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Investigating the Roles for Essential Genes in the Regulation of the Circadian Clock in Synechococcus elongatus Using CRISPR Interference. 利用 CRISPR 干扰技术研究基本基因在拉长鞘氨醇梭菌昼夜节律钟调控中的作用。
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-15 DOI: 10.1177/07487304241228333
Nouneh Boodaghian, Hyunsook Park, Susan E Cohen

Circadian rhythms are found widely throughout nature where cyanobacteria are the simplest organisms, in which the molecular details of the clock have been elucidated. Circadian rhythmicity in cyanobacteria is carried out via the KaiA, KaiB, and KaiC core oscillator proteins that keep ~24 h time. A series of input and output proteins-CikA, SasA, and RpaA-regulate the clock by sensing environmental changes and timing rhythmic activities, including global rhythms of gene expression. Our previous work identified a novel set of KaiC-interacting proteins, some of which are encoded by genes that are essential for viability. To understand the relationship of these essential genes to the clock, we applied CRISPR interference (CRISPRi) which utilizes a deactivated Cas9 protein and single-guide RNA (sgRNA) to reduce the expression of target genes but not fully abolish their expression to allow for survival. Eight candidate genes were targeted, and strains were analyzed by quantitative real-time PCR (qRT-PCR) for reduction of gene expression, and rhythms of gene expression were monitored to analyze circadian phenotypes. Strains with reduced expression of SynPCC7942_0001, dnaN, which encodes for the β-clamp of the replicative DNA polymerase, or SynPCC7942_1081, which likely encodes for a KtrA homolog involved in K+ transport, displayed longer circadian rhythms of gene expression than the wild type. As neither of these proteins have been previously implicated in the circadian clock, these data suggest that diverse cellular processes, DNA replication and K+ transport, can influence the circadian clock and represent new avenues to understand clock function.

昼夜节律广泛存在于自然界中,其中蓝藻是最简单的生物,其时钟的分子细节已被阐明。蓝藻中的昼夜节律是通过 KaiA、KaiB 和 KaiC 核心振荡蛋白实现的,它们能保持约 24 小时的时间。一系列输入和输出蛋白--CikA、SasA 和 RpaA--通过感知环境变化和为节律活动(包括基因表达的全局节律)计时来调节时钟。我们之前的工作发现了一组新的与 KaiC 相互作用的蛋白质,其中一些是由对生命力至关重要的基因编码的。为了了解这些重要基因与时钟的关系,我们应用了CRISPR干扰(CRISPRi)技术,该技术利用失活的Cas9蛋白和单导RNA(sgRNA)来降低目标基因的表达,但并不完全消除其表达,从而使其得以存活。研究人员以八个候选基因为靶标,通过实时定量 PCR(qRT-PCR)分析菌株基因表达的减少情况,并监测基因表达的节律,以分析昼夜节律表型。与野生型相比,SynPCC7942_0001、编码复制 DNA 聚合酶β钳的 dnaN 或可能编码参与 K+ 转运的 KtrA 同源物的 SynPCC7942_1081 表达减少的菌株显示出更长的基因表达昼夜节律。这些数据表明,DNA 复制和 K+ 运输等多种细胞过程都能影响昼夜节律,是了解时钟功能的新途径。
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引用次数: 0
The Impact of Pupil Constriction on the Relationship Between Melanopic EDI and Melatonin Suppression in Young Adult Males. 瞳孔收缩对青壮年男性黑色素生成指数和褪黑激素抑制之间关系的影响
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-13 DOI: 10.1177/07487304241226466
Isabel Schöllhorn, Oliver Stefani, Robert J Lucas, Manuel Spitschan, Christian Epple, Christian Cajochen

The pupil modulates the amount of light that reaches the retina. Not only luminance but also the spectral distribution defines the pupil size. Previous research has identified steady-state pupil size and melatonin attenuation to be predominantly driven by melanopsin, which is expressed by a unique subgroup of intrinsically photosensitive retinal ganglion cells (ipRGCs) that are sensitive to short-wavelength light (~480 nm). Here, we aimed to selectively target the melanopsin system during the evening, while measuring steady-state pupil size and melatonin concentrations under commonly experienced evening light levels (<90 lx). Therefore, we used a five-primary display prototype to generate light conditions that were matched in terms of L-, M-, and S-cone-opic irradiances, but with high and low melanopic irradiances (~3-fold difference). Seventy-two healthy, male participants completed a 2-week study protocol. The volunteers were assigned to one of the four groups that differed in luminance levels (27-285 cd/m2). Within the four groups, each volunteer was exposed to a low melanopic (LM) and a high melanopic (HM) condition. The two 17-h study protocols comprised 3.5 h of light exposure starting 4 h before habitual bedtime. Median pupil size was significantly smaller during HM than LM in all four light intensity groups. In addition, we observed a significant correlation between melanopic weighted corneal illuminance (melanopic equivalent daylight illuminance [mEDI]) and pupil size, such that higher mEDI values were associated with smaller pupil size. Using pupil size to estimate retinal irradiance showed a qualitatively similar goodness of fit as mEDI for predicting melatonin suppression. Based on our results here, it remains appropriate to use melanopic irradiance measured at eye level when comparing light-dependent effects on evening melatonin concentrations in healthy young people at rather low light levels.

瞳孔调节到达视网膜的光量。决定瞳孔大小的不仅是亮度,还有光谱分布。先前的研究发现,稳态瞳孔大小和褪黑激素衰减主要由黑视蛋白驱动,而黑视蛋白是由对短波长光(约 480 纳米)敏感的内感光视网膜神经节细胞(ipRGCs)的独特亚群表达的。在这里,我们的目的是在傍晚选择性地靶向黑视蛋白系统,同时测量傍晚常见光照水平下的稳态瞳孔大小和褪黑激素浓度(2)。在四组志愿者中,每名志愿者分别暴露于低黑色素(LM)和高黑色素(HM)条件下。两个 17 小时的研究方案包括 3.5 小时的光照,从习惯就寝时间前 4 小时开始。在所有四个光照强度组中,HM 条件下的瞳孔中位数明显小于 LM 条件下的瞳孔中位数。此外,我们还观察到黑色素加权角膜照度(黑色素等效日光照度 [mEDI])与瞳孔大小之间存在明显的相关性,即 mEDI 值越高,瞳孔越小。在预测褪黑激素抑制时,使用瞳孔大小估算视网膜辐照度显示出与 mEDI 相似的质量拟合度。根据我们的研究结果,在比较光照对健康年轻人晚间褪黑激素浓度的影响时,使用在眼睛水平测量的黑色素辐照度仍然是合适的。
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引用次数: 0
Circadian Variation in the Response to Vaccination: A Systematic Review and Evidence Appraisal. 疫苗接种反应的昼夜节律变化:系统回顾与证据评估》。
IF 2.9 3区 生物学 Q2 BIOLOGY Pub Date : 2024-06-01 Epub Date: 2024-03-08 DOI: 10.1177/07487304241232447
Cathy A Wyse, Laura M Rudderham, Enya A Nordon, Louise M Ince, Andrew N Coogan, Lorna M Lopez

Molecular timing mechanisms known as circadian clocks drive endogenous 24-h rhythmicity in most physiological functions, including innate and adaptive immunity. Consequently, the response to immune challenge such as vaccination might depend on the time of day of exposure. This study assessed whether the time of day of vaccination (TODV) is associated with the subsequent immune and clinical response by conducting a systematic review of previous studies. The Cochrane Library, PubMed, Google, Medline, and Embase were searched for studies that reported TODV and immune and clinical outcomes, yielding 3114 studies, 23 of which met the inclusion criteria. The global severe acute respiratory syndrome coronavirus 2 vaccination program facilitated investigation of TODV and almost half of the studies included reported data collected during the COVID-19 pandemic. There was considerable heterogeneity in the demography of participants and type of vaccine, and most studies were biased by failure to account for immune status prior to vaccination, self-selection of vaccination time, or confounding factors such as sleep, chronotype, and shiftwork. The optimum TODV was concluded to be afternoon (5 studies), morning (5 studies), morning and afternoon (1 study), midday (1 study), and morning or late afternoon (1 study), with the remaining 10 studies reporting no effect. Further research is required to understand the relationship between TODV and subsequent immune outcome and whether any clinical benefit outweighs the potential effect of this intervention on vaccine uptake.

被称为昼夜节律钟的分子计时机制驱动着大多数生理功能(包括先天性免疫和适应性免疫)的内源性 24 小时节律性。因此,对疫苗接种等免疫挑战的反应可能取决于一天中接触疫苗的时间。本研究通过对以往的研究进行系统回顾,评估了接种疫苗的时间(TODV)是否与随后的免疫和临床反应有关。研究人员在 Cochrane 图书馆、PubMed、Google、Medline 和 Embase 中检索了报告 TODV 与免疫和临床结果的研究,共获得 3114 项研究,其中 23 项符合纳入标准。全球严重急性呼吸系统综合征冠状病毒 2 疫苗接种计划促进了对 TODV 的调查,所纳入的研究中有近一半报告了在 COVID-19 大流行期间收集的数据。参与研究的人员构成和疫苗类型存在相当大的异质性,大多数研究因未考虑接种前的免疫状态、接种时间的自我选择或睡眠、时间型和轮班工作等混杂因素而存在偏差。最佳接种时间为下午(5 项研究)、上午(5 项研究)、上午和下午(1 项研究)、中午(1 项研究)、上午或下午晚些时候(1 项研究),其余 10 项研究报告称没有影响。要了解 TODV 与后续免疫结果之间的关系,以及临床益处是否超过了这种干预对疫苗接种的潜在影响,还需要进一步的研究。
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引用次数: 0
Using Polygenic Scores for Circadian Rhythms to Predict Wellbeing, Depressive Symptoms, Chronotype, and Health. 利用昼夜节律的多基因评分预测幸福感、抑郁症状、慢性型和健康。
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-01 DOI: 10.1177/07487304241230577
Anne Landvreugd, René Pool, Michel G Nivard, Meike Bartels

The association between circadian rhythms and diseases has been well established, while the association with mental health is less explored. Given the heritable nature of circadian rhythms, this study aimed to investigate the relationship between genes underlying circadian rhythms and mental health outcomes, as well as a possible gene-environment correlation for circadian rhythms. Polygenic scores (PGSs) represent the genetic predisposition to develop a certain trait or disease. In a sample from the Netherlands Twin Register (N = 14,021), PGSs were calculated for two circadian rhythm measures: morningness and relative amplitude (RA). The PGSs were used to predict mental health outcomes such as subjective happiness, quality of life, and depressive symptoms. In addition, we performed the same prediction analysis in a within-family design in a subset of dizygotic twins. The PGS for morningness significantly predicted morningness (R2 = 1.55%) and depressive symptoms (R2 = 0.22%). The PGS for RA significantly predicted general health (R2 = 0.12%) and depressive symptoms (R2 = 0.20%). Item analysis of the depressive symptoms showed that 4 out of 14 items were significantly associated with the PGSs. Overall, the results showed that people with a genetic predisposition of being a morning person or with a high RA are likely to have fewer depressive symptoms. The four associated depressive symptoms described symptoms related to decision-making, energy, and feeling worthless or inferior, rather than sleep. Based on our findings future research should include a substantial role for circadian rhythms in depression research and should further explore the gene-environment correlation in circadian rhythms.

昼夜节律与疾病之间的关系已得到公认,但与心理健康的关系却鲜有探讨。鉴于昼夜节律的可遗传性,本研究旨在调查昼夜节律的基础基因与心理健康结果之间的关系,以及昼夜节律基因与环境之间可能存在的相关性。多基因评分(PGS)代表了患某种性状或疾病的遗传易感性。在荷兰双胞胎登记样本(N = 14,021)中,计算了两种昼夜节律测量指标的 PGSs:晨起性和相对振幅(RA)。PGSs用于预测心理健康结果,如主观幸福感、生活质量和抑郁症状。此外,我们还对双卵双胞胎子集进行了同样的家庭内设计预测分析。晨起时间的 PGS 可显著预测晨起时间(R2 = 1.55%)和抑郁症状(R2 = 0.22%)。RA的PGS能明显预测一般健康状况(R2 = 0.12%)和抑郁症状(R2 = 0.20%)。抑郁症状的项目分析显示,14 个项目中有 4 个与 PGSs 有明显关联。总体而言,研究结果表明,具有晨起倾向或高 RA 遗传倾向的人可能具有较少的抑郁症状。四种相关的抑郁症状描述的是与决策、精力、无价值感或自卑感相关的症状,而不是睡眠。基于我们的研究结果,未来的研究应包括昼夜节律在抑郁症研究中的重要作用,并应进一步探讨昼夜节律中基因与环境的相关性。
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引用次数: 0
Divergent Circadian Foraging Strategies in Response to Diurnal Predation Versus Persistent Rain in Asian Weaver Ant, Oecophylla smaragdina, Suggest Possible Energetic Trade-offs. 亚洲纺织蚁(Oecophylla smaragdina)对昼夜捕食和持续降雨的不同昼夜觅食策略表明可能存在能量权衡。
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-08 DOI: 10.1177/07487304241233778
Avishek Dolai, Severine Soltani, Benjamin Smarr, Amlan Das

The study of chronobiology of foraging behavior in social insects offers valuable models for the investigation of circadian rhythms. We scored hourly nest entries and exits of Oecophylla smaragdina (Asian weaver ant) workers in 9 active non-polydomous nests on days with and without rain and with and without a primarily diurnal predator present. After determining that Oecophylla display a high nest fidelity, we focused exclusively on analyzing nest entry counts: we found a significant decrease in overall entry counts of individual ants on rainy days compared with non-rainy days (p < 0.0001). They usually maintain a typical diurnal pattern of foraging activity; however, that regularity was often distorted during rainy periods but appeared to quickly revert to typical patterns following rain. This lack of compensatory foraging activity following a period of rain supports the hypothesis that these ants have enough food reserves to withstand a pure masking-induced suppression of foraging activity. Predation through bird anting, too, decreased foraging activity but appeared to cause a reversal in foraging activity timing from diurnal to nocturnal foraging. Daily periodicity of foraging was significantly disrupted in most nests during rain; however, daily foraging periodicity was disrupted in only one nest due to presence of predators. Thus, rain and predation both exert significant impacts on the overall foraging activity of Asian weaver ants, but while persistent pressure from rain seemed to primarily cause masking (diminution) of circadian foraging activity, predation restricted to the daytime resulted in phase-inversion to nocturnal foraging activity, with little diminution. This is consistent with different energetic strategies being used in response to different pressures by this species.

社会性昆虫觅食行为的时间生物学研究为研究昼夜节律提供了宝贵的模型。我们在有雨和无雨、有天敌和无天敌的情况下,对 9 个活跃的非多巢性巢穴中的 Oecophylla smaragdina(亚洲纺织蚁)工蚁每小时的进出巢情况进行了评分。在确定 Oecophylla 对巢穴的忠诚度很高之后,我们集中分析了蚂蚁的入巢数:我们发现,与无雨天相比,雨天蚂蚁个体的总体入巢数明显减少(p<0.05)。
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引用次数: 0
One Health: Circadian Medicine Benefits Both Non-human Animals and Humans Alike. 同一健康:昼夜节律医学对非人类动物和人类同样有益。
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-20 DOI: 10.1177/07487304241228021
Hesham I Farag, Barbara A Murphy, James R Templeman, Charlene Hanlon, Jessica Joshua, Thomas G Koch, Lee Niel, Anna K Shoveller, Gregoy Y Bedecarrats, Amy Ellison, David Wilcockson, Tami A Martino

Circadian biology's impact on human physical health and its role in disease development and progression is widely recognized. The forefront of circadian rhythm research now focuses on translational applications to clinical medicine, aiming to enhance disease diagnosis, prognosis, and treatment responses. However, the field of circadian medicine has predominantly concentrated on human healthcare, neglecting its potential for transformative applications in veterinary medicine, thereby overlooking opportunities to improve non-human animal health and welfare. This review consists of three main sections. The first section focuses on the translational potential of circadian medicine into current industry practices of agricultural animals, with a particular emphasis on horses, broiler chickens, and laying hens. The second section delves into the potential applications of circadian medicine in small animal veterinary care, primarily focusing on our companion animals, namely dogs and cats. The final section explores emerging frontiers in circadian medicine, encompassing aquaculture, veterinary hospital care, and non-human animal welfare and concludes with the integration of One Health principles. In summary, circadian medicine represents a highly promising field of medicine that holds the potential to significantly enhance the clinical care and overall health of all animals, extending its impact beyond human healthcare.

昼夜节律生物学对人类身体健康的影响及其在疾病发生和发展中的作用已得到广泛认可。目前,昼夜节律研究的前沿集中在临床医学的转化应用上,旨在提高疾病诊断、预后和治疗效果。然而,昼夜节律医学领域主要集中在人类医疗保健领域,忽视了其在兽医领域的变革性应用潜力,从而忽略了改善非人类动物健康和福利的机会。本综述包括三个主要部分。第一部分重点介绍昼夜节律医学在当前农业动物行业实践中的转化潜力,尤其侧重于马、肉鸡和蛋鸡。第二部分深入探讨了昼夜节律医学在小动物兽医护理中的潜在应用,主要侧重于我们的伴侣动物,即狗和猫。最后一部分探讨了昼夜节律医学的新兴前沿领域,包括水产养殖、兽医医院护理和非人类动物福利,并以整合 "一体健康 "原则作为结束语。总之,昼夜节律医学是一个极具发展前景的医学领域,有可能显著提高所有动物的临床护理和整体健康水平,其影响将超越人类医疗保健。
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引用次数: 0
Association Between Augmentation Index and Total Sleep Time in Night Shift Workers. 夜班工人的增强指数与总睡眠时间之间的关系
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-03 DOI: 10.1177/07487304241229180
Waléria D P Gusmão, Victor M Silva, Annelise M G Paiva, Marco Antonio Mota-Gomes, Wilson Nadruz, Claudia R C Moreno

Augmentation index and pulse wave velocity are markers of vascular compromise and independent predictors of cardiovascular risk and mortality. While the link between shift work and heightened cardiovascular risk is established, the intricate genesis of early cardiovascular outcomes in shift workers remains incompletely understood. However, there is evidence that sleep duration plays a role in this regard. Here we evaluate the association of total sleep time with pulse wave velocity, augmentation index, and central blood pressure in night shift workers. This study cross-sectionally evaluated the association of total sleep time evaluated by 10-day monitoring actigraphy with augmentation index, pulse wave velocity, and brachial and central blood pressure evaluated by oscillometry in nursing professionals, 63 shift workers (89% women; age = 45.0 ± 10.5 years), and 17 (100% women; age = 41.8 ± 15.6) day workers. There were no differences in the studied variables between shift workers and day workers. Results of correlation analysis demonstrated that pulse wave velocity, central systolic blood pressure, central diastolic blood pressure, brachial systolic blood pressure, and brachial diastolic blood pressure tended to have significant correlation with each other, while these measures did not have a significant relationship with augmentation index in both groups. However, results of adjusted restricted cubic spline analysis showed a U-shaped-curve association between total sleep time and augmentation index (p < 0.001 for trend) with a nadir at 300-360 min of total sleep time in shift workers. The present study showed that total sleep time, assessed by actigraphy, had a U-shaped association with augmentation index in shift workers, which indicated better characteristics of vascular functionality when sleep time was 5-6 h in the workers studied.

增强指数和脉搏波速度是血管受损的标志,也是心血管风险和死亡率的独立预测指标。虽然轮班工作与心血管风险增加之间的联系已经确立,但对轮班工作者早期心血管后果的复杂成因仍不完全了解。不过,有证据表明,睡眠时间在这方面发挥了作用。在此,我们对夜班工人的总睡眠时间与脉搏波速度、增强指数和中心血压的关系进行了评估。本研究横向评估了护理专业人员、63 名倒班工人(89% 为女性;年龄 = 45.0 ± 10.5 岁)和 17 名白班工人(100% 为女性;年龄 = 41.8 ± 15.6 岁)的 10 天监测动图评估的总睡眠时间与增强指数、脉搏波速度以及示波法评估的肱动脉血压和中心血压之间的关系。轮班工作者和日间工作者的研究变量没有差异。相关性分析结果表明,脉搏波速度、中心收缩压、中心舒张压、肱动脉收缩压和肱动脉舒张压之间存在显著的相关性,而在两组中,这些指标与增强指数之间没有显著的关系。然而,调整后的限制性三次样条分析结果显示,总睡眠时间与增强指数之间呈 U 型曲线关系(p
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引用次数: 0
Circadian Rhythms in Skin Barrier Function in Atopic Dermatitis: A Pilot Study. 特应性皮炎患者皮肤屏障功能的昼夜节律:一项试点研究
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-02 DOI: 10.1177/07487304231220695
Marta Iwanaszko, Nathan Waldeck, Ron Anafi, Amy S Paller, Phyllis C Zee, Anna B Fishbein

Atopic dermatitis (AD) is symptomatically worse in the evening, but the mechanism driving nocturnal eczema remains elusive. Our objective was to determine the circadian rhythm of skin barrier function measured by transepidermal water loss (TEWL) in AD patients and explore the molecular underpinnings. A pilot study was performed on a diverse group of AD (n = 4) and control (n = 2) young patients. We used an inpatient tightly controlled, modified, constant routine protocol. TEWL was measured at least every 90 min in the antecubital fossa (lesional) and forearm, while whole blood samples were collected every 4 h. Results show a significant difference in the antecubital fossa TEWL in the AD group versus controls. TEWL in control skin decreases starting a few hours prior to bedtime, both in the antecubital fossa and in the forearm, while in the AD forearm skin, pre-bedtime TEWL increases. We identified 1576 differentially expressed genes using a time-dependent model. The top 20 upregulated gene ontology pathways included neuronal pathways, while the downregulated functional terms included innate immune signaling and viral response. Similar pathways positively correlated with forearm TEWL in controls and inversely with the AD group. Upregulation in sensory perception pathways correlated with increases in lesional (antecubital fossa) TEWL in the evening. Results show skin barrier function worsens in the evening in the AD group, at a time when barrier is normally rejuvenating in healthy skin. This timing and the detection of transcriptomic signatures of sensory perception and diminished viral response might correspond to the nocturnal itch. Larger studies are needed to evaluate these associations in the skin.

特应性皮炎(AD)的症状在傍晚会加重,但夜间湿疹的驱动机制仍不明确。我们的目标是确定通过经表皮失水(TEWL)测量的 AD 患者皮肤屏障功能的昼夜节律,并探索其分子基础。我们对一组不同的注意力缺失症(4 例)和对照组(2 例)年轻患者进行了试点研究。我们采用了严格控制的、经过修改的、恒定的住院常规方案。至少每隔 90 分钟测量一次眶前窝(病变部位)和前臂的 TEWL,同时每隔 4 小时采集一次全血样本。对照组皮肤的 TEWL 从睡前几小时开始下降,包括眶前窝和前臂,而注意力缺失症组前臂皮肤的 TEWL 则在睡前增加。我们利用时间依赖模型确定了 1576 个差异表达基因。前20个上调的基因本体通路包括神经元通路,而下调的功能术语包括先天免疫信号转导和病毒反应。类似的通路与对照组的前臂TEWL呈正相关,而与AD组呈反相关。感觉通路的上调与晚间病变部位(眶前窝)TEWL的增加相关。结果表明,晚间AD组的皮肤屏障功能会恶化,而此时健康皮肤的屏障功能通常正在恢复。这个时间点以及感知和病毒反应减弱的转录组特征的检测可能与夜间瘙痒相对应。需要进行更大规模的研究来评估皮肤中的这些关联。
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引用次数: 0
Tanya Leise. 问 Leise。
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-10 DOI: 10.1177/07487304241229766
Mary E Harrington, Kurt Bryan, Rob Benedetto, Alec Davidson, Jennifer Evans, Todd Holmes, Stephanie Taylor
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引用次数: 0
Managing Circadian Disruption due to Hospitalization: A Pilot Randomized Controlled Trial of the CircadianCare Inpatient Management System. 管理住院导致的昼夜节律紊乱:CircadianCare住院病人管理系统随机对照试验》。
IF 3.5 3区 生物学 Q2 Medicine Pub Date : 2024-04-01 Epub Date: 2023-12-28 DOI: 10.1177/07487304231213916
Chiara Mangini, Lisa Zarantonello, Chiara Formentin, Gianluca Giusti, Esther D Domenie, Domenico Ruggerini, Rodolfo Costa, Debra J Skene, Daniela Basso, Lisa Battagliarin, Antonino Di Bella, Paolo Angeli, Sara Montagnese

The objective of the present study was to test the effects of an inpatient management system (CircadianCare) aimed at limiting the negative impact of hospitalization on sleep by enhancing circadian rhythmicity. Fifty inpatients were randomized to either CircadianCare (n = 25; 18 males, 62.4 ± 1.9 years) or standard of care (n = 25; 14 males, 64.5 ± 2.3 years). On admission, all underwent a full sleep-wake evaluation; they then completed daily sleep diaries and wore an actigraph for the whole length of hospitalization. On days 1 (T0), 7 (T1), and 14 (T2, if still hospitalized), salivary melatonin for dim light melatonin onset (DLMO) and 24-h skin temperature were recorded. In addition, environmental noise, temperature, and illuminance were monitored. Patients in the CircadianCare arm followed 1 of 3 schedules for light/dark, meal, and physical activity timings, based on their diurnal preference/habits. They wore short-wavelength-enriched light-emitting glasses for 45 min after awakening and short-wavelength light filter shades from 18:00 h until sleep onset. While the first, primary registered outcome (reduced sleep-onset latency on actigraphy or diary) was not met, based on sleep diaries, there was a trend (0.05 < p < 0.1) toward an advance in bedtime for CircadianCare compared to standard of care patients between T0 and T1. Similarly, DLMO time significantly advanced in the small group of patients for whom it could be computed on both occasions, with untreated ones starting from earlier baseline values. Patients sleeping near the window had significantly higher sleep efficiency, regardless of treatment arm. As noise fluctuation increased, so did the number of night awakenings, regardless of treatment arm. In conclusion, the CircadianCare management system showed positive results in terms of advancing sleep timing and the circadian rhythm of melatonin. Furthermore, our study identified a combination of environmental noise and lighting indices, which could be easily modulated to prevent hospitalization-related insomnia.

本研究的目的是测试住院病人管理系统(CircadianCare)的效果,该系统旨在通过提高昼夜节律性来限制住院对睡眠的负面影响。50名住院病人被随机分配到CircadianCare系统(25人,18名男性,62.4 ± 1.9岁)或标准护理系统(25人,14名男性,64.5 ± 2.3岁)。入院时,所有患者都接受了全面的睡眠-觉醒评估,然后填写每日睡眠日记,并在整个住院期间佩戴行动计。在第 1 天(T0)、第 7 天(T1)和第 14 天(T2,如果仍在住院),记录暗光褪黑激素起始时间(DLMO)的唾液褪黑激素和 24 小时皮肤温度。此外,还对环境噪声、温度和照度进行了监测。昼夜节律护理组的患者根据自己的昼夜节律偏好/习惯,在光照/黑暗、进餐和体育锻炼时间上遵循 3 个时间表中的 1 个。他们在起床后的 45 分钟内佩戴短波长富集发光眼镜,并在 18:00 时至睡眠开始前佩戴短波长滤光遮光罩。虽然第一项主要登记结果(通过动觉仪或日记减少睡眠开始潜伏期)没有达到,但根据睡眠日记,有一种趋势(0.05 p.
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Journal of Biological Rhythms
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