Sleep duration and remaining teeth among older people

BackgroundNo studies have examined the associations between the numbers of teeth and sleep disturbance. Therefore, we examined the associations between the number of teeth and sleep duration in older people, considering the evidence linking fewer teeth and sleep apnoea through changes in jaw position.MethodsFor this study we used information from a sample of 23,444 cohort participants, randomly selected from the Japan Gerontological Evaluation Study 2010 (N = 169,215). The outcome variable was self-reported sleep duration (h/day), and the explanatory variable was self-reported number of teeth (0, 1–9, 10–19, ≥20). We treated age, sex, body mass index, educational attainment, annual equalized household income, depressive symptoms, physical activity, activities of daily living, presence of diabetes, and smoking status as covariates. Multinomial logistic regression was used among the 20,548 eligible participants with all necessary information.ResultsThe mean age was 73.7 (standard deviation = 6.13) years. Most participants (28.1%) reported sleep duration of 7 h, while a small proportion of the participants reported short (≤4 h, 2.7%) or long (≥10 h, 4.7%) sleep duration. The proportion of edentulous participants was 14.7%. Taking the 7-h sleep duration as the reference category, edentulous participants (relative risk ratio (RRR) = 1.43, 95% confidence interval (CI) = 1.07–1.90) or one to nine teeth (RRR = 1.29, 95% CI = 1.02–1.63) had a significantly higher relative risk ratio for short sleep, independent of covariates. Furthermore, they had a higher relative risk ratio for long sleep duration (RRR = 1.75, 95% CI = 1.40–2.19; RRR = 1.48, 95% CI = 1.21–1.81, respectively).ConclusionsCompared to people with 20 or more teeth, older adults with fewer than 10 teeth have higher risks for short and long sleep durations.     

Associations of sleep duration and sleep quality with life satisfaction in elderly Chinese: The mediating role of depression

This study investigated whether sleep duration and quality were related to life satisfaction (LS) among older Chinese adults and whether depression mediated those relationships. Cross-sectional data from the aging arm of the Rugao Longevity and Aging Study were used. Sleep duration, sleep quality, depression, LS and covariates were analyzed using logistic regressions. To assess the potential mediation of depression on the association between sleep duration and quality and LS, Aroian tests were used. Of 1756 older Chinese adults aged 70–84 years, 90.7% of the men and 83.3% of the women reported being satisfied with their lives. After adjusting for covariates, older adults who slept ≤6 h per night were more likely to suffer from life dissatisfaction compared with those who slept 7–8 h (OR = 2.67, 95% CI 1.86–3.79), and individuals who slept poorly were almost 2 times (OR = 2.91, 95% CI 2.16–3.91) more likely to have life dissatisfaction. The Aroian tests confirmed that these relationships were partially mediated by depression (p < 0.001). Between short sleep and LS, the mediating effect of depression accounted for 13.9% of the total effects. Moreover, the mediating effect of depression on the association between sleep quality and LS was 13.3%. Short sleep duration and poor sleep quality were inversely associated with LS, and the relationships were partially mediated by depression. Our study suggests that both sleep and depression status are important factors for LS among the elderly.     

病程对后半规管良性阵发性位置性眩晕疗效的影响

目的探究病程是否会影响后半规管良性阵发性位置性眩晕（PC BPPV）患者的疗效。方法收集2009年10月~2017年12月确诊的428例原发性PC BPPV，其中男155例，女273例；年龄16~89岁，中位年龄53岁；病程0.5 d至7年，中位病程7 d。按照1周、1个月、半年为时间节点，将患者分为短期组、中期组、中长期组及长期组。并经Epley或李氏复位法治疗的患者，记录患者治疗3 d及治疗1周的疗效，并统计复位治疗的有效率。结果通过手法复位，4组患者治疗后3 d有效率分别为：94.55%（208/220）、90.80%（132/147）、86.27%（44/51）、90.00%（9/10）；治疗1周后有效率分别为：97.73%（215/220）、97.28%（143/147）、96.08%（49/51）、100%（10/10）；两个时间点的治疗效果差异均无统计学意义（P>0.05）。结论BPPV的病程或自愈性并不会引起手法复位的短期疗效，BPPV的自愈性可能与患者的年龄相关。     

Comparative Effectiveness and Resource Usage in Patients Receiving First-line Taxane-based Chemotherapy for Stage IV Non–Small-cell Lung Cancer in a US Community Oncology Setting

BackgroundWeekly (qw) nanoparticle albumin-bound (nab)-paclitaxel was approved for advanced non–small-cell lung cancer based on the results from a phase III trial in which nab-paclitaxel/carboplatin demonstrated a significantly greater response rate compared with paclitaxel/carboplatin every 3 weeks (q3w). Little information exists on relative real-world results.Materials and MethodsThe present retrospective study used data from a national electronic medical record database. Patients receiving first-line nab-paclitaxel qw, paclitaxel qw, or paclitaxel q3w for stage IV non–small-cell lung cancer (NSCLC) were identified. The total cumulative dose, time to treatment discontinuation (TTD), and database persistence (a proxy measure for survival) were analyzed for all patients and for the squamous and elderly subgroups.ResultsA total of 114, 208, and 153 patients received nab-paclitaxel qw, paclitaxel qw, and paclitaxel q3w, respectively. In the corresponding treatment arms, the median age was 72, 69, and 67 years; 56%, 48%, and 37% were aged ≥ 70 years; and 75%, 43%, and 23% had squamous cell NSCLC. The total cumulative dose was significantly greater with nab-paclitaxel qw. The TTD was longer with nab-paclitaxel qw than with paclitaxel qw (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.40-0.72; P < .001) or with paclitaxel q3w (HR, 0.53; 95% CI, 0.38-0.73; P < .001). Database persistence was longer with nab-paclitaxel qw than with paclitaxel qw (HR, 0.56; 95% CI, 0.39-0.79; P = .001) or with paclitaxel q3w (HR, 0.52; 95% CI, 0.34-0.78; P = .002). The TTD after experiencing any hematologic adverse event was longer with nab-paclitaxel qw. The findings were consistent across the subgroup analyses.ConclusionIn a real-world setting, nab-paclitaxel qw was associated with a significantly greater cumulative dose and significantly longer TTD and database persistence compared with paclitaxel qw and paclitaxel q3w.     

The prevalence of retinopathy in subjects with and without type 2 diabetes mellitus

Purpose:  To evaluate the prevalence of and risk factors for, retinopathy in a geographically defined population with type 2 diabetes mellitus compared with a control group of subjects without diabetes, matched by age, sex and residence in order to find the retinopathy attributable to type 2 diabetes. Methods:  The study populations are, on one hand, a prevalence cohort of subjects with type 2 diabetes resident in the community of Laxå, Sweden, and on the other a control group, matched by age, gender and residence with those with a diagnosis of type 2 diabetes mellitus. Retinopathy was graded from fundus photographs using a modification of the Early Treatment Retinopathy Study (ETDRS) adaptation of the modified Airlie House classification of diabetic retinopathy (DR). Results:  Any retinopathy was found in 34.6% in the type 2 diabetes cohort and in 8.8% in the control group without diabetes. Among the diabetic patients, any retinopathy was significantly associated with duration of diabetes (p = 0.0001), HbA1c (p = 0.0056), systolic blood pressure (p = 0.0091) and lower serum cholesterol (p = 0.0197) in multivariate logistic regression analyses. Having retinopathy in the control group was associated only with systolic blood pressure (p = 0.0014) in logistic regression analysis. Conclusions:  The prevalence of retinopathy among patients with type 2 diabetes in Laxå, Sweden, was similar or somewhat lower compared with other studies in the Nordic countries. The prevalence of retinopathy in a control group without diabetes equalled numbers from population studies worldwide. Our study indicates that the retinopathy that can be attributed to hyperglycaemia in the diabetic state is less common than is usually accounted for. A considerable fraction of retinopathy in subjects with diabetes may instead be due to other factors such as hypertension and should thus be treated correspondingly.     

受孕龄28～30周早产儿脑电图高幅慢波改变对其预后的评估价值及临床意义

目的 观察受孕龄(conceptional age,CA) 28～ 30周早产儿脑电图高幅慢波改变情况,探讨其对早产儿预后的评估价值及临床意义.方法 2011年8月至2012年5月我院新生儿重症监护病房收治受孕龄28～30周早产儿34例,于生后1～3d进行床旁视频脑电图(video electroencephalogram,VEEG)监测,根据受孕龄将受监测者分为受孕龄28～ 29周及30周2个观察组,根据随访结果又将2个观察组细分为死亡组和存活组,各12例,对每份VEEG记录的暴发间隔时间(interburst interval duration,IBI)及高幅慢波进行20 min半定量分析.结果 死亡组与存活组比较,最大IBI时程在受孕龄28 ～ 29周及30周均差异显著(P＜0.01)；高幅慢波主要分布于颞、枕区,形态以光滑δ波占优势,其次为δ刷,波幅以150～300 μV为主,在该波幅段优势空间分布及优势波形分布无差异,＞300 μV慢波在死亡组中数量高于存活组,在空间分布上于颞、枕及前额区有差异(P＜0.05),在形态上重叠多高尖波的δ波分布差异最为显著(P＜0.01),其次为尖样δ波和δ刷(P＜0.05)；畸形δ刷、畸形δ波中重叠多高尖波的δ波和一般畸形δ波在死亡组中的发生率均高于存活组(P＜0.05).结论 早产儿早期床旁VEEG中IBI时程过长及特殊形态的畸形高幅慢波过多提示脑损伤和/或预后不良发生可能.     

Influence of L2 proficiency on kinematic duration of single words: Real and novel word production by Bengali-English speakers

The study explored the influence of second language proficiency on the kinematic duration of single words. Participants produced real and novel words with variable stress targets (e.g., trochaic and iambic) embedded in first language (L1) and second language (L2) sentence frames. Participants were monolingual English speakers (n=10) and Bengali-English bilinguals with early exposure to English (n=10) and late exposure to English (n=10). Bengali was the L1 and English was the L2 for all 20 bilingual participants. Duration of lip movements for the target real and novel words was analysed. Results suggest that kinematic duration of single words was not influenced by speakers' L2 proficiency. However, L2 proficiency influenced foreign accent ratings for the real words, but not the novel words. Kinematic duration and perception of accent were not correlated, which might imply that accent reduction might not always be a direct consequence of shorter word duration.