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Search Results (2,867)

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18 pages, 1943 KiB  
Article
The Interplay of Dual Tasks, Sleep Quality and Load Carriage on Postural Stability in Young, Healthy Adults
by Joel Martin, Megan Sax van der Weyden and Amanda Estep
Biomechanics 2025, 5(1), 1; https://doi.org/10.3390/biomechanics5010001 (registering DOI) - 1 Jan 2025
Abstract
Background/Objectives: To examine the combined effects of sleep quality, dual tasks, and load carriage on postural stability. Methods: Twenty-three university student participants (12 males, ages: 24.6 ± 6.1 year) completed the Pittsburgh Sleep Quality Index (PSQI), then performed quiet standing and [...] Read more.
Background/Objectives: To examine the combined effects of sleep quality, dual tasks, and load carriage on postural stability. Methods: Twenty-three university student participants (12 males, ages: 24.6 ± 6.1 year) completed the Pittsburgh Sleep Quality Index (PSQI), then performed quiet standing and a dual task while standing on force plates with and without load carriage. Correlations and repeated measures analysis of variances were used to assess relationships, main effects, and interaction effects of tasks on center of pressure (COP) to assess postural stability. Both a traditional PSQI global score and a sensitivity analysis of the PSQI cut-off were conducted. Results: With the traditional PSQI criteria, a main effect of sleep quality on 95% ellipse area was observed, with good sleepers outperforming bad sleepers (p = 0.016). Additionally, a significant interaction between sleep quality and task (p = 0.049) indicated that COP anterior–posterior velocity was lower during the dual task for good sleepers. No effects on sleep quality or interaction were found for other COP measures. The sensitivity analysis yielded no effect on sleep quality or interaction effects on any COP measure. There were no significant correlations between the PSQI global scores and COP variables. Conclusions: Overall, the results indicate that sleep quality alone had a limited effect and did not significantly interact with dual tasks or load carriage during quiet standing. Practitioners working with individuals who commonly experience poor sleep quality and perform load carriage and dual tasks should consider that common COP screens to assess postural stability may not detect differences due to self-reported sleep quality in healthy, young adults. Full article
(This article belongs to the Section Gait and Posture Biomechanics)
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<p>Box plots of median values of center of pressure variables by load, task, and sleep conditions. Note: Good sleepers were defined as having a PSQI global score ≤ 5.</p>
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<p>Box plots of median values of center of pressure variables by load, task, and sleep conditions. Note: Good sleepers were defined as having a PSQI global score ≤ 5.</p>
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<p>Box plots of median values of center of pressure variables by load, task, and sleep conditions. Note: Good sleepers were defined as having a PSQI global score ≤ 5.</p>
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<p>Box plots of median values of center of pressure variables by load, task and sleep conditions. Note: Good sleepers were defined as having a PSQI global score ≤ 6.</p>
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<p>Box plots of median values of center of pressure variables by load, task and sleep conditions. Note: Good sleepers were defined as having a PSQI global score ≤ 6.</p>
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<p>Box plots of median values of center of pressure variables by load, task and sleep conditions. Note: Good sleepers were defined as having a PSQI global score ≤ 6.</p>
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13 pages, 338 KiB  
Article
Chronobiological Factors Influencing Glycemic Control and Birth Outcomes in Gestational Diabetes Mellitus
by Amalia Messika, Yoel Toledano, Eran Hadar, Riva Tauman, Oren Froy and Raanan Shamir
Nutrients 2025, 17(1), 157; https://doi.org/10.3390/nu17010157 - 31 Dec 2024
Viewed by 176
Abstract
Background/Objectives: Studies have shown that chronobiological factors may adversely affect glycemic control in patients with type 2 diabetes mellitus. We assessed the association of chronobiological factors with glycemic control and neonatal birth weight in women with GDM. Methods: A prospective cohort study included [...] Read more.
Background/Objectives: Studies have shown that chronobiological factors may adversely affect glycemic control in patients with type 2 diabetes mellitus. We assessed the association of chronobiological factors with glycemic control and neonatal birth weight in women with GDM. Methods: A prospective cohort study included 208 women aged 18–45 years with a singleton pregnancy who were randomly selected from among women undergoing follow-up for GDM at the Maternal-Fetal Medicine Unit of a tertiary medical center. Nutrition, sleep, and lifestyle patterns were assessed from onset of GDM until birth along with glycemic control and birth outcomes. Results: Multivariate analyses on a cohort of 208 women revealed that suboptimal glycemic control was associated with a late breakfast (RR = 2.26; 95% CI 1.09–4.67), increased carbohydrate intake in the evening (RR = 1.19; 95% CI 1.003–1.42), and poor sleep quality (RR = 2.14; 95% CI 1.04–4.41). The adjusted relative risk for neonatal birth weight above the 85th percentile was associated with increased carbohydrate intake in the morning (RR = 1.70; 95%CI 1.30–2.23) and increased carbohydrate intake in the evening (RR = 1.39; 95% CI 1.16–1.67). Conclusions: Chronobiological factors are associated with suboptimal glycemic control and birth weight above the 85th percentile in women with GDM. The study was registered under ClinicalTrials.gov.org, identifier: NCT02916667. Full article
(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)
12 pages, 416 KiB  
Article
The Use of Principal Component Analysis for Reduction in Sleep Quality and Quantity Data in Female Professional Soccer
by Eider Barba, David Casamichana, Pedro Figueiredo, Fábio Yuzo Nakamura and Julen Castellano
Sensors 2025, 25(1), 148; https://doi.org/10.3390/s25010148 - 30 Dec 2024
Viewed by 216
Abstract
The main aim of the present study was to uncover multivariate relationships between sleep quantity and quality using principal component analysis (PCA) in professional female soccer players. A second aim was to examine the extent to which objective sleep quantity and quality variables [...] Read more.
The main aim of the present study was to uncover multivariate relationships between sleep quantity and quality using principal component analysis (PCA) in professional female soccer players. A second aim was to examine the extent to which objective sleep quantity and quality variables can discriminate between perceived sleep. Ten objective sleep variables from the multisensory sleep-tracker were analyzed. PCA was conducted on the sleep variables, and meaningful principal components (PCs) were identified (eigenvalue > 2). Two sleep PCs were identified, representing the ‘quantity of sleep’ (quantity PC: eigenvalue = 4.1 and variance explained = 45.1%) and the ‘quality of sleep’ (quality PC: eigenvalue = 2.4 and variance explained = 24.1%). Cluster analysis grouped the players’ sleep into three types: long and efficient, short and efficient, and long and inefficient; however, no association was found between the perceived sleep and the sleep clusters. In conclusion, a combination of both quantity and quality sleep metrics is recommended for sleep monitoring of professional female soccer players. Players should undergo a training process to improve self-assessment of sleep quality recorded from a subjective questionnaire, contrasting the perceived information with the sleep quality recorded objectively during a defined period in order to optimize the validity of their perceptions. The aim is to optimize the validity of their perceptions of sleep quality. Full article
(This article belongs to the Special Issue Wearable Sensors for Optimising Rehabilitation and Sport Training)
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<p>Correlation matrix for the sleep variables. Note: EFFICENCY (%) Is the percentage of the sleep period spent asleep; REST (%) is the percentage of sleep time during which the user was moving; ONSET (hr:min) is the detected latency from the start of bedtime to the beginning of the first five minutes of persistent sleep; DURA (hr:min) is the total duration of the sleep period; TOTAL (hr:min) is the total amount of sleep registered; AWAKE (hr:min) is the total amount of awake time registered; REM (hr:min) is the total amount of REM sleep registered; DEEP (hr:min) is the total amount of deep sleep registered; LIGHT (hr:min) is the total amount of light sleep registered; MIDP (hr:min) is the time from the start of sleep to the midpoint of sleep based on the connected mobile device clock, ignoring awake periods.</p>
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16 pages, 729 KiB  
Review
Long-Term Management of Sleep Apnea-Hypopnea Syndrome: Efficacy and Challenges of Continuous Positive Airway Pressure Therapy—A Narrative Review
by Zishan Rahman, Ahsan Nazim, Palvi Mroke, Khansa Ali, MD Parbej Allam, Aakash Mahato, Mahveer Maheshwari, Camila Sanchez Cruz, Imran Baig and Ernesto Calderon Martinez
Med. Sci. 2025, 13(1), 4; https://doi.org/10.3390/medsci13010004 - 30 Dec 2024
Viewed by 270
Abstract
Sleep apnea-hypopnea syndrome (SAHS) is a respiratory disorder characterized by cessation of breathing during sleep, resulting in daytime somnolence and various comorbidities. SAHS encompasses obstructive sleep apnea (OSA), caused by upper airway obstruction, and central sleep apnea (CSA), resulting from lack of brainstem [...] Read more.
Sleep apnea-hypopnea syndrome (SAHS) is a respiratory disorder characterized by cessation of breathing during sleep, resulting in daytime somnolence and various comorbidities. SAHS encompasses obstructive sleep apnea (OSA), caused by upper airway obstruction, and central sleep apnea (CSA), resulting from lack of brainstem signaling for respiration. Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for SAHS, reducing apnea and hypopnea episodes by providing continuous airflow. CPAP enhances sleep quality and improves overall health by reducing the risk of comorbidities such as hypertension, type 2 diabetes mellitus, cardiovascular disease and stroke. CPAP nonadherence leads to health deterioration and occurs due to mask discomfort, unsupportive partners, upper respiratory dryness, and claustrophobia. Technological advancements such as auto-titrating positive airway pressure (APAP) systems, smart fit mask interface systems, and telemonitoring devices offer patients greater comfort and enhance adherence. Future research should focus on new technological developments, such as artificial intelligence, which may detect treatment failure and alert providers to intervene accordingly. Full article
(This article belongs to the Section Pneumology and Respiratory Diseases)
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<p>CPAP therapy alternatives and adjuvants for patients with SAHS. Abbreviations: SAHS—sleep apnea hypopnea syndrome, CPAP—continuous positive airway pressure, BiPaP—bilevel positive airway pressure, ASV—adaptive servo-ventilation, PNS—phrenic nerve stimulation. Figure created with BioRender. All credits to Aakash Mahato.</p>
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12 pages, 653 KiB  
Review
Empowering the Sports Scientist with Artificial Intelligence in Training, Performance, and Health Management
by Nuno Mateus, Eduardo Abade, Diogo Coutinho, Miguel-Ángel Gómez, Carlos Lago Peñas and Jaime Sampaio
Sensors 2025, 25(1), 139; https://doi.org/10.3390/s25010139 - 29 Dec 2024
Viewed by 428
Abstract
Artificial Intelligence (AI) is transforming the field of sports science by providing unprecedented insights and tools that enhance training, performance, and health management. This work examines how AI is advancing the role of sports scientists, particularly in team sports environments, by improving training [...] Read more.
Artificial Intelligence (AI) is transforming the field of sports science by providing unprecedented insights and tools that enhance training, performance, and health management. This work examines how AI is advancing the role of sports scientists, particularly in team sports environments, by improving training load management, sports performance, and player well-being. It explores key dimensions such as load optimization, injury prevention and return-to-play, sports performance, talent identification and scouting, off-training behavior, sleep quality, and menstrual cycle management. Practical examples illustrate how AI applications have significantly advanced each area and how they support and enhance the effectiveness of sports scientists. This manuscript also underscores the importance of ensuring that AI technologies are context-specific and communicated transparently. Additionally, it calls for academic institutions to update their curriculums with AI-focused education, preparing future sports professionals to fully harness its potential. Finally, the manuscript addresses future challenges, such as the unpredictable nature of team sports, emphasizing the need for interdisciplinary collaboration, including clear communication and mutual understanding between sports scientists and AI experts, and the critical balance between AI-driven insights and human expertise. Full article
(This article belongs to the Special Issue Feature Review Papers in Intelligent Sensors)
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<p>Diagram illustrating key AI-driven dimensions for sports scientists.</p>
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11 pages, 285 KiB  
Article
Multistrategic Approaches in the Treatment of Acute Migraine During Pregnancy: The Effectiveness of Physiotherapy, Exercise, and Relaxation Techniques
by Özge Baykan Çopuroğlu and Mehmet Çopuroğlu
Medicina 2025, 61(1), 28; https://doi.org/10.3390/medicina61010028 - 28 Dec 2024
Viewed by 284
Abstract
Background and Objectives: Migraine is a common neurological condition that significantly impacts quality of life, especially in women during their reproductive years. Pregnancy poses unique challenges for migraine management due to hormonal changes and the limited use of pharmacological treatments. Non-pharmacological interventions, [...] Read more.
Background and Objectives: Migraine is a common neurological condition that significantly impacts quality of life, especially in women during their reproductive years. Pregnancy poses unique challenges for migraine management due to hormonal changes and the limited use of pharmacological treatments. Non-pharmacological interventions, such as physiotherapy, exercise, and relaxation techniques, offer promising alternatives for managing migraines during this critical period. This study aims to evaluate the effectiveness of physiotherapy, structured exercise, and relaxation techniques in reducing migraine frequency, severity, and duration while improving psychosocial outcomes such as quality of life, stress levels, and sleep quality in pregnant women. Materials and Methods: Sixty pregnant women diagnosed with acute migraine were randomly assigned into three intervention groups: physiotherapy, structured exercise, and relaxation techniques. Each intervention lasted 8 weeks. The primary outcomes included migraine frequency, severity (measured by VAS), and duration. The secondary outcomes included quality of life (SF-36), stress (PSS), and sleep quality (PSQI). Statistical analyses were conducted using one-way ANOVA and paired t-tests. Results: All interventions significantly reduced migraine frequency, severity, and duration (p < 0.05). Physiotherapy demonstrated the greatest reduction in migraine frequency (45%) and severity (36%), while exercise yielded the most significant improvement in duration (42%). Relaxation techniques were particularly effective in reducing stress and anxiety levels. Quality of life and sleep quality improved across all groups, with unique benefits observed for each intervention. Conclusions: Physiotherapy, structured exercise, and relaxation techniques are effective, safe, and non-invasive interventions for managing acute migraines during pregnancy. These findings provide evidence-based alternatives to pharmacological treatments, highlighting the importance of holistic approaches to migraine management during pregnancy. Further research is needed to confirm long-term efficacy and explore combined interventions. Full article
14 pages, 908 KiB  
Article
The Effects of Confiding on Shift Work Nurses’ Emotion Regulation and Self-Perceived Well-Being: An Online Randomized Controlled Trial
by Cui Lu, Yawen Sun, Chunyan Wang, Tianyong Chen and Yi Tang
Behav. Sci. 2025, 15(1), 9; https://doi.org/10.3390/bs15010009 - 26 Dec 2024
Viewed by 362
Abstract
Shift work nurses suffered great stress and emotion dysregulation during the COVID-19 pandemic. Interpersonal emotion regulation has emerged as a promising therapeutic approach, often facilitated through confiding. It has been suggested that medical staff benefit from confiding, with the act of reflecting on [...] Read more.
Shift work nurses suffered great stress and emotion dysregulation during the COVID-19 pandemic. Interpersonal emotion regulation has emerged as a promising therapeutic approach, often facilitated through confiding. It has been suggested that medical staff benefit from confiding, with the act of reflecting on the social support gained from confiding being associated with higher well-being. Consequently, we hypothesized that thinking about the social support derived from confiding about work-related hassles could enhance emotion regulation and well-being in shift work nurses. This study aimed to evaluate the effects of the intervention “thinking about the social support obtained from confiding about work-related hassles” on shift work nurses’ emotion regulation and self-perceived well-being. An online randomized controlled trial was conducted with 66 shift work nurses, including 34 in the experimental group and 32 in the control group, to assess the impact of an 8-week confiding intervention focused on thinking about the social support obtained from confiding. The results indicated that the intervention significantly improved the interpersonal emotion regulation of shift work nurses in the experimental group compared to the control group. In terms of intrapersonal emotion regulation, the intervention appeared to reduce the cognitive reappraisal in the intervention group; however, there was no significant difference in cognitive reappraisal or expressive inhibition between the intervention group and control group. Furthermore, self-rated general health and sleep quality showed significant improvement in the intervention group compared to pre-test levels, but no significant differences were observed between the experimental and control groups. In conclusion, the online confiding intervention effectively enhanced interpersonal emotion regulation among shift work nurses. However, its effects on intrapersonal emotion regulation were not significant. Similarly, while participants in the intervention group reported improved self-rated general health and sleep quality, these improvements did not significantly differ from those in the control group. Full article
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<p>The flow chart of recruitment.</p>
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<p>Changes in perceived social support over intervention time.</p>
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14 pages, 1989 KiB  
Article
Surface Electromyographic Responses During Rest on Mattresses with Different Firmness Levels in Adults with Normal BMI
by Xiaohong Hu, Yuhong Gao, Keyang Liu, Luyao Xiang, Bin Luo and Li Li
Sensors 2025, 25(1), 14; https://doi.org/10.3390/s25010014 - 25 Dec 2024
Viewed by 331
Abstract
Mattress firmness is a critical factor influencing sleep quality. This study investigates the effects of time, mattress firmness, and anthropometric parameters on surface electromyographic (sEMG) activity during supine rest. Eleven participants were analyzed, and the RMS values for lower back sEMG on three [...] Read more.
Mattress firmness is a critical factor influencing sleep quality. This study investigates the effects of time, mattress firmness, and anthropometric parameters on surface electromyographic (sEMG) activity during supine rest. Eleven participants were analyzed, and the RMS values for lower back sEMG on three mattresses were measured as 8.37 ± 0.85 μV, 8.43 ± 1.06 μV, and 7.77 ± 1.15 μV during the final five minutes of testing, showing no statistical significance. Similarly, no significant differences in electromyographic activity were observed across different time periods. Anthropometric parameters such as BMI, waist circumference (WC), and waist-to-hip ratio (WHR) significantly influenced sEMG activity on firm mattresses. Higher BMI, waist circumference, and waist-to-hip ratio were negatively correlated with RMS and iEMG values on firm mattresses, suggesting that firmer mattresses are better suited for individuals with higher BMI, larger waist circumference, and a more balanced distribution of body weight between the upper and lower body. The medium-firm mattress had the lowest discomfort scores, indicating its broader adaptability. These findings provide a foundation for designing ergonomically optimized, personalized mattresses to improve sleep quality across diverse populations. Full article
(This article belongs to the Section Biomedical Sensors)
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<p>(<b>a</b>): Diagram of EEG electrode placement; (<b>b</b>): Picture of the sEMG recording equipment.</p>
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<p>Pressure map on mattresses with different firmness levels of one subject.</p>
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<p>Electromyographic changes over time under different mattress firmness levels. (<b>a</b>–<b>c</b>) root mean square (<span class="html-italic">RMS</span>) changes over time under soft, medium, and firm mattresses. (<b>d</b>–<b>f</b>) Mean frequency (<span class="html-italic">MF</span>) changes over time under soft, medium, and firm mattresses. Note: Sh: Shoulder (Upper Trapezius Descendens); UB: Upper Back (Lower Trapezius Descendens); LB: Lower Back (Erector Spinae, Iliocostalis); Hip: Hip (Gluteus Medius). The x-axis represents successive 5–minute intervals: 0–5 min, 5–10 min, 10–15 min, 15–20 min, and 20–25 min. All data are presented as mean ± SEM, <span class="html-italic">n</span> = 11.</p>
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<p>(<b>a</b>–<b>c</b>) Pearson correlation heatmap between participant anthropometric measurements and muscle activation across different mattresses on the lower back. Note: WC: waist circumference; HC: hip circumference; WHR: waist-to-hip ratio (WHR); <span class="html-italic">RMS</span>5, <span class="html-italic">RMS</span>10, <span class="html-italic">RMS</span>15, <span class="html-italic">RMS</span>20, and <span class="html-italic">RMS</span>25 represent the root mean square (<span class="html-italic">RMS</span>) values of muscle activation within successive 5 min intervals (0–5 min, 5–10 min, 10–15 min, 15–20 min, and 20–25 min, respectively). Similarly, <span class="html-italic">iEMG</span> values are calculated over the same intervals to assess muscle activation and frequency characteristics across time. Significant correlations after FDR correction are indicated by * for FDR-adjusted <span class="html-italic">p</span> &lt; 0.05.</p>
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<p>(<b>a</b>,<b>b</b>) Comparison of <span class="html-italic">RMS</span> values across different mattresses during the first and last five minutes. (<b>c</b>,<b>d</b>) Comparison of <span class="html-italic">MF</span> values across different mattresses during the first and last five minutes. Note: Sh: Shoulder (Upper Trapezius Descendens); UB: Upper Back (Lower Trapezius Descendens); LB: Lower Back (Erector Spinae, Iliocostalis); Hip: Hip (Gluteus Medius). All data are presented as mean ± SEM, <span class="html-italic">n</span> = 11.</p>
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28 pages, 2448 KiB  
Article
Impact of CPAP Therapy on Cognition and Fatigue in Patients with Moderate to Severe Sleep Apnea: A Longitudinal Observational Study
by Oumaïma Benkirane, Olivier Mairesse and Philippe Peigneux
Clocks & Sleep 2024, 6(4), 789-816; https://doi.org/10.3390/clockssleep6040051 - 23 Dec 2024
Viewed by 374
Abstract
Continued solicitation of cognitive resources eventually leads to cognitive fatigue (CF), i.e., a decrease in cognitive efficiency that develops during sustained cognitive demands in conditions of constrained processing time, independently of sleepiness. The expression of CF and its impact on cognition are partly [...] Read more.
Continued solicitation of cognitive resources eventually leads to cognitive fatigue (CF), i.e., a decrease in cognitive efficiency that develops during sustained cognitive demands in conditions of constrained processing time, independently of sleepiness. The expression of CF and its impact on cognition are partly contingent upon prior sleep quality and its restorative effects. Sleep in obstructive sleep apnea (OSA) may be largely restored through the use of continuous positive airway pressure (CPAP) treatment, contributing to a gradual improvement in sleep quality. In this longitudinal observational study, we investigated immediate and longer-term behavioral effects of CPAP treatment on cognitive functioning, evaluating outcomes after the initiation of treatment, and at three and six months, in compliant CPAP-treated OSA patients. Results indicate that CPAP therapy significantly enhances subjective sleep quality and cognitive functions, including episodic memory, inhibition, sustained attention, working memory, and executive control. Noticeable performance improvements were observed in CF-inducing tasks, particularly after six months of CPAP use. Participants also reported substantial gains in quality of life, reduced daytime sleepiness, and improved mood. These results confirm that CPAP therapy not only alleviates immediate physiological disturbances associated with OSA, but also supports cognitive recovery and enhanced overall daily functioning. Full article
(This article belongs to the Section Disorders)
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<p>Subjective evaluations from the St-Mary’s Sleep Questionnaire. Evaluations of sleep quality, sleep depth, number of intercurrent awakenings resulting from the CPAP use, and night sleep duration in hours, assessed on the first day of each session. Note: Session 1 = start of the experiment, Session 2 = after three months of CPAP treatment, Session 3 = after six months of CPAP treatment. For Sleep Depth scores, 1 = very light, 2 = light, 3 = quite light, 4 = moderately light, 5 = moderately deep, 6 = quite deep, 7 = deep, 8 = very deep. For Sleepiness scores, 1 = very sleepy, 2 = quite sleepy, 3 = a little sleepy, 4 = lucid, 5 = alert, 6 = very alert. * <span class="html-italic">p</span> &lt; 0.05. Error bars represent standard errors.</p>
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<p>Evolution of neuropsychological test outcomes across sessions. <b>Top Panel (Left):</b> RLS-15 task scores showing the percentage of correctly recalled words (RLTC) and the number of correctly classified words (RD) across sessions. <b>Top Panel (Right):</b> Number of words generated in the Semantic Fluency task. <b>Middle Panel (Left and Right):</b> Digit span (forward and reverse) performance from the WAIS test across sessions. <b>Bottom Panel:</b> Stroop task scores, including denomination time, interference (intermediate and total time), and inhibition scores. Note: Session 1 = start of the experiment, Session 2 = after three months of CPAP treatment, Session 3 = after six months of CPAP treatment. * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, *** <span class="html-italic">p</span> &lt; 0.001. Error bars represent standard errors.</p>
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<p><b>Top Left Panel:</b> Interstimulus interval in seconds in the calibration task of the TloadDback task across sessions. <b>Top Right Panel:</b> Performance in percent during the four blocks of the TloadDback task during Session 1. <b>Bottom Left Panel:</b> Performance in percent during the four blocks of the TloadDback task during Session 2. <b>Bottom Right Panel:</b> Performance in percent during the four blocks of the TloadDback task during Session 3. Note: Session 1 = start of the experiment, Session 2 = after three months of CPAP treatment, Session 3 = after six months of CPAP treatment. * <span class="html-italic">p</span> &lt; 0.05, <span class="html-italic">*** p</span> &lt; 0.001. Error bars represent standard errors.</p>
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<p>Visual analog scales before and after the TloadDback task. <b>Top Left Panel:</b> Subjective evaluation of the sleepiness pre- and post-task. <b>Top Right Panel:</b> Subjective evaluation of the cognitive fatigue pre- and post-task. <b>Bottom Left Panel:</b> Subjective evaluation of the stress pre- and post-task. <b>Bottom Right Panel:</b> Subjective evaluation of the motivation pre- and post-task. Note: Session 1 = start of the experiment, Session 2 = after three months of CPAP treatment, Session 3 = after six months of CPAP treatment. * <span class="html-italic">p</span> &lt; 0.05, <span class="html-italic">** p</span> &lt; 0.01, *** <span class="html-italic">p</span> &lt; 0.001. Error bars represent standard errors.</p>
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<p>Experimental protocol. Note: VAS = visual analog scales (fatigue, sleepiness, stress, and motivation), each completed two times (before and after the TloadDback task). The same protocol took place after three then six months of CPAP use.</p>
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10 pages, 241 KiB  
Article
Sex Differences in Sleep Profiles and the Effect of Elexacaftor/Tezacaftor/Ivacaftor on Sleep Quality in Adult People with Cystic Fibrosis: A Prospective Observational Study
by Sarah Dietz-Terjung, Svenja Straßburg, Tim Schulte, Paul Dietz, Gerhard Weinreich, Christian Taube, Christoph Schöbel, Matthias Welsner and Sivagurunathan Sutharsan
Diagnostics 2024, 14(24), 2859; https://doi.org/10.3390/diagnostics14242859 - 19 Dec 2024
Viewed by 400
Abstract
Background/Objectives: Recent studies indicate that sleep and sleep disorders differ between men and women, but corresponding data in people with chronic lung diseases are lacking. This study aims to answer the question of what the sex-specific differences in sleep profiles and responses to [...] Read more.
Background/Objectives: Recent studies indicate that sleep and sleep disorders differ between men and women, but corresponding data in people with chronic lung diseases are lacking. This study aims to answer the question of what the sex-specific differences in sleep profiles and responses to elexacaftor/tezacaftor/ivacaftor (ETI) therapy in people with cystic fibrosis (pwCF) are. Methods: Adult pwCF and a matched control group (adults with suspected sleep-disordered breathing undergoing in-laboratory polysomnography (PSG)) were included. PSG data at baseline and after 6 months’ ETI therapy were compared between men (mwCF) and women (wwCF) with cystic fibrosis. PSG data at baseline and 6-month follow-up for mwCF/wwCF were compared with baseline PSG data for men/women in the control group. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). Correlations between change in percentage predicted forced expiratory volume in 1 s from baseline to 6 months were correlated with corresponding changes in key sleep parameters. Changes in transferrin during ETI therapy were also documented. Results: Twenty-eight pwCF (12 wwCF, 16 mwCF) and 28 matched controls were included. Both mwCF (4 ± 5 vs. 9 ± 20 events/h, p = 0.028) and wwCF (3 ± 3 vs. 8 ± 9 events/h, p = 0.004) had fewer respiratory events during sleep versus male and female controls, but worse sleep efficiency (75 ± 11% vs. 84 ± 11%; p = 0.004 and 76 ± 10% vs. 83 ± 11%; p = 0.011. The baseline ESS score was significantly higher in wwCF versus female controls (8 ± 4 vs. 14 ± 8; p = 0.040). Although some sleep parameters normalized during ETI therapy in pwCF, sleep quality remained poor. The transferrin levels at baseline (2.7 ± 0.4 vs. 2.2 ± 0.5; p = 0.049) and 6 months (3.8 ± 0.4 vs. 2.6 ± 0.5; p < 0.001) were significantly higher in the wwCF versus the mwCF, and the change from baseline during ETI therapy was significantly greater in women versus men (1.1 ± 0.6 vs. 0.4 ± 0.4; p < 0.001). Conclusions: These data suggest that wwCF and mwCF should be managed differently with respect to their sleep. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
17 pages, 4836 KiB  
Article
Condylar Parameters and Mandibular Movement Patterns in Bruxers Using an Optical Jaw Tracking System
by Manuela Tăut, Solene Chanteux, Andreea Kui, Rareș Buduru, Marius Negucioiu, Manuela Manziuc, Ioana Gheorghiu, Mihaela Hedeșiu, Smaranda Buduru and Aranka Ilea
J. Clin. Med. 2024, 13(24), 7761; https://doi.org/10.3390/jcm13247761 - 19 Dec 2024
Viewed by 321
Abstract
Background/Objectives: Eccentric bruxism is a complex parafunctional activity that involves grinding of teeth and occurs more frequently during sleep. This study aimed to assess differences in condylar parameters (sagittal condylar inclination -SCI and Bennett angle -BA) and mandibular and condylar kinematics during [...] Read more.
Background/Objectives: Eccentric bruxism is a complex parafunctional activity that involves grinding of teeth and occurs more frequently during sleep. This study aimed to assess differences in condylar parameters (sagittal condylar inclination -SCI and Bennett angle -BA) and mandibular and condylar kinematics during functional and parafunctional movements in bruxers and non-bruxers and to assess a digital method for quantifying eccentric bruxism using an optical jaw tracking system (Modjaw®). Methods: The study group included subjects diagnosed with eccentric bruxism according to validated clinical diagnostic criteria. A control group of non-bruxer subjects with demographic characteristics similar to the study group was considered. Each participant underwent Modjaw® examination twice to assess the recordings’ repeatability. The anterior guidance, mastication, and simulated eccentric bruxism were recorded. The SCI and BA were computed. The trajectories of interincisal inferior point (IIP), left condyle (LC), and right condyle (RC) in the frontal (F), sagittal (S), and horizontal (H) planes were outlined in rectangles to calculate areas of mastication and areas of eccentric bruxism (mm2). Intraclass correlation coefficient (ICC) was used to assess the recordings’ repeatability. Comparisons between groups were performed using Student’s t- and Mann–Whitney tests. The receiver–operator characteristic (ROC) curve was used to assess the diagnostic quality of the digital method. Results: Twenty bruxers (10 F and 10 M) and 20 non-bruxers (10 F and 10 M) were included. The ICC had values higher than 0.85. SCI, BA, and area of mastication for IIP, LC, and RC were similar between the groups (p > 0.05). The area of eccentric bruxism was significantly wider in the bruxers (p < 0.001). According to the ROC curve, the following cut-off areas (mm2) for eccentric bruxism were found in F, S, and H planes: IIP (18.05, 13.43, 16.28); LC (3.74, 10.83, 3.35); and RC (4.21, 10.63, 2.9), corresponding to sensitivity > 0.8, specificity > 0.75 and area under the curve (AUC) > 0.85. Conclusions: Mandibular and condylar kinematics during functional movements were similar in bruxers and non-bruxers. A novel digital method for quantifying eccentric bruxism was found using Modjaw®, which could serve as a tool for early detection of eccentric bruxism before the onset of clinical consequences. Full article
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<p>Modjaw<sup>®</sup> examination: (<b>A</b>). real hinge axis computation; (<b>B</b>). SCI—computation; (<b>C</b>). BA—computation.</p>
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<p>Mastication for a bruxer: interincisal inferior point, left condyle, and right condyle in the frontal, sagittal, and horizontal planes.</p>
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<p>Mastication for a non-bruxer: interincisal inferior point, left condyle, and right condyle in the frontal, sagittal, and horizontal planes.</p>
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<p>Simulated eccentric bruxism for a bruxer: interincisal inferior point, left condyle, and right condyle in frontal, sagittal, and horizontal planes.</p>
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<p>Simulated eccentric bruxism for a non-bruxer: interincisal inferior point, left condyle, and right condyle in frontal, sagittal, and horizontal planes.</p>
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<p>Receiver–operator characteristic curve for interincisal inferior point in frontal, sagittal, and horizontal plane. The blue dot represents the optimal sensitivity to specificity ratio (Youden index) and corresponds to the ideal cut-off value for the area of eccentric bruxism. ROC—receiver–operator characteristic; IIP—interincisal inferior point.</p>
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<p>Receiver–operator characteristic curve for left condyle in frontal, sagittal, and horizontal plane. The blue dot represents the optimal sensitivity to specificity ratio (Youden index) and corresponds to the ideal cut-off value for the area of eccentric bruxism. ROC—receiver–operator characteristic; LC—left condyle.</p>
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<p>Receiver–operator characteristic curve for right condyle in frontal, sagittal, and horizontal plane. The blue dot represents the optimal sensitivity to specificity ratio (Youden index) and corresponds to the ideal cut-off value for the area of eccentric bruxism. ROC—receiver–operator characteristic; RC—right condyle.</p>
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11 pages, 1177 KiB  
Article
Lifestyle and Environment Influence the Psychological Well-Being of Elderly Subjects in Italy
by Simone Migliore, Marco De Angelis, Ilaria Di Pompeo, Daniele Lozzi, Martina Marcaccio and Giuseppe Curcio
Brain Sci. 2024, 14(12), 1276; https://doi.org/10.3390/brainsci14121276 - 19 Dec 2024
Viewed by 440
Abstract
Background/Objective: Aging is associated with both cognitive and physical decline. Some factors, such as lifestyle and environment, can significantly contribute to accelerating or slowing down the decline processes. Our study aimed to evaluate the impact of lifestyle (active vs. non-active) and environmental context [...] Read more.
Background/Objective: Aging is associated with both cognitive and physical decline. Some factors, such as lifestyle and environment, can significantly contribute to accelerating or slowing down the decline processes. Our study aimed to evaluate the impact of lifestyle (active vs. non-active) and environmental context (institutionalized vs. non-institutionalized) on the cognitive functioning, psychological well-being, sleep quality, and daily living skills of elderly people. Methods: Our sample consisted of 182 subjects divided into active and non-active groups (subjects who engage or not in physical and social activities, respectively; mean age in years: 67.19 vs. 68.75) and 245 subjects divided into institutionalized and non-institutionalized groups (i.e., living in a nursing home or not, respectively; mean age in years: 79.49 vs. 71.72). Participants were enrolled voluntarily and randomly in the city of L’Aquila. A battery of psychological instruments was administered to evaluate general cognitive decline, depressive symptoms, self-assessed sleep quality, and daily living skills. Results: Regarding lifestyle, the active group exhibited significantly lower levels of depression, better sleep quality, and daily living skills with respect to the non-active group. Regarding environmental context, institutionalized subjects showed higher levels of depression and reduced cognitive functioning, which were linked to reduced sleep quality and worsened daily living skills. When comparing the non-active with the institutionalized group, the latter showed higher levels of depression and reduced cognitive functioning, more sleep complaints, and reduced daily living skills. Conclusions: Our study highlights that an active lifestyle and a non-institutionalized environment, both allowing greater mobility and autonomy, are two factors that positively contribute to the mental and physical well-being of elderly individuals. Furthermore, the healthcare institution context appears to have a greater negative impact on the psycho-physical well-being of the subjects involved compared to a non-active lifestyle. Full article
(This article belongs to the Section Behavioral Neuroscience)
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<p>Statistically significant differences in the active and non-active groups’ scores. GDS: Geriatric Depression Scale; ECQ_lsa: leisure activities; ECQ_s: sports, ECQ_swb: subjective well-being; ECQ_dr: daily routines; ECQ_ms: manual skills; ECQ_m: mobility; PSQI_C1: subjective sleep quality; ECQ_tot: Everyday Competence Questionnaire, total score.</p>
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<p>Statistically significant differences in institutionalized and non-institutionalized groups. GDS: Geriatric Depression Scale; ECQ_lsa: leisure activities; ECQ_s: sports, ECQ_swb: subjective well-being; ECQ_hk: housekeeping; ECQ_dr: daily routines; ECQ_ms: manual skills; ECQ_m: mobility; PSQI_C4: habitual sleep efficiency; MMSE: Mini-Mental State Examination; ECQ_tot: Everyday Competence Questionnaire, total score.</p>
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<p>Statistically significant differences in institutionalized and non-active groups. GDS: Geriatric Depression Scale; ECQ_swb: subjective well-being; ECQ_la: general linguistic usage; ECQ_hk: housekeeping; ECQ_dr: daily routines; ECQ_ms: manual skills; ECQ_m: mobility; PSQI_C1: subjective sleep quality; PSQI_C4: habitual sleep efficiency; PSQI_C5: sleep disturbances; PSQI_C6: use of sleep medications; PSQI_C7: daytime dysfunction; MMSE: Mini-Mental State Examination; ECQ_tot: Everyday Competence Questionnaire, total score.</p>
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21 pages, 1015 KiB  
Review
Chronobiology in Paediatric Neurological and Neuropsychiatric Disorders: Harmonizing Care with Biological Clocks
by Gabriele Giannotta, Marta Ruggiero and Antonio Trabacca
J. Clin. Med. 2024, 13(24), 7737; https://doi.org/10.3390/jcm13247737 - 18 Dec 2024
Viewed by 485
Abstract
Background: Chronobiology has gained attention in the context of paediatric neurological and neuropsychiatric disorders, including migraine, epilepsy, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). Disruptions in circadian rhythms are associated with key symptoms such as sleep disturbances, [...] Read more.
Background: Chronobiology has gained attention in the context of paediatric neurological and neuropsychiatric disorders, including migraine, epilepsy, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). Disruptions in circadian rhythms are associated with key symptoms such as sleep disturbances, mood dysregulation, and cognitive impairments, suggesting a potential for chronobiology-based therapeutic approaches. Methods: This narrative review employs a systematic approach to identify relevant studies through searches of three major scientific databases, NCBI/PubMed, ScienceDirect, and Scopus, up to July 2024. We used a combination of broad and condition-specific keywords, such as “chronobiology”, “biorhythm”, “pediatric”, “epilepsy”, “ADHD”, and “ASD”, among others. Articles in English that focused on clinical features, treatments, or outcomes related to circadian rhythms in paediatric populations were included, while non-peer-reviewed articles and studies lacking original data were excluded. Rayyan software was used for article screening, removing duplicates, and facilitating consensus among independent reviewers. Results: A total of 87 studies were included in the analysis. Findings reveal a consistent pattern of circadian rhythm disruptions across the disorders examined. Specifically, dysregulation of melatonin and cortisol secretion is observed in children with ASD, ADHD, and PTSD, with altered circadian timing contributing to sleep disturbances and mood swings. Alterations in core clock genes (CLOCK, BMAL1, PER, and CRY) were also noted in children with epilepsy, which was linked to seizure frequency and timing. Chronotherapy approaches showed promise in managing these disruptions: melatonin supplementation improved sleep quality and reduced ADHD symptoms in some children, while light therapy proved effective in stabilizing sleep–wake cycles in ASD and ADHD patients. Additionally, behaviour-based interventions, such as the Early Start Denver Model, showed success in improving circadian alignment in children with ASD. Conclusions: This review highlights the significant role of circadian rhythm disruptions in paediatric neurological and neuropsychiatric disorders, with direct implications for treatment. Chronobiology-based interventions, such as melatonin therapy, light exposure, and individualized behavioural therapies, offer potential for improving symptomatology and overall functioning. The integration of chronotherapy into clinical practice could provide a paradigm shift from symptom management to more targeted, rhythm-based treatments. Future research should focus on understanding the molecular mechanisms behind circadian disruptions in these disorders and exploring personalized chronotherapeutic approaches tailored to individual circadian patterns. Full article
(This article belongs to the Section Clinical Pediatrics)
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<p>Potential consequences of biorhythm dysregulation in paediatric neurological and neuropsychiatric disorders. Legend: ASD: autism spectrum disorder; ADHD: attention-deficit/hyperactivity disorder; PTSD: Post-traumatic stress disorder.</p>
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<p>Interdependent chronobiological factors to consider in chronotherapy.</p>
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11 pages, 1357 KiB  
Article
Lifestyle, Cognition, and Disability Outcomes in Multiple Sclerosis: A Comprehensive Cohort Study
by Kenia R. Campanholo, Graziella A. S. Faria, Milena S. Pitombeira, Samira L. Apóstolos-Pereira, Dagoberto Callegaro, Carlos Alberto Buchpiguel and Daniele de Paula Faria
Sclerosis 2024, 2(4), 394-404; https://doi.org/10.3390/sclerosis2040026 - 18 Dec 2024
Viewed by 810
Abstract
Background/Objectives: People with multiple sclerosis (MS) often experience sensory, psychomotor, and cognitive impairment, sphincter disturbances, and fatigue, which can affect their ability to perform work-related tasks, self-care, and daily activities. This study aimed to analyze the lifestyle changes, cognitive function, and disability outcomes [...] Read more.
Background/Objectives: People with multiple sclerosis (MS) often experience sensory, psychomotor, and cognitive impairment, sphincter disturbances, and fatigue, which can affect their ability to perform work-related tasks, self-care, and daily activities. This study aimed to analyze the lifestyle changes, cognitive function, and disability outcomes over a seven-year follow-up period, exploring potential associations with predictive markers. Methods: At the end of the seven-year follow-up period, 32 participants returned for cognitive and clinical reassessment with the Twenty-Five-Foot Walk Test, Nine-Hole Peg Test, and Brief Repeatable Neuropsychological Battery. Lifestyle data were acquired via interviews regarding sleep quality, reading habits, technology use, physical activity levels, household responsibilities, and participation in leisure and cultural activities. Results: The occupational profile did not demonstrate significant changes, but 11 (34%) participants showed disability accumulation, and the number of relapses increased (p = 0.001). Over time, improvement was observed in verbal episodic memory and worsening in psychomotor speed. Better cognitive performance in mental agility was associated with higher levels of physical activity (p = 0.021) and technology use (p = 0.039). In addition, better cognition (verbal memory p = 0.038 and processing speed 0.015) and psychomotor speed (upper limbs p = 0.017 and lower limbs p = 0.003) and lower functional disability (p = 0.022) were associated with maintenance of household activities. Conclusions: The changes in verbal memory and psychomotor speed were more prominent over time, and verbal memory, psychomotor and processing speed, and mental agility were associated with good lifestyle habits, mainly household activities. The treatment strategies should include lifestyle changes and pharmacological interventions. Full article
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<p>Longitudinal comparisons for cognitive test and psychomotor speed tasks. Legend: the graphs show crude scores. (*) Generalized Equation Estimation time effect. (**) Generalized Equation Estimation time effect adjusted for age and years of education. Acronyms: PASAT—Paced Auditory Serial Addition Test; SDMT—Symbol Digit Modalities Test; SpRT—Spatial Recall Test; SRT—Selective Reminding Test; WLG—Word List Generation; 9HPT—Nine-Hole Peg Test; 25FWT—Twenty-Five-Foot Walk Test.</p>
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<p>Lifestyle activities at follow-up: frequency and proportion.</p>
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8 pages, 2395 KiB  
Brief Report
Can Quality of Life Tests Be Useful in Patients Affected by Alpha-1 Antitrypsin Deficiency?
by José María Hernández-Pérez, Hassan Khadour-Khadour, Gema Romero-Romero and Miguel Ángel García-Bello
J. Clin. Med. 2024, 13(24), 7711; https://doi.org/10.3390/jcm13247711 - 17 Dec 2024
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Abstract
Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that predisposes a person to certain diseases over their lifetime, mainly including lung disease (in the form of emphysema) and liver disease (liver cirrhosis). Quality of life questionnaires are instruments designed to quantify the deterioration [...] Read more.
Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that predisposes a person to certain diseases over their lifetime, mainly including lung disease (in the form of emphysema) and liver disease (liver cirrhosis). Quality of life questionnaires are instruments designed to quantify the deterioration of a patient’s health. Background/Objectives: This study aimed to assess whether certain quality of life tests that are routinely used in clinical practice can be useful for patients with AATD. Methods: A sample of AATD patients, with various genotypes, but with the common characteristic that they must have both altered alleles (Pi* ≠ M), participated in the study. Different quality of life tests were used, including the COPD Assessment Test (CAT), COPD and Asthma Sleep Impact Scale, the short form of the Short Form Health Survey, and EuroQol 5 dimensions, and were related to differing clinical and functional characteristics. Results: The sample was composed of 54 patients, and slightly more than half of the participants were women (57.4%), with a mean age of 51.5 ± 13.7. The main genotypes were Pi*SZ (43.4%) and Pi*ZZ (34%). In patients under 65 years of age (n = 47), those who were actively working could walk a greater distance in the walking test, namely, 573 m (511–629), compared to those who were not actively working, namely, 415.5 m (392–469; p < 0.001). Active non-workers had a worse CAT (13.6 ± 7.8 vs. 4.6 ± 4.3; p < 0.001). In total, 80% of non-working patients had exacerbations, but only 46. 9% of those who were active, although the association did not reach statistical significance (p = 0.068). Having a lower score in the physical component of SF-12 was related to suffering from lung disease (46.0 ± 11.4 vs. 38.4 ± 11.1 (p = 0.026)). Conclusions: Quality of life tests were able to detect differences and relate them to functional factors such as the distance covered in the walking test, being sensitive and specific in this regard. Full article
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<p>(<b>A</b>) Box and whisker diagram representing CAT scores depending on whether the patient was working, in those under 65 years of age. (<b>B</b>) Correlation matrix between the two main components of the SF-12 questionnaire and lung function parameters. (<b>C</b>) Correlation matrix between quality of life questionnaires and lung function parameters. (<b>D</b>) Correlation matrix between the different quality of life questionnaires used. Only significative correlations are shown. FVC: Forced vital capacity. FEV1: Forced expired volume in the first second. DLCO: Diffusion carbon monoxide test. CAT: COPD Assessment Test. CASIS: Asthma Sleep Impact Scale. EQ5D5L: EuroQol 5 Dimensions 5 Levels.</p>
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<p>(<b>A</b>) Box and whisker diagram representing CAT scores depending on whether the patient was working, in those under 65 years of age. (<b>B</b>) Correlation matrix between the two main components of the SF-12 questionnaire and lung function parameters. (<b>C</b>) Correlation matrix between quality of life questionnaires and lung function parameters. (<b>D</b>) Correlation matrix between the different quality of life questionnaires used. Only significative correlations are shown. FVC: Forced vital capacity. FEV1: Forced expired volume in the first second. DLCO: Diffusion carbon monoxide test. CAT: COPD Assessment Test. CASIS: Asthma Sleep Impact Scale. EQ5D5L: EuroQol 5 Dimensions 5 Levels.</p>
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