Sleep regularity and predictors of sleep efficiency and sleep duration in elite team sport athletes

Background Many elite athletes have suboptimal sleep duration and efficiency, potentially due to factors that may impact sleep onset and offset times. Variability in sleep onset and offset may negatively influence sleep. The sleep regularity index (SRI) is a novel metric for sleep regularity, however there are no published descriptions of SRI in elite athletes. Further, contributors to sleep efficiency and duration in elite athletes using objective measures have not been explored. Methods Sleep was monitored over a minimum of seven consecutive days (7 to 43)—in 203 elite team sport athletes (age range = 19–36 years; female, n = 79; male, n = 124, total sleep nights = 1975) using activity monitoring and sleep diaries. The sleep regularity index (SRI) was calculated to reflect the night-to-night shifts in sleep by accounting for changes in sleep onset and sleep offset. Sleep characteristics were compared between regular and irregular sleepers and important contributors to sleep efficiency and total sleep time were assessed using multiple linear regression models. Results The median sleep regularity index and interquartile range were 85.1 (81.4 to 88.8). When compared to irregular sleepers, regular sleepers demonstrated (1) significantly greater sleep efficiency (p = 0.006; 0.31 medium effect size [ES]), (2) significantly less variability in total sleep time (− p ≤ 0.001; − 0.69, large ES) and sleep efficiency (− 0.34, small ES), (3) similar total sleep time and (4) significantly less variation in sleep onset (p ≤ 0.001; − 0.73, large ES) and offset (p ≤ 0.001; − 0.74, large ES) times. Sleep characteristics explained 73% and 22% of the variance in total sleep time and sleep efficiency, respectively. The most important contributor to total sleep time was a later sleep offset time, while the most important contributors to sleep efficiency were an earlier bedtime and less variable sleep onset times. Conclusions Bedtime and a consistent sleep onset time are important factors associated with sleep efficiency in athletes, while sleep offset is an important factor for total sleep time. Coaches and staff can assist their athletes by providing training schedules that allow for both regularity and sufficiency of time in bed where possible

Use of short-term culture for identification of Mycobacterium avium subsp. paratuberculosis in tissue from Crohn's disease patients

ObjectiveTo investigate the role of Mycobacterium avium subsp. paratuberculosis (MAP) in Crohn's disease (CD), using short-term mycobacterial culture media.MethodsSixty-three tissue specimens from 27 CD patients and 36 controls were processed and inoculated into a modified 7H9 broth base medium and incubated at 37°C and 5% CO2 for up to 1 year. Acid-fast staining, determination of mycobactin dependency, PCR analysis using two IS900-derived oligonucleotides and hybridization with an internal probe were performed.ResultsMAP was present in six of seven (86%) surgically resected tissue samples and in four of 20 (20%) biopsies, with an overall 37% from CD patients, as compared to two of 36 (5.6%) of control specimens. The presence of MAP in Mycobacterial Growth Indicator Tube (MGIT) cultures was detected within 10–12 weeks for surgically resected tissue and after 40 weeks for biopsy specimens, with no MAP growth detected in 12B* Bactec cultures.ConclusionsBecause MAP was present in 86% of resected tissue compared to 20% of biopsy specimens from CD patients, we speculate that MAP resides in the submucosal layer closer to the active part of the ulcer rather than on the surface of the mucosal cells. Thus, surgically resected tissue cultured in MGIT medium is a favorable protocol for rapid cultivation of MAP and for investigating its role in CD pathogenesis. The data support the mycobacterial role in CD pathogenesis

Omission of radiotherapy in elderly patients with early breast cancer : 15-Year results of a prospective non-randomised trial

Background: Whether radiotherapy (RT) is beneficial in elderly ( 6570. years) patients undergoing conservative surgery for early breast cancer has long been controversial. Recent randomised trials show that most elderly patients do not benefit from RT. We started a prospective non-randomised trial to address this issue in 1987 and now present results for the 627 consecutive pT1/2cN0 patients recruited, and treated by conservative surgery (quadrantectomy) and tamoxifen, and assigned non-randomly to RT or no RT. Methods: We used multivariate competing risks models to estimate 15-crude cumulative incidence (CCI) of ipsilateral breast tumour recurrence (IBTR), distant metastasis and breast cancer mortality. The models incorporated a propensity score as a measure of probability of receiving RT based on baseline characteristics, to account for the lack of randomisation. Results: For pT1 patients, 15-year CCIs of IBTR, distant metastasis and breast cancer death were indistinguishable in the RT and no RT groups. For pT2 patients, 15-year CCI of IBTR was much higher in those not given RT (14.6% versus 0.8%, p = 0.004), although breast cancer mortality and distant metastasis did not differ significantly between RT and no RT. Conclusions: Consistent with the findings of recent randomised trials, our long-term data indicate that most elderly, ER-positive patients with pT1 cN0 breast cancer treated by quadrantectomy do not benefit from RT. The 14.6% CCI of IBTR in our pT2 patients is an additional finding not presented in the trials and suggests that RT should be administered to elderly patients with pT2 disease