risk during hospitalization. Increased awareness of subclinical depression symptoms may aid delirium prevention.
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Affiliation(s)
- Arlen Gaba
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
| | - Peng Li
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Xi Zheng
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Chenlu Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Ruixue Cai
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Kun Hu
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Lei Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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8
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Gao C, Lage C, Scullin MK. Medical malpractice litigation and daylight saving time. J Clin Sleep Med 2024. [PMID: 38445709 DOI: 10.5664/jcsm.11038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
STUDY OBJECTIVES Daylight saving time (DST) constitutes a natural quasi-experiment to examine the influence of mild sleep loss and circadian misalignment. We investigated the acute effects of spring transition into DST and the chronic effects of DST (compared to standard time) on medical malpractice claims in the United States over three decades. METHODS We analyzed 288,432 malpractice claims from the National Practitioner Data Bank. To investigate the acute effects of spring DST transition, we compared medical malpractice incidents/decisions one week before spring DST transition, one week following spring DST transition, and the rest of the year. To investigate the chronic effects of DST months, we compared medical malpractice incidents/decisions averaged across the 7-8 months of DST versus the 4-5 months of standard time. RESULTS With regard to acute effects, spring DST transitions were significantly associated with higher payment decisions, but not associated with the severity of medical incidents. With regard to chronic effects, the 7-8 DST months were associated with higher average payments and worse severity of incidents than the 4-5 standard time months. CONCLUSIONS The mild sleep loss and circadian misalignment associated with DST may influence incidence of medical errors and decisions on medical malpractice payments both acutely and chronically.
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Affiliation(s)
- Chenlu Gao
- Department of Psychology and Neuroscience, Baylor University, Department of Psychology and Neuroscience, Waco, Texas
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Candice Lage
- Department of Psychology and Neuroscience, Baylor University, Department of Psychology and Neuroscience, Waco, Texas
| | - Michael K Scullin
- Department of Psychology and Neuroscience, Baylor University, Department of Psychology and Neuroscience, Waco, Texas
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9
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Duan LL, Zhao YB, Er YL, Ye PP, Wang W, Gao X, Deng X, Jin Y, Wang Y, Ji CR, Ma XY, Gao C, Zhao YH, Zhu SQ, Su SZ, Guo XE, Peng JJ, Yu Y, Yang C, Su YY, Zhao M, Guo LH, Wu YP, Luo YN, Meng RL, Xu HF, Liu HZ, Ruan HH, Xie B, Zhang HM, Liao YH, Chen Y, Wang LH. [The effect of Ba Duan Jin on the balance of community-dwelling older adults: a cluster randomized control trial]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:250-256. [PMID: 38413065 DOI: 10.3760/cma.j.cn112338-20230506-00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Objective: To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults. Methods: A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test. Results: A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95%CI: 2.23-3.88) points (P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95%CI: 4.03-5.37) points (P<0.001). Ba Duan Jin showed significant improvement (P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions: This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.
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Affiliation(s)
- L L Duan
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y B Zhao
- Shijiazhuang People's Hospital, Shijiazhuang 050031, China
| | - Y L Er
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - P P Ye
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - W Wang
- National Clinical Research Center for Cardiovascular Diseases/National Center for Cardiovascular Diseases/Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - X Gao
- Office of Chronic Disease and Ageing Health Management, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Deng
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y Jin
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y Wang
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - C R Ji
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - X Y Ma
- Institute for Chronic and Non-communicable Disease Control and Prevention, Shijiazhuang Municipal Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - C Gao
- Institute for Chronic and Non-communicable Disease Control and Prevention, Shijiazhuang Municipal Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - Y H Zhao
- Shijiazhuang Chang'an District Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - S Q Zhu
- Department of Chronic Prevention and Control, Shijiazhuang Chang'an District Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - S Z Su
- Department of Nursing, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050051, China
| | - X E Guo
- Department of Nursing, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050051, China
| | - J J Peng
- Department of Injury Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Y Yu
- Department of Injury Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - C Yang
- Department of Cancer and Injury Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China
| | - Y Y Su
- Department of Cancer and Injury Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China
| | - M Zhao
- Department of Chronic and Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - L H Guo
- Department of Chronic and Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Y P Wu
- General Office, Cixi Municipal Center for Disease Control and Prevention of Zhejiang Province, Ningbo 315302, China
| | - Y N Luo
- General Office, Cixi Municipal Center for Disease Control and Prevention of Zhejiang Province, Ningbo 315302, China
| | - R L Meng
- Department of Chronic and Non-communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511483, China
| | - H F Xu
- Department of Chronic and Non-communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511483, China
| | - H Z Liu
- Guangzhou Municipal Center for Disease Control and Prevention, Guangzhou 510440, China
| | - H H Ruan
- Department of Chronic and Non-communicable Disease Control and Prevention, Chronic Disease Prevention and Control Station of Guangzhou Panyu District, Guangzhou 511400, China
| | - B Xie
- Department of Psychiatric, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - H M Zhang
- Department of Psychiatric, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - Y H Liao
- Department of Psychiatric, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - Y Chen
- Department of Psychiatric, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - L H Wang
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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10
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Xuri Chen, Yang Y, Gu Y, Yi J, Yao W, Sha Z, Wu H, Zhou Y, Wu Z, Bao F, Wang J, Wang Y, Xie Y, Gao C, Heng BC, Liu H, Yin Z, Chen X, Zhou J, Ouyang H. Inhibition of PI3K/AKT signaling pathway prevents blood-induced heterotopic ossification of the injured tendon. J Orthop Translat 2024; 44:139-154. [PMID: 38328343 PMCID: PMC10847949 DOI: 10.1016/j.jot.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 02/09/2024] Open
Abstract
Objective It is a common clinical phenomenon that blood infiltrates into the injured tendon caused by sports injuries, accidental injuries, and surgery. However, the role of blood infiltration into the injured tendon has not been investigated. Methods A blood-induced rat model was established and the impact of blood infiltration on inflammation and HO of the injured tendon was assessed. Cell adhesion, viability, apoptosis, and gene expression were measured to evaluate the effect of blood treatment on tendon stem/progenitor cells (TSPCs). Then RNA-seq was used to assess transcriptomic changes in tendons in a blood infiltration environment. At last, the small molecule drug PI3K inhibitor LY294002 was used for in vivo and in vitro HO treatment. Results Blood caused acute inflammation in the short term and more severe HO in the long term. Then we found that blood treatment increased cell apoptosis and decreased cell adhesion and tenonic gene expression of TSPCs. Furthermore, blood treatment promoted osteochondrogenic differentiation of TSPCs. Next, we used RNA-seq to find that the PI3K/AKT signaling pathway was activated in blood-treated tendon tissues. By inhibiting PI3K with a small molecule drug LY294002, the expression of osteochondrogenic genes was markedly downregulated while the expression of tenonic genes was significantly upregulated. At last, we also found that LY294002 treatment significantly reduced the tendon HO in the rat blood-induced model. Conclusion Our findings indicate that the upregulated PI3K/AKT signaling pathway is implicated in the aggravation of tendon HO. Therefore, inhibitors targeting the PI3K/AKT pathway would be a promising approach to treat blood-induced tendon HO.
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Affiliation(s)
- Xuri Chen
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Yuwei Yang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Yuqing Gu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Junzhi Yi
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Wenyu Yao
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zhuomin Sha
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Hongwei Wu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Yunting Zhou
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zhonglin Wu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Fangyuan Bao
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Jiasheng Wang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Ying Wang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Yuanhao Xie
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
| | - Chenlu Gao
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Boon Chin Heng
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Hua Liu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
| | - Zi Yin
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
| | - Xiao Chen
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
| | - Jing Zhou
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
| | - Hongwei Ouyang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China
- Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 314400, China
- China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
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Cai R, Gao L, Gao C, Yu L, Zheng X, Bennett DA, Buchman AS, Hu K, Li P. Circadian disturbances and frailty risk in older adults. Nat Commun 2023; 14:7219. [PMID: 37973796 PMCID: PMC10654720 DOI: 10.1038/s41467-023-42727-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023] Open
Abstract
Frailty is characterized by diminished resilience to stressor events. It is associated with adverse future health outcomes and impedes healthy aging. The circadian system orchestrates ~24-h rhythms in bodily functions in synchrony with the day-night cycle, and disturbed circadian regulation plays an important role in many age-related health consequences. We investigated prospective associations of circadian disturbances with incident frailty in over 1000 older adults who had been followed annually for up to 16 years. We found that decreased rhythm strength, reduced stability, or increased variation were associated with a higher risk of incident frailty and faster progress of frailty over time. Perturbed circadian rest-activity rhythms may be an early sign or risk factor for frailty in older adults.
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Affiliation(s)
- Ruixue Cai
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA.
- School of Public Health, Southeast University, Nanjing, Jiangsu, 210000, China.
| | - Lei Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, 02115, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Chenlu Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, 02115, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Xi Zheng
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Kun Hu
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, 02115, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Peng Li
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, 02115, USA.
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
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Gao C, Hofer C, Pennycook TJ. On central focusing for contrast optimization in direct electron ptychography of thick samples. Ultramicroscopy 2023; 256:113879. [PMID: 37944427 DOI: 10.1016/j.ultramic.2023.113879] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/10/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023]
Abstract
Ptychography provides high dose efficiency images that can reveal light elements next to heavy atoms. However, despite ptychography having an otherwise single signed contrast transfer function, contrast reversals can occur when the projected potential becomes strong for both direct and iterative inversion ptychography methods. It has recently been shown that these reversals can often be counteracted in direct ptychography methods by adapting the focus. Here we provide an explanation of why the best contrast is often found with the probe focused to the middle of the sample. The phase contribution due to defocus at each sample slice above and below the central plane in this configuration effectively cancels out, which can prevent contrast reversals when dynamical scattering effects are not overly strong. In addition we show that the convergence angle can be an important consideration for removal of contrast reversals in relatively thin samples.
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Affiliation(s)
- C Gao
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - C Hofer
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - T J Pennycook
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
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13
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Gaba A, Li P, Xi Z, Gao C, Ruixue C, Hu K, Gao L. Associations between depression symptom burden and delirium risk: a prospective cohort study. medRxiv 2023:2023.09.21.23295926. [PMID: 37790485 PMCID: PMC10543040 DOI: 10.1101/2023.09.21.23295926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Delirium and depression are increasingly common in aging. There is considerable clinical overlap, including shared symptoms and comorbid conditions, including Alzheimer's disease (AD), functional decline, and mortality. Despite this, the long-term relationship between depression and delirium remains unclear. This study assessed the associations of depression symptom burden and its trajectory with delirium risk in a 12-year prospective study of older individuals during hospitalization. RESEARCH DESIGN AND METHODS 319,141 UK biobank participants between 2006-2010 (mean 58y [range 37-74, SD=8], 54% female) reported frequency (0-3) of four depressive symptoms (mood, disinterest, tenseness, or lethargy) in the preceding 2 weeks, and aggregated into a depressive symptom burden score (0-12). New-onset delirium was obtained from hospitalization records during 12y median follow-up. 40,451 (mean age 57±8; range 40-74y) had repeat assessment on average 8y after their first. Cox proportional hazard models examined whether depression symptom burden and trajectory predicted incident delirium during hospitalization. RESULTS 5,753 (15 per 1000) newly developed delirium during follow-up. Increased risk for delirium was seen for mild (aggregated scores 1-2, hazards ratio, HR=1.16, [95% confidence interval 1.08-1.25], p<0.001), modest (scores 3-5, 1.30 [1.19-1.43], p<0.001) and severe (scores ≥ 5, 1.38 [1.24-1.55], p<0.001) depressive symptoms, versus none in the fully adjusted model. These findings were independent of the number of hospitalizations and consistent across hospitalization settings (e.g., surgical, medical, or critical care) and specialty (e.g., neuropsychiatric, cardiorespiratory or other). Worsening depression symptoms (≥1 point increase), compared to no change/improved score, were associated with an additional 39% increased risk (1.39 [1.03-1.88], p=0.03) independent of baseline depression burden. The association was strongest in those over 65y at baseline (p for interaction <0.001). DISCUSSION AND IMPLICATIONS Depression symptom burden and worsening trajectory predicted delirium risk during hospitalization. Increased awareness of subclinical depression symptoms may be warranted for delirium prevention.
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Affiliation(s)
- Arlen Gaba
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Peng Li
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Zheng Xi
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Chenlu Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Cai Ruixue
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Kun Hu
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Lei Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Chen RW, Ulsa MC, Li P, Gao C, Zheng X, Xu J, Luo Y, Shen S, Lane J, Scheer FAJL, Hu K, Gao L. Sleep behavior traits and associations with opioid-related adverse events: a cohort study. Sleep 2023; 46:zsad118. [PMID: 37075812 PMCID: PMC10485566 DOI: 10.1093/sleep/zsad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 04/02/2023] [Indexed: 04/21/2023] Open
Abstract
STUDY OBJECTIVES Opioid-related adverse events (OAEs), including opioid use disorders, overdose, and death, are serious public health concerns. OAEs are often associated with disrupted sleep, but the long-term relationship between poor sleep and subsequent OAE risk remains unknown. This study investigates whether sleep behavior traits are associated with incident OAEs in a large population cohort. METHODS 444 039 participants (mean age ± SD 57 ± 8 years) from the UK Biobank reported their sleep behavior traits (sleep duration, daytime sleepiness, insomnia-like complaints, napping, and chronotype) between 2006 and 2010. The frequency/severity of these traits determined a poor sleep behavior impacts score (0-9). Incident OAEs were obtained from hospitalization records during 12-year median follow-up. Cox proportional hazards models examined the association between sleep and OAEs. RESULTS Short and long sleep duration, frequent daytime sleepiness, insomnia symptoms, and napping, but not chronotype, were associated with increased OAE risk in fully adjusted models. Compared to the minimal poor sleep behavior impacts group (scores of 0-1), the moderate (4-5) and significant (6-9) groups had hazard ratios of 1.47 (95% confidence interval [1.27, 1.71]), p < 0.001, and 2.19 ([1.82, 2.64], p < 0.001), respectively. The latter risk magnitude is greater than the risk associated with preexisting psychiatric illness or sedative-hypnotic medication use. In participants with moderate/significant poor sleep impacts (vs. minimal), subgroup analysis revealed that age <65 years was associated with a higher OAE risk than in those ≥65 years. CONCLUSIONS Certain sleep behavior traits and overall poor sleep impacts are associated with an increased risk for opioid-related adverse events.
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Affiliation(s)
- Rudy W Chen
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Ma Cherrysse Ulsa
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Peng Li
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Chenlu Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Xi Zheng
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jiawei Xu
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Yong Luo
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Shiqian Shen
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jacqueline Lane
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Frank A J L Scheer
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kun Hu
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Lei Gao
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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15
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Liu X, Zeng RH, Gao C, Wang YL, Zhu LL, Wang WJ. [Establishment of induced pluripotent stem cell model of Aicardi-Goutières Syndrome mutated in TREX1]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:923-928. [PMID: 37357214 DOI: 10.3760/cma.j.cn112150-20220627-00657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
To establish and identify induced pluripotent stem cells (iPSCs) derived from patients with Aicardi-Goutières syndrome (AGS) with TREX1 gene 667G>A mutation, and obtain a specific induced pluripotent stem cell model for Aicardi-Goutières syndrome (AGS-iPSCs). A 3-year-old male child with Aicardi-Goutieres syndrome was admitted to Zhongshan People's Hospital in December 2020. After obtaining the informed consent of the patient's family members, 5 ml peripheral blood samples from the patient were collected, and mononuclear cells were isolated. Then,the peripheral blood mononuclear cells(PBMCs) were transduced with OCT3/4, SOX2, c-Myc and Klf4 by using Sendai virus, and PBMCs were reprogrammed into iPSCs. The pluripotency and differentiation ability of the cells were identified by cellular morphological analysis, real-time PCR, alkaline phosphatase staining (AP), immunofluorescence, teratoma formation experiments in mice. The results showed that the induced pluripotent stem cell line of Aicardi-Goutieres syndrome was successfully constructed and showed typical embryonic stem-like morphology after stable passage, RT-PCR showed mRNA expression of stem cell markers, AP staining was positive, OCT4, SOX2, NANOG, SSEA4, TRA-1-81 and TRA-1-60 pluripotency marker proteins were strongly expressed. In vivo teratoma formation experiments showed that iPSCs differentiate into the ectoderm (neural tube like tissue), mesoderm (vascular wall tissue) and endoderm (glandular tissue). Karyotype analysis also confirmed that iPSCs still maintained the original karyotype (46, XY). In conclusion, induced pluripotent stem cell line for Aicardi-Goutières syndrome was successfully established using Sendai virus, which provided an important model platform for studying the pathogenesis of the disease and for drug screening.
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Affiliation(s)
- X Liu
- Zhuhai Campus of Zunyi Medical University, Zhuhai 519000, China
| | - R H Zeng
- Clinical Laboratory, Zhongshan People's Hospital, Zhongshan 528400, China
| | - C Gao
- Clinical Laboratory, Zhongshan People's Hospital, Zhongshan 528400, China
| | - Y L Wang
- Clinical Laboratory, Zhongshan People's Hospital, Zhongshan 528400, China
| | - L L Zhu
- Clinical Laboratory, Zhongshan People's Hospital, Zhongshan 528400, China
| | - W J Wang
- Zhuhai Campus of Zunyi Medical University, Zhuhai 519000, China
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Barley BK, Gao C, Luster T, Porro A, Parizi-Robinson M, Quigley D, Zinke P, Scullin MK. Chronotype in college science students is associated with behavioral choices and can fluctuate across a semester. Chronobiol Int 2023; 40:710-724. [PMID: 37080776 DOI: 10.1080/07420528.2023.2203251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/18/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
Many students self-report that they are "night owls," which can result from neurodevelopmental delays in the circadian timing system. However, whether an individual considers themselves to be an evening-type versus a morning-type (self-reported chronotype) may also be influenced by academic demands (e.g. class start times, course load) and behavioral habits (e.g. bedtime social media use, late caffeine consumption, daytime napping). If so, then chronotype should be malleable. We surveyed 858 undergraduate students enrolled in demanding science courses at up to three time points. The survey assessed morning/evening chronotype, global sleep quality, academics, and behavioral habits. Evening and morning-type students showed similar demographics, stress levels, and academic demands. At baseline measurements, relative to morning-types, evening-types showed significantly worse sleep quality and duration as well as 22% greater bedtime social media usage, 27% greater daytime napping duration, and 46% greater likelihood of consuming caffeine after 5pm. These behavioral habits partially mediated the effects of self-reported chronotype on sleep quality/duration, even after controlling for demographic factors. Interestingly, 54 students reported switching from being at least moderate evening-types at baseline to being at least moderate morning-types later in the semester and 56 students showed the reverse pattern (6.3% of students switched from "definitely" one chronotype to the other chronotype). Evening-to-morning "chrono-switchers" consumed less caffeine after 5pm and showed significantly better sleep quantity/quality at the later timepoint. Thus, some students may consider themselves to be night owls in part because they consume caffeine later, take more daytime naps, or use more social media at bedtime. Experimental work is needed to determine whether nudging night owls to behave like morning larks results in better sleep health or academic achievement.
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Affiliation(s)
- Blake K Barley
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Chenlu Gao
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Taylor Luster
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Abbye Porro
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | | | - Dena Quigley
- Department of Biology, Baylor University, Waco, Texas, USA
| | - Paul Zinke
- Department of Chemistry and Biochemistry, Baylor University, Waco, Texas, USA
| | - Michael K Scullin
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
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17
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Abstract
Background Chronic infectious wounds seriously affect patients' quality of life. Aim To assess the effect of whole course seamless nursing mode on patients with chronic infectious wounds. Methodology One hundred patients treated between January 2019 and December 2020 were randomly divided into control and observation groups (n=50) that were given routine nursing and whole course seamless nursing, respectively. Their pain score, comfort score, wound healing time, wound healing effect, psychological state scores, sleep indices, quality-of-life scores and degree of satisfaction with nursing were compared. Results Observation group had lower pain score and higher comfort score than those of control group after nursing (P<0.05). Compared with control group, observation group had shorter wound healing time and higher grade-A wound healing rate (P<0.05). The SDS and SAS scores of observation group were lower than those of control group (P<0.05). Observation group also had significantly shorter sleep latency, longer actual sleep time, lower PSQI score, as well as higher quality-of-life score and overall satisfaction rate than those of control group (P<0.05). Conclusion For patients with chronic infectious wounds, whole course seamless nursing effectively relieves wound pain, facilitates wound healing, improves comfort, psychological state and sleep status, and makes them more satisfied.
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Affiliation(s)
- Yun Peng
- Qingdao Central Hospital, 127 Siliu South Road, Qingdao 266000, Shandong Province, China
| | - Chenlu Gao
- Qingdao Central Hospital, 127 Siliu South Road, Qingdao 266000, Shandong Province, China
| | - Yan Sun
- Qingdao Central Hospital, 127 Siliu South Road, Qingdao 266000, Shandong Province, China
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18
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An SL, Ji ZH, Li XB, Liu G, Zhang YB, Gao C, Zhang K, Zhang XJ, Yan GJ, Yan LJ, Li Y. [Construction and evaluation of a nomogram for predicting the prognosis of patients with colorectal cancer with peritoneal carcinomatosis treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:434-441. [PMID: 37217351 DOI: 10.3760/cma.j.cn441530-20230309-00071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Objectives: To construct a nomogram incorporating important prognostic factors for predicting the overall survival of patients with colorectal cancer with peritoneal metastases treated with cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC), the aim being to accurately predict such patients' survival rates. Methods: This was a retrospective observational study. Relevant clinical and follow-up data of patients with colorectal cancer with peritoneal metastases treated by CRS + HIPEC in the Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University from 2007 January to 2020 December were collected and subjected to Cox proportional regression analysis. All included patients had been diagnosed with peritoneal metastases from colorectal cancer and had no detectable distant metastases to other sites. Patients who had undergone emergency surgery because of obstruction or bleeding, or had other malignant diseases, or could not tolerate treatment because of severe comorbidities of the heart, lungs, liver or kidneys, or had been lost to follow-up, were excluded. Factors studied included: (1) basic clinicopathological characteristics; (2) details of CRS+HIPEC procedures; (3) overall survival rates; and (4) independent factors that influenced overall survival; the aim being to identify independent prognostic factors and use them to construct and validate a nomogram. The evaluation criteria used in this study were as follows. (1) Karnofsky Performance Scale (KPS) scores were used to quantitatively assess the quality of life of the study patients. The lower the score, the worse the patient's condition. (2) A peritoneal cancer index (PCI) was calculated by dividing the abdominal cavity into 13 regions, the highest score for each region being three points. The lower the score, the greater is the value of treatment. (3) Completeness of cytoreduction score (CC), where CC-0 and CC-1 denote complete eradication of tumor cells and CC-2 and CC-3 incomplete reduction of tumor cells. (4) To validate and evaluate the nomogram model, the internal validation cohort was bootstrapped 1000 times from the original data. The accuracy of prediction of the nomogram was evaluated with the consistency coefficient (C-index), and a C-index of 0.70-0.90 suggest that prediction by the model was accurate. Calibration curves were constructed to assess the conformity of predictions: the closer the predicted risk to the standard curve, the better the conformity. Results: The study cohort comprised 240 patients with peritoneal metastases from colorectal cancer who had undergone CRS+HIPEC. There were 104 women and 136 men of median age 52 years (10-79 years) and with a median preoperative KPS score of 90 points. There were 116 patients (48.3%) with PCI≤20 and 124 (51.7%) with PCI>20. Preoperative tumor markers were abnormal in 175 patients (72.9%) and normal in 38 (15.8%). HIPEC lasted 30 minutes in seven patients (2.9%), 60 minutes in 190 (79.2%), 90 minutes in 37 (15.4%), and 120 minutes in six (2.5%). There were 142 patients (59.2%) with CC scores 0-1 and 98 (40.8%) with CC scores 2-3. The incidence of Grade III to V adverse events was 21.7% (52/240). The median follow-up time is 15.3 (0.4-128.7) months. The median overall survival was 18.7 months, and the 1-, 3- and 5-year overall survival rates were 65.8%, 37.2% and 25.7%, respectively. Multivariate analysis showed that KPS score, preoperative tumor markers, CC score, and duration of HIPEC were independent prognostic factors. In the nomogram constructed with the above four variables, the predicted and actual values in the calibration curves for 1, 2 and 3-year survival rates were in good agreement, the C-index being 0.70 (95% CI: 0.65-0.75). Conclusions: Our nomogram, which was constructed with KPS score, preoperative tumor markers, CC score, and duration of HIPEC, accurately predicts the survival probability of patients with peritoneal metastases from colorectal cancer treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy.
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Affiliation(s)
- S L An
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Z H Ji
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - X B Li
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - G Liu
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y B Zhang
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - C Gao
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - K Zhang
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - X J Zhang
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - G J Yan
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - L J Yan
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y Li
- Department of Surgical Oncology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
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Ladis I, Gao C, Scullin MK. COVID-19-Related News Consumption Linked with Stress and Worry, but Not Sleep Quality, Early in the Pandemic. PSYCHOL HEALTH MED 2023; 28:980-994. [PMID: 36322027 DOI: 10.1080/13548506.2022.2141281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Beginning in early 2020, the novel coronavirus was the subject of frequent and sustained news coverage. Building on prior literature on the stress-inducing effects of consuming news during a large-scale crisis, we used network analysis to investigate the association between coronavirus disease 2019 (COVID-19) news consumption, COVID-19-related psychological stress, worries about oneself and one's loved ones getting COVID-19, and sleep quality. Data were collected in March 2020 from 586 adults (45.2% female; 72.9% White) recruited via Amazon Mechanical Turk in the U.S. Participants completed online surveys assessing attitudes and behaviors related to COVID-19 and a questionnaire assessing seven domains of sleep quality. Networks were constructed using partial regularized correlation matrices. As hypothesized, COVID-19 news consumption was positively associated with COVID-19-related psychological stress and concerns about one's loved ones getting COVID-19. However, there were very few associations between COVID-19 news consumption and sleep quality indices, and gender did not moderate any of the observed relationships. This study replicates and extends previous findings that COVID-19-news consumption is linked with psychological stress related to the pandemic, but even under such conditions, sleep quality can be spared due to the pandemic allowing for flexibility in morning work/school schedules.
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Affiliation(s)
- Ilana Ladis
- Department of Psychology, University of Virginia, Charlottesville, VA USA
| | - Chenlu Gao
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA USA.,Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Michael K Scullin
- Department of Psychology and Neuroscience, Baylor University, Waco, TX USA
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Donington J, Hu X, Zhang S, Song Y, Gao C, Arunachalam A, Chirovsky D, Lerner A, Jiang A, Signorovitch J, Samkari A. 95P Neoadjuvant treatment pattern and association between real-world event-free survival (rwEFS) and overall survival (OS) in patients (pts) with resected early-stage non-small cell lung cancer (eNSCLC). J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00350-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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21
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Dai EH, Guo XR, Wang JT, Hu QG, Li JH, Tang QY, Zu HM, Huan H, Wang Y, Gao YF, Hu GQ, Li W, Liu ZJ, Ma QP, Song YL, Yang JH, Zhu Y, Huang SD, Meng ZJ, Bai B, Chen YP, Gao C, Huang MX, Jin SQ, Lu MZ, Xu Z, Zhang QH, Zheng S, Zeng QL, Qi XL. [Investigate of the etiology and prevention status of liver cirrhosis]. Zhonghua Yi Xue Za Zhi 2023; 103:913-919. [PMID: 36973219 DOI: 10.3760/cma.j.cn112137-20221017-02164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Objective: To investigate the etiology, prevention and treatment status, and their corresponding regional differences of the patients with liver cirrhosis in China, in order to provide scientific basis for the development of diagnosis and control strategies in China. Methods: Clinical data of patients diagnosed with liver cirrhosis for the first time through January 1, 2018 to December 31, 2020 from 50 hospitals in seven different regions of China were collected and analyzed retrospectively, and the difference of etiology, treatment, and their differences in various regions were analyzed. Results: A total of 11 861 cases with liver cirrhosis were included in the study. Thereinto, 5 093 cases (42.94%) were diagnosed as compensated cirrhosis, and 6 768 cases (57.06%) had decompensated cirrhosis. Notably, 8 439 cases (71.15%) were determined as chronic hepatitis B-caused cirrhosis, 1 337 cases (11.27%) were alcoholic liver disease, 963 cases (8.12%) were chronic hepatitis C, 698 cases (5.88%) were autoimmune liver disease, 367 cases (3.09%) were schistosomiasis, 177 cases (1.49%) were nonalcoholic fatty liver, and 743 cases (6.26%) of other types of liver disease. There were significant differences in the incidence of chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, fatty liver, schistosomiasis liver disease, and autoimmune liver disease among the seven regions (P<0.001). Only 1 139 cases (9.60%) underwent endoscopic therapy, thereinto, 718 cases (6.05%) underwent surgical therapy, and 456 cases (3.84%) underwent interventional therapy treatment. In patients with compensated liver cirrhosis, 60 cases (0.51%) underwent non-selective β receptor blockers(NSBB), including 59 cases (0.50%) underwent propranolol and 1 case (0.01%) underwent carvedilol treatment. In patients with decompensated liver cirrhosis, 310 cases (2.61%) underwent NSBB treatment, including 303 cases (2.55%) underwent propranolol treatment and 7 cases (0.06%) underwent carvedilol treatment. Interestingly, there were significant differences in receiving endoscopic therapy, interventional therapy, NSBB therapy, splenectomy and other surgical treatments among the seven regions (P<0.001). Conclusion: Currently, chronic hepatitis B is the main cause (71.15%) of liver cirrhosis in several regions of China, and alcoholic liver disease has become the second cause (11.27%) of liver cirrhosis in China. The three-level prevention and control of cirrhosis in China should be further strengthened.
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Affiliation(s)
- E H Dai
- Division of Liver Disease, the Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Shijiazhuang 050021, China
| | - X R Guo
- School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - J T Wang
- CHESS Center, Xingtai People's Hospital, Xingtai 054001, China
| | - Q G Hu
- Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - J H Li
- Department of Infectious Diseases, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Q Y Tang
- Second Department of Hepatology, Shenzhen Third People's Hospital, Shenzhen 518112, China
| | - H M Zu
- Department of Gastroenterology, Fourth People's Hospital of Qinghai Province, Xining 810007, China
| | - H Huan
- Department of Gastroenterology, Hospital of Chengdu Office of Tibet Autonomous Region People's Government, Chengdu 610041, China
| | - Y Wang
- Working Group of CHESS Frontier Center, Shenyang Sixth People's Hospital, Shenyang 110006, China
| | - Y F Gao
- Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - G Q Hu
- Department of Infectious Diseases, People's Hospital of Jieshou, Jieshou 236502, China
| | - W Li
- the Third Department of Infection, the Second People's Hospital of Fuyang City, Fuyang 236029, China
| | - Z J Liu
- Department of Infectious Diseases, Anqing Municipal Hospital, Anqing 246004, China
| | - Q P Ma
- Department of Infectious Diseases, People's Hospital of Linquan County, Anhui Province, Linquan 236499, China
| | - Y L Song
- Department of Infectious Diseases, Tongling People's Hospital, Tongling 244099, China
| | - J H Yang
- Department of Infectious Diseases, Yijishan Hospital, the First Affiliated to Wannan Medical College, Wuhu 241006, China
| | - Y Zhu
- Department of Infectious Diseases, Chizhou People's Hospital, Chizhou 247099, China
| | - S D Huang
- Department of Infectious Diseases, the Second People's Hospital of Jingzhou City, Jingzhou 434002, China
| | - Z J Meng
- Department of Infectious Diseases, Taihe Hospital, Shiyan 442099, China
| | - B Bai
- Department of Infectious Diseases, Union Shenzhen Hospital, Huazhong University of Science and Technology, Shenzhen 518052, China
| | - Y P Chen
- Department of Infectious Diseases, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China
| | - C Gao
- Department of Infectious Diseases, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China
| | - M X Huang
- Department of Infectious Diseases, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
| | - S Q Jin
- Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - M Z Lu
- Department of Infectious Diseases, Shenzhen Longgang Central Hospital, Shenzhen 518116, China
| | - Z Xu
- Department of Gastroenterology, Dongguan People's Hospital, Dongguan 523058, China
| | - Q H Zhang
- Department of Hepatology, Second People's Hospital of Zhongshan City, Zhongshan 528447, China
| | - S Zheng
- Department of Endoscopy, Shenyang Sixth People's Hospital, Shenyang 110006, China
| | - Q L Zeng
- Department of Infectious Diseases and Hepatology, the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China
| | - X L Qi
- CHESS Center, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
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22
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Cai R, Gao L, Gao C, Yu L, Zheng X, Bennett D, Buchman A, Hu K, Li P. Circadian disturbances and frailty risk in older adults: a prospective cohort study. Res Sq 2023:rs.3.rs-2648399. [PMID: 37034594 PMCID: PMC10081385 DOI: 10.21203/rs.3.rs-2648399/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Frailty is characterized by diminished resilience to stressor events. It associates with adverse future health outcomes and impedes healthy aging. The circadian system orchestrates a ~24-h rhythm in bodily functions in synchrony with the day-night cycle, and disturbed circadian regulation plays an important role in many age-related health consequences. We investigated prospective associations of circadian disturbances with incident frailty in over 1,000 older adults who had been followed annually for up to 16 years. We found that decreased rhythm strength, reduced stability, or increased variation, were associated with a higher risk of incident frailty, and faster worsening of the overall frailty symptoms over time. Perturbed circadian rest-activity rhythms may be an early sign or risk factor for frailty in older adults.
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Affiliation(s)
| | - Lei Gao
- Brigham and Women's Hospital
| | | | - Lei Yu
- Rush University Medical Center
| | | | | | | | - Kun Hu
- Brigham and Women's Hospital
| | - Peng Li
- Brigham and Women's Hospital/ Harvard Medical School
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23
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Zhang Y, Gao C, Wang P, Liu Y, Liu Z, Xie W, Xu H, Dang Y, Liu D, Ren Z, Yan S, Wang Z, Hu W, Dong H. High Electron Mobility Hot-Exciton Induced Delayed Fluorescent Organic Semiconductors. Angew Chem Int Ed Engl 2023; 62:e202217653. [PMID: 36631427 DOI: 10.1002/anie.202217653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
The development of high mobility emissive organic semiconductors is of great significance for the fabrication of miniaturized optoelectronic devices, such as organic light emitting transistors. However, great challenge exists in designing key materials, especially those who integrates triplet exciton utilization ability. Herein, dinaphthylanthracene diimides (DNADIs), with 2,6-extended anthracene donor, and 3'- or 4'-substituted naphthalene monoimide acceptors were designed and synthesized. By introducing acceptor-donor-acceptor structure, both materials show high electron mobility. Moreover, by fine-tuning of substitution sites, good integration with high solid state photoluminescence quantum yield of 26 %, high electron mobility of 0.02 cm2 V-1 s-1 , and the feature of hot-exciton induced delayed fluorescence were obtained in 4'-DNADI. This work opens a new avenue for developing high electron mobility emissive organic semiconductors with efficient utilization of triplet excitons.
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Affiliation(s)
- Y Zhang
- National Laboratory for Molecular Sciences, Key Laboratory of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China.,Department of Chemistry, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - C Gao
- National Laboratory for Molecular Sciences, Key Laboratory of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
| | - P Wang
- National Laboratory for Molecular Sciences, Key Laboratory of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China.,Department of Chemistry, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Y Liu
- Department Key Laboratory of Rubber-Plastics, Ministry of Education/ Shandong Provincial Key Laboratory of Rubber-plastics, Qingdao University of Science & Technology, Qingdao, 266042, China
| | - Z Liu
- College of Materials Science and Engineering, Fuzhou University, Fuzhou, 350108, China
| | - W Xie
- Key Laboratory of Advanced Energy Materials Chemistry (Ministry of Education) Renewable Energy Conversion and Storage Center, College of Chemistry, Nankai University, Tianjin, 300071, China
| | - H Xu
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Sciences, Tianjin University & Collaborative Innovation Center of Chemical Science and Engineering, Tianjin, 300072, China
| | - Y Dang
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Sciences, Tianjin University & Collaborative Innovation Center of Chemical Science and Engineering, Tianjin, 300072, China
| | - D Liu
- National Laboratory for Molecular Sciences, Key Laboratory of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
| | - Z Ren
- State Key Laboratory of Chemical Resource Engineering, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - S Yan
- Department Key Laboratory of Rubber-Plastics, Ministry of Education/ Shandong Provincial Key Laboratory of Rubber-plastics, Qingdao University of Science & Technology, Qingdao, 266042, China.,State Key Laboratory of Chemical Resource Engineering, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Z Wang
- Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - W Hu
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Sciences, Tianjin University & Collaborative Innovation Center of Chemical Science and Engineering, Tianjin, 300072, China.,Joint School of National University of Singapore and Tianjin University, International Campus of Tianjin University, Binhai New City, 350207, China
| | - H Dong
- National Laboratory for Molecular Sciences, Key Laboratory of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China.,Department of Chemistry, University of Chinese Academy of Sciences, Beijing, 100049, China
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24
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Chi L, Wang H, Yu F, Gao C, Dai H, Si X, Liu L, Wang Z, Zheng J, Ke Y, Liu H, Zhang Q. Recent Progress of Ubiquitin-Specific-Processing Protease 7 Inhibitors. Russ J Bioorg Chem 2023. [DOI: 10.1134/s1068162023020073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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25
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Gao L, Li P, Gaykova N, Zheng X, Gao C, Lane JM, Saxena R, Scheer FAJL, Rutter MK, Akeju O, Hu K. Circadian Rest-Activity Rhythms, Delirium Risk, and Progression to Dementia. Ann Neurol 2023; 93:1145-1157. [PMID: 36808743 DOI: 10.1002/ana.26617] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Delirium is a complex neurocognitive syndrome suspected to be bidirectionally linked to dementia. Circadian rhythm disturbances likely contribute to dementia pathogenesis, but whether these disturbances are related to delirium risk and progression to all-cause dementia is unknown. METHODS We analyzed continuous actigraphy data from 53,417 middle-aged or older UK Biobank participants during a median 5 years of follow-up. Four measures were used to characterize the 24-hour daily rest-activity rhythms (RARs): normalized amplitude, acrophase representing the peak activity time, interdaily stability, and intradaily variability (IV) for fragmentation of the rhythm. Cox proportional hazards models examined whether RARs predicted incident delirium (n = 551) and progression to dementia (n = 61). RESULTS Suppressed 24-hour amplitude, lowest (Q1) versus highest (Q4) quartile (hazard ratio [HR]Q1 vs Q4 = 1.94, 95% confidence interval [CI] = 1.53-2.46, p < 0.001), and more fragmented (higher IV: HRQ4 vs Q1 = 1.49, 95% CI = 1.18-1.88, p < 0.001) rhythms predicted higher delirium risk, after adjusting for age, sex, education, cognitive performance, sleep duration/disturbances, and comorbidities. In those free from dementia, each hour of delayed acrophase was associated with delirium risk (HR = 1.13, 95% CI = 1.04-1.23, p = 0.003). Suppressed 24-hour amplitude was associated with increased risk of progression from delirium to new onset dementia (HR = 1.31, 95% CI = 1.03-1.67, p = 0.03 for each 1-standard deviation decrease). INTERPRETATION Twenty-four-hour daily RAR suppression, fragmentation, and potentially delayed acrophase were associated with delirium risk. Subsequent progression to dementia was more likely in delirium cases with suppressed rhythms. The presence of RAR disturbances before delirium and prior to progression to dementia suggests that these disturbances may predict higher risk and be involved in early disease pathogenesis. ANN NEUROL 2023.
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Affiliation(s)
- Lei Gao
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Peng Li
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Nicole Gaykova
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Xi Zheng
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Chenlu Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Jacqueline M Lane
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA.,Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Richa Saxena
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA.,Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Frank A J L Scheer
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA.,Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Martin K Rutter
- Division of Diabetes, Endocrinology, and Gastroenterology, University of Manchester, Manchester, UK.,Diabetes Endocrinology and Metabolism Centre, Manchester University National Health Service Foundation Trust, Manchester, UK
| | - Oluwaseun Akeju
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kun Hu
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
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26
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Gao C, Scullin MK. Longitudinal trajectories of spectral power during sleep in middle-aged and older adults. Aging Brain 2023; 3:100058. [PMID: 36911257 PMCID: PMC9997163 DOI: 10.1016/j.nbas.2022.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/09/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Age-related changes in sleep appear to contribute to cognitive aging and dementia. However, most of the current understanding of sleep across the lifespan is based on cross-sectional evidence. Using data from the Sleep Heart Health Study, we investigated longitudinal changes in sleep micro-architecture, focusing on whether such age-related changes are experienced uniformly across individuals. Participants were 2,202 adults (ageBaseline = 62.40 ± 10.38, 55.36 % female, 87.92 % White) who completed home polysomnography assessment at two study visits, which were 5.23 years apart (range: 4-7 years). We analyzed NREM and REM spectral power density for each 0.5 Hz frequency bin, including slow oscillation (0.5-1 Hz), delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), sigma (12-15 Hz), and beta-1 (15-20 Hz) bands. Longitudinal comparisons showed a 5-year decline in NREM delta (p <.001) and NREM sigma power density (p <.001) as well as a 5-year increase in theta power density during NREM (p =.001) and power density for all frequency bands during REM sleep (ps < 0.05). In contrast to the notion that sleep declines linearly with advancing age, longitudinal trajectories varied considerably across individuals. Within individuals, the 5-year changes in NREM and REM power density were strongly correlated (slow oscillation: r = 0.46; delta: r = 0.67; theta r = 0.78; alpha r = 0.66; sigma: r = 0.71; beta-1: r = 0.73; ps < 0.001). The convergence in the longitudinal trajectories of NREM and REM activity may reflect age-related neural de-differentiation and/or compensation processes. Future research should investigate the neurocognitive implications of longitudinal changes in sleep micro-architecture and test whether interventions for improving key sleep micro-architecture features (such as NREM delta and sigma activity) also benefit cognition over time.
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Affiliation(s)
- Chenlu Gao
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Michael K Scullin
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
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27
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Li P, Sun H, Gao C, Gao L, Yu L, Yang J, Bennett DA, Buchman AS, Hu K. Circadian age, chronological age, and Alzheimer’s dementia. Alzheimers Dement 2022. [DOI: 10.1002/alz.063334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Peng Li
- Harvard Medical School Boston MA USA
- Broad Institute of MIT and Harvard Cambridge MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Haoqi Sun
- Massachusetts General Hospital Boston MA USA
| | - Chenlu Gao
- Harvard Medical School Boston MA USA
- Broad Institute of MIT and Harvard Cambridge MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Lei Gao
- Broad Institute of MIT and Harvard Cambridge MA USA
- Massachusetts General Hospital Boston MA USA
- Brigham and Women’s Hospital Boston MA USA
| | - Lei Yu
- Rush Alzheimer's Disease Center Chicago IL USA
| | | | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | | | - Kun Hu
- Harvard Medical School Boston MA USA
- Broad Institute of MIT and Harvard Cambridge MA USA
- Brigham and Women's Hospital Boston MA USA
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28
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Freisenhausen J, Khera N, Gao C, Srivastava A, Luo L, Pivarcsi A, Sonkoly E. 375 miR-484: a microRNA with altered subcellular localization in psoriasis keratinocytes. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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29
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Ye LL, Zhang JW, Yan RJ, Xiang L, Hu YL, Cui J, Tang YX, Chai X, Gao C, Xiao L, Jiang Y, Zhang J, Yang Y. [Association between the awareness of Nutrition Facts Panel and prepackaged food purchase behavior among residents]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1478-1483. [PMID: 36274617 DOI: 10.3760/cma.j.cn112150-20211101-01006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To explore the association between the cognition of Nutrition Facts Panel and prepackaged food purchase behavior among residents in six provinces in China. Methods: Using a multi-stage sampling method, 3 002 adults aged 18-70 were selected from the western region (Sichuan), eastern region (Guangdong, Jiangsu, Beijing), central region (Henan), and northeastern region (Heilongjiang) of China from July 2020 to March 2021. Socio-demographic characteristics of participants and their cognition of Nutrition Facts Panel and prepackaged food purchase behavior were collected through questionnaire. A multivariate binary logistic regression model was used to analyze the association between cognition of Nutrition Facts Panel and prepackaged food purchase behavior. Results: The age of 3 002 subjects was (42.3±13.4) years, among which 63.8% (1 914) were female, 66.7% knew the Nutrition Facts Panel, 49.8% would read it when purchasing, 30.7% could understand it, and 56.6% (1 699) bought prepackaged food more than once a week. The results of multivariate analysis showed that after adjusting for relevant confounding factors, compared with the participants knowing but not reading the Nutrition Facts Panel, the group knowing and reading was more likely to buy 11 types of prepackaged food at least once a week (all P<0.05). Compared with the participants reading but not understanding the Nutrition Facts Panel, the group reading and understanding was less likely to buy 11 types of prepackaged food at least once a week (all P<0.05). Conclusion: There was a correlation between cognition of Nutrition Facts Panel and prepackaged food purchase behavior among residents.
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Affiliation(s)
- L L Ye
- School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 10005, China
| | - J W Zhang
- Shijiazhuang Municipal Bureau of Statistics, Shijiazhuang 050011, China
| | - R J Yan
- School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 10005, China
| | - L Xiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 10005, China
| | - Y L Hu
- School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 10005, China
| | - J Cui
- School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 10005, China
| | - Y X Tang
- School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 10005, China
| | - X Chai
- School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 10005, China
| | - C Gao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L Xiao
- Chinese Health Education Network, Beijing 100020, China
| | - Y Jiang
- Chinese Nutrition Society, Beijing 100022, China
| | - Juan Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 10005, China
| | - Yuexin Yang
- Chinese Nutrition Society, Beijing 100022, China
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30
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Ninomiya K, Serruys PW, Garg S, Gao C, Masuda S, Lunardi M, Burzotta F, Morice MC, Colombo A, Mack MJ, Holmes DR, Davierwala PM, Thuijs D, Onuma Y. Impact of bifurcation lesion on 10-year mortality in the SYNTAX trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Percutaneous coronary intervention (PCI) of bifurcation lesions is associated with higher rates of adverse events, and currently it is unclear whether PCI or coronary artery bypass grafting (CABG) is the safer treatment for these patients at very long-term follow up.
Objectives
To investigate the impact of bifurcation lesions on observed all-cause 10-year mortality in the SYNTAX trial.
Methods
In the SYNTAX Extended Survival study, 10-year observed mortality was compared among four groups: (a) presence of ≥1 bifurcation lesion and treatment with PCI (n=649), (b) no bifurcation lesion and treatment with PCI (n=248), (c) presence of ≥1 bifurcation lesion and treatment with CABG (n=651), and (d) no bifurcation lesion and treatment with CABG (n=239).
Results
Compared to patients without bifurcations, those with bifurcation lesion(s) treated with PCI had a significantly higher risk of all-cause death (19.8% vs 30.1%; HR: 1.55, 95% CI: 1.12 to 2.14; p=0.007), whereas following CABG, mortality was similar in patients with or without bifurcation lesion(s) (23.3% vs 23.0%; HR: 0.81, 95% CI: 0.59 to 1.12; p=0.207). (Figure1) There was a significant interaction between bifurcation lesion(s) and treatment arm (p for interaction=0.006).
In PCI patients, at 5-years there was no significant difference in mortality between 1- vs 2-stent techniques, whereas at 10-years, a 2-stent technique was associated with higher mortality (33.3% vs 25.9%; HR: 1.51, 95% CI: 1.06 to 2.14; p=0.021, Figure2).
Conclusions
Bifurcation lesion(s) require special attention from the heart team discussion, considering the higher 10-year all-cause mortality associated with PCI. Careful evaluation of bifurcation lesion complexity may be helpful in decision-making.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The SYNTAX Extended Survival study was supported by the German Foundation of Heart Research (Frankfurt am Main, Germany). The SYNTAX trial, during 0-5 years follow-up, was funded by Boston Scientific Corporation (Marlborough, MA, USA). Both sponsors had no role in the study design, data collection, data analyses, and interpretation of the study data, nor were involved in the decision to publish the final manuscript. The principal investigators and authors had complete scientific freedom.
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Affiliation(s)
- K Ninomiya
- National University of Ireland , Galway , Ireland
| | - P W Serruys
- National University of Ireland , Galway , Ireland
| | - S Garg
- Royal Blackburn Hospital , Blackburn , United Kingdom
| | - C Gao
- National University of Ireland , Galway , Ireland
| | - S Masuda
- National University of Ireland , Galway , Ireland
| | - M Lunardi
- National University of Ireland , Galway , Ireland
| | - F Burzotta
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - M C Morice
- Jacques Cartier Private Hospital , Massy , France
| | - A Colombo
- Humanitas Research Hospital , Milan , Italy
| | - M J Mack
- Baylor University Medical Center , Dallas , United States of America
| | - D R Holmes
- Mayo Clinic , Rochester , United States of America
| | | | - D Thuijs
- Erasmus University Medical Centre , Rotterdam , The Netherlands
| | - Y Onuma
- National University of Ireland , Galway , Ireland
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31
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Serruys PW, Gao C, Ninomiya K, Hara H, Garg S, Onuma Y, Kappetein AP, Mohr FW, Mack M. Ten years survival benefit of CABG or PCI based on individual prediction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
To compare the observed and individual predicted mortalities according to the SYNTAX score II 2020 (SSII-2020) in the all-comers SYNTAX population, and retrospectively assess the appropriateness of revascularization with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with three vessel disease (3VD) and/or left main disease (LMCAD).
Methods
Internal and external validation of the SSII-2020 to predict 10-year all-cause death was performed in the respective randomized and registry SYNTAX populations. Differences in individual predicted mortalities following CABG or PCI were ranked and displayed with the observed mortalities. The proportions of screened patients deriving a survival benefit from CABG or PCI were determined retrospectively.
Results
A total of 2602 participants (as-treated population) were included in the randomized and registry cohorts. In the randomized cohort, all-cause mortality at 10 years, as an average treatment effect, was 23.8% (199/865) with CABG and 28.6% (249/901) with PCI, with a differential survival benefit of 4.6% (95% CI: 0.58% to 8.7%, log-rank p value=0.023). In the CABG and PCI registries, mortalities were 27.8% (167/644) and 55.4% (99/192), respectively. Calibration and discrimination of the SSII-2020 was helpful in CABG and PCI patients in the randomized and registry cohorts. In the PCI registry, the SSII-2020 underestimated mortality since specific comorbidities that entail high mortality are not included in the formula (C-index: 0.72, intercept: 0.38, slope: 0.66), whilst in the CABG registry, it predicted mortality with a helpful calibration and discrimination (C-index: 0.70, intercept: 0.00, slope: 0.76). The proportions of patients with a predicted survival benefit following CABG and PCI were respectively 78.3% (1383/1766) and 21.7% (383/1766) in the randomized cohort, and 82.4% (2143/2602) and 17.7% (459/2602) in the whole SYNTAX trial population.
Conclusion
In the randomized and registry cohort of this all-comers population with 3VD and/or LMCAD, there was reasonable agreement between the individual predicted and observed mortalities after CABG or PCI, such that the predicted 10-year survival benefit might be helpful in determining the appropriateness of each modality of revascularization.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The SYNTAX Extended Survival study was supported by the German Foundation of Heart Research (Frankfurt am Main, Germany). The SYNTAX trial, during 0-5 years follow-up, was funded by Boston Scientific Corporation (Marlborough, MA, USA). Both sponsors had no role in the study design, data collection, data analyses, and interpretation of the study data, nor were involved in the decision to publish the final manuscript. The principal investigators and authors had complete scientific freedom.
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Affiliation(s)
- P W Serruys
- National University of Ireland , Galway , Ireland
| | - C Gao
- National University of Ireland , Galway , Ireland
| | - K Ninomiya
- National University of Ireland , Galway , Ireland
| | - H Hara
- National University of Ireland , Galway , Ireland
| | - S Garg
- Royal Blackburn Hospital , Blackburn , United Kingdom
| | - Y Onuma
- National University of Ireland , Galway , Ireland
| | - A P Kappetein
- Erasmus University Medical Centre , Rotterdam , The Netherlands
| | - F W Mohr
- Heart Center of Leipzig , Leipzig , Germany
| | - M Mack
- Baylor Scott and White The Heart Hospital , Plano , United States of America
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Wang Y, Liu X, Guo C, Xiong Y, Cao L, Bing Z, Song Y, Gao C, Tian Z, Lin Y, Xu Y, Xue J, Li B, Huang Z, Yang X, Cao Z, Li J, Jiang X, Si X, Zhang L, Song M, Zhou Z, Chen R, Li S, Yang H, Liang N. EP16.01-017 T-cell Repertoire Heterogeneity and Homogeneity in Synonymous Multiple Primary Lung Cancers. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hu YL, Yan RJ, Jiang Y, Zhang JW, Ye LL, Xiang L, Cui J, Tang YX, Gao C, Xiao L, Yang YX, Zhang J. [The preference for Front-of-Pack Labeling and its association with the understanding of Nutrition Facts Panel among residents aged 18 to 70: results of a survey in 6 provinces of China]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:952-959. [PMID: 35899348 DOI: 10.3760/cma.j.cn112150-20211102-01013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the preference for Front-of-Pack Labeling (FOP) and its association with the understanding of the Nutrition Facts Panel among Chinese residents. Methods: A multi-stage sampling strategy was adopted to select 3 002 people aged between 18 and 70 years old from the eastern region of China (Beijing, Jiangsu Province, Guangdong Province), the northeast region (Heilongjiang Province), the central region (Henan Province) and the western region (Sichuan Province) from July 2020 to March 2021. Socio-demographic characteristics of participants and their understanding of the Nutrition Facts Panel and preference for FOP were collected. The χ² test was conducted to compare the preference for FOP in different groups of population, and multivariate logistic regression was used to analyze the association between the preference for FOP and the understanding of the Nutrition Facts Panel. Results: The mean age of 3 002 participants was (42.3±13.4) years, of which 1 914 (63.8%) were females and 69.3% could not understand the Nutrition Facts Panel. About 2 458 respondents (81.9%) suggested that FOP could be promoted. The top three nutrients that should be labeled were sugar (68.4%), salt (68.2%) and total fat (62.4%). The number of participants who believed that the Multiple Traffic Lights (MTL) could be easier to help consumers to quickly choose healthy food, attract attention and provide the most needed information was 1 064 (35.4%), 1 026 (34.2%) and 1 140 (38.0%), respectively. The multivariate logistic regression analysis showed that, compared with the Guideline Daily Amount (GDA) system, participants who could not understand the Nutrition Facts Panel preferred (1) Nutri-Score, Warning labels, and Health logos: Smart Choice in terms of"Which format of FOP could quickly help you choose food more easily?"[OR (95%CI): 2.21 (1.62-3.02), 1.64 (1.22-2.22), 1.79 (1.31-2.45), respectively]; (2) Nutri-Score, Warning labels, and Health logos: Smart Choice in terms of"Which format of FOP could attract your attention the most?"[OR (95%CI): 2.62 (1.92-3.59), 1.96 (1.45-2.66), 2.25 (1.66-3.04), respectively]; and (3) Nutri-Score, Warning labels, and Health logos: Smart Choice in terms of"Which format of FOP could provide you with the most needed information?"[OR (95%CI): 2.33 (1.70-3.21), 2.21 (1.66-2.95), 2.01 (1.50-2.71), respectively]. Conclusion: The residents from six provinces in China have a supportive attitude towards FOP. The interpretive FOP with color information, specific nutrient information and summary indicator can be launched. The nutrition information of sugar, salt and total fat could be prioritized to be labeled on the FOP.
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Affiliation(s)
- Y L Hu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - R J Yan
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Y Jiang
- Chinese Nutrition Society, Beijing 100022, China
| | - J W Zhang
- Shijiazhuang Municipal Bureau of Statistics, Shijiazhuang 050011, China
| | - L L Ye
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - L Xiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - J Cui
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Y X Tang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - C Gao
- National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L Xiao
- Chinese Center for Health Education, Beijing 100020, China
| | - Y X Yang
- National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Juan Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Wagner M, Li P, Lim A, Gao L, Gao C, Yang HW, Yu L, Fan W, Bennett D, Buchman A, Schneider J, Saper C, Hu K. 0132 Loss of Neurons in the Intermediate Nucleus is Related to Perturbed Sleep-Wake Rhythms in Older Adults. Sleep 2022. [DOI: 10.1093/sleep/zsac079.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The ventrolateral preoptic nucleus (VLPO) is composed of neurons that are maximally active during sleep. In animal studies, VLPO lesion decreased the amount of sleep but only marginally attenuated circadian rhythm. The human intermediate nucleus (IN) is believed to be the homologue of the VLPO. Neuronal loss in IN has found to be associated with increased sleep fragmentation in older adults. We investigated whether IN neuronal loss is also associated with perturbed sleep-wake rhythms in humans.
Methods
We studied 50 deceased participants [age at death: 88.9±6.1 (mean±SD; female: 33 (66%)] from the Rush Memory and Aging Project, who had actigraphy assessment 1.6±1.3 years (range: 0.1-5.1 years) before death. Post-mortem immunohistochemical and stereological analysis was performed to quantify the count of galanin-immunoreactive neurons (Gal+) in the IN of them. Actigraphy data were used to calculate amplitude, acrophase, interdaily stability, and intradaily variability of the 24-h activity rhythms. Linear regression models were used to determine the associations of the four measures of sleep-wake rhythms with the GAL+ neuron counts, adjusting for age at death and sex. Further covariates considered included sleep fragmentation (derived from actigraphy) and the time interval between actigraphy assessment and death.
Results
The number of Gal+ neurons in IN was positively associated with interdaily stability and amplitude, and negatively associated with intradaily variability. Specifically, for one-SD decrease in Gal+ neurons, interdaily stability decreased by 0.06±0.02 (mean±standard error; equivalent to 40% SD of interdaily stability; p=0.009), amplitude decreased by 5.8±2.3 (equivalent to 35% SD of amplitude; p=0.014), and intradaily variability increased by 0.12±0.04 (equivalent to 36% SD of intradaily variability; p=0.009). Longer time interval between actigraphy and death showed a trend to attenuate these associations although not statistically significant (all p>0.1). These observations also remained statistically significant after adjusting for sleep fragmentation.
Conclusion
Neuronal loss in the IN was linked with perturbed sleep-wake rhythms in older adults. Further investigations are warranted to examine whether the observed associations are mediated by reduced sleep quantity or other aspects of sleep quality.
Support (If Any)
NIH RF1AG064312, RF1AG059867, R01AG017917, R01AG56352; and the BrightFocus Foundation A2020886S.
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Affiliation(s)
| | - Peng Li
- Brigham and Women's Hospital
| | | | - Lei Gao
- Brigham and Women's Hospital
| | | | | | - Lei Yu
- Rush Alzheimer's Disease Center
| | | | | | | | | | | | - Kun Hu
- Brigham and Women's Hospital
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Gao C, Li P, Morris C, Zheng X, Ulsa MC, Gao L, Scheer F, Hu K. 0099 Comparison of two actigraphy-based algorithms for detecting daytime and nighttime sleep. Sleep 2022. [DOI: 10.1093/sleep/zsac079.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The Actiware software that comes with Philips Respironics’ actiwatches tends to overestimate sleep, due to its poor accuracy in distinguishing immobility from sleep. Re-scoring rules were introduced in the Cole-Webster algorithm to overcome this issue. Previous validation of the two algorithms was based on nighttime sleep, and their performance in daytime sleep detection is unknown. This study aims to test/compare the performance of the two algorithms in detecting daytime sleep and nighttime sleep.
Methods
We analyzed actigraphy and polysomnography data that were simultaneously collected from 25 participants (14 non-shift-workers and 11 shift-workers; age: 30.93±8.96 [mean±SD]; female: 14 [56%]) each in two in-lab visits with scheduled nighttime or daytime sleep. The sleep/wake epochs scored by the Cole-Webster algorithm and Actiware (using medium wake threshold) were compared to those obtained from polysomnography. We conducted linear mixed-effects regression models to compare the sensitivity, specificity, and F1-score (a measure of performance less affected by imbalanced datasets) in detecting daytime and nighttime sleep and between the two algorithms.
Results
The Cole-Webster algorithm (mean±SE: daytime=0.66±0.02, nighttime=0.60±0.02) yielded lower sensitivity than Actiware (daytime=0.96±0.02, nighttime=0.96±0.02; p<0.0001), which was consistent for both daytime and nighttime sleep (daytime/nighttime×algorithm interaction: p=0.2). The Cole-Webster algorithm (daytime=0.91±0.04, nighttime=0.94±0.05) yielded higher specificity than Actiware (daytime=0.45±0.04, nighttime=0.56±0.05; p<0.0001), which was consistent for both daytime and nighttime sleep (daytime/nighttime×algorithm interaction: p=0.2). Both sensitivity and specificity did not differ between daytime and nighttime sleep (p>0.05). F1 scores of the Cole-Webster algorithm were lower (daytime=0.77±0.02, nighttime=0.74±0.02) than those of Actiware (daytime=0.92±0.02, nighttime=0.97±0.02; p<0.0001) for both daytime and nighttime sleep. There was a significant daytime/nighttime×algorithm interaction on F1 score (p=0.02). Specifically, the Cole-Webster algorithm performed better in scoring daytime than nighttime sleep, whereas Actiware performed better in scoring nighttime than daytime sleep.
Conclusion
For both algorithms, the performance was similar in detecting daytime and nighttime sleep. Compared to Actiware, the Cole-Webster algorithm was generally better at detecting wake (i.e., high specificity) but worse at detecting sleep epochs (i.e., low sensitivity) and yielded worse overall performance (i.e., low F1). Future studies should test/validate other Actigraphy-based algorithms’ performance in scoring daytime sleep.
Support (If Any)
NIH R01HL094806, RF1AG064312, RF1AG059867, BrightFocus Foundation A2020886S
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Affiliation(s)
- Chenlu Gao
- Brigham and Women's Hospital/ Harvard Medical School
| | - Peng Li
- Brigham and Women's Hospital/ Harvard Medical School
| | | | | | | | - Lei Gao
- Massachusetts General Hospital/ Harvard Medical School
| | - Frank Scheer
- Brigham and Women's Hospital/ Harvard Medical School
| | - Kun Hu
- Brigham and Women's Hospital/ Harvard Medical School
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Do A, Gao C, Scullin M. 0242 Intraindividual Variability in Sleep Duration Blunts Response to Academic Stressors. Sleep 2022. [DOI: 10.1093/sleep/zsac079.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cross-sectional studies indicate that greater intra-individual variability (IIV) in sleep is correlated with poorer cognitive-emotional outcomes. Yet, the causal direction of these relationships is unclear. Therefore, we conducted an experimental study to compare cognitive and stress outcomes following random assignment to normal sleep, sleep restriction, and irregular/IIV sleep conditions.
Methods
Ninety college students (mean age=19.16, SD=0.98; 77.78% female) completed an Organic Chemistry virtual lecture during session 1. Then, for the next five days, participants were randomly assigned to the following conditions: normal sleep (8h in bed every night), sleep restriction (6h in bed every night), or IIV sleep (nightly oscillation between 6.5h and 9.5h in bed, with mean of 8h/night). Adherence was confirmed using actigraphy. On the sixth day (session 2), participants took a test on the Organic Chemistry lecture (retention measure) and then completed a new lecture and test (acquisition measure). Participants reported their stress levels across the lectures and tests.
Results
ANCOVA tests showed that sleep condition did not affect retention (F=0.50, p=.611) or acquisition of Organic Chemistry knowledge (F=1.33, p=.275; adjusted for Grade Point Average). Interestingly, participants in the IIV condition reported lower stress levels throughout session 2 than students in the normal sleep condition, adjusting for baseline stress levels (p=.025). Furthermore, when collapsing across conditions, correlation analyses confirmed that greater IIV in TST predicted lower stress throughout session 2, after adjusting for mean TST and baseline stress level (r=-.33, p=.014). This “blunted” stress response following nightly sleep fluctuations was in contrast to the heightened stress levels that were associated with shorter mean TST (r=-.22, p=.051).
Conclusion
Brief sleep variability and mild sleep restriction had minimal impact on laboratory measures of STEM knowledge retention and acquisition. However, greater sleep IIV blunted reactivity to academic stressors, which may reflect altered hypothalamic–pituitary–adrenal axis functions and have implications for student metacognition and course persistence. Future research should investigate the chronic effect of maintaining irregular sleep patterns and whether improving regularity of sleep across longer time intervals promotes cognitive and emotional functioning.
Support (If Any)
American Psychological Association, APAGS, Psi Chi, National Science Foundation (1920730, 1943323)
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Affiliation(s)
| | - Chenlu Gao
- Brigham and Women’s Hospital, Harvard Medical School
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Gao C, Luo LL, Yue S, Wang FT, Duan XM, Qian YD, Dong YJ, Li HY, Yue J, Xu RX, Liu Y, Gong YD. [Gender differences of genetic etiology in the incidence of major depressive disorder among Han freshmen]. Zhonghua Yi Xue Za Zhi 2022; 102:1437-1444. [PMID: 35599408 DOI: 10.3760/112137-20220130-00224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To analyze the gender differences of genetic etiology in the incidence of major depression disorder among Han freshmen. Methods: A 1-year follow-up survey was carried out among 8 079 Han freshmen from Jining, Rizhao and Weifang without lifetime major depressive disorder (MDD) at baseline (April to October 2018) and 4 828 venous blood samples were also collected. After extracting DNA, Sequenom Mass Array time-of-flight mass spectrometry biochip technology was used to detect the genotypes of 17 single nucleotide polymorphisms (SNPs) MDD-related loci. Logistic regression was used for univariate analysis. Generalized multifactor dimension reduction was used to analyze gene-gene interactions. Composite International Diagnostic Interview (CIDI) 3.0 was used for MDD diagnosis. Results: The 1-year incidence of MDD among Han freshmen was 2.23% (95%CI: 1.91%-2.60%) and the gender difference of incidence between males (1.97%, 95%CI: 1.52%-2.56%) and females (2.39%, 95%CI: 1.98%-2.90%) was not statistically significant (P>0.05). AG genotype of rs768705 (nearby gene: TMEM161B) was a risk factor for MDD (OR=1.98, 95%CI: 1.24-2.83). The TC genotype of rs17727765 (nearby gene: CRYBA1) was only a risk factor for MDD in males (OR=9.61, 95%CI: 2.04-45.30). An 8-loci interaction model (PMFBP1, OLFM4, LHPP, ENOX1, TMEM161B, SPPL3, FBXL4 and L3MBTL2) could predict MDD in women with an accuracy rate of 60.05%. No effective prediction model was found for MDD in men. Conclusions: There might be gender differences in the genetic etiology of MDD. Further researches on the genetic causes of MDD in men should be explored.
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Affiliation(s)
- C Gao
- School of Mental Health, Jining Medical University, Jining 272013, China
| | - L L Luo
- School of Basic Medicine, Weifang Medical University, Weifang 261053, China
| | - S Yue
- School of Basic Medicine, Weifang Medical University, Weifang 261053, China
| | - F T Wang
- School of Mental Health, Jining Medical University, Jining 272013, China
| | - X M Duan
- Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Y D Qian
- School of Mental Health, Jining Medical University, Jining 272013, China
| | - Y J Dong
- School of Mental Health, Jining Medical University, Jining 272013, China
| | - H Y Li
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - J Yue
- School of Public Health, Weifang Medical University, Weifang 261053, China
| | - R X Xu
- School of Public Health, Yantai Medical University, Yantai 264003, China
| | - Y Liu
- Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Y D Gong
- Shandong Mental Health Center, Shandong University, Jinan 250014, China
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Jannis D, Hofer C, Gao C, Xie X, Béché A, Pennycook TJ, Verbeeck J. Event driven 4D STEM acquisition with a Timepix3 detector: Microsecond dwell time and faster scans for high precision and low dose applications. Ultramicroscopy 2022; 233:113423. [PMID: 34837737 DOI: 10.1016/j.ultramic.2021.113423] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/11/2021] [Accepted: 10/31/2021] [Indexed: 10/19/2022]
Abstract
Four dimensional scanning transmission electron microscopy (4D STEM) records the scattering of electrons in a material in great detail. The benefits offered by 4D STEM are substantial, with the wealth of data it provides facilitating for instance high precision, high electron dose efficiency phase imaging via centre of mass or ptychography based analysis. However the requirement for a 2D image of the scattering to be recorded at each probe position has long placed a severe bottleneck on the speed at which 4D STEM can be performed. Recent advances in camera technology have greatly reduced this bottleneck, with the detection efficiency of direct electron detectors being especially well suited to the technique. However even the fastest frame driven pixelated detectors still significantly limit the scan speed which can be used in 4D STEM, making the resulting data susceptible to drift and hampering its use for low dose beam sensitive applications. Here we report the development of the use of an event driven Timepix3 direct electron camera that allows us to overcome this bottleneck and achieve 4D STEM dwell times down to 100 ns; orders of magnitude faster than what has been possible with frame based readout. We characterize the detector for different acceleration voltages and show that the method is especially well suited for low dose imaging and promises rich datasets without compromising dwell time when compared to conventional STEM imaging.
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Affiliation(s)
- D Jannis
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - C Hofer
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - C Gao
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - X Xie
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - A Béché
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - T J Pennycook
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - J Verbeeck
- EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
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Abstract
STUDY OBJECTIVES To determine the accuracy of early and newer versions of a nonwearable sleep tracking device relative to polysomnography and actigraphy, under conditions of normal and restricted sleep duration. METHODS Participants were 35 healthy adults (mean age = 18.97; standard deviation = 0.95 years; 77.14% female; 42.86% White). In a controlled sleep laboratory environment, we randomly assigned participants to go to bed at 10:30 pm (normal sleep) or 1:30 am (restricted sleep), setting lights-on at 7:00 am. Sleep was measured using polysomnography, wristband actigraphy (the Philips Respironics Actiwatch Spectrum Plus), self-report, and an early or newer version of a nonwearable device that uses a sensor strip to measure movement, heart rate, and breathing (the Apple, Inc. Beddit). We tested accuracy against polysomnography for total sleep time, sleep efficiency, sleep onset latency, and wake after sleep onset. RESULTS The early version of the nonwearable device (Beddit 3.0) displayed poor reliability (intraclass correlation coefficient [ICC] < 0.30). However, the newer nonwearable device (Beddit 3.5) yielded excellent reliability with polysomnography for total sleep time (ICC = 0.998) and sleep efficiency (ICC = 0.98) across normal and restricted sleep conditions. Agreement was also excellent for the notoriously difficult metrics of sleep onset latency (ICC = 0.92) and wake after sleep onset (ICC = 0.92). This nonwearable device significantly outperformed clinical-grade actigraphy (ICC between 0.44 and 0.96) and self-reported sleep measures (ICC < 0.75). CONCLUSIONS A nonwearable device showed better agreement than actigraphy with polysomnography outcome measures. Future work is needed to test the validity of this device in clinical populations. CITATION Hsiou DA, Gao C, Matlock RC, Scullin MK. Validation of a nonwearable device in healthy adults with normal and short sleep durations. J Clin Sleep Med. 2022;18(3):751-757.
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Affiliation(s)
- David A. Hsiou
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas,School of Medicine, Baylor College of Medicine, Houston, Texas
| | - Chenlu Gao
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts,Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Robert C. Matlock
- Ascension Medical Group Providence, Department of Sleep Medicine, Waco, Texas
| | - Michael K. Scullin
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas,Address correspondence to: Michael K. Scullin, PhD, Department of Psychology and Neuroscience, Baylor University, One Bear Place 97334, Waco, TX 76798; Tel: (254) 710-2241;
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Gao C, Li P, Morris CJ, Zheng X, Ulsa MC, Gao L, Scheer FAJL, Hu K. Actigraphy-Based Sleep Detection: Validation with Polysomnography and Comparison of Performance for Nighttime and Daytime Sleep During Simulated Shift Work. Nat Sci Sleep 2022; 14:1801-1816. [PMID: 36275180 PMCID: PMC9581540 DOI: 10.2147/nss.s373107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Actigraphy-based sleep detection algorithms were mostly validated using nighttime sleep, and their performance in detecting daytime sleep is unclear. We evaluated and compared the performance of Actiware and the Cole-Kripke algorithm (C-K) - two commonly used actigraphy-based algorithms - in detecting daytime and nighttime sleep. PARTICIPANTS AND METHODS Twenty-five healthy young adults were monitored by polysomnography and actigraphy during two in-lab protocols with scheduled nighttime and/or daytime sleep (within-subject design). Mixed-effect models were conducted to compare the sensitivity, specificity, and F1 score (a less-biased measure of accuracy) of Actiware (with low/medium/high threshold setting, separately) and C-K in detecting sleep epochs from actigraphy recordings during nighttime/daytime. t-tests and intraclass correlation coefficients were used to assess the agreement between actigraphy-based algorithms and polysomnography in scoring total sleep time (TST). RESULTS Sensitivity was similar between nighttime (Actiware: 0.93-0.99 across threshold settings; C-K: 0.61) and daytime sleep (Actiware: 0.93-0.99; C-K: 0.66) for both the C-K and Actiware (daytime/nighttime×algorithm interaction: p > 0.1). Specificity for daytime sleep was lower (Actiware: 0.35-0.54; C-K: 0.91) than that for nighttime sleep (Actiware: 0.37-0.62; C-K: 0.93; p = 0.001). Specificity was also higher for C-K than Actiware (p < 0.001), with no daytime/nighttime×algorithm interaction (p > 0.1). C-K had lower F1 (nighttime = 0.74; daytime = 0.77) than Actiware (nighttime = 0.95-0.98; daytime = 0.90-0.91) for both nighttime and daytime sleep (all p < 0.05). The daytime-nighttime difference in F1 was opposite for Actiware (daytime: 0.90-0.91; nighttime: 0.95-0.98) and C-K (daytime: 0.77; nighttime: 0.74; interaction p = 0.003). Bias in TST was lowest in Actiware (with medium-threshold) for nighttime sleep (underestimation of 5.99 min/8h) and in Actiware (with low-threshold) for daytime sleep (overestimation of 17.75 min/8h). CONCLUSION Daytime/nighttime sleep affected specificity and F1 but not sensitivity of actigraphy-based sleep scoring. Overall, Actiware performed better than the C-K algorithm. Actiware with medium-threshold was the least biased in estimating nighttime TST, and Actiware with low-threshold was the least biased in estimating daytime TST.
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Affiliation(s)
- Chenlu Gao
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Peng Li
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Christopher J Morris
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Xi Zheng
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ma Cherrysse Ulsa
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Lei Gao
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kun Hu
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Kong Y, Ye B, Yang L, Liu X, Gao C. Comparative molecular dynamics study on interaction of acetamide and glycerol with phospholipid bilayer. Cryo Letters 2022; 43:42-49. [PMID: 35315869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The exact mechanisms that acetamide and glycerol interact with cell membrane remains a matter of debate. OBJECTIVE To investigate the microscopic interactions of acetamide and glycerol with phospholipid bilayers at various temperatures. MATERIALS AND METHODS Molecular dynamics simulations of a hydrated dipalmitoyl-phosphatidylcholine (DPPC) bilayer in the presence of glycerol and acetamide were performed. The system contains 128 lipids and about 700 cryoprotectant molecules, and simulations extended to 15 ns. RESULT When compared to glycerol, acetamide shows a stronger affinity with water rather than the lipid bilayer. CONCLUSION The knowledge of the mixing dynamics of present system helps to develop better cryoprotective formulas and to propose more optimal cooling/warming protocols.
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Affiliation(s)
- Y Kong
- Department of Refrigeration and Cryogenics Engineering, Hefei University of Technology, Hefei, China
| | - B Ye
- Department of Refrigeration and Cryogenics Engineering, Hefei University of Technology, Hefei, China
| | - L Yang
- Department of Refrigeration and Cryogenics Engineering, Hefei University of Technology, Hefei, China
| | - X Liu
- Department of Refrigeration and Cryogenics Engineering, Hefei University of Technology, Hefei, China
| | - C Gao
- Department of Refrigeration and Cryogenics Engineering, Hefei University of Technology, Hefei, China.
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Zhang Z, Gao C, Ma X, Li Z, Ashby CJ, Wei L, Chen ZS. Taletrectinib adipate. Dual ROS1 and NTRK inhibitor, Treatment of non-small cell lung cancer, Treatment of solid tumors. DRUG FUTURE 2022. [DOI: 10.1358/dof.2022.47.7.3413462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gao C, Ma X, Zhang Z, Lu Q, Ashby CJ, Wei L, Chen ZS. Asparaginase Erwinia chrysanthemi for acute lymphoblastic leukemia and lymphoblastic lymphoma. Drugs Today (Barc) 2022; 58:261-271. [DOI: 10.1358/dot.2022.58.6.3413459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Li P, Gao L, Gao C, Parker RA, Katz IT, Montano MA, Hu K. Daytime Sleep Behaviors and Cognitive Performance in Middle- to Older-Aged Adults Living with and without HIV Infection. Nat Sci Sleep 2022; 14:181-191. [PMID: 35173500 PMCID: PMC8843344 DOI: 10.2147/nss.s339230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/20/2022] [Indexed: 12/11/2022] Open
Abstract
PURPOSE We investigated whether daytime sleep behaviors (DSBs) such as frequent daytime sleepiness or napping are associated with worse cognitive performance, and whether HIV infection moderates this relationship. METHODS Among 502,507 participants in the UK Biobank study, we identified 562 people living with HIV infection (PLWH; M age= 50.51±7.81; 25.09% female; 78.83% white) and extracted 562 uninfected controls who matched on age, sex, ethnic background, social-economic status, and comorbidities. DSB burden was assessed based on answers to two questions on DSBs. Participants who answered "sometimes" or "often/usually" to one of them were considered to have poor DSB burden, or otherwise were considered not having any. A composite cognition score was computed by averaging the available standardized individual test results from four neurocognitive tests: ie, a reaction time test for information processing speed, a pairs matching test for visual episodic memory, a fluid intelligence test for reasoning, and a prospective memory test. Mixed-effects models with adjustment for the variables used in extracting matched uninfected controls were performed to test the hypotheses. RESULTS Having poor DSB burden was associated with a 0.15 - standard deviation (SD) decrease in cognitive performance (p = 0.006). People living with HIV infection (PLWH) also performed worse on the cognitive tasks than uninfected controls, with an effect size similar to that of having poor DSB burden (p = 0.003). HIV infection significantly modified the negative association between DSB burden and cognition (p for interaction: 0.008). Specifically, the association between DSB burden and cognition was not statistically significant in uninfected controls, whereas PLWH who reported having poor DSB burden had a 0.28 - SD decrease in cognitive performance compared to PLWH who did not. CONCLUSION HIV infection significantly increased the adverse association between DSBs and cognitive performance. Further studies are needed to investigate the potential mechanisms that underlie this interaction effect and whether poor DSBs and worse cognitive performance are causally linked.
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Grants
- P30 AI060354 NIAID NIH HHS
- he Harvard University Center for AIDS Research (CFAR), an NIH funded program
- NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, NIDDK, NIMHD, NIDCR, NINR, OAR, and FIC, by a Pilot Grant (to P.L.) sponsored by the AIDS and Aging Research Platform
- Foundation Alzheimer’s Disease Research Program
- the National Institute on Aging (NIA) grant
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Affiliation(s)
- Peng Li
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Correspondence: Peng Li, Email
| | - Lei Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Chenlu Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Robert A Parker
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for AIDS Research, Harvard University, Boston, MA, USA
| | - Ingrid T Katz
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Global Health Institute, Cambridge, MA, USA
| | - Monty A Montano
- Harvard Medical School, Boston, MA, USA
- Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kun Hu
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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Cotton SM, Menssink J, Filia K, Rickwood D, Hickie IB, Hamilton M, Hetrick S, Parker A, Herrman H, McGorry PD, Gao C. The psychometric characteristics of the Kessler Psychological Distress Scale (K6) in help-seeking youth: What do you miss when using it as an outcome measure? Psychiatry Res 2021; 305:114182. [PMID: 34455216 DOI: 10.1016/j.psychres.2021.114182] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
This is the first study to describe psychometric properties of the Kessler Psychological Distress Scale (K6) in a large cohort of help-seeking young people presenting to primary mental health care services. The aim was to determine whether the K6 was appropriate for monitoring outcomes in such settings. 1067 young people were recruited from Australian headspace services. We examined dimensionality of the K6, measurement invariance, and how the K6 correlated with the the Patient Health Questionnaire-9 (PHQ-9)and the Generalised Anxiety Disorder-7 Scale (GAD-7). Standardised Response Mean (SRM) and Cohen's d effect size (ES) were used to examine 3-month stability of the K6. The best-fitting model was a two-factor model: (i) nervous and restlessness; and (ii) hopeless, worthless, depressed and effort. Measurement non-invariance was observed for sex and age groups. K6 strongly correlated with the PHQ-9 and GAD-7. The K6 was less sensitive to change compared to these other two measures. There was some support for the K6 being a screener for young people presenting to primary care; however, there issues arise with its use as an outcome measure. These issues include measurement non-invariance, concern about the dimensionality and focus of items, and its sensitivity to change.
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Affiliation(s)
- S M Cotton
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia.
| | - J Menssink
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - K Filia
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - D Rickwood
- headspace National Youth Mental Health Foundation Ltd, Melbourne VIC, Australia; Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - I B Hickie
- Brain and Mind, University of Sydney, Camperdown, NSW, Australia
| | - M Hamilton
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - S Hetrick
- Department of Psychological Medicine, The University of Auckland, Auckland, Australia
| | - A Parker
- Orygen, Parkville, Melbourne VIC, Australia; Victoria University, Institute of Health and Sport, Melbourne VIC, Australia
| | - H Herrman
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - P D McGorry
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - C Gao
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne VIC, Australia
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Kingma BRM, Steenhoff H, Toftum J, Daanen HAM, Folkerts MA, Gerrett N, Gao C, Kuklane K, Petersson J, Halder A, Zuurbier M, Garland SW, Nybo L. ClimApp-Integrating Personal Factors with Weather Forecasts for Individualised Warning and Guidance on Thermal Stress. Int J Environ Res Public Health 2021; 18:ijerph182111317. [PMID: 34769832 PMCID: PMC8583482 DOI: 10.3390/ijerph182111317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/15/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022]
Abstract
This paper describes the functional development of the ClimApp tool (available for free on iOS and Android devices), which combines current and 24 h weather forecasting with individual information to offer personalised guidance related to thermal exposure. Heat and cold stress assessments are based on ISO standards and thermal models where environmental settings and personal factors are integrated into the ClimApp index ranging from -4 (extremely cold) to +4 (extremely hot), while a range of -1 and +1 signifies low thermal stress. Advice for individuals or for groups is available, and the user can customise the model input according to their personal situation, including activity level, clothing, body characteristics, heat acclimatisation, indoor or outdoor situation, and geographical location. ClimApp output consists of a weather summary, a brief assessment of the thermal situation, and a thermal stress warning. Advice is provided via infographics and text depending on the user profile. ClimApp is available in 10 languages: English, Danish, Dutch, Swedish, Norwegian, Hellenic (Greek), Italian, German, Spanish and French. The tool also includes a research functionality providing a platform for worker and citizen science projects to collect individual data on physical thermal strain and the experienced thermal strain. The application may therefore improve the translation of heat and cold risk assessments and guidance for subpopulations. ClimApp provides the framework for personalising and downscaling weather reports, alerts and advice at the personal level, based on GPS location and adjustable input of individual factors.
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Affiliation(s)
- B. R. M. Kingma
- Section for Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-2200 Copenhagen, Denmark;
- TNO, Unit Defence, Safety & Security, Department of Human Performance, Netherlands Organization for Applied Scientific Research, 3769 DE Soesterberg, The Netherlands
- Correspondence: or
| | - H. Steenhoff
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Building 402, DK-2800 Lyngby, Denmark; (H.S.); (J.T.)
| | - J. Toftum
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Building 402, DK-2800 Lyngby, Denmark; (H.S.); (J.T.)
| | - H. A. M. Daanen
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7-9, 1081 BT Amsterdam, The Netherlands; (H.A.M.D.); (M.A.F.); (N.G.)
| | - M. A. Folkerts
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7-9, 1081 BT Amsterdam, The Netherlands; (H.A.M.D.); (M.A.F.); (N.G.)
| | - N. Gerrett
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7-9, 1081 BT Amsterdam, The Netherlands; (H.A.M.D.); (M.A.F.); (N.G.)
| | - C. Gao
- Thermal Environment Laboratory, Department of Design Sciences, Division of Ergonomics and Aerosol Technology, Faculty of Engineering (LTH), Lund University, 221 00 Lund, Sweden; (C.G.); (K.K.); (J.P.); (A.H.)
| | - K. Kuklane
- Thermal Environment Laboratory, Department of Design Sciences, Division of Ergonomics and Aerosol Technology, Faculty of Engineering (LTH), Lund University, 221 00 Lund, Sweden; (C.G.); (K.K.); (J.P.); (A.H.)
- Institute for Safety (IFV), 2718 RP Zoetermeer, The Netherlands
| | - J. Petersson
- Thermal Environment Laboratory, Department of Design Sciences, Division of Ergonomics and Aerosol Technology, Faculty of Engineering (LTH), Lund University, 221 00 Lund, Sweden; (C.G.); (K.K.); (J.P.); (A.H.)
| | - A. Halder
- Thermal Environment Laboratory, Department of Design Sciences, Division of Ergonomics and Aerosol Technology, Faculty of Engineering (LTH), Lund University, 221 00 Lund, Sweden; (C.G.); (K.K.); (J.P.); (A.H.)
| | - M. Zuurbier
- Public Health Services Gelderland Midden, 6828 HZ Arnhem, The Netherlands;
| | | | - L. Nybo
- Section for Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-2200 Copenhagen, Denmark;
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Lu L, Lu Y, Gao C, Zhang N. Age moderates the relationships between obesity, glucose variability, and intensive care unit mortality: a retrospective cohort study. J Intensive Care 2021; 9:68. [PMID: 34702376 PMCID: PMC8549309 DOI: 10.1186/s40560-021-00582-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/15/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Although the associations between obesity, glucose variability (GV), and Intensive Care Unit (ICU) mortality have been studied extensively, whether age moderates these associations is not well understood. MATERIALS AND METHODS The medical records of 1062 patients, who were admitted into ICU at Sir Run Run Shaw Hospital (Zhejiang, China), were studied. Logistic regression was used to test the associations between obesity, GV, and ICU mortality. Furthermore, the moderation effect of age was tested. RESULTS After controlling for covariates, the underweight group had the highest odds of death (OR 2.38, 95% CI 1.43-3.95, p < 0.001) in comparison with the control group (overweight). However, normal weight (OR 1.29, 95% CI 0.88-1.89, p = 0.185) and obese (OR 1.08, 95% CI 0.61-1.90, p = 0.790) groups had similar odds of death, compared to the overweight group. Age significantly moderated the association between obesity and mortality, where being overweight was more advantageous than being normal weight in older adults (B = 0.03, SE = 0.01, OR 1.03, 95% CI 1.001-1.06, p = 0.045). Meanwhile, higher GV predicted greater mortality in adjusted models (OR 1.23, 95% CI 1.06-1.42, p = 0.005). We also found an interaction between age and GV (B = - 0.01, SE = 0.01, OR 0.99, 95% CI 0.98-0.999, p = 0.025), which suggested that the association between GV and mortality becomes weaker with increasing age. CONCLUSIONS With increasing age, the association between BMI and mortality becomes stronger and the association between glucose variability and mortality becomes weaker. Future studies should investigate the underlying mechanisms of such phenomenon and the causal relationship between obesity, GV, and ICU mortality.
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Affiliation(s)
- Lusi Lu
- Department of Endocrinology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Qingchun E Rd, Hangzhou, Zhejiang, China
| | - Yifeng Lu
- Touro College of Osteopathic Medicine, 60 Prospect Ave, Middletown, NY, 10940, USA
| | - Chenlu Gao
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
- Division of Sleep Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Nan Zhang
- Department of Endocrinology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Qingchun E Rd, Hangzhou, Zhejiang, China.
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Gamal Setih A, Hara H, Tomaniak M, Lunardi M, Gao C, Ono M, Kawashima H, Juni P, Vranckx P, Windecker S, Hamm C, Gabriel Steg P, Onuma Y, Serruys P. Efficacy and safety of early aspirin withdrawal and continuation of ticagrelor monotherapy post PCI for STEMI. A post hoc analysis of the randomized global leaders trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Clinical presentation with STEMI is considered as a highly prothrombotic condition often associated with recurrent ischemic events. The role of aspirin as part of antiplatelet regimens in STEMI patients needs to be clarified especially in the context of new potent P2Y12 inhibitors
Aim
To assess the benefit and risk of 23-month ticagrelor monotherapy after one month of DAPT against the conventional 12-month DAPT with aspirin and ticagrelor followed by aspirin monotherapy among STEMI patients in the GLOBAL LEADERS trial.
Methods
We did a post hoc analysis of STEMI patients in the GLOBAL LEADERS trial (2092 patients). We compared the experimental ticagrelor monotherapy group (1062 patients) with the standard 12-month DAPT group (1030 patients) in rates of GLOBAL LEADERS predefined primary (composite of all-cause mortality or non-fatal, new Q-wave myocardial infarction (MI) and secondary end points (BARC 3 or 5 bleeding). NACE (Net Adverse Clinical Events) and POCE (Patient- Oriented Composite End points). We also compared GLOBAL LEADERS predefined end points in STEMI, UA, NSTEMI and CCS in both treatment arms.
Results
At two years, there were no significant differences in rates of GLOBAL LEADERS primary end points in patients who had or did not have STEMI. BARC bleeding in either treatment group didn't vary significantly among STEMI, NSTEMI and UA. Nevertheless, the experimental strategy had led to significant increase in BARC bleeding in CCS compared with STEMI at 1 and 2 years. There were similar rates of NACE and POCE in both the experimental and reference treatment groups at 1 and 2 years post PCI.
Conclusions and relevance
The incidence of GLOBAL LEADRER defined end points has not been impacted by STEMI presentation. Our findings suggest that an earlier cessation of DAPT at 1 month post primary PCI, with continuation of a potent P2Y12 antagonist monotherapy, could be safe and avoids additional bleeding risk in the STEMI setting. Given the post-hoc nature of the analysis, our findings should not necessitate changes in recommendations for practice by professional associations and regulatory agencies. However, all reported findings should rather be considered only as hypothesis-generating and need be replicated in dedicated large-scale randomized trials to further assess the role of Aspirin free antithrombotic strategies post PCI in STEMI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Gamal Setih
- National University of Ireland Galway, Galway, Ireland
| | - H Hara
- National University of Ireland Galway, Galway, Ireland
| | - M Tomaniak
- Medical University of Warsaw, Warsaw, Poland
| | - M Lunardi
- National University of Ireland Galway, Galway, Ireland
| | - C Gao
- National University of Ireland Galway, Galway, Ireland
| | - M Ono
- National University of Ireland Galway, Galway, Ireland
| | - H Kawashima
- National University of Ireland Galway, Galway, Ireland
| | - P Juni
- St. Michael's Hospital, Toronto, Canada
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
| | - S Windecker
- Bern University Hospital, Inselspital, Bern, Switzerland
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - P Gabriel Steg
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T, Paris, France
| | - Y Onuma
- National University of Ireland Galway, Galway, Ireland
| | - P Serruys
- National University of Ireland Galway, Galway, Ireland
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Ahmed O, Gao C, Buchanan M, Pfleiderer A, Al-lami A. 247 Single-Photon Emission Computed Tomography (SPECT) In Predicting Localisation of Parathyroid Adenomas: A Closed-Loop Prospective Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
to measure the sensitivity of SPECT in localising parathyroid adenomas particularly whilst attempting minimally invasive parathyroidectomy.
Method
2-cycles prospective study correlating SPECT and operative findings was conducted. All patients underwent ultrasound and SPECT, those with concordant findings on both modalities underwent minimally invasive parathyroidectomy, whilst patients with discordant findings on both modalities had central neck exploration. Following operative findings, recommendations of changing the SPECT reporting method such as surgically relevant structures adjacent to the lesion, such as the thyroid, were implemented. Following which, a second prospective study assessed the outcome of change.
Results
In the first cycle, 20 patients underwent partial parathyroidectomy, either by open (n = 13), or minimally invasive (n = 7) approach. SPECT sensitivity was 85% (n = 17) in identifying the adenoma. Out of all histologically confirmed adenomas, SPECT identified all adenomas (n = 17) on the correct side and 41% (n = 7) on the correct level (superior vs. inferior parathyroid). In the second cycle following recommendation, 14 patients had surgery, 9 as minimally invasive and 5 as open approach. SPECT sensitivity was 79% (n = 11) for adenoma identification. Of all confirmed adenomas, SPECT identifying adenomas at the correct side increased to 91% (n = 10) and correct level to 91% (n = 10).
Conclusions
SPECT alone is not yet regarded as gold standard in parathyroid adenoma localisation. The study has demonstrated that feedback to the radiologist of the operative findings may enhance its usefulness, particularly in attempting to proceed with a minimally invasive parathyroidectomy.
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Affiliation(s)
- O Ahmed
- East Kent Hospitals, Kent, United Kingdom
| | - C Gao
- East Kent Hospitals, Kent, United Kingdom
| | - M Buchanan
- Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - A Pfleiderer
- Peterborough City Hospital, Peterborough, United Kingdom
| | - A Al-lami
- East Kent Hospitals, Kent, United Kingdom
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