Sleep patterns and insomnia in young adults: A national survey of Norwegian university students

The aim of this study was to describe sleep patterns and rate of insomnia according to diagnostic criteria in college and university students, as well as to examine potential changes in sleep problems from 2010 to 2018. Data stemmed from a national student health survey from 2018 for higher education in Norway (the SHoT study), which invited all 162,512 fulltime students in Norway. A total of 50,054 students (69.1% women) aged 18–35 years were included, yielding a response rate of 30.8%. Sleep parameters, reported separately for weekdays and weekends, included calculations of bedtime, rise time, sleep duration, sleep‐onset latency, wake after sleep onset, sleep need and sleep deficit. Insomnia was defined according to the Diagnostic and Statistical Manual of Mental Disorders (5th edn) criteria. For the trend analysis, we used one item measuring difficulties initiating and/or maintaining sleep, over three time points (2010, 2014 and 2018). The results from 2018 showed large weekday–weekend differences across most sleep parameters. Both male and female students obtained a mean sleep duration in the lower end of the normal range on weekdays (7:24 hr), but met their own sleep need and sleep recommendations at weekends (8:25 hr). The overall prevalence of insomnia was 34.2% in women and 22.2% in men. There was a substantial increase in sleep problems from 2010 (22.6%) to 2018 (30.5%), which was especially pronounced in women. We conclude that sleep problems are both prevalent and increasing among students. This warrants attention as a public health problem in this population.     

Urinary incontinence and disordered eating in female elite athletes

Objectives

To evaluate the association between urinary incontinence and disordered eating, in elite female athletes.

Using the CER Hub to ensure data quality in a multi-institution smoking cessation study

Comparative effectiveness research (CER) studies involving multiple institutions with diverse electronic health records (EHRs) depend on high quality data. To ensure uniformity of data derived from different EHR systems and implementations, the CER Hub informatics platform developed a quality assurance (QA) process using tools and data formats available through the CER Hub. The QA process, implemented here in a study of smoking cessation services in primary care, used the ‘emrAdapter’ tool programmed with a set of quality checks to query large samples of primary care encounter records extracted in accord with the CER Hub common data framework. The tool, deployed to each study site, generated error reports indicating data problems to be fixed locally and aggregate data sharable with the central site for quality review. Across the CER Hub network of six health systems, data completeness and correctness issues were prevalent in the first iteration and were considerably improved after three iterations of the QA process. A common issue encountered was incomplete mapping of local EHR data values to those defined by the common data framework. A highly automated and distributed QA process helped to ensure the correctness and completeness of patient care data extracted from EHRs for a multi-institution CER study in smoking cessation.     

A National Cancer Database Analysis of Radiofrequency Ablation versus Stereotactic Body Radiotherapy in Early-Stage Non–Small Cell Lung Cancer

Purpose

To compare overall survival (OS) after radiofrequency (RF) ablation and stereotactic body radiotherapy (SBRT) at high-volume centers in patients with early-stage non–small cell lung cancer (NSCLC).

<Superscript>18</Superscript>F-FDG-PET/CT based total metabolic tumor volume change during neoadjuvant chemotherapy predicts outcome in advanced epithelial ovarian cancer

Objective

To evaluate the predictive potential of total metabolic tumor volume (MTV) reduction during neoadjuvant chemotherapy (NACT) with ¹⁸F–FDG-PET/CT in an advanced FIGO stage III/IV epithelial ovarian cancer (EOC) patient cohort.

Methods

Twenty-nine primarily inoperable EOC patients underwent ¹⁸F–FDG-PET/CT before and after NACT. The pre- and post-NACT total MTV, in addition to the percentage MTV reduction during NACT, were compared with primary therapy outcome and progression-free survival (PFS). ROC-analysis determined an optimal threshold for MTV reduction identifying patients with progressive or stable disease (PD/SD) at the end of primary therapy. A multivariate analysis with residual tumor (0/>0), FIGO stage (III/IV) and MTV reduction compared to PFS was performed. The association between MTV reduction and overall survival (OS) was evaluated.

Results

The median pre- and post-NACT total MTV were 352 cm³ (range 150 to 1322 cm³) and 51 cm³ (range 0 to 417 cm³), respectively. The median MTV reduction during NACT was 89% (range 24% to 100%). Post-NACT MTV and MTV reduction associated with primary therapy outcome (MTV post-NACT p?=?0.007, MTV reduction p?=?0.001) and PFS (MTV post-NACT p?=?0.005, MTV reduction p?=?0.005). MTV reduction <85% identified the PD/SD patients (sensitivity 70%, specificity 78%, AUC 0.79). In a multivariate analysis, MTV reduction (p?=?0.002) and FIGO stage (p?=?0.003) were statistically significant variables associated with PFS. MTV reduction during NACT corresponded to OS (p?=?0.05).

Conclusion

¹⁸F–FDG-PET/CT is helpful in NACT response evaluation. Patients with total MTV reduction <85% during NACT might be candidates for second-line chemotherapy and clinical trials, instead of interval debulking surgery.