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UNLABELLED: The period of the year from spring to fall, when clocks in most parts of the United States are set one hour ahead of standard time, is called daylight saving time, and its beginning and ending dates and times are set by federal law. The human biological clock is regulated by the timing of light and darkness, which then dictates sleep and wake rhythms. In daily life, the timing of exposure to light is generally linked to the social clock. When the solar clock is misaligned with the social clock, desynchronization occurs between the internal circadian rhythm and the social clock. The yearly change between standard time and daylight saving time introduces this misalignment, which has been associated with risks to physical and mental health and safety, as well as risks to public health. In 2020, the American Academy of Sleep Medicine (AASM) published a position statement advocating for the elimination of seasonal time changes, suggesting that evidence best supports the adoption of year-round standard time. This updated statement cites new evidence and support for permanent standard time. It is the position of the AASM that the United States should eliminate seasonal time changes in favor of permanent standard time, which aligns best with human circadian biology. Evidence supports the distinct benefits of standard time for health and safety, while also underscoring the potential harms that result from seasonal time changes to and from daylight saving time. CITATION: Rishi MA, Cheng JY, Strang AR, et al. Permanent standard time is the optimal choice for health and safety: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2024;20(1):121-125.

STUDY OBJECTIVES: To examine the association of self-identified race with sleep quality in heavy smokers. METHODS: We studied baseline data from 1965 non-Hispanic White and 462 African American participants from SPIROMICS with ≥ 20 pack-years smoking history. We first examined the Pittsburgh Sleep Quality Indexs (PSQI) internal consistency and item-total correlation in a population with chronic obstructive pulmonary disease. We then used staged multivariable regression to investigate the association of race and sleep quality as measured by the PSQI) The first model included demographics, the second added measures of health status, and the third, indicators of socioeconomic status. We next explored the correlation between sleep quality with 6-minute walk distance and St. Georges Respiratory Questionnaire score as chronic obstructive pulmonary disease-relevant outcomes. We tested for interactions between self-identified race and the most important determinants of sleep quality in our conceptual model. RESULTS: We found that the PSQI had good internal consistency and item-total correlation in our study population of heavy smokers with and without chronic obstructive pulmonary disease. African American race was associated with increased PSQI in univariable analysis and after adjustment for demographics, health status, and socioenvironmental exposures (P = .02; 0.44 95%CI: .06 to .83). Increased PSQI was associated with higher postbronchodilator forced expiratory volume in 1 second and lower household income, higher depressive symptoms, and female sex. We identified an interaction wherein depressive symptoms had a greater impact on PSQI score for non-Hispanic White than African American participants (P for interaction = .01). CONCLUSIONS: In heavy smokers, self-reported African American race is independently associated with worse sleep quality. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Study of COPD Subgroups and Biomarkers (SPIROMICS); URL: https://clinicaltrials.gov/ct2/show/NCT01969344; Identifier: NCT01969344. CITATION: Baugh AD, Acho M, Arhin A, et al. African American race is associated with worse sleep quality in heavy smokers. J Clin Sleep Med. 2023;19(8):1523-1532.

Metabolic cost plays a critical role in gait biomechanics, particularly in rehabilitation. Several factors influence metabolic cost during walking. Therefore, this study aimed to examine the relationship between metabolic cost and muscle activity, focusing on the frequency of EMG signals during walking. We recruited nine participants (five male and four female, age range 20–48 years) who walked for four minutes at six different speeds (ranging from 1.8 to 5.9 mph). EMG data were collected from the dominant lower leg muscles, specifically the lateral gastrocnemius (GAS-L) and the anterior tibialis (AT). Oxygen respiration was measured using open-circuit spirometry. Energy expenditure was estimated as the cost of transport (COT). The EMG data were analyzed using frequency domain features, such as the area under the curve of power spectral density (PSD-AUC) and the maximal distance between two points before and after the peak of the power spectral density curve (MDPSD). The results indicated that PSD-AUC is a better measure than MDPSD for understanding the relationship between activation frequency and COT. PSD-AUC demonstrated an increasing curvilinear trend (R2 = 0.93 and 0.77, second order polynomial fit), but the AT displayed higher variability. MDPSD exhibited more nonlinearity (R2 = 0.17–28, second order polynomial fit), but MDPSD demonstrated statistically significant differences (p < 0.05, t-test independent) in frequency between the GAS-L (64–237 Hz) and AT (114–287 Hz) during slow walking. Additionally, the relationship between COT and PSD-AUC revealed a U-shaped curve, suggesting that high COT is a function of both active and passive dynamics during walking. These findings will be valuable in rehabilitating individuals who suffer from gait-related disorders, especially those related to muscle inefficiency.

Because educator licensure is gained by passing licensure examinations in most states, scores on high stakes tests are determining factors as to who will be teaching in America's classrooms. Due to a focus on program graduation rates, state funding cuts, and production of quality teachers, it is vital that teacher preparation programs produce the quality and quantity of teachers needed to fill the educator deficit. The purpose of the study was to analyze various performance variables of pre-service teachers enrolled in a teacher preparation to identify predictors of performance on required licensure examinations. Findings of the study revealed there is a relationship between Praxis I: Reading scores and Praxis II scores, Praxis I: Writing scores and Praxis II scores, Praxis I: Mathematics scores and Praxis II scores, GPA and Praxis II scores, and CBASE scores and Praxis II scores. The strongest relationships that exist between variables and Praxis II scores are initial Praxis I: Reading scores and overall CBASE scores.

Study objectivesSleep is an important dimension in the care of chronic obstructive pulmonary disease (COPD), but its relevance to exacerbations is unclear. We wanted to assess whether sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) is associated with an increased risk of COPD exacerbations and does this differ by socio-environmental exposures.MethodsWe included 1647 current and former smokers with spirometrically confirmed COPD from the SPIROMICS cohort. We assessed incidence rate ratios for exacerbation using zero-inflated negative binomial regression adjusting for demographics, medical comorbidities, and multiple metrics of disease severity, including respiratory medications, airflow obstruction, and symptom burden. Our final model adjusted for socio-environmental exposures using the Area Deprivation Index, a composite measure of contemporary neighborhood quality, and Adversity-Opportunity Index, a composite measure of individual-level historic and current socioeconomic indicators. We used a pre-determined threshold of 20% missingness to undertake multiple imputation by chained equations. As sensitivity analyses, we repeated models in those with complete data and after controlling for prior exacerbations. As an exploratory analysis, we considered an interaction between socio-environmental condition and sleep quality.ResultsAfter adjustment for all co-variates, increasing PSQI scores (range 0-21) were associated with a 5% increased risk for exacerbation per point (p = .001) in the imputed dataset. Sensitivity analyses using complete cases and after controlling for prior exacerbation history were similar. Exploratory analysis suggested less effect among those who lived in poor-quality neighborhoods (p-for-interaction = .035).ConclusionsPoor sleep quality may contribute to future exacerbations among patients with COPD. This represents one target for improving disease control.Clinical trial registrationSubpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). ClinicalTrials.gov Identifier# NCT01969344. Registry URL: https://clinicaltrials.gov/ct2/show/.

Abstract Background The circulating metabolome, reflecting underlying cellular processes and disease biology, has not been fully characterized in patients with idiopathic pulmonary fibrosis (IPF). We evaluated whether circulating levels of metabolites correlate with the presence of IPF, with the severity of IPF, or with the risk of clinically relevant outcomes among patients with IPF. Methods We analyzed enrollment plasma samples from 300 patients with IPF in the IPF-PRO Registry and 100 individuals without known lung disease using a set of targeted metabolomics and clinical analyte modules. Linear regression was used to compare metabolite and clinical analyte levels between patients with IPF and controls and to determine associations between metabolite levels and measures of disease severity in patients with IPF. Unadjusted and adjusted univariable Cox regression models were used to evaluate associations between circulating metabolites and the risk of mortality or disease progression among patients with IPF. Results Levels of 64 metabolites and 5 clinical analytes were significantly different between patients with IPF and controls. Among analytes with greatest differences were non-esterified fatty acids, multiple long-chain acylcarnitines, and select ceramides, levels of which were higher among patients with IPF versus controls. Levels of the branched-chain amino acids valine and leucine/isoleucine were inversely correlated with measures of disease severity. After adjusting for clinical factors known to influence outcomes, higher levels of the acylcarnitine C:16-OH/C:14-DC were associated with all-cause mortality, lower levels of the acylcarnitine C16:1-OH/C14:1DC were associated with all-cause mortality, respiratory death, and respiratory death or lung transplant, and higher levels of the sphingomyelin d43:2 were associated with the risk of respiratory death or lung transplantation. Conclusions IPF has a distinct circulating metabolic profile characterized by increased levels of non-esterified fatty acids, long-chain acylcarnitines, and ceramides, which may suggest a more catabolic environment that enhances lipid mobilization and metabolism. We identified select metabolites that were highly correlated with measures of disease severity or the risk of disease progression and that may be developed further as biomarkers. Trial registration ClinicalTrials.gov; No: NCT01915511; URL: www.clinicaltrials.gov .

Purpose To explore the impact of having relatives with addiction problems on students’ health, substance use, social life, and cognitive functioning, and to establish possible contributions of the participants’ gender, type of relationship, and type of addiction of the relative(s). Methods A qualitative, cross-sectional study of semi-structured interviews with thirty students from a University of Applied Sciences in the Netherlands who had relatives with addiction problems. Results Nine major themes were identified: (1) violence; (2) death, illness, and accidents of relatives; (3) informal care; (4) perception of addiction; (5) ill health, use of alcohol and illegal drugs; (6) financial problems; (7) pressured social life; (8) affected cognitive functioning, and (9) disclosure. Conclusions Having relatives with addiction problems severely affected the life and health of participants. Women were more likely to be informal carers, to experience physical violence, and to choose a partner with addiction problems than men. Conversely, men more often struggled with their own substance use. Participants who did not share their experiences reported more severe health complaints. It was impossible to make comparisons based on the type of relationship or type of addiction because participants had more than one relative or addiction in the family.

Introduction: We assessed the prognostic utility of circulating levels of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in patients with idiopathic pulmonary fibrosis (IPF) in the IPF-PRO Registry. Methods: MMP and TIMP concentrations were quantified by ELISA in plasma from 300 patients. A Cox proportional hazard regression model was used to assess associations between select MMPs and TIMPs and death and disease progression (absolute decline in forced vital capacity ≥10% predicted, death, or lung transplant). Results: Over a median follow-up of 30.4 months, 98 patients died and 182 patients had disease progression. In unadjusted analyses, higher concentrations of MMPs 2, 3, 8 and 9 and TIMPs 1, 2 and 4 were associated with an increased risk of death. MMPs 2 and 8 and TIMP1 remained associated with death after adjustment for clinical factors. In unadjusted analyses, higher concentrations of MMPs 8 and 9 and TIMPs 1 and 4 were associated with an increased risk of disease progression. MMPs 8 and 9 and TIMP1 remained associated with progression after adjustment for clinical factors. Conclusion: Circulating levels of MMP8 and TIMP1 may provide information on the risk of outcomes in patients with IPF not captured by clinical measures. [ABSTRACT FROM AUTHOR]

Mediante el presente estudio retrospectivo se revisaron 466 historias clínicas de pacientes atendidos por el servicio de urgencias quirúrgicas del Hospital San Juan de Dios de Bogotá, durante el periodo entre el 1° de marzo de 1981 y el 28 de febrero de 1986. Los pacientes en la serie estudiada fueron en su mayoría de sexo masculino (92%); se estableció una relación hombre/mujer de 11:1. El grupo de edad más afectado estuvo entre los 10 y 29 años (58%). La mayoría de los pacientes sufrió trauma penetrante (96,3%); 17 pacientes (3,7%) sufrieron trauma cerrado. El hemidiafragma más comprometido fue el izquierdo. Las manifestaciones clínicas más sobresalientes fueron: dolor abdominal, hipoventilación del hemitórax afectado, disnea, hemoneumotórax y defensa abdominal. Los métodos paraclínicos demostraron un bajo grado de especificidad diagnóstica. Las lesiones asociadas en su orden de frecuencia estuvieron localizadas en nivel del hígado, estómago, bazo, colon, intestino delgado, pulmón, páncreas, sistema vascular y óseo. El acceso quirúrgico en 413 casos se efectuó por laparotomía, en 37 por toracolaárotomía, y en los 13 restantes por toracotomía. La hernia diafragmática se presentó, en el 6%; y la mortalidad global fue del 10,5%.

The study of lithic raw material quality has become one of the major interpretive tools to investigate the raw material selection behaviour and its influence to the knapping technology. In order to make objective assessments of raw material quality, we need to measure their mechanical properties (e.g., fracture resistance, hardness, modulus of elasticity). However, such comprehensive investigations are lacking for the Palaeolithic of Kazakhstan. In this work, we investigate geological and archaeological lithic raw material samples of chert, porphyry, and shale collected from the Inner Asian Mountain Corridor (henceforth IAMC). Selected samples of aforementioned rocks were tested by means of Vickers and Knoop indentation methods to determine the main aspect of their mechanical properties: their indentation fracture resistance (a value closely related to fracture toughness). These tests were complemented by traditional petrographic studies to characterise the mineralogical composition and evaluate the level of impurities that could have potentially affected the mechanical properties. The results show that materials, such as porphyry possess fracture toughness values that can be compared to those of chert. Previously, porphyry was thought to be of lower quality due to the anisotropic composition and coarse feldspar and quartz phenocrysts embedded in a silica rich matrix. However, our analysis suggests that different raw materials are not different in terms of indentation fracture resistance. This work also offers first insight into the quality of archaeological porphyry that was utilised as a primary raw material at various Upper Palaeolithic sites in the Inner Asian Mountain Corridor from 47-21 ka cal BP.