Effects of sleep disturbance on dyspnoea and impaired lung function following hospital admission due to COVID-19 in the UK: a prospective multicentre cohort study

Background: Sleep disturbance is common following hospital admission both for COVID-19 and other causes. The clinical associations of this for recovery after hospital admission are poorly understood despite sleep disturbance contributing to morbidity in other scenarios. We aimed to investigate the prevalence and nature of sleep disturbance after discharge following hospital admission for COVID-19 and to assess whether this was associated with dyspnoea. Methods: CircCOVID was a prospective multicentre cohort substudy designed to investigate the effects of circadian disruption and sleep disturbance on recovery after COVID-19 in a cohort of participants aged 18 years or older, admitted to hospital for COVID-19 in the UK, and discharged between March, 2020, and October, 2021. Participants were recruited from the Post-hospitalisation COVID-19 study (PHOSP-COVID). Follow-up data were collected at two timepoints: an early time point 2–7 months after hospital discharge and a later time point 10–14 months after hospital discharge. Sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index questionnaire and a numerical rating scale. Sleep quality was also assessed with an accelerometer worn on the wrist (actigraphy) for 14 days. Participants were also clinically phenotyped, including assessment of symptoms (ie, anxiety [Generalised Anxiety Disorder 7-item scale questionnaire], muscle function [SARC-F questionnaire], dyspnoea [Dyspnoea-12 questionnaire] and measurement of lung function), at the early timepoint after discharge. Actigraphy results were also compared to a matched UK Biobank cohort (non-hospitalised individuals and recently hospitalised individuals). Multivariable linear regression was used to define associations of sleep disturbance with the primary outcome of breathlessness and the other clinical symptoms. PHOSP-COVID is registered on the ISRCTN Registry (ISRCTN10980107). Findings: 2320 of 2468 participants in the PHOSP-COVID study attended an early timepoint research visit a median of 5 months (IQR 4–6) following discharge from 83 hospitals in the UK. Data for sleep quality were assessed by subjective measures (the Pittsburgh Sleep Quality Index questionnaire and the numerical rating scale) for 638 participants at the early time point. Sleep quality was also assessed using device-based measures (actigraphy) a median of 7 months (IQR 5–8 months) after discharge from hospital for 729 participants. After discharge from hospital, the majority (396 [62%] of 638) of participants who had been admitted to hospital for COVID-19 reported poor sleep quality in response to the Pittsburgh Sleep Quality Index questionnaire. A comparable proportion (338 [53%] of 638) of participants felt their sleep quality had deteriorated following discharge after COVID-19 admission, as assessed by the numerical rating scale. Device-based measurements were compared to an age-matched, sex-matched, BMI-matched, and time from discharge-matched UK Biobank cohort who had recently been admitted to hospital. Compared to the recently hospitalised matched UK Biobank cohort, participants in our study slept on average 65 min (95% CI 59 to 71) longer, had a lower sleep regularity index (–19%; 95% CI –20 to –16), and a lower sleep efficiency (3·83 percentage points; 95% CI 3·40 to 4·26). Similar results were obtained when comparisons were made with the non-hospitalised UK Biobank cohort. Overall sleep quality (unadjusted effect estimate 3·94; 95% CI 2·78 to 5·10), deterioration in sleep quality following hospital admission (3·00; 1·82 to 4·28), and sleep regularity (4·38; 2·10 to 6·65) were associated with higher dyspnoea scores. Poor sleep quality, deterioration in sleep quality, and sleep regularity were also associated with impaired lung function, as assessed by forced vital capacity. Depending on the sleep metric, anxiety mediated 18–39% of the effect of sleep disturbance on dyspnoea, while muscle weakness mediated 27–41% of this effect. Interpretation: Sleep disturbance following hospital admission for COVID-19 is associated with dyspnoea, anxiety, and muscle weakness. Due to the association with multiple symptoms, targeting sleep disturbance might be beneficial in treating the post-COVID-19 condition. Funding: UK Research and Innovation, National Institute for Health Research, and Engineering and Physical Sciences Research Council

Phase III ResonantSonic{reg_sign} report

The ResonantSonic drilling system was tested at the hanford Site in the fiscal year 1991-1992 under the auspices of the Drilling Technology Development Program and the Environmental Restoration Program. The purpose of that program was to develop, test, and demonstrate drilling methods that are environmentally acceptable, safe, efficient, and cost effective when drilling and sampling in hazardous and radioactive waste sites. The cable-tool method has historically been the primary drilling method employed for characterization and remediation projects at the Hanford site. The cable-tool method can be used reliably in a wide variety of geologic conditions and yields continuous, relatively intact core samples. however, the disadvantages of this method are that the penetration rates are slow relative to most other drilling techniques. This report represents the completion of the ResonantSonic drilling program test activities. A brief description of the ResonantSonic drilling program is given. Phases I and II activities are also presented. Phase III activities are outlined. The conclusions drawn from the results and recommendations for further work to improve the drilling technology are discussed

Estudo comparativo entre as provas de ELISA e imunofluorescência indireta (IFI) para detectar anticorpos contra Babesia bovis A comparative study between ELISA and indirect imunofluorescent (IFI) tests to detect antibodies against Babesia bovis

Comparou-se o desempenho de um kit de ELISA para detectar anticorpos contra Babesia bovis, em hemoparasita bovino, com o teste de Imunofluorescência Indireta (IFI) usualmente empregado em rotina sorológica. Sobre 97 amostras de soros oriundas de uma região livre de carrapatos e hematozoários, o teste de ELISA demonstrou uma especificidade de 98.9% contra 97.9% do teste de IFI. Ambos os testes apresentaram uma sensibilidade de 100% quando utilizados sobre 22 amostras de soro de bovinos experimentalmente infectados com B. bovis. Os resultados obtidos sobre 1560 amostras colhidas à campo, mostraram uma concordância de 90,1% (1406/1560) entre amostras positivas e negativas, enquanto que 4,2% (66) foram positivas para IFI e negativas para ELISA e 5,6% (88) foram negativas para IFI e positivas para ELISA.<br>Performance of an ELISA kit for detecting antibodies to Babesia bovis, a bovine haemoparasite, was compared with the Indirect Fluorescent Antibody Test (IFAT) used in serological routine. Over 97 sera samples from a free tick area, ELISA showed an specificity of 98.9% against 97.9% obtained by IFA T. Both tests showed a sensitivity of 100% when compared over 22 sera samples from experimentally infected bovine with B. bovis. Results obtained with 1560 field samples showed an agreement of 90.1% (1406/1560) between positive and negativo samples while 4.2% (66) were positives to IFAT and negatives to ELISA, and 5.6% (88) owere negatives to IFAT and positives to ELISA

Perfil fenotípico de linfócitos periféricos de bovinos de raças européias Phenotypic profile of peripheral blood lymphocytes from European bovines

<abstract language="eng">The phenotypic profile of bovine lymphocytes was evaluated in 18 bovines (Bos taurus) from three different breeds, being nine Holstein, six Hereford, and three Brown Swiss. All animals were free from ticks and hemoparasites, as determined after jugular vein blood sampling. The immunophenotypes of peripheral lymphocytes were evaluated by flow cytometry. Peripheral lymphocytes were exposed to bovine fluorescein-labeled monoclonal antibodies including anti-CD4, anti-CD8, and anti-purified bovine CD21 specificities. After lysing the erythrocytes with a commercial lysing solution (FACS TM ), the lymphocytes were washed, fixed, and evaluated by flow cytometry. Significant differences in the phenotypic profiles of peripheral lymphocytes among all breeds were found. Holstein animals showed a lower percentage of total T lymphocytes (CD4 and CD8) and higher percentage of B lymphocytes (CD21). In addition, the lymphocytes from Holstein animals showed a lower T/B ratio than the lymphocytes from Hereford animals. These results suggest the existence of different phenotypic profiles of peripheral lymphocytes from European breeds of cattle. Such differences may be related to the different pattern of immune response described for these breeds in the literature and may account to varying disease resistance among breeds