Sleep effort and its measurement: A scoping review.

Insomnia disorder is characterized by disruption in sleep continuity and an overall dissatisfaction with sleep. A relevant feature of insomnia is sleep effort, which refers to both cognitive and behavioural conscious attempts to initiate sleep. The Glasgow Sleep Effort Scale is a self-report tool developed to assess this construct. The objective of the current scoping review was to map how sleep effort has been discussed in the literature and operationalized through its respective measure. Medline/PubMed, Scopus, Web of Science and PsycInfo databases were used to search for potential studies. The search query used in databases was the specific name of the self-reported tool itself (Glasgow Sleep Effort Scale) and "sleep effort" term. This scoping review followed JBI guidelines. To be included, records pertaining to any type of study that mentioned the Glasgow Sleep Effort Scale were considered. No language constraint was used. At the end, 166 initial records were retrieved. From those, 46 records met eligibility criteria and were analysed. Among the main findings, it was observed that the Glasgow Sleep Effort Scale has been increasingly used in recent years, with a notable observed upward trend, especially in the last 2 years. In addition to the original measure, only three published adapted versions of the instrument were identified. This suggests that there is limited research on adapting the scale for different populations or contexts. Sleep effort has been increasingly studied in the last few years. Nonetheless, more research on the Glasgow Sleep Effort Scale tool is recommended, including cross-cultural adaptations.

Does valerian work for insomnia? An umbrella review of the evidence.

Valerian is one of the most used herbal agents (phytotherapeutics) to manage sleep disturbances, in particular, sleep-onset difficulties in young adults. However, the evidence based on primary studies and systematic reviews that supports its use in this domain is weak or inconclusive. In the current study, an umbrella review was performed on the efficacy of valerian for sleep disturbances with a focus on insomnia. As such, only systematic reviews (with or without meta-analysis) were considered for this study. Systematic searches in PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, PROSPERO and CNKI databases retrieved 70 records. Only 8 articles were considered eligible for qualitative analysis. Overall, data suggested that valerian has a good safety profile, however, the results showed no evidence of efficacy for the treatment of insomnia. Moreover, valerian appears to be effective concerning subjective improvement of sleep quality, although its effectiveness has not been demonstrated with quantitative or objective measurements. Despite its widespread use and prescription by general practitioners, psychiatrists and other professionals, valerian does not have empirical support for insomnia. Further studies, in particular high quality randomized controlled trials, are highly recommended since there are scarce studies and the existing ones are quite heterogeneous and with low methodological quality. The implications of our findings for clinical practice are critically discussed.

Development and validation of a predictive tool for adverse drug reactions in neonates under intensive care.

AIMS: Neonates hospitalized in neonatal intensive care units (NICUs) commonly experience adverse drug reactions (ADRs). Thus, we aimed to develop and validate a tool for predicting ADRs in neonates hospitalized in NICUs. METHODS: A nested case-control study in an open cohort with neonates admitted to the NICU of a maternity hospital in Natal, Brazil was conducted from January 2019 to January 2022 [Correction added on 4 December 2023, after first online publication: 2023 has been changed to 2019 in the preceding sentence.]. Neonates with ADR were randomly paired with 2 controls. For the development of the tool, a multivariate logistic regression was applied on 2/3 of the sample (cases with respective controls). The model's fit was evaluated using the Hosmer-Lemeshow test for calibration and the Brier score for performance assessment. Validation of the tool was performed by determining the area under the receiver operating characteristic curve with bootstrap adjusted c-statistics. RESULTS: In all, 450 neonates (150 cases and 300 controls) were included in the study. We identified 5 independent risk factors for ADR, 4 related to the neonate (current mechanical ventilation, heart rate ≥178 beats/min, intravenous medications, ≥5 prescription medications) and 1 to the mother (gestational hypertension). The tool had a classification cut-off point of ≥15, and its total score ranged from 0 to 34. In validation, the tool had an area under the receiver operating characteristic curve of 0.74 (95% confidence interval [CI] 0.66-0.81) with sensitivity of 52.02% (95% CI 47.40-56.64) and specificity of 81.35% (95% CI 77.75-84.95). CONCLUSION: The tool demonstrated adequate discriminative ability and utilized 5 commonly monitored variables in the NICU.

The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023.

Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential-diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders, etc.), treatment-resistant insomnia (A) and for other indications (B). Cognitive-behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in-person or digitally (A). When cognitive-behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low-dose sedating antidepressants (B) can be used for the short-term treatment of insomnia (≤ 4 weeks). Longer-term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged-release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive-behavioural therapy for insomnia (B).

Temporal profile of adverse drug reactions and associated clinical factors: a prospective observational study in a neonatal intensive care unit.

OBJECTIVE: Although adverse drug reactions (ADRs) are quite common in hospitalised neonates, pharmacovigilance activities in this public are still incipient. This study aims to characterise ADRs in neonates in a neonatal intensive care unit (NICU), identifying causative drugs, temporal profile and associated factors. DESIGN: Prospective observational study. SETTING: NICU of a public maternity hospital in Natal/Brazil. PARTICIPANTS: All neonates admitted to the NICU for more than 24 hours and using at least one medication were followed up during the time of hospitalisation. PRIMARY OUTCOME MEASURES: Incidence rate and risk factors for ADRs. The ADRs were detected by an active search in electronic medical records and analysis of spontaneous reports in the hospital pharmacovigilance system. RESULTS: Six hundred neonates were included in the study, where 118 neonates had a total of 186 ADRs. The prevalence of ADRs at the NICU was 19.7% (95% CI 16.7% to 23.0%). The most common ADRs were tachycardia (30.6%), polyuria (9.1%) and hypokalaemia (8.6%). Tachycardia (peak incidence rate: 57.1 ADR/1000 neonates) and hyperthermia (19.1 ADR/1000 neonates) predominated during the first 5 days of hospitalisation. The incidence rate of polyuria and hypokalaemia increased markedly after the 20th day, with both reaching a peak of 120.0 ADR/1000 neonates. Longer hospitalisation time (OR 0.018, 95% CI 0.007 to 0.029; p<0.01) and number of prescribed drugs (OR 0.127, 95% CI 0.075 to 0.178; p<0.01) were factors associated with ADRs. CONCLUSION: ADRs are very common in NICU, with tachycardia and hyperthermia predominant in the first week of hospitalisation and polyuria and hypokalaemia from the third week onwards.

Epworth sleepiness scale: A meta-analytic study on the internal consistency.

OBJECTIVE/BACKGROUND: The Epworth Sleepiness Scale (ESS) is one of the most used self-reported instruments to assess sleepiness. Thus, several adaptations into different Languages have been performed worldwide over the years. The scale has produced disparate psychometric properties when applied in different settings. In the current study, our aim was to perform a Reliability Generalization meta-analysis of the Cronbachá¾½s alphas of all published studies on ESS, specifically with a psychometric focus. PATIENTS/METHODS: Three reference databases (Scopus, PubMed and Web of Science) were searched since 1991 to October 2022 and all the records on psychometric or validation studies that reported Cronbach's alphas, from clinical and nonclinical groups, were included. In total, data from 46 publications (63 estimates) were extracted, comprising 92,503 participants. RESULTS: Using a Random-Effects Model, the cumulative Cronbach's alpha for the 63 estimates was about 0.82 (CI: 0.798, 0.832) which can be considered as a good measure. However, and as expected, it was observed a high level of heterogeneity (I2 = 98.96%). Moderation analyses considering setting, date, continent, risk of bias, sex, age and language were performed in order to account for the heterogeneity. Even so, only the variables study setting and continent were significant, and had little importance in explaining the heterogeneity. CONCLUSIONS: The ESS is a reliable tool to measure sleepiness; however, further studies are needed to investigate what variables might explain the observed variability. Moreover, it will be important to include empirical studies beyond psychometric ones.

Photobiomodulation and vitamin B treatment alleviate both thermal and mechanical orofacial pain in rats.

PURPOSE: The present study investigates the efficacy of Photobiomodulation (PBM) and Vitamin B Complex (VBC) to relieve pain, both in separately and combined (PBM and VBC). METHODS: Rats with chronic constriction injury of the right infraorbital nerve (CCI-IoN) or Sham surgery were used. PBM was administered at a wavelength of 904 nm and energy density of 6.23 J/cm2 and VBC (containing B1, B6 and B12) subcutaneously, both separately and combined. Behavioral tests were performed to assess mechanical and thermal hypersensitivity before and after CCI and after PBM, VBC, or PBM + VBC. The expression of inflammatory proteins in the trigeminal ganglion and the immunohistochemical alterations of Periaqueductal Gray (PAG) astrocytes and microglia were examined following CCI and treatments. RESULTS: All testeds treatments reversed the painful behavior. The decrease in pain was accompanied by a decrease of Glial Fibrillary Acidic Protein (GFAP), a specific astrocytic marker, and Ionized calcium-binding adaptor molecule 1 (Iba-1), a marker of microglia, and decreased expression of Transient Receptor Potential Vanilloid 1 (TRPV1), Substance P, and Calcitonin Gene-Related Peptide (CGRP) induced by CCI-IoN in PAG and Trigeminal ganglion. Furthermore, both treatments showed a higher expression of Cannabinoid-type 1 (CB1) receptor in the trigeminal ganglion compared to CCI-IoN rats. Our results show that no difference was observed between groups. CONCLUSION: We showed that PBM or VBC regulates neuroinflammation and reduces inflammatory protein expression. However, the combination of PBM and VBC did not enhance the effectiveness of both therapies alone.

The Dysfunctional Beliefs and Attitudes about Sleep scale: Dimensions of the European Portuguese DBAS-30 and development of a new short version (DBAS-SF-16).

OBJECTIVES: The Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) is the most widely validated instrument for assessing sleep-related cognitions. This study aimed to examine the reliability of the DBAS-30 European Portuguese version, explore its dimensionality, and develop a new short version suitable for differentiating the presence/absence of insomnia. METHODS: From 824 participants aged 18-85 years, the Insomnia Group (IG, n = 355, 261 females and 94 males) and Normal Sleepers Group (NSG, n = 292, 237 females, 54 males and 1 with no response) were constituted. Thirty-one patients with Obstructive Sleep Apnea Syndrome were also recruited. For the DBAS 16-items version, the ability to differentiate dysfunctional beliefs between people with and without insomnia was used as the main criterion for item retention. RESULTS: DBAS-30 PT demonstrated good internal consistency and significantly discriminated IG from NSG. Based on a robust EFA (RDWLS), a three-dimensional structure was determined for IG (Ageing and Hopelessness, Sleep Expectations, and Consequences and Helplessness). DBAS-SF-16 presented as an internally-consistent measure with a reliable two-factor structure (Consequences and Helplessness, Medication and Hopelessness) and showed construct and known groups validity. ROC analysis demonstrated DBAS-SF-16's relevant clinical accuracy, and 4.3 provides the best cut-off score in detecting the level of dysfunctional beliefs associated with clinical insomnia. CONCLUSIONS: A new and meaningful dimensionality of the DBAS-30 was found. DBAS-SF-16 showed to be a reliable, valid, and robust tool for evaluating dysfunctional beliefs about insomnia in clinical and non-clinical populations.

Insomnia Severity Index: A reliability generalisation meta-analysis.

The aim of the current study was to conduct a reliability generalisation (RG) meta-analysis of Cronbach's alpha for the Insomnia Severity Index (ISI). A systematic search of three databases (PubMed, Scopus, and Web of Science) from inception to 12 March 2021 was performed. Publications that reported Cronbach's alpha for the total ISI score were included. Only psychometric-focussed studies were considered. Meta-analysis was carried out using a random-effects model to derive a pooled estimate of Cronbach's alphas. The number of participants in the included publications ranged from 25 to 12,056, with 33 studies (42 estimates) comprising internal consistency coefficients, and a combined sample size of N = 29,688. The age range of the included publications was from 13.4 to 74.3 years. Data extraction implied 33 publications out of 706 found through the database search. Cronbach's alphas ranged from 0.65 to 0.92. The majority of the reported coefficients were ≥0.7 and presented a low risk of bias (n = 32). The pooled alpha coefficient was 0.83 (IC [0.81-0.85]; SE = 0.009) with high heterogeneity among the included publications (I2  = 97%). Subgroup analyses including moderators such as continent, setting, risk of bias, and age did not affect significantly the overall result. In general, the cumulative estimate of Cronbach's alpha for the ISI is good. However, this finding should be interpreted with caution since there is a high heterogeneity level and some of the studies might not have checked the assumptions underlying Cronbach's alphas.

The Role of Sleep Effort as a Mediator Between Anxiety and Depression.

Depression, anxiety, and insomnia are all conditions that share a complex bidirectional relationship. Sleep effort is a construct with cognitive and behavioral components that perpetuates insomnia. Although many studies have examined the associations between these three variables, no studies have yet examined sleep effort as a mediating variable between anxiety and depression and vice versa. Online versions of the Hospital Anxiety and Depression Scale and the Glasgow Sleep Effort Scale were administered to a sample of 1927 higher education students aged 18-40 years (75.9% women and 76% from 18 to 23 years old). As part of the survey, participants also completed a sociodemographic questionnaire. Mediation analysis indicated that sleep effort mediates the relationship between depression and anxiety, when the former was the predictor and the latter was the criterion. Moreover, sleep effort also mediated the relationship between anxiety and depression when the former was the predictor and the latter was the criterion, albeit in a lesser extent. Sleep effort appears to play a bidirectional mediational role between depression and anxiety, being a potential target for intervention.

Psychometric Properties of the Sleep Locus of Control (SLOC) Scale in a Portuguese Sample.

Over the past few decades, research has suggested that cognitive variables play a key role in sleep disorders, particularly, in insomnia. The SLOC (Sleep Locus of Control Scale) evaluates the sleep locus of control, which is associated with the degree to which an individual attributes her/his experiences of sleep to chance or internal causes. The aim of this study was to develop the first translation and adaptation of the SLOC into the European Portuguese, as well as to analyze its psychometric properties. In this study, it was recruited a sample of 2029 Portuguese Higher Education students, aged ≥ 18 years, where approximately 75% of the sample were women and 25% men. The results showed that the SLOC had acceptable internal consistency value (α = .64), considering that it is a measure with a reduced number of items. As in the original study, a principal component analysis with varimax rotation identified two components. A parallel analysis was also conducted, identifying two factors. The correlation between the two subscales "internal sleep locus of control" and "chance sleep locus of control" was positive albeit of low magnitude (r = .15). Through the analysis carried out, it was also observed that individuals with "insomnia", relative to those without, had a more chance sleep locus of control. Overall, these findings show similarities with the original study. The SLOC seems to be a useful psychological assessment measure to be used in clinical and research settings.

A preliminary study on the association between social media at night and sleep quality: The relevance of FOMO, cognitive pre-sleep arousal, and maladaptive cognitive emotion regulation.

Research shows that nighttime social media is negatively associated with sleep quality and that it might be utilized to cope with aversive psychological states related to cognitive pre-sleep arousal (i.e., transdiagnostic psychopathology variables, referring to maladaptive repetitive thought), namely Fear of Missing Out (FoMO). The use of nighttime social media to cope with other aversive cognitive states (i.e., worry/rumination), their relationship with FoMO, and these variables' association with sleep are not fully understood. This study explored the relationships between nighttime social media, sleep quality, FoMO, cognitive pre-sleep arousal, and maladaptive cognitive emotion regulation (i.e., worry/rumination). The present correlational study followed a cross-sectional design. Participants were 525 university students, ranging in age from 18 to 64 (M = 22.39, SD = 5.62). Measures of sleep quality, morningness/eveningness, cognitive pre-sleep arousal, worry, rumination, FoMO, nighttime screen, and social media use were collected online or in pencil-paper format. Multiple linear regression analyses were performed. Nighttime social media and FoMO were associated with rumination, worry (H1) and cognitive pre-sleep arousal. Both FoMO and worry predicted higher levels of cognitive pre-sleep arousal (H2) and nighttime social media use (H3). Nighttime social media use independently predicted poor sleep quality (H4). These results suggest that worry and FoMO may potentially affect sleep quality by increasing cognitive pre-sleep arousal and nighttime social media. A possible explanation for these findings is that nighttime social media might be used as a strategy to cope with aversive cognitive states. These conclusions may contribute to improving sleep intervention in this population.

Repercussões da pandemia por COVID-19 no perfil de saúde dos acadêmicos de Fisioterapia / Repercussions of the COVID-19 pandemic on the health profile of Physiotherapy students

A pandemia da doença por coronavírus (COVID-19), teve seus primeiros casos localizados em Wuhan, na China, em dezembro de 2019. Por ser considerada infecciosa e altamente contagiosa causando problemas respiratórias, levou à inúmeras mudanças no calendário letivo das instituições de ensino. O presente estudo tem como objetivos rastrear o perfil dos acadêmicos de Fisioterapia reconhecendo os impactos da pandemia em sua saúde geral, bem como examinar as maiores dificuldades acadêmicas durante esse período. Trata-se de um levantamento de dados de caráter qualitativo, cuja fonte foi o Centro Universitário São Camilo (CUSC) durante os meses de agosto, setembro e outubro de 2021, totalizando 169 respostas. Foi observado que durante a pandemia, 45 (26,6%) dos estudantes apresentaram algum problema de saúde. Quanto às atividades diárias, 111 (65,7%) afirmaram que conseguiram adaptar atividades de lazer em casa, 84 (49,7%) tiveram seus hábitos alimentares piorados e 57 (33,7%) afirmaram ter menos de oito horas de sono. Em relação ao ensino à distância, 68 (40,2%) consideraram seu rendimento acadêmico regular e 156 (92,3%) se sentiram prejudicados de alguma forma. Além disso, 111 (65,7%) consideraram o ensino remoto extremamente estressante, onde a maioria optou pelo retorno presencial, sendo que 77 (45,6%) gostariam de retomar as atividades presenciais de forma completa e 76 (45,0%) optaram pelo retorno gradual. Foi constatado que o perfil dos acadêmicos de fisioterapia do CUSC passou por mudanças significativas em diversos aspectos, como sono, alimentação e principalmente referente à questões psicológicas e acadêmicas, havendo pontos positivos e negativos dessa forma de ensino.

The first case of the coronavirus disease (COVID-19) pandemic was located in Wuhan, China, in December 2019. As it is considered infectious and highly contagious, causing respiratory problems, it has led to numerous changes in the academic calendar of educational institutions. The present study aims to track the profile of physiotherapy students, recognizing the impacts of the pandemic on their overall health, as well as examining the greatest academic difficulties during this period. This is a qualitative data survey, collected from Centro Universitário São Camilo (CUSC) students during the months of August, September, and October 2021, totaling 169 responses. It was observed that during the pandemic, 45 (26.6%) students had some health problems. As for daily activities, 111 (65.7%) stated that they managed to adapt leisure activities at home, 84 (49.7%) worsened their eating habits, and 57 (33.7%) stated that they had less than eight hours of sleep. Regarding online learning, 68 (40.2%) considered their academic performance regular and 156 (92.3%) felt impaired in some way. In addition, 111 (65.7%) considered remote learning extremely stressful, where the majority opted for in-person classes, with 77 (45.6%) wanting to resume in-person activities completely, and 76 (45.0%) opted for a gradual return. It was found that the profile of CUSC physiotherapy students underwent significant changes in several aspects, such as sleep and diet, but mainly psychological and academic issues were referred to, with positive and negative points concerning online learning.

Identificação e condução de manifestação oftálmica de mpox pela vigilância epidemiológica: relato de experiência / Identification and management of ophthalmic manifestation of mpox by epidemiological surveillance: experience report / Identificación y manejo de la manifestación oftálmica del mpox mediante vigilancia epidemiológica: informe de una experiencia

Objetivo: descrever o processo de condução de um caso com manifestação oftálmica pela mpox, destacando o trabalho da enfermagem na prevenção de complicações da doença. Método: relato de experiência da condução de um caso de mpox ocorrido em setembro de 2022 com manifestação oftálmica. Resultados: a pronta identificação da complicação oftálmica, com a presença de conjuntivite e edema palpebral, apresentada por um paciente com suspeita de mpox pela equipe de enfermagem da vigilância epidemiológica durante as ações de monitoramento, e o envolvimento da equipe com outras equipes de diversos níveis da assistência à saúde permitiram a instituição precoce do tratamento com antiviral recomendado pelo Ministério da Saúde, o que contribuiu para um melhor desfecho. Conclusão: é importante que se dissemine o conhecimento sobre as manifestações oftálmicas associadas à mpox para que a equipe de enfermagem, que atua nos diversos níveis de atenção à saúde, esteja atenta para implementar, de forma precoce, medidas de prevenção, diagnóstico e tratamento adequados.

Objective: to describe the process of conducting a case with ophthalmic manifestation by mpox, highlighting the work of nursing in preventing complications of the disease. Method: experience report of managing a case of mpox that occurred in September 2022 with ophthalmic manifestation. Results: the prompt identification of the ophthalmic complication, with the presence of conjunctivitis and eyelid edema, presented by a patient with suspected mpox by the epidemiological surveillance nursing team during monitoring actions and the team's involvement with other teams from different levels of the health care allowed the early initiation of antiviral treatment recommended by the Ministry of Health, which contributed to a better outcome. Conclusion: it is important to disseminate knowledge about ophthalmic manifestations associated with mpox for the nursing team that works at different levels of health care to be attentive to implement preventive measures, diagnosis and adequate and early treatment.

Objetivo: describir el proceso de manejo de un caso con manifestación of- talmológica por mpox, destacando la labor de enfermería en la prevención de complica- ciones de la enfermedad. Material y método: relato de experiencia de manejo de un caso de mpox ocurrido en septiembre de 2022 con manifestación oftálmica. Resultados: la rápida identificación de la complicación oftálmica, con la presencia de conjuntivitis y edema de párpados, presentada por un paciente con sospecha de mpox por el equipo de enfermería de vigilancia epidemiológica durante las acciones de monitoreo y la partici- pación del equipo con otros equipos de diferentes niveles de la asistencia sanitaria per- mitió el inicio precoz del tratamiento antiviral recomendado por el Ministerio de Salud, lo que contribuyó a un mejor resultado. Conclusión: es importante difundir el conoci- miento sobre las manifestaciones oftálmicas asociadas a la viruela del mono para que el equipo de enfermería que actúa en los diferentes niveles de atención a la salud esté atento a implementar medidas preventivas, diagnósticas y de tratamiento adecuado y precoz.

Sleep Quality and Insomnia Severity among Italian University Students: A Latent Profile Analysis.

Insomnia is a widespread sleep disorder associated with physical and mental health conditions. Although the heterogeneity of insomnia presentations has been acknowledged, research investigating clinically meaningful insomnia subtypes is still ongoing. This study aimed at exploring insomnia subtypes according to widely-used measures of symptoms severity and sleep quality among Italian university students using a latent profile analysis. Data were collected from 490 students reporting relevant insomnia symptoms through an online cross-sectional survey comprising the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the 21-item Depression Anxiety Stress Scale, and the Short Form-12. Latent profile analysis identified five insomnia subtypes. The severe insomnia (8.8%) group showed the highest insomnia severity, with diverse complaints concerning sleep quality and daytime functioning. Moderate insomnia with sleep duration complaints (8.4%) and moderate insomnia with medication use (15.9%) subgroups were characterized by middle range insomnia severity, with problems of sleep continuity and sleep medication use, respectively. Subthreshold insomnia with sleep latency complaints (20.4%) and subthreshold insomnia (46.5%) groups showed attenuated insomnia symptoms. Higher psychological complaints and worse quality of life were associated with greater sleep complaints. Overall, these findings highlight the relevance of sleep quality domains in identifying insomnia subtypes and might help optimize insomnia treatments.

Data-driven strategies in operation management: mining user-generated content in Twitter.

In recent years, the business ecosystem has focused on understanding new ways of automating, collecting, and analyzing data in order to improve products and business models. These actions allow operations management to improve prediction, value creation, optimization, and automatization. In this study, we develop a novel methodology based on data-mining techniques and apply it to identify insights regarding the characteristics of new business models in operations management. The data analyzed in the present study are user-generated content from Twitter. The results are validated using the methods based on Computer-Aided Text Analysis. Specifically, a sentimental analysis with TextBlob on which experiments are performed using vector classifier, multinomial naïve Bayes, logistic regression, and random forest classifier is used. Then, a Latent Dirichlet Allocation is applied to separate the sample into topics based on sentiments to calculate keyness and p-value. Finally, these results are analyzed with a textual analysis developed in Python. Based on the results, we identify 8 topics, of which 5 are positive (Automation, Data, Forecasting, Mobile accessibility and Employee experiences), 1 topic is negative (Intelligence Security), and 2 topics are neutral (Operational CRM, Digital teams). The paper concludes with a discussion of the main characteristics of the business models in the OM sector that use DDI. In addition, we formulate 26 research questions to be explored in future studies.