Introduction Poor sleep among pregnant women is a growing public health concern that has been linked to adverse maternal and child health outcomes. Most studies examining sleep health during ...pregnancy have focused on non-Hispanic Whites and/or Hispanics/Latinas, while few have included Blacks, who are most susceptible to poor sleep and adverse pregnancy outcomes. Methods Using a nationally representative sample of 71,644 (2,349 pregnant) women from the 2004-2017 National Health Interview Survey, we investigated cross-sectional associations between self-reported pregnancy status and various sleep dimensions. Sleep duration per day was defined as short: <7 hours; sufficient: 7-9 hours, and long: >9 hours. Adjusting for age, other sociodemographic characteristics, health behaviors, and health conditions, we used average marginal predictions from fitted logistic regression models to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for each sleep dimension among pregnant compared to non-pregnant women, stratified by race/ethnicity. We then stratified by pregnancy status, comparing sleep among Blacks and Hispanic/Latinas to Whites. Results Among 71,644 eligible pregnant (3%) and non-pregnant (97%) women, 69% were White, 19% Black, and 12% Hispanic/Latina. Mean age±SD was 28±0.14 (pregnant) and 34±0.07 (non-pregnant) years, and many (66% pregnant, 41% non-pregnant women) were married. When making overall and within-race/ethnicity comparisons, pregnant women were less likely than non-pregnant women to report short sleep (PROverall=0.74, 95%CI:0.67-0.81, PRWhite=0.72, 95%CI:0.64-0.81, PRBlack=0.74, 95%CI:0.61-0.89, PRHispanic/Latina=0.76, 95%CI:0.60-0.96). Only pregnant Whites (PRWhite=0.45, 95%CI:0.31-0.65) were less likely to report sleep medication use, while there was no difference between pregnant and non-pregnant Blacks (PRBlack=0.98, 95%CI:0.46-2.09) and Hispanics/Latinas (PRHispanic/Latina=0.83, 95%CI:0.38-1.78). Pregnant women had a 2-fold higher prevalence of long sleep (PROverall=2.06, 95%CI:1.74-2.43) and were 34% more likely to report trouble staying asleep (PROverall=1.34, 95%CI:1.25-1.43). Compared to pregnant Whites, pregnant Blacks had a 31% higher prevalence of reporting short sleep (PRBlack=1.31, 95%CI:1.05-1.63) and pregnant Hispanics/Latinas were less likely to report trouble staying asleep (PRHispanic/Latina=0.79, 95%CI:0.64-0.98). Conclusion Sleep patterns differed between pregnant and non-pregnant women and by race/ethnicity. Expectant mothers may need additional screening for sleep difficulties during pregnancy, especially racial/ethnic minority women. Support (If Any)
Background Obstructive sleep apnea (OSA) is a serious health condition that affects approximately 30-50% of older adults and contributes to risk for cardiometabolic disorders and dementia. Despite ...the well-documented role of partners in treatment seeking and adherence to positive airway pressure (PAP), treatments for OSA have nearly exclusively focused on the patient and current treatments for OSA do not address co-existing sleep problems such as insomnia that are prevalent in both patients with OSA and their partners. Therefore, the goal of this study is to develop and test a novel couples-based sleep health intervention to promote adherence to PAP and improve sleep health of the couple. Methods We are conducting a two-arm, parallel group, single blind, randomized controlled pilot/feasibility trial to compare our novel couples-based sleep health intervention (We-PAP) to an information control group (IC). We-PAP is based on a transdiagnostic model and uses a dyadic approach including increasing effective partner support, communication skills, and couple-level goal-setting. We-PAP involves 3 sessions and delivered via telehealth in weekly sessions. The IC includes standardized patient educational materials. Both groups receive the usual follow-up with their medical team. The study involves assessments at pre-treatment, post-intervention (approximately 1 month after starting PAP and completing We-PAP sessions or IC) and 3 months after starting PAP. Our main outcomes are feasibility and acceptability ratings. Secondary outcomes include comparing We-PAP to IC for PAP adherence, sleep quality (self-report and objective) and cognitive measures. Discussion We-PAP is the first couples-based transdiagnostic sleep health intervention for patients with OSA and their partners. Results of this study will be used to inform the design of a subsequent fully powered clinical trial. If successful, this intervention could significantly advance current clinical practice in the treatment of OSA and sleep health more comprehensively in older adults. Moreover, this intervention may be useful for improving sleep in other aging populations with multiple sleep and other health problems, including patients with chronic illnesses or those at risk for Alzheimer's disease and their caregivers. Trial registration NCT04759157. Date of registration: February 8, 2021. URL of trial registry record. Keywords: Obstructive sleep apnea (OSA), Couple, Positive airway pressure (PAP), Adherence, Sleep, Transdiagnostic, BBTI, Cognitive behavioral, CBTi, Treatment, Alzheimer's disease
Background The current diagnostic criteria for dermatomyositis (DM) exclude patients without muscle involvement. As a result there is a paucity of research related to the complete spectrum of the ...disease. Objective The goal of this study was to evaluate differences in the clinical manifestations of DM seen by dermatology relative to rheumatology. We hypothesized that patients with minimal (hypomyopathic) or no (amyopathic) muscle disease would more likely be seen in dermatology, whereas those with more severe (classic) muscle disease would be seen in rheumatology. Methods We performed a retrospective chart review of patients with DM seen by our dermatology and rheumatology departments to classify spectrum, presentation, and complications. Patients seen between July 1, 2003, and June 30, 2006, were identified by Current Procedural Terminology billing code 710.3. Patients with mixed connective tissue diseases or miscoded DM were excluded. Results In all, 131 (65%) patients seen in dermatology, 58 (29%) in rheumatology, and 13 (6%) in both departments were identified. In all, 83 (69%) patients seen in dermatology, 27 (23%) in rheumatology, and 10 (8%) in both departments met criteria for inclusion in the study. The number of patients seen in rheumatology given the classification of classic DM (CDM) (24 of 27 89%), hypomyopathic DM (2 of 27 7%), and amyopathic DM (ADM) (1 of 27 4%) differed significantly from dermatology, where CDM comprised 27 of 83 (33%), hypomyopathic DM comprised 23 of 83 (28%), and ADM comprised 33 of 83 (40%) of the population, respectively ( P < .001). Sex, ethnicity, and rates of interstitial lung disease differed between departments. There was no difference in the rates of interstitial lung disease between CDM and ADM ( P = .30). The degree of muscle involvement did not correlate with the rates of DM-associated malignancy ( P = .57). Few patients with ADM had muscle biopsy (n = 1) or electromyography (n = 7) testing. Positive anti-Jo-1 was seen in 2 of 96 patients (2%; one CDM and one ADM, both with interstitial lung disease), reflecting an overall low prevalence of this autoantibody, or a potential problem with the laboratory assay. Limitations Patients reflect the population in only one institution and, thus, the results may not be generalizable to other settings or referral centers. Because this is a retrospective chart review, results are limited by missing data and nonstandardized physical examinations and laboratory data across patients and physicians. Conclusions There is a clear difference in DM presentation to dermatology and rheumatology by degree of myositis-complicated disease.
We present density split statistics, a framework that studies lensing and counts-in-cells as a function of foreground galaxy density, thereby providing a large-scale measurement of both 2-point and ...3-point statistics. Our method extends our earlier work on trough lensing and is summarized as follows: given a foreground (low redshift) population of galaxies, we divide the sky into subareas of equal size but distinct galaxy density. We then measure lensing around uniformly spaced points separately in each of these subareas, as well as counts-in-cells statistics (CiC). The lensing signals trace the matter density contrast around regions of fixed galaxy density. Through the CiC measurements this can be related to the density profile around regions of fixed matter density. Together, these measurements constitute a powerful probe of cosmology, the skewness of the density field and the connection of galaxies and matter. In this paper we show how to model both the density split lensing signal and CiC from basic ingredients: a non-linear power spectrum, clustering hierarchy coefficients from perturbation theory and a parametric model for galaxy bias and shot-noise. Using N-body simulations, we demonstrate that this model is sufficiently accurate for a cosmological analysis on year 1 data from the Dark Energy Survey.
The Large Synoptic Survey Telescope (LSST) Dark Energy Science Collaboration (DESC) will use five cosmological probes: galaxy clusters, large scale structure, supernovae, strong lensing, and weak ...lensing. This Science Requirements Document (SRD) quantifies the expected dark energy constraining power of these probes individually and together, with conservative assumptions about analysis methodology and follow-up observational resources based on our current understanding and the expected evolution within the field in the coming years. We then define requirements on analysis pipelines that will enable us to achieve our goal of carrying out a dark energy analysis consistent with the Dark Energy Task Force definition of a Stage IV dark energy experiment. This is achieved through a forecasting process that incorporates the flowdown to detailed requirements on multiple sources of systematic uncertainty. Future versions of this document will include evolution in our software capabilities and analysis plans along with updates to the LSST survey strategy.
Changes in the frequency, duration, and nature of military deployments over the past 14 years have spurred efforts to understand the effects of deployment on the health of military service members ...and their spouses. However, few studies have examined the impact of deployments on health outcomes in both veterans and their partners. This study aims to examine the association between deployment length and health, including ambulatory blood pressure (BP) and stress-related markers of inflammation, in military veterans and their spouses.
This study includes 32 male veterans and 29 female civilian partners. Veterans reported about their deployment and military experiences, including deployment length, combat exposure, and post-traumatic stress disorder (PTSD) symptoms. Plasma measures of inflammatory markers, C-reactive protein (CRP) and interleukin 6 (IL-6), were collected from veterans and spouses. Participants also completed 48 hours of BP monitoring for calculation of mean arterial pressure (MAP) during wakefulness and sleep, and sleep/wake MAP ratio, as an indicator BP nondipping. Regression models examined the association between deployment length and each outcome in the combined sample of veterans and their spouses, including tests of interactions between gender and deployment length, controlling for age, gender, waist circumference, current PTSD, and combat exposure.
Longer deployment length was associated with higher CRP levels in veterans and their spouses, although this effect became nonsignificant when limiting analyses to individuals with CRP ≤10 mg/L. There was a significant gender by deployment length interaction effect on MAP ratio, such that longer deployments were associated with higher MAP ratios in female spouses. There was no significant effect of combat exposure in these models.
Longer deployments are associated with health-related markers in military veterans as well as their spouses. These results suggest the importance of monitoring health during and postdeployment, and of finding ways to mitigate the adverse impact of deployment on health in both members of military couples.
Obtaining accurate distributions of galaxy redshifts is a critical aspect of weak lensing cosmology experiments. One of the methods used to estimate and validate redshift distributions is apply ...weights to a spectroscopic sample so that their weighted photometry distribution matches the target sample. In this work we estimate the \textit{selection bias} in redshift that is introduced in this procedure. We do so by simulating the process of assembling a spectroscopic sample (including observer-assigned confidence flags) and highlight the impacts of spectroscopic target selection and redshift failures. We use the first year (Y1) weak lensing analysis in DES as an example data set but the implications generalise to all similar weak lensing surveys. We find that using colour cuts that are not available to the weak lensing galaxies can introduce biases of \(\Delta~z\sim0.015\) in the weighted mean redshift of different redshift intervals. To assess the impact of incompleteness in spectroscopic samples, we select only objects with high observer-defined confidence flags and compare the weighted mean redshift with the true mean. We find that the mean redshift of the DES Y1 weak lensing sample is typically biased at the \(\Delta~z=0.005-0.05\) level after the weighting is applied. The bias we uncover can have either sign, depending on the samples and redshift interval considered. For the highest redshift bin, the bias is larger than the uncertainties in the other DES Y1 redshift calibration methods, justifying the decision of not using this method for the redshift estimations. We discuss several methods to mitigate this bias.
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