Factors Influencing Sleep Difficulty and Sleep Quantity in the Citizen Pscientist Psoriatic Cohort.

IntroductionSleep is essential for overall health and well-being, yet more than one-third of adults report inadequate sleep. The prevalence is higher among people with psoriasis, with up to 85.4% of the psoriatic population reporting sleep disruption. Poor sleep among psoriasis patients is particularly concerning because psoriasis is independently associated with many of the same comorbidities as sleep dysfunction, including cardiovascular disease, obesity, and depression. Given the high prevalence and serious consequences of disordered sleep in psoriasis, it is vital to understand the nature of sleep disturbance in this population. This study was designed to help meet this need by using survey data from Citizen Pscientist, an online patient portal developed by the National Psoriasis Foundation.MethodsOur analysis included 3118 participants who identified as having a diagnosis by a physician of psoriasis alone or psoriasis with psoriatic arthritis. Demographic information, psoriasis severity and duration, sleep apnea status, smoking and alcohol consumption, itch timing, and sleep characteristics were included. Two separate multivariate logistic regression models in STATA were used to determine whether the presence of psoriatic arthritis, age, gender, body mass index, comorbid sleep apnea, psoriasis severity, timing of worst itch, smoking status, or high-risk alcohol consumption were associated with sleep difficulty or low sleep quantity, defined by the American Academy of Sleep Medicine as less than 7 h of sleep per night on average.ResultsResults from the multivariate logistic regressions found that sleep difficulty was associated with psoriatic arthritis (OR 2.15, 95% CI [1.79-2.58]), female gender (2.03 [1.67-2.46]), obese body mass index (BMI ≥ 30) (1.25 [1.00-1.56]), sleep apnea (1.41 [1.07-1.86]), psoriasis severity of moderate (1.59 [1.30-1.94]) or severe (2.40 [1.87-3.08]), and smoking (1.60 [1.26-2.02]). Low sleep quantity was associated with obese BMI (1.62 [1.29-2.03]), sleep apnea (1.30 [1.01-1.68]), psoriasis severity of moderate (1.41 [1.16-1.72]) or severe (1.40 [1.11-1.76]), and smoking (1.62 [1.31-2.00]). Sleep difficulty and low sleep quantity were not associated with age, alcohol consumption, or timing of worst itch.ConclusionThese results are potentially meaningful in several aspects. We identify an important distinction between sleep difficulty and sleep quantity in psoriatic disease, whereby having psoriatic arthritis and being female are each associated with sleep difficulty despite no association with low sleep quantity. Furthermore, there is conflicting evidence from prior studies as to whether psoriasis severity is associated with sleep difficulty, but this well-powered, large study revealed a strong, graded relationship between psoriasis severity and both sleep difficulty and low sleep quantity. Overall, our results show that both sleep difficulty and low sleep quantity were associated with multiple factors in this analysis of a large psoriatic cohort. These findings suggest that dermatologists may gather clinically useful information by screening psoriatic patients for trouble sleeping and low sleep quantity to identify potential comorbidities and to more effectively guide disease management

Spectacular nucleosynthesis from early massive stars

Stars formed with initial mass over 50 Msun are very rare today, but they are thought to be more common in the early universe. The fates of those early, metal-poor, massive stars are highly uncertain. Most are expected to directly collapse to black holes, while some may explode as a result of rotationally powered engines or the pair-creation instability. We present the chemical abundances of J0931+0038, a nearby low-mass star identified in early followup of SDSS-V Milky Way Mapper, which preserves the signature of unusual nucleosynthesis from a massive star in the early universe. J0931+0038 has relatively high metallicity ([Fe/H] = -1.76 +/- 0.13) but an extreme odd-even abundance pattern, with some of the lowest known abundance ratios of [N/Fe], [Na/Fe], [K/Fe], [Sc/Fe], and [Ba/Fe]. The implication is that a majority of its metals originated in a single extremely metal-poor nucleosynthetic source. An extensive search through nucleosynthesis predictions finds a clear preference for progenitors with initial mass > 50 Msun, making J0931+0038 one of the first observational constraints on nucleosynthesis in this mass range. However the full abundance pattern is not matched by any models in the literature. J0931+0038 thus presents a challenge for the next generation of nucleosynthesis models and motivates study of high-mass progenitor stars impacted by convection, rotation, jets, and/or binary companions. Though rare, more examples of unusual early nucleosynthesis in metal-poor stars should be found in upcoming large spectroscopic surveys.Comment: 11 pages + 22 page appendix, accepted to ApJ

Spectacular Nucleosynthesis from Early Massive Stars

Stars that formed with an initial mass of over 50 M ⊙ are very rare today, but they are thought to be more common in the early Universe. The fates of those early, metal-poor, massive stars are highly uncertain. Most are expected to directly collapse to black holes, while some may explode as a result of rotationally powered engines or the pair-creation instability. We present the chemical abundances of J0931+0038, a nearby low-mass star identified in early follow-up of the SDSS-V Milky Way Mapper, which preserves the signature of unusual nucleosynthesis from a massive star in the early Universe. J0931+0038 has a relatively high metallicity ([Fe/H] = −1.76 ± 0.13) but an extreme odd–even abundance pattern, with some of the lowest known abundance ratios of [N/Fe], [Na/Fe], [K/Fe], [Sc/Fe], and [Ba/Fe]. The implication is that a majority of its metals originated in a single extremely metal-poor nucleosynthetic source. An extensive search through nucleosynthesis predictions finds a clear preference for progenitors with initial mass >50 M ⊙, making J0931+0038 one of the first observational constraints on nucleosynthesis in this mass range. However, the full abundance pattern is not matched by any models in the literature. J0931+0038 thus presents a challenge for the next generation of nucleosynthesis models and motivates the study of high-mass progenitor stars impacted by convection, rotation, jets, and/or binary companions. Though rare, more examples of unusual early nucleosynthesis in metal-poor stars should be found in upcoming large spectroscopic surveys

A transistor-like pH nanoprobe for tumour detection and image-guided surgery

It is challenging to detect a broad range of malignant tumours at high resolution, because of profound genetic and histological differences in cancerous tissue. Here, we report the design and performance of a fluorescent nanoprobe with transistor-like responses (transition pH = 6.9) for the detection of deregulated pH, which drives many of the invasive properties of cancer. The nanoprobe amplifies the fluorescence signal in the tumour over that in the surrounding normal tissues, resulting in a discretized, binary output signal with a spatial resolution smaller than 1 mm. The nanoprobe allowed us to image a broad range of tumours in mouse models using a variety of clinical cameras. We were able to perform real-time tumour-acidosis-guided detection and surgery of occult nodules (<1 mm(3)) in mice bearing head and neck or breast tumours, significantly lengthening mice survivability. We also show that the pH nanoprobe can be used as a reporter in a fast, quantitative assay to screen for tumour-acidosis inhibitors. The binary delineation of pH achieved by the nanoprobe promises to improve the accuracy of cancer detection, surveillance and therapy