Search

BACKGROUND: Research on the health and economic costs due to insufficient sleep remains scant in developing countries. In this study we aimed to estimate the years of life lost (YLLs) due to short sleep and quantify its economic burden in China. METHODS: We estimated both individual and aggregate YLLs due to short sleep (ie, ≤6 hours) among Chinese adults aged 20 years or older by sex and five-year age groups in 2010, 2014, and 2018. YLL estimates were derived from 1) the prevalence of short sleep using three survey waves of the China Family Panel Studies, 2) relative mortality risks from meta-analyses, and 3) life tables in China. YLL was the difference between the estimated life expectancy of an individual in the short sleep category vs in the recommended sleep category. We estimated the economic cost using the human capital approach. RESULTS: The sample sizes of the three survey waves were 31 393, 31 207, and 28 618. Younger age groups and men had more YLLs due to short sleep compared to their counterparts. For individuals aged 20-24, men had an average YLL of nearly 0.95, in contrast to the approximate 0.75 in women across the observed years of 2010, 2014, and 2018. The trend in individual YLLs remained consistent over these years. In aggregate, China experienced a rise from 66.75 million YLLs in 2010 to 95.29 million YLLs in 2014, and to 115.05 million YLLs in 2018. Compared to 2010 (USD 191.83 billion), the associated economic cost in 2014 increased to USD 422.24 billion, and the cost in 2018 more than tripled (USD 628.15 billion). The percentage of cost to Chinese gross domestic product in corresponding years was 3.23, 4.09, and 4.62%. CONCLUSIONS: Insufficient sleep is associated with substantial YLLs in China, potentially impacting the populations overall life expectancy. The escalating economic toll attributed to short sleep underscores the urgent need for public health interventions to improve sleep health at the population level.

Abstract This study aimed to determine whether punitive state alcohol policies targeting pregnant women who drink alcohol are associated with decreased alcohol consumption among pregnant women over time. This study used data from the Pregnancy Risk Assessment Monitoring System (15 states) between 1990 and 2015. A difference-in-difference (DiD) approach was employed to determine whether passage of state laws changed alcohol consumption rates among pregnant women, while controlling for state and time fixed effects. The study specifically examined punitive state alcohol policies that clarify the admissibility of evidence in child welfare proceedings related to prenatal alcohol exposure, focusing on allegations of child abuse, child neglect, child deprivation, or child dependence, as well as proceedings seeking termination of parental rights. Punitive state alcohol policies were not significantly associated with decreased rates of alcohol consumption among pregnant women (+ 1.54%, 95% CI, -1.47-4.55), within 3 years of implementation. State alcohol policies that adopted a punitive stance toward pregnant women who drink alcohol did not result in the reduction of drinking during pregnancy. Given that punitive policies may not effectively reduce alcohol consumption during pregnancy, our findings highlight the need for reevaluation and potential reform to better address maternal/child health outcomes.

Abstract Introduction Satralizumab, an anti-interleukin-6 receptor antibody, is approved in Japan for relapse prevention in neuromyelitis optica spectrum disorder (NMOSD) and is undergoing post-marketing surveillance (PMS) of clinical use. We aimed to describe the real-world safety and effectiveness of satralizumab in Japanese patients with NMOSD. Methods This is an ongoing PMS (planned completion: February 2027). This 6-month interim analysis assessed the safety and effectiveness of satralizumab in Japanese patients with NMOSD using data collected from August 2020 to July 2021. Results Among 570 patients who participated, 523 (91.75%) were female and the mean ± standard deviation (SD) age was 52.4 ± 14.1 years. At baseline, NMOSD expanded disability status scale mean ± SD was 4.19 ± 2.19; 490 (85.96%) patients used glucocorticoids and 277 (48.59%) patients used immunosuppressants concomitantly. Of 570 satralizumab-treated patients, 85 (14.91%) had discontinued satralizumab treatment at 6 months. For the overall adverse drug reactions (ADRs), 76.22 (66.07–87.48) events/100 person-years occurred in 118 (20.70%) patients, and infections occurred in 28 (4.91%) patients. Serious infections occurred in 18 (3.15%) patients, with an event rate of 9.05 (5.80–13.47) events/100 person-years. Of the 24 events of serious infections, respiratory tract infections (29.17%; 7) and urinary tract infections (25.00%; 6) were the most common serious infection events. One fatal ADR (septic shock) suspected to be related to satralizumab was reported. The mean ± SD glucocorticoid dose reduced from 12.28 ± 10.17 mg/day at the index date to 8.11 ± 7.30 mg/day at 6 months. The Kaplan–Meier cumulative relapse-free rate (95% confidence interval) was 94.59% (92.25–96.23) at 6 months. Conclusion In this study, satralizumab was found to be safe, well tolerated, and effective in patients with NMOSD in routine clinical practice. The results are consistent with those of previous clinical trials. The safety and effectiveness of satralizumab in Japanese patients with NMOSD will be analyzed over the 6-year surveillance period. Trial Registration: UMIN Clinical Trials Registry, UMIN000041047.

Abstract Own child’s face is one of the most socially salient stimuli for parents, and a faster search for it than for other children’s faces may help provide warmer and more sensitive care. However, it has not been experimentally examined whether parents find their child’s face faster. In addition, although own child’s face is specially processed, the search time for own child’s face may be similar to that for other socially salient stimuli, such as own or spouse’s faces. This study tested these possibilities using a visual search paradigm. Participants (parents) searched for their child’s, own, spouse’s, other child’s, same-sex adult’s, or opposite-sex adult’s faces as search targets. Our findings indicate that both mothers and fathers identified their child’s face more quickly than other children’s faces. Similarly, parents found their own and spouse’s faces more quickly than other adults’ faces. Moreover, the search time for family members’ faces increased with the number of faces on the search display, suggesting an attentional serial search. These results suggest that robust face representations learned within families and close relationships can support reduced search times for family members’ faces.

Abstract Background This study adopts a novel approach of using single-item surveys to simplify the assessment of oral health status and behaviors among Japanese private sector employees. We aimed to establish the validity of self-reported oral health in relation to clinical dental examinations, and to elucidate the relationship between oral diseases, health behaviors, and self-assessments. A secondary aim was to explore the association of self-rated oral health with oral health behaviors. Materials and methods Self-administered questionnaires and dental examinations were obtained from 2262 Japanese private sector employees. Workers self-rated their overall oral health status according to five choices: “very good,” “good,” “fair,” “poor,” or “bad.” Self-reports were then compared with the results of clinical dental examinations, which included measuring the oral hygiene index (DI-S), the number of decayed teeth, periodontal status (Community Periodontal Index) and number of missing teeth. Convergent validity was also tested by examining the correlations of self-reported oral health status with oral health behaviors. Results Overall, 30.8% of workers reported their oral health as “poor” or “bad.” “Poor” or “bad” oral health status was significantly correlated with missing teeth, periodontitis, and decayed teeth. However, lower correlations were found for gingivitis and the oral hygiene index. Most self-reported oral health behaviors were correlated with self-rated oral health; exceptions were “tooth brushing instructions received in a dental clinic,” “having a primary-care dentist,” and “habitual snacking between meals.” Conclusions Self-rated oral health provides reasonably valid data, and correlated well with clinically assessed oral health status, including dental caries, periodontal status, and tooth loss. Convergent validity was also found for oral health behaviors. Trial registration Clinical trial registration number: UMIN000023011 (UMIN-CTR). Date of clinical trial registration: 06/07/2016.

A 4-year-old girl presented with complaints of transient speech disorder and left-sided weakness. Magnetic resonance imaging revealed multiple strokes, computed tomography showed a right axillary artery aneurysm of 40 mm, and an angiogram indicated retrograde embolism. She underwent aneurysm resection and reconstruction with a saphenous vein graft. Two years after surgery, a mass lesion occurred in the native artery on the proximal side of the prior surgical anastomosis. Surgical resection and reconstruction were performed. An isolated 1-mm diameter lesion was found in the retrospectively reviewed completion angiogram from the initial surgery, which was the origin of the subsequent progressive lesion. The pathological examination, including after the initial surgery, revealed a myopericytoma.

A new concept called complex multimorbidity provides a more reliable measure of disease burden than multimorbidity based on a simple count of diseases, by categorizing diseases according to the body system they affect. This study examined associations between sleep measures and complex multimorbidity among Chinese and Korean Americans in the Baltimore-Washington DC Metropolitan Area, using cross-sectional data (n = 400) from the Screening to Prevent Colorectal Cancer study (2018-2020). Sleep disturbance was measured using the 8-item Patient Reported Outcomes Measurement Information System Sleep Disturbance scale and sleep apnea risk was assessed using the Berlin questionnaire. Complex multimorbidity was defined as the coexistence of 3 or more of body system disorders assessed by self-report of physician-diagnosed diseases. Poisson regression models with adjustments indicated that individuals with sleep disturbance had 2.15 times the prevalence of having complex multimorbidity (95% confidence interval (CI): 1.07, 4.29). Individuals with a high risk of sleep apnea had 1.19 times the prevalence of having complex multimorbidity (95% CI: 0.47, 3.01). These findings suggest a need for interventions to increase awareness of the importance of sleep among health-care providers and the public and to educate them about causes, signs, and treatment of sleep disturbance and sleep apnea.

UNLABELLED: Few studies have prospectively examined long-term associations between neighborhood socioeconomic status (nSES) and mortality risk, independent of demographic and lifestyle risk factors. METHODS: We assessed associations between nSES and all-cause, nonaccidental mortality among women in the Nurses Health Study (NHS) 1986-2014 (N = 101,701) and Nurses Health Study II (NHSII) 1989-2015 (N = 101,230). Mortality was ascertained from the National Death Index (NHS: 19,228 deaths; NHSII: 1556 deaths). Time-varying nSES was determined for the Census tract of each residential address. We used principal component analysis (PCA) to identify nSES variable groups. Multivariable Cox proportional hazards models were conditioned on age and calendar period and included time-varying demographic, lifestyle, and individual SES factors. RESULTS: For NHS, hazard ratios (HRs) comparing the fifth to first nSES quintiles ranged from 0.89 (95% confidence interval [CI] = 0.84, 0.94) for percent of households receiving interest/dividends, to 1.11 (95% CI = 1.06, 1.17) for percent of households receiving public assistance income. In NHSII, HRs ranged from 0.72 (95% CI: 0.58, 0.88) for the percent of households receiving interest/dividends, to 1.27 (95% CI: 1.07, 1.49) for the proportion of households headed by a single female. PCA revealed three constructs: education/income, poverty/wealth, and racial composition. The racial composition construct was associated with mortality (HRNHS: 1.03; 95% CI = 1.01, 1.04). CONCLUSION: In two cohorts with extensive follow-up, individual nSES variables and PCA component scores were associated with mortality. nSES is an important population-level predictor of mortality, even among a cohort of women with little individual-level variability in SES.