Association between sleep quality and subjective cognitive decline: evidence from a community health survey

ObjectivesLittle is known concerning whether subjective cognitive decline (SCD) is associated with sleep quality. This study aimed to identify the association between self-reported quality of sleep and SCD in a large population of middle-aged and older adults in Korea.MethodsWe conducted this study based on data collected from the 2018 Korean Community Health Survey. Individuals aged 40 years and older who responded to the Behavioral Risk Factor Surveillance System (BRFSS) and Pittsburgh Sleep Quality Index (PSQI) assessments and did not lack data about multiple covariates were included. A total of 37,712 respondents with SCD and 135,119 those without SCD were included. Sleep quality was estimated using the PSQI, which includes seven self-reported components for sleep health assessment. SCD was assessed using the BRFSS. Logistic regression models adjusted for confounders were used to examine whether each component of the sleep quality index was related to SCD. Additional analysis of the correlation between quantified scores for each component and SCD-related functional limitations as ordinal variables was performed.ResultsThe mean age was 62.7 years in the SCD group and 56.4 years in the control group. In total, 13,777 (28.9%) respondents were male in the SCD group and 62,439 (50.7%) in the control group. The adjusted odds ratios of SCD were 1.25 for very bad sleep quality, 1.26 for long sleep latency, 1.16 for <5 h of sleep duration, 1.08 for <65% habitual sleep efficiency, 2.29 for high sleep disturbance, 1.26 for use of sleep medication ≥3 times a week, and 2.47 for high daytime dysfunction due to sleep problems compared to good sleep conditions. Furthermore, a higher score for each component of the sleep quality index correlated with greater SCD-related functional limitations.ConclusionsOur study provides evidence that poor sleep quality is closely related to both SCD and SCD-related functional limitations.     

Community Workers’ Social Support and Sleep Quality during the Coronavirus Disease 2019 (COVID-19): A Moderated Mediation Model

To explore the relationship between social support and sleep quality of community workers in Wuhan during the coronavirus disease 2019 (the COVID-19 infection epidemic), this research constructed a mediating effect model to explore the mediating psychological mechanism of social support influencing sleep quality of front-line community workers. A total of 500 front-line community workers in Wuhan were investigated. We used the perceived social support scale (PSSS), the Connor-Davidson Resilience Scale (CD-RISC), the perceived stress scale (PSS), and the Pittsburgh sleep quality index (PSQI) to measure social support, psychological resilience, perceived stress and sleep quality. Specifically, the higher the PSQI, the worse the sleep quality. Pearson correlation structural equation model was used to analyze the relationship between these factors. The results showed that: (1) There was a significant negative correlation between social support, psychological resilience, and perceived stress of community workers and PSQI, that means, the higher the level of social support, psychological resilience, and perceived stress, the higher the sleep quality. (2) Social support positively predicted psychological resilience and perceived stress, and perceived stress negatively predicted PSQI. (3) Social support can affect sleep quality through the mediating role of psychological resilience and perceived stress, and the mediating role includes two paths: the single mediating role of perceived stress and the chain mediating role of psychological resilience-perceived stress. (4) Gender moderates the relationship between social support and perceived stress, and the influence of social support on perceived stress of women is higher than that of men. Gender moderates the relationship between psychological resilience and PSQI, and only women’s psychological resilience had a negatively predictive effect on PSQI, while men did not, which means that psychological resilience of female frontline community workers can positively predict sleep quality. This research reveals the relationship between social support and sleep quality and its mechanism and verifies that social support can indirectly affect physical health through psychological resilience and perceived stress. It provides reference suggestions and intervention guidance for improving the sleep quality of community workers.     

Effectiveness of Half-Cut Wood Training of Close and Kinetic Chain Method on Mental Health and Physical Health of Patients with Knee Instability in China

Knee instability as a symptom of ligament injury usually only receives attention when it causes pain or impacts patients’ mobility in China. In this study both the physical and psychosocial impact of an innovative approach to treatment, Half-cut Wood Training, was examined. Twenty individuals with knee instability who received Halfcut Wood Training (Intervention group) and twenty two individuals with knee instability who did not receive Half-cut Wood Training (as Control group) participated in the study. The electric WIFI based HBF-306 was used to collect the anthropometry and biomedical data. Symptom severity was assessed by a doctor and through response to a specific question. Half-cut Wood Training was used as the intervention for the knee instability patients, and the effects among pre-intervention, post-intervention and control group on self-esteem, self-efficacy, quality of life and reductions in knee instability were assessed and compared to patients in the control group. The Half-cut Wood Training has significantly improved the physical health, self-esteem, self-efficacy, legs and feet functioning of patients in the intervention group compared with control group. Moreover, the Symptom were decreased (F = 15.47, P < 0.001), and the doctor reported knee function was improved (F = 36.20, P < 0.001). The subgroups including number of sessions of attending the Half-cut Wood Training had effects on the reduction of symptoms and duration of training time more than one month has effect on the improvement of physical health. Half-cut Wood Training provides beneficial means of improving knee function, self-esteem, self-efficacy, and physical health of the quality of life of patients with the knee instability.     

高脂饮食上调兔子血管内膜与血清炎性因子表达

目的:分析高脂饮食致肥胖或动脉粥样硬化兔子血管内膜白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)水平变化。方法:12只健康新西兰大白兔,分为普通饮食组(OD组)和高脂饮食组(HFD组)。依据动脉粥样硬化造模方法,高脂饮食喂养兔8周后,获取兔子血液或颈动脉组织。检测血细胞相关参数和血液生化参数及动脉内膜的厚度,同时用ELISA检测IL-1β和TNF-α水平,Western Blot法检测血管内膜IL-1β和TNF-α蛋白的表达。比较分析两组各检测参数的差异。结果:两组兔子外周血细胞检测项目无统计学差异(P>0.05)。HFD组脂质检测指标甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白B(ApoB)均显著高于OD组(P<0.05,P<0.01),而高密度脂蛋白胆固醇(HDL-C)则显著低于OD组(P<0.05)。其它血液生化项目在两组间的水平无显著差异(P>0.05)。ELISA检测OD组血浆IL-1β和TNF-α的水平显著低于HFD组(P<0.05)。以高脂饮食喂养健康兔子发现HFD组兔血管内膜的厚度明显高于OD组(P<0.05),且血管内膜炎性因子IL-1β和TNF-α蛋白表达具有同样的趋势。结论:以高脂饮食喂养健康兔子发现动脉粥样硬化模型兔子炎性因子IL-1β和TNF-α在血液中和血管内膜均有表达增高,或可与动脉粥样硬化相关。     

Association of UGT1A6 gene polymorphism with clinical outcome in pediatric epileptic patients on sodium valproate monotherapy

Pediatric epilepsy comprises chronic neurological disorders characterized by recurrent seizures. Sodium valproate is one of the common antiseizure medications used for treatment. Glucuronide conjugation is the major metabolic pathway of sodium valproate, carried out by the enzyme uridine 5′-diphosphate (UDP) glucuronosyl transferase (UGT) whose gene polymorphisms may alter the clinical outcome. The objective of this study was to assess the association between UGT1A6 genetic polymorphism and clinical outcome in terms of efficacy and tolerability in pediatric epileptic patients on sodium valproate monotherapy. Pediatric epileptic patients (n=65) aged 2-18 years receiving sodium valproate monotherapy for the past one month were included. Genetic polymorphism patterns of UGT1A6 (T19G, A541G, A552C) were evaluated by PCR-RFLP. Clinical outcome was seizure control during the 6 months observation period. Tolerability was measured by estimating the hepatic, renal, and other lab parameters. Out of 65 patients, TT (40%), TG (57%), and GG (3%) patterns were observed in UGT1A6 (T19G) gene, AA (51%), AG (40%), and GG (9%) in (A541G) gene, and AA (43%), AC (43%), and CC (14%) in (A552C) gene. No statistical difference in clinical outcome was found for different UGT1A6 genetic polymorphism patterns. We concluded that different patterns of UGT1A6 genetic polymorphism were not associated with the clinical outcome of sodium valproate in terms of efficacy and tolerability. Sodium valproate was well-tolerated among pediatric patients with epilepsy and can be used as an effective antiseizure medication.     

Sleep problems,internalizing and externalizing symptoms,and domains of health-related quality of life: bidirectional associations from early childhood to early adolescence

Study ObjectivesTo examine longitudinal, bidirectional associations among behavioral sleep problems, internalizing and externalizing symptoms, and domains of health-related quality of life (HRQoL) from early childhood to adolescence in a population sample of Australian children.MethodData were drawn from the Longitudinal Study of Australian Children, a national prospective cohort study with 4983 children participating in the Kindergarten cohort. Data were collected when children were aged 4–5, 6–7, 8–9, 10–11, and 12–13 years. At each study wave, the primary parent (97% mothers) reported on behavioral child sleep problems, internalizing and externalizing symptoms, and HRQoL domains (psychosocial and physical). Cross-lagged structural equation models were used to evaluate bidirectional associations.ResultsAt nearly every age, behavioral sleep problems were associated with worse subsequent psychosocial and physical HRQoL. Despite bidirectional associations between mental health and HRQoL at many waves, HRQoL domains more strongly predicted later internalizing symptoms, while externalizing symptoms more strongly predicted later HRQoL. Many of the bidirectional associations among sleep, mental health, and HRQoL were found earlier in childhood.ConclusionsBehavioral sleep problems may forecast later HRQoL psychosocial and physical impairments. Attending to both sleep problems and HRQoL could prevent the progression of internalizing conditions, while a focus on externalizing concerns could prevent the worsening of these symptoms, sleep problems, and HRQoL, particularly during the transition to school.     

Assessment of Image Quality for Selective Intracoronary Contrast-Injected CT Angiography in a Hybrid Angio-CT System: A Feasibility Study in Swine

PurposeTo compare image quality in selective intracoronary contrast-injected computed tomography angiography (Selective-CTA) with that in conventional intravenous contrast-injected CTA (IV-CTA).Materials and MethodsSix pigs (35 to 40 kg) underwent both IV-CTA using an intravenous injection (60 mL) and Selective-CTA using an intracoronary injection (20 mL) through a guide-wire during/after percutaneous coronary intervention. Images of the common coronary artery were acquired. Scans were performed using a combined machine comprising an invasive coronary angiography suite and a 320-channel multi-slice CT scanner. Quantitative image quality parameters of CT attenuation, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), mean lumen diameter (MLD), and mean lumen area (MLA) were measured and compared. Qualitative analysis was performed using intraclass correlation coefficient (ICC), which was calculated for analysis of interobserver agreement.ResultsQuantitative image quality, determined by assessing the uniformity of CT attenuation (399.06 vs. 330.21, p<0.001), image noise (24.93 vs. 18.43, p<0.001), SNR (16.43 vs. 18.52, p=0.005), and CNR (11.56 vs. 13.46, p=0.002), differed significantly between IV-CTA and Selective-CTA. MLD and MLA showed no significant difference overall (2.38 vs. 2.44, p=0.068, 4.72 vs. 4.95, p=0.078). The density of contrast agent was significantly lower for selective-CTA (13.13 mg/mL) than for IV-CTA (400 mg/mL). Agreement between observers was acceptable (ICC=0.79±0.08).ConclusionOur feasibility study in swine showed that compared to IV-CTA, Selective-CTA provides better image quality and requires less iodine contrast medium.