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Passive daytime radiative cooling (PDRC) is a promising practice to realize sustainable thermal management with no energy and resources consumption. However, there remains a challenge of simultaneously integrating desired solar reflectivity, environmental durability, and mechanical robustness for polymeric composites with nanophotonic structures. Herein, inspired by a classical armor shell of a pangolin, we adopt a generic design strategy that harnesses supramolecular bonds between the TiO2-decorated mica microplates and cellulose nanofibers to collectively produce strong interfacial interactions for fabricating interlayer nanostructured PDRC materials. Owing to the strong light scattering excited by hierarchical nanophotonic structures, the bioinspired film demonstrates a desired reflectivity (92%) and emissivity (91%) and an excellent temperature drop of 10 °C under direct sunlight. Notably, the film guarantees high strength (41.7 MPa), toughness (10.4 MJ m-3), and excellent environmental durability. This strategy provides possibilities in designing polymeric PDRC materials, further establishing a blueprint for other functional applications like soft robots, wearable devices, etc.
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While the significance of obtaining restful sleep at night and maintaining daytime alertness is well recognized for human performance and overall well-being, substantial variations exist in the development of sleepiness during diurnal waking periods. Despite the established roles of the hypothalamus and striatum in sleep-wake regulation, the specific contributions of this neural circuit in regulating individual sleep homeostasis remain elusive. This study utilized resting-state functional magnetic resonance imaging (fMRI) and mathematical modeling to investigate the role of hypothalamus-striatum connectivity in subjective sleepiness variation in a cohort of 71 healthy adults under strictly controlled in-laboratory conditions. Mathematical modeling results revealed remarkable individual differences in subjective sleepiness accumulation patterns measured by the Karolinska Sleepiness Scale (KSS). Brain imaging data demonstrated that morning hypothalamic connectivity to the dorsal striatum significantly predicts the individual accumulation of subjective sleepiness from morning to evening, while no such correlation was observed for the hypothalamus-ventral striatum connectivity. These findings underscore the distinct roles of hypothalamic connectivity to the dorsal and ventral striatum in individual sleep homeostasis, suggesting that hypothalamus-dorsal striatum circuit may be a promising target for interventions mitigating excessive sleepiness and promoting alertness.
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Hipotálamo , Individualidade , Imageamento por Ressonância Magnética , Humanos , Masculino , Feminino , Hipotálamo/diagnóstico por imagem , Hipotálamo/fisiologia , Adulto , Adulto Jovem , Ritmo Circadiano/fisiologia , Sonolência , Vias Neurais/fisiologia , Vias Neurais/diagnóstico por imagem , Corpo Estriado/diagnóstico por imagem , Corpo Estriado/fisiologia , Vigília/fisiologia , Sono/fisiologiaRESUMO
BACKGROUND: The causal relationship between daytime napping and the risk of Parkinson's disease (PD) remains unclear, with prospective studies providing limited evidence. This study investigated the association between daytime napping frequency and duration and PD incidence and explored the causality relationship between this association by conducting Mendelian randomization (MR) analysis. METHODS: This prospective cohort study included 393,302 participants, and accelerometer-measured daytime napping data were available only for 78,141 individuals. Cox proportional hazards regression was used to estimate the association between the daytime napping frequency and duration and the PD risk. The role of the systemic immune-inflammation index (SII) in the association between daytime napping frequency and PD risk was assessed through mediation analyses. Moreover, the causal association between the daytime napping frequency and the PD risk was preliminarily explored by conducting two-sample MR analyses. RESULTS: The median follow-up duration was 12.18 years. The participants who reported napping sometimes or usually exhibited a significantly higher PD risk than those who never/rarely napped during the day [sometimes: hazard ratio (HR), 1.13; 95% confidence interval (CI), 1.03-1.23; usually: HR, 1.33; 95% CI, 1.14-1.55], and SII played a mediating role in this association. However, the MR analyses did not indicate that the daytime napping frequency and PD risk were significantly associated. The participants napping for over 1 h exhibited a significantly elevated PD risk (HR, 1.54; 95% CI, 1.11-2.16). Moreover, no significant interaction was identified between napping frequency or duration and genetic susceptibility to PD (P for interaction > 0.05). CONCLUSIONS: In this study, increased daytime napping frequency and duration were associated with an increased PD risk, but no causal relationship was observed between napping frequency and PD risk in the MR analysis. Larger GWAS-based cohort studies and MR studies are warranted to explore potential causal relationships.
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Análise da Randomização Mendeliana , Doença de Parkinson , Sono , Humanos , Doença de Parkinson/genética , Doença de Parkinson/epidemiologia , Estudos Prospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Incidência , Sono/fisiologia , Idoso , Fatores de Risco , Modelos de Riscos Proporcionais , AdultoRESUMO
Developing versatile systems that can concurrently achieve energy saving and energy generation is critical to accelerate carbon neutrality. However, challenges on designing highly effective, large scale, and multifunctional photonic film hinder the concurrent combination of passive daytime radiative cooling (PDRC) and utilization of sustainable clean energies. Herein, a versatile scalable photonic film (Ecoflex@h-BN) with washable property and excellent mechanical stability is developed by combining the excellent scattering efficiency of the hexagonal boron nitride (h-BN) nanoplates with the high infrared emissivity and ideal triboelectric negative property of the Ecoflex matrix. Strikingly, sufficiently high solar reflectance (0.92) and ideal emissivity (0.97) endow the Ecoflex@h-BN film with subambient cooling effect of ≈9.5 °C at midday during the continuous outdoor measurements. In addition, the PDRC Ecoflex@h-BN film-based triboelectric nanogenerator (PDRC-TENG) exhibits a maximum peak power density of 0.5 W m-2 . By reasonable structure design, the PDRC-TENG accomplishes effective wind energy harvesting and can successfully drive the electronic device. Meanwhile, an on-skin PDRC-TENG is fabricated to harvest human motion energy and monitor moving states. This research provides a novel design of a multifunctional PDRC photonic film, and offers a versatile strategy to realize concurrent PDRC and sustainable energies harvesting.
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Passive daytime radiative cooling (PDRC) materials with sustainable energy harvesting capability is critical to concurrently reduce traditional cooling energy utilized for thermal comfort and transfer natural clean energies into electricity. Herein, a versatile photonic film (Ecoflex@BTO@UAFL) based on a novel fluorescent luminescence color passive radiative cooling with triboelectric and piezoelectric effect is developed by filling the dielectric BaTiO3 (BTO) nanoparticles and ultraviolet absorption fluorescent luminescence (UAFL) powder into the elastic Ecoflex matrix. Test results demonstrate that the Ecoflex@BTO@UAFL photonic film exhibits a maximum passive radiative cooling effect of â½10.1 °C in the daytime. Meanwhile, its average temperature drop in the daytime is ~4.48 °C, which is 0.91 °C higher than that of the Ecoflex@BTO photonic film (3.56 °C) due to the addition of UAFL material. Owing to the high dielectric constant and piezoelectric effect of BTO nanoparticles, the maximum power density (0.53 W m-2, 1 Hz @ 10 N) of the Ecoflex@BTO photonic film-based hybrid nanogenerator is promoted by 70.9% compared to the Ecoflex film-based TENG. This work provides an ingenious strategy for combining PDRC effects with triboelectric and piezoelectric properties, which can spontaneously achieve thermal comfort and energy conservation, offering a new insight into multifunctional energy saving.
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BACKGROUND: Gastric cancer is a major cause of morbidity and mortality in Japan and worldwide. Emerging literature has suggested unfavorable health outcomes associated with daytime napping. Herein, we aimed to investigate the association between daytime napping and the risk of gastric cancer among Japanese people. METHODS: This prospective cohort study included 49,037 participants, aged 40-79 years, from the Japan Collaborative Cohort Study (JACC Study). Participants with positive cancer history and those who reported night or rotational shift work were excluded. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident gastric cancer among daytime nappers. RESULTS: Within 650,040 person-years (median = 13.7 years) of follow-up, 1,164 participants developed gastric cancer. Daytime napping was associated with the increased risk of gastric cancer in the multivariable-adjusted model: HR (95% CI) = 1.14 (1.01, 1.29). The excess risk did not significantly differ across sexes, age groups (<65 and ≥65 years), and employment status (employed and unemployed) (p-interactions > 0.40). However, sleep duration modified this effect: HRs (95% CIs) = 1.66 (1.23, 2.23) in sleep duration ≤6 h/night versus 1.06 (0.93, 1.21) in sleep duration >6 h/night (p-interaction = 0.006). CONCLUSION: Daytime napping was associated with increased gastric cancer risk, especially among those who reported short sleep duration.
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Sono , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/epidemiologia , Pessoa de Meia-Idade , Masculino , Feminino , Idoso , Adulto , Estudos Prospectivos , Sono/fisiologia , Japão/epidemiologia , Fatores de Risco , Estudos de Coortes , Modelos de Riscos Proporcionais , IncidênciaRESUMO
We aimed to explore the causal effect of daytime napping on the risk of osteoporosis and the mediation role of testosterone in explaining this relationship. Summary data for Mendelian randomization (MR) analysis were obtained from the IEU OpenGWAS database. Univariable MR(UVMR) analysis and multiple sensitivity analyses were applied to explore the casual relationship between daytime napping and bone mineral density (BMD)/osteoporosis. We also conducted multivariable Mendelian randomization (MVMR) analysis to evaluate the correlation between testosterone-associated single-nucleotide variations and BMD/osteoporosis. Then, mediation analysis was performed to explore whether the association between daytime napping and BMD/osteoporosis was mediated via testosterone. Genetically predicted daytime napping was significantly associated with femoral neck BMD (ß [95% CI]: 0.2573 [0.0487, 0.4660]; P = 0.0156), lumbar spine BMD (ß [95% CI]: 0.2526 [0.0211, 0.4840]; P = 0.0324), and osteoporosis (OR [95% CI]: 0.5063 [0.2578, 0.9942]; P = 0.0481). ß and 95%CIs indicate the standard deviation (SD) unit of BMD increase per category increase in daytime napping. OR and 95%CIs represent the change in the odds ratio of osteoporosis per category increase in daytime napping. We observed a potentially causal effect of more frequent daytime napping on higher BMD and a lower risk of osteoporosis. Daytime napping was causally associated with a higher level of bioavailable testosterone (ß [95% CI]: 0.1397 [0.0619, 0.2175]; P = 0.0004). ß and 95%CIs represent the change in the SD of testosterone per category increase in daytime napping. Furthermore, the causal effects of daytime napping on BMD/osteoporosis were partly mediated by bioavailable testosterone. Daytime napping can efficiently increase BMD and reduce the risk of osteoporosis, and testosterone plays a key mediating role in this process.
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Densidade Óssea , Análise da Randomização Mendeliana , Osteoporose , Sono , Testosterona , Humanos , Osteoporose/epidemiologia , Osteoporose/genética , Testosterona/sangue , Sono/fisiologia , Polimorfismo de Nucleotídeo Único , Masculino , População Branca , Feminino , Fatores de Risco , Europa (Continente)/epidemiologiaRESUMO
PURPOSE OF REVIEW: To review the evidence on the relationship between daytime napping and obesity. RECENT FINDINGS: There is concern that napping may be harmful to metabolic health. Prospective studies have shown long time daytime napping (> 1 h) is associated with increased diabetes risk which may be partly associated with obesity. Evidence from numerous cross-sectional studies and meta-analyses of cross-sectional studies have shown that long time napping (> 1 h) but not short time napping is associated with increased risk of obesity, and this is seen worldwide. Inference regarding the nature of association from cross-sectional studies is limited; it is suggested the association is bidirectional. Prospective studies on the association between daytime napping and obesity are few and results unclear. Large longitudinal studies integrating daytime napping duration and night-time sleep behaviour and detailed information on lifestyle influences is needed to help elucidate further the associations of long time napping with obesity.
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Obesidade , Sono , Humanos , Obesidade/epidemiologia , Obesidade/complicações , Sono/fisiologia , Adulto , Fatores de Risco , Ritmo Circadiano/fisiologia , Fatores de Tempo , Estudos TransversaisRESUMO
OBJECTIVE: To examine the associations of excessive daytime sleepiness (EDS) and probable rapid eye movement sleep behavior disorder (pRBD), respectively, with impulsive-compulsive behaviors (ICBs) over a 5-year follow-up in patients with early Parkinson's disease (PD). METHODS: The Parkinson's Progression Markers Initiative is a multicenter cohort study based on an ongoing and open-ended registry. Longitudinal associations of sleep disorders with ICB over 5-year follow-up visits were estimated using generalized linear mixed-effects models among PD participants. RESULTS: A total of 825 PD participants were enrolled at baseline. The study sample had a median baseline age of 63.1 (interquartile range: 55.6-69.3) years and comprised 496 (61.5%) men. Among them, 201 (24.9%) had ICB at baseline. In the generalized mixed-effects models, EDS (odds ratio [OR] = 1.09, 95% confidence interval [CI] 1.05, 1.12) and RBD (OR = 1.07, 95% CI 1.03, 1.12) were substantially associated with higher odds of developing ICB over time in PD patients, after multivariate adjustment including age, gender, family history, GDS score, STAI-Y score, MDS-UPDRS part III score, LEDD, and disease duration. Consistent results were observed when stratifying by age at baseline, gender, and PD family history. CONCLUSIONS: The study findings suggest a longitudinal association between EDS and pRBD with an increased risk of developing ICB in patients with PD. The findings emphasize the significance of evaluating and addressing sleep disorders in PD patients as a potential approach to managing ICB.
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Doença de Parkinson , Humanos , Masculino , Feminino , Doença de Parkinson/epidemiologia , Doença de Parkinson/complicações , Doença de Parkinson/psicologia , Pessoa de Meia-Idade , Idoso , Estudos Prospectivos , Transtorno do Comportamento do Sono REM/epidemiologia , Transtorno do Comportamento do Sono REM/complicações , Transtornos do Sono-Vigília/epidemiologia , Comportamento Compulsivo/epidemiologia , Comportamento Impulsivo , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Estudos de CoortesRESUMO
Natural short sleepers (NSS)-individuals who report minimal sleepiness or daytime dysfunction despite habitually sleeping less than the recommended amount (i.e., <7 h)-are a focus of growing interest in sleep research. Yet, the predominance of research on NSS has relied on subjective reports of functionality. The present study examined subjective and objective sleepiness among actigraphy-verified NSS in comparison with recommended (7-9 h/day) length sleepers (RLS) who reported similarly minimal daytime dysfunction. The study tested the hypothesis that under conditions of low environmental stimulation, NSS have increased risk of drowsiness and sleep onset, regardless of perceived alertness. The NSS and RLS groups were identified via screening and verified with a 14 day assessment with actigraphy, sleep diaries, and morning ratings of sleep restoration. In-laboratory resting electroencephalography (EEG) data were analysed using a computerised EEG-based algorithm (Vigilance Algorithm Leipzig; VIGALL) to classify second-by-second changes in objective sleepiness ranging from cognitively active alertness to sleep onset. Results demonstrated that NSS exhibited significantly higher drowsiness and sleep onset ('microsleeps') across 15 min of resting EEG despite perceptions of lower subjective sleepiness compared to RLS. Findings suggest that irrespective of perceived sleep restoration and alertness, NSS appear to be at high risk of objective sleepiness that is rapidly unmasked under conditions of low environmental stimulation. Such apparent discrepancy between subjective and objective sleepiness has potentially important public health implications. Future research directions, including tests of mechanisms and tailored sleep extension intervention, are discussed.
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Actigrafia , Eletroencefalografia , Sonolência , Humanos , Actigrafia/métodos , Masculino , Feminino , Adulto , Eletroencefalografia/métodos , Sono/fisiologia , Vigília/fisiologia , Pessoa de Meia-Idade , Fases do Sono/fisiologia , Adulto Jovem , Privação do Sono/fisiopatologiaRESUMO
The aim of the present study was to examine gender and age-specific effects on subjective daytime sleepiness (as measured by the Epworth Sleepiness Scale), body weight and eating behaviour in patients with central disorders of hypersomnolence. Based on the European Narcolepsy Network database, we compared 1035 patients with narcolepsy type I and 505 patients with other central disorders of hypersomnolence ("narcoleptic borderland"), including narcolepsy type II (N = 308) and idiopathic hypersomnia (N = 174), using logistic regression and general linear models. In the entire study population, the Epworth Sleepiness Scale was higher in women (N = 735, mean age = 30 years, mean Epworth Sleepiness Scale = 16.6 ± SD 3.9) than in men (N = 805, mean age = 32 years, mean Epworth Sleepiness Scale = 15.8 ± SD 4.4). In women with narcolepsy type I (N = 475), both Epworth Sleepiness Scale and body mass index increased in parallel with age. In women of the narcoleptic borderland (N = 260), the Epworth Sleepiness Scale markedly peaked in their early 30s, while body mass index only started to rise at that age. This rise in body mass index following the Epworth Sleepiness Scale peak cannot be explained by sleepiness-induced uncontrolled eating, as self-reported uncontrolled eating was negatively associated with the Epworth Sleepiness Scale in this group. We propose that the narcoleptic borderland harbours a unique cluster of women in their fertile years with an unexplored aetiology requiring further investigation towards tailored interventions.
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How memory representations are shaped during and after their encoding is a central question in the study of human memory. Recognition responses to stimuli that are similar to those observed previously can hint at the fidelity of the memories or point to processes of generalization at the expense of precise memory representations. Experimental studies utilizing this approach showed that emotions and sleep both influence these responses. Sleep, and more specifically rapid eye movement sleep, is assumed to facilitate the generalization of emotional memories. We studied mnemonic discrimination by the emotional variant of the Mnemonic Separation Task in participants (N = 113) who spent a daytime nap between learning and testing compared with another group that spent an equivalent time awake between the two sessions. Our findings indicate that the discrimination of similar but previously not seen items from previously seen ones is enhanced in case of negative compared with neutral and positive stimuli. Moreover, whereas the sleep and the wake groups did not differ in memory performance, participants entering rapid eye movement sleep exhibited increased generalization of emotional memories. Our findings indicate that entering into rapid eye movement sleep during a daytime nap shapes emotional memories in a way that enhances recognition at the expense of detailed memory representations.
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Emoções , Sono REM , Humanos , Masculino , Emoções/fisiologia , Feminino , Sono REM/fisiologia , Adulto Jovem , Adulto , Generalização Psicológica/fisiologia , Reconhecimento Psicológico/fisiologia , Memória/fisiologia , Sono/fisiologia , PolissonografiaRESUMO
Obstructive sleep apnea (OSA) syndrome commonly leads to excessive daytime sleepiness (EDS). Pitolisant, a selective histamine-3 receptor antagonist, is efficacious at doses up to 20 mg once daily in OSA treated or not with continuous positive airway pressure (CPAP). We assessed the efficacy and safety of pitolisant at doses up to 40 mg once daily in patients with moderate to severe OSA treated or not with CPAP therapy. In this phase 3, multicentre, randomised, double-blind, placebo-controlled clinical trial, patients with OSA were assigned 2:1 to receive pitolisant (according to an individual up-titration scheme, 10, 20 or 40 mg once daily) or placebo for 12 weeks. The primary endpoint was a change in the Epworth Sleepiness Scale (ESS) score from baseline to week 12. Secondary endpoints included a change in reaction time using the Oxford Sleep Resistance test (OSleR), Clinical Global Impression of Change (CGI-C), and Patient's Global Opinion of the Effect (PGOE) of study treatment. Overall, 361 patients (mean age 52.4 years, 77.3% male; mean apnea-hypopnea index [AHI] 27.0 events/h) were randomised to receive pitolisant (n = 242; 50% received CPAP) or placebo (n = 119; 48.7% CPAP). After the dose-adjustment phase (week 3), 88.8% of patients received pitolisant 40 mg. Compared with placebo, pitolisant produced a significant reduction in the ESS score at week 12 (least square mean difference -2.6 (95% CI: -3.4; -1.8; p < 0.001)) irrespective of CPAP use; and improved the reaction time on OSleR, CGI-C, and PGOE at week 12. Pitolisant was well tolerated; no new safety signals were identified. In conclusion, pitolisant up to 40 mg once daily was an effective treatment for EDS in patients with moderate to severe OSA irrespective of CPAP use.
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Obstructive sleep apnea (OSA) causes sleep fragmentation and excessive daytime sleepiness (EDS). OSA has been hypothesised to impair the circadian sleep-wake rhythm, and this dysregulation may in turn exacerbate OSA-related diurnal symptoms. Hence, this study aimed to assess the sleep-wake rhythm through actigraphy, and its relationship with EDS in patients with untreated OSA. Patients with moderate-severe OSA (apnea-hypopnea index ≥15/h) and healthy controls (HC) underwent a 7-day actigraphic recording to evaluate the sleep-wake rhythm. Participants underwent a sleep medicine visit and completed the self-report questionnaires assessing EDS (Epworth sleepiness scale, ESS), sleep quality (Pittsburgh sleep quality index, PSQI), and chronotype (morningness-eveningness questionnaire, MEQ). This study included 48 OSA patients (72.9% males; mean age 56.48 ± 9.53 years), and 22 HC (45.5% males; mean age 53.73 ± 18.20 years). After controlling for MEQ scores, actigraphic recording showed that the OSA patients present a lower sleep time (p = 0.011) and sleep efficiency (p = 0.013), as well as a higher sleep latency (p = 0.047), and sleep fragmentation (p = 0.029) than the HC. Regarding the sleep-wake rhythm actigraphic parameters, the OSA patients showed a lower average activity during the most active 10-hour period (p = 0.036) and a lower day/night activity ratio (p = 0.007) than the HC. Patients with OSA also reported higher ESS (p = 0.005) and PSQI scores (p < 0.001), and a chronotype less of morning type (p = 0.027) than the HC. In conclusion, this study documented a reduced diurnal motor activity and lower day/night activity ratio in OSA patients than in controls. These findings suggest a dysregulation of the circadian sleep-wake rhythm in OSA, possibly related to both EDS and reduced daytime motor activity.
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Periodic leg movements during sleep (PLMS) may have crucial consequences in adults. This study aimed to identify baseline characteristics, symptoms, or questionnaires that could help to identify sleep-disordered breathing patients with significant PLMS. Patients aged 20-80 years who underwent polysomnography for assessing sleep disturbance were included. Various factors such as sex, age, body measurements, symptoms, apnea-hypopnea index (AHI), and sleep quality scales were analysed to determine the presence of PLMS. The study included 1480 patients with a mean age of 46.4 ± 13.4 years, among whom 110 (7.4%) had significant PLMS with a PLM index of 15 or higher. There were no significant differences observed in terms of sex or BMI between patients with and without significant PLMS. However, the odds ratios (OR) for PLMS were 4.33, 4.41, and 4.23 in patients who were aged over 50 years, had insomnia, or had an ESS score of less than 10, respectively. Notably, the OR increased up to 67.89 times in patients who presented with all three risk factors. Our analysis identified significant risk factors for PLMS: age over 50, self-reported insomnia, and lower daytime sleepiness levels. These findings aid in identifying potential PLMS patients, facilitating confirmatory examinations and managing associated comorbidities.
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BACKGROUND AND PURPOSE: Hypertension significantly contributes to stroke. Previous research has indicated a connection between daytime napping and stroke. Research on the connection between daytime napping duration and first stroke in hypertensive individuals is lacking nevertheless. METHODS: This research, which ran from 24 August 2013 to 31 December 2022, recruited 11,252 individuals with hypertension and without a history of stroke from the China Stroke Primary Prevention Trial. To determine the relationship between daytime napping duration and stroke onset in hypertensive individuals, we conducted analyses for threshold effects, multivariate-adjusted Cox proportional hazard regression models, and Kaplan-Meier survival curves. RESULTS: The duration of daytime napping (<75 min) was positively correlated with stroke risk; beyond 75 min, the risk did not increase further. When compared to hypertensive individuals who napped for 1-30 min, daytime napping 31-60 min (hazard ratio [HR] = 1.27, 95% confidence interval [CI] = 1.06-1.53) and >60 min (HR = 1.37, 95% CI = 1.14-1.65) were substantially related with a greater risk of first stroke. Additionally, this correlation was absent in cases of hemorrhagic stroke, but present in cases of ischemic stroke, specifically for hypertensive individuals who napped for 31-60 min or >60 min (p < 0.05). Kaplan-Meier survival curves displayed that hypertensive individuals who extended daytime napping had an elevated incidence of stroke. CONCLUSIONS: Hypertensive individuals who take longer daytime naps (>30 min) are at an elevated risk of stroke onset, particularly ischemic stroke, irrespective of other factors.
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Hipertensão , Sono , Acidente Vascular Cerebral , Humanos , Masculino , Hipertensão/epidemiologia , Hipertensão/complicações , Feminino , Pessoa de Meia-Idade , Sono/fisiologia , Idoso , Acidente Vascular Cerebral/epidemiologia , China/epidemiologia , Fatores de Tempo , Fatores de Risco , AVC Isquêmico/epidemiologiaRESUMO
BACKGROUND: Excessive daytime sleepiness (EDS) is a common complication of stroke that has a detrimental effect on patients' daily life and functional recovery. The clinical characteristics and risk factors for poststroke EDS may differ between males and females. METHODS: A retrospective study based on hospital medical records was conducted on patients with a diagnosis of stroke who participated in polysomnographic monitoring at the Affiliated Hospital of Yangzhou University from February 2022 to May 2024. Baseline data, laboratory test data, polysomnographic data, and related scale scores were retrospectively collected. The Epworth Sleepiness Scale (ESS) score was used to assess EDS after stroke. Binary logistic regression was used to determine the risk factors for daytime sleepiness. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Statistical analysis was performed via IBM SPSS 26.0. RESULTS: ESS scores were higher in males than in females, whereas females had higher Pittsburgh Sleep Quality Index (PSQI) scores and Hospital Anxiety and Depression Scale (HADS) scores. Male sex and higher depression scores were risk factors for EDS; among male patients, higher anxiety scores were a risk factor for EDS, whereas smoking was a protective factor. Depression, a higher arousal index and a reduced proportion of N3 sleep periods were risk factors for EDS in females. CONCLUSIONS: The characteristics and influencing factors of EDS differ between the sexes in patients with mild and moderate ischaemic stroke. Our study may provide evidence and guidance for clinical diagnosis and treatment. Interventional studies are needed to assess the impact of treating these risk factors in the future.
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Distúrbios do Sono por Sonolência Excessiva , AVC Isquêmico , Humanos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , AVC Isquêmico/epidemiologia , AVC Isquêmico/complicações , Idoso , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Distúrbios do Sono por Sonolência Excessiva/etiologia , Fatores de Risco , Caracteres Sexuais , Bases de Dados Factuais , Fatores Sexuais , Adulto , PolissonografiaRESUMO
BACKGROUND: Sleep disorders are a prevalent non-motor symptom of Parkinson's disease (PD), although reliable biological markers are presently lacking. OBJECTIVES: To explore the associations between sleep disorders and serum neurofilament light chain (NfL) levels in individuals with prodromal and early PD. METHODS: The study contained 1113 participants, including 585 early PD individuals, 353 prodromal PD individuals, and 175 healthy controls (HCs). The correlations between sleep disorders (including rapid eye movement sleep behavior disorder (RBD) and excessive daytime sleepiness (EDS)) and serum NfL levels were researched using multiple linear regression models and linear mixed-effects models. We further investigated the correlations between the rates of changes in daytime sleepiness and serum NfL levels using multiple linear regression models. RESULTS: In baseline analysis, early and prodromal PD individuals who manifested specific behaviors of RBD showed significantly higher levels of serum NfL. Specifically, early PD individuals who experienced nocturnal dream behaviors (ß = 0.033; P = 0.042) and movements of arms or legs during sleep (ß = 0.027; P = 0.049) showed significantly higher serum NfL levels. For prodromal PD individuals, serum NfL levels were significantly higher in individuals suffering from disturbed sleep (ß = 0.038; P = 0.026). Our longitudinal findings support these baseline associations. Serum NfL levels showed an upward trend in early PD individuals who had a higher total RBDSQ score (ß = 0.002; P = 0.011) or who were considered as probable RBD (ß = 0.012; P = 0.009) or who exhibited behaviors on several sub-items of the RBDSQ. In addition, early PD individuals who had a high total ESS score (ß = 0.001; P = 0.012) or who were regarded to have EDS (ß = 0.013; P = 0.007) or who exhibited daytime sleepiness in several conditions had a trend toward higher serum NfL levels. CONCLUSION: Sleep disorders correlate with higher serum NfL, suggesting a link to PD neuronal damage. Early identification of sleep disorders and NfL monitoring are pivotal in detecting at-risk PD patients promptly, allowing for timely intervention. Regular monitoring of NfL levels holds promise for tracking both sleep disorders and disease progression, potentially emerging as a biomarker for evaluating treatment outcomes.
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Biomarcadores , Proteínas de Neurofilamentos , Doença de Parkinson , Transtornos do Sono-Vigília , Humanos , Doença de Parkinson/sangue , Doença de Parkinson/diagnóstico , Doença de Parkinson/complicações , Masculino , Feminino , Proteínas de Neurofilamentos/sangue , Pessoa de Meia-Idade , Idoso , Transtornos do Sono-Vigília/sangue , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/epidemiologia , Biomarcadores/sangue , Transtorno do Comportamento do Sono REM/sangue , Transtorno do Comportamento do Sono REM/diagnóstico , Sintomas ProdrômicosRESUMO
Nitrous acid (HONO) is crucial in atmospheric chemistry as a precursor to morning peak hydroxyl radicals and significantly affects urban air quality by forming secondary pollutants, yet the mechanisms of its daytime formation is not fully understood. This study investigates the role of formic acid (HCOOH), a prevalent electron and proton donor, in the transformation of nitrogen oxides (NOx) and the formation of HONO on photoactive mineral dust. Exploiting hematite (Fe2O3) as an environmental indicator, we demonstrate that HCOOH significantly promotes the photoreduction of NO2 to HONO, while suppressing nitrate accumulation. This occurs through the formation of a surface ≡Fe-OOCH complex, where sunlight activates the C-H bond to generate and transfer active hydrogen, directly converting NO2 to HONO. Additionally, HCOOH can trigger the photolysis of nitrates as predeposited on Fe2O3, further increasing HONO production. These findings show that HCOOH-mediated photochemical reactions on iron minerals may contribute to elevated atmospheric HONO levels, highlighting a crucial pathway with broad effects on atmospheric chemistry and public health.
Assuntos
Hidrogênio , Óxidos de Nitrogênio , Hidrogênio/química , Óxidos de Nitrogênio/química , Ácido Nitroso/química , Ferro/química , Minerais/química , Oxirredução , Formiatos/química , Nitratos/químicaRESUMO
BACKGROUND: Appendicitis is one of the most common acute surgical conditions globally. However, the association between nighttime appendectomy and patients' morbidity and mortality is unclear. This study aims to compare outcomes following nighttime versus daytime appendectomy. METHODS: The PubMed, Embase, Cochrane Library, and Web of Science databases up to March 26, 2024 (updated on July 1, 2024) were searched. The primary outcomes were postoperative complications and mortality. Secondary outcomes included intraoperative complications, reoperation, readmission, conversion to laparotomy, hospital stay and operation time. Mean difference (MD) or odds ratios (OR) and 95% confidence intervals were calculated. RESULTS: Fifteen studies totaling 33,596 patients were included. There were no differences between nighttime and daytime appendectomy for rates of overall postoperative complications (OR 0.93, 95% CI 0.87, 1.00, 14 studies), mortality (OR 1.70, 95% CI 0.37, 7.88, 7 studies), intraoperative complications (OR 0.88, 95% CI 0.08, 9.86; 2 studies), reoperation (OR 0.39, 95% CI 0.06, 2.55; 3 studies) and readmission (OR 0.86, 95% CI 0.65, 1.13; I2 = 0%, 5 studies). However, the conversion to laparotomy risks (OR 1.92, 95% CI 1.12, 3.29; 6 studies) among patients who underwent appendectomy during nighttime was significantly elevated compared to daytime. CONCLUSIONS: There was no increased risk or difference in postoperative mortality and complication rates associated with nighttime compared with daytime appendectomy. However, future studies should assess the reasons for higher conversion rates during the night.