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Over half reported significant insomnia symptoms, and almost two-thirds reported significant depressive symptoms. Latent profile analysis revealed 4 sleep pattern change profiles that were significantly differentiated by pre-pandemic sleep patterns, gender, and various COVID-19-related impacts on daily living such as severity of change in routines, and family stress and discord.

In an international online sample, poor sleep and depressive symptoms were widespread, and negative shifts in sleep patterns from pre-pandemic patterns were common. Differences in sleep pattern response to the COVID-19 crisis suggest potential and early targets for behavioral sleep health interventions.
In an international online sample, poor sleep and depressive symptoms were widespread, and negative shifts in sleep patterns from pre-pandemic patterns were common. Differences in sleep pattern response to the COVID-19 crisis suggest potential and early targets for behavioral sleep health interventions.
Emerging evidence shows that later high school start times are associated with increased sleep duration; however, little is known if this extends to the university setting. This study investigated associations of first lecture start times with sleep characteristics among university students.

Daily diaries.

Lincoln, UK.

One hundred and fifty-five undergraduate students completed 7-night sleep diaries MEASUREMENTS Of the plausible lecture-day diaries (Monday-to-Friday, expected N=755 days), 567 days were lecture days (M=3.8 lecture-days per student, SD=1.1). The Consensus Sleep Diary was used to collect sleep characteristics. Two-level multilevel mixed effect generalized linear models were employed in the analyses.

Seventy-five percent of first lectures occurred before noon. Students reported short sleep (M=7.0 hours, SD=1.9) and fewer reported highest levels of sleep quality (42.8%) and restfulness (24.8%) when first lectures started at 0900 or 0930 compared to 1000 or later. Every hour delay of first lecture start time was associated with 15.1 (95% confidence interval [CI] 9.5; 20.7) minutes increase in sleep duration and higher odds of reporting the highest levels of sleep quality and restfulness. Focusing on attended lectures starting before noon, hourly delay of first lecture start time was associated with 37.4 (95% CI 22.0; 52.8) minutes increased sleep duration. Bedtime, sleep time, and sleep onset latency were not significantly associated with first lecture start times.

This study found that undergraduate students had longer sleep and healthier sleep quality when university first lectures started later. The earliest lecture start time that afforded sufficient sleep duration for students was 1000.
This study found that undergraduate students had longer sleep and healthier sleep quality when university first lectures started later. The earliest lecture start time that afforded sufficient sleep duration for students was 1000.
Since waste from swine industrial livestock operations (ILOs) produces air pollutants associated with negative health outcomes among nearby residents, we assessed the impact of odorant emissions on sleep duration and awakenings.

A repeated-measures design.

Sixteen residential communities in eastern North Carolina hosting swine ILOs.

Eighty participants residing in eastern North Carolina from 2003 to 2005.

Not applicable.

Study participants completed twice-daily diaries in which they rated the strength of hog odors and indicated whether they were asleep or awake per hour for 2 weeks. Simultaneously, a monitoring trailer placed in a central location in each community measured the atmospheric concentration of hydrogen sulfide (H
S). Subject-conditional fixed-effects regression models were used to estimate associations between 2 markers of swine ILO pollutant exposures (H
S and swine odor) and 2 self-reported sleep outcomes (nightly sleep duration and awakening from sleep).

Among 80 participants, nightly (across a 12-hour period) swine odor was associated with lower nightly sleep duration (mean difference=-14.3 minutes, 95% confidence interval -25.0 to -3.3 minutes) compared to odor-free nights and detection of nightly hydrogen sulfide was associated with an increased risk of awakening (hazard ratio=1.23, 95% confidence interval 0.98 to 1.55) compared to nights with no detection of hydrogen sulfide.

These results suggest that environmental odorants are important considerations for sleep health and highlight the importance of sleep as a potential mediator between environmental air pollution and health outcomes impacted by poor sleep.
These results suggest that environmental odorants are important considerations for sleep health and highlight the importance of sleep as a potential mediator between environmental air pollution and health outcomes impacted by poor sleep.The use of Wide Awake Local Anaesthetic No Tourniquet (WALANT) amongst Plastic and Orthopaedic Hand Surgeons has been accelerated by the impact of the COVID-19 pandemic and associated risks of general anaesthesia. Benefits of WALANT include a bloodless field, improved recovery, on-table testing, as well as cost and time savings. Whilst more clinical trials are underway to fully elucidate safety-profile and outcomes, there is a lack of consensus and clarity over contraindications to WALANT. A survey of trainees identified that only one-in-five were aware of the appropriate reversal agent in the event of inadequate perfusion. We feel that a WALANT checklist should be developed and implemented for use immediately prior to administration of local anaesthetic with adrenaline to an extremity, building on the successes of the World Health Organisation (WHO) and the Royal College of Anaesthetists checklists. Such a checklist should include contraindications to WALANT and make the operator aware of the availability, dose and location of Phentolamine as a reversal agent. Introducing this checklist will help to facilitate safer and more effective use of WALANT within Hand Surgery.Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is one of the worst medical emergencies that has hit the world in almost a century. The virus has now spread to a large number of countries/territories and has caused over three million deaths. Evidently, the virus has been mutating and adapting during this period. selleck inhibitor Significant effort has been spent on identifying these variations and their impact on transmission, virulence and pathogenicity of SARS-CoV-2. Binding of the SARS-CoV-2 spike protein to the angiotensin converting enzyme 2 (ACE2) promotes cellular entry. Therefore, human ACE2 variations could also influence susceptibility or resistance to the virus. A deeper understanding of the evolution and genetic variations in SARS-CoV-2 as well as ACE2 could contribute to the development of effective treatment and preventive measures. Here, we review the literature on SARS-CoV-2 and ACE2 variations and their role in COVID-19.
There is a fourfold higher prevalence of sleep problems in multiple sclerosis (MS) than the general population.

This study examined cross-sectional associations among device-measured sedentary and physical activity behavior with perceived sleep quality in adults with MS.

Adults with MS (N=290) completed the Pittsburgh Sleep Quality Index (PSQI) and wore an accelerometer for seven days providing a measure of time spent in sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) using MS-specific cut-points. We conducted multiple linear regression analysis to identify the independent contributions of variables for explaining PSQI scores.

The overall model accounted for 2% of the variance in global PSQI scores, and MVPA was significantly and independently associated with global PSQI scores (β=─0.123; p=0.045; partial r=─0.118) when accounting for average wear time, sedentary behavior, and time spent in LPA. There were no other significant associations with PSQI global score.

Our results suggest that time spent in MVPA may be associated with better sleep quality in adults with MS, but adults with MS do not spend sufficient time in physical activity. Researchers should evaluate these relationships in longitudinal study designs and behavior change interventions, as physical activity may provide a unique opportunity to improve sleep quality outcomes.
Our results suggest that time spent in MVPA may be associated with better sleep quality in adults with MS, but adults with MS do not spend sufficient time in physical activity. Researchers should evaluate these relationships in longitudinal study designs and behavior change interventions, as physical activity may provide a unique opportunity to improve sleep quality outcomes.
Operative mortality after endovascular aneurysm repair (EVAR) has been reported as lower than open surgical repair (OSR) for abdominal aortic aneurysm (AAA) in randomized controlled trials. However, many cohort studies have demonstrated similar mortality rates for both procedures. We compared operative mortality between EVAR and OSR, at our institution.

All AAA operations from 2012 to 2017 were reviewed, and baseline characteristics were collected. Outcomes included 30-day mortality, operative data, complications, length of hospital stay (LOS), costs, re-intervention, and survival rates were compared. A multivariable analysis with unbalanced characteristics was performed.

We had a total of 162 patients, 100 having OSR and 62 for EVAR. The EVAR group was older, with higher ASA classification. Thirty-day mortality rate did not significantly differ (0/100 for OSR and 2/62 (3%) for EVAR; p=0.145), while the EVAR group had less blood loss, shorter operative times, and LOS, but higher re-intervention rates (adjusted hazard ratio 6.4 (95%CI 1.4, 26.8)). Survival rates did not significantly differ between the groups. EVAR cost approximately 1-million yen more.

OSR had low 30-day mortality rate in selected low-risk patients whereas EVAR had less blood loss, shorter operative times, LOS and could be done in high-risk patients with low 30-day mortality but with higher re-intervention rate.
OSR had low 30-day mortality rate in selected low-risk patients whereas EVAR had less blood loss, shorter operative times, LOS and could be done in high-risk patients with low 30-day mortality but with higher re-intervention rate.
Assess cognitive impairment (global cognition and executive functioning) in older incarcerated males overall, and according to education and race.

Cross-sectional PARTICIPANTS The sample included 239 racially diverse (37.7% White, 41.4% Black, 20.9% Hispanic/Other) incarcerated males age ≥50 (mean age=56.4 ± 6.1; range 50-79 years).

Global cognitive impairment assessed using the Montreal Cognitive Assessment (MoCA)-standard MoCA scoring (1-point adjustment for ≤12 years education, and score <26 indicating cognitive impairment) versus education- and race-specific cutpoints. Trail Making Test (TMT) assessed executive functioning. The relationship between race and cognitive impairment was evaluated using Chi-Square, One-Way ANOVA, and Tukey's HSD post-hoc analyses. Chi-Square was also used to evaluate the relationship between race and frequency of missed MoCA items.

Average MoCA score was 24.12 ± 3.38. Overall, 62.8% and 38.5% of participants met criteria for cognitive impairment using standard scoring and education- and race-specific cutpoints, respectively.
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