bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erectile dysfunction in ankylosing spondylitis: a systematic review and meta-analysis
Authors: Zhang Yuyang , Wu Xu , Zhang Wei , Liu Guodong , Feng Xingliang , Jiang Hui , Zhang Xiansheng 
Published: May 2023

Abstract

Background
The prevalence of erectile dysfunction (ED) in ankylosing spondylitis (AS) patients was reported rarely and with small sample.

Aim
The study sought to explore the prevalence of ED in men with AS and to determine whether AS is a risk factor for ED.

Methods
A systematic search was conducted in the China National Knowledge Infrastructure, Wanfang, VIP Database, CBM, PubMed, Web of Science, and Cochrane Library. The search was restricted to the articles published up to October 2022. Assessment tools adapted for prevalence studies were used to evaluate the quality of cross-sectional studies, and the quality of case-control studies was assessed by Newcastle–Ottawa scale. The relative risk (RR) and the standard mean difference (SMD) were used to evaluate the association between AS and ED. The subgroup analyses were conducted to identify the resources of heterogeneity. The sensitivity analysis was performed to assess the stability of the pooled estimates. Data were analyzed and graphed using STATA 16.0.

Outcomes
The pooled prevalence of ED in AS patients was calculated and the RR and the SMD were used to evaluate the association between AS and ED.

Results
A total of 393 AS patients, enrolled in the 8 included studies, were assessed for the prevalence of ED. The pooled ED prevalence estimate was 44% (95% confidence interval [CI], 25% to 63%, P &lt; .001) with the statistical heterogeneity (I2 = 95.1%, P &lt; .001). After pooling the data for RR, the results showed that men with AS were at a significantly higher risk for ED when compared with the general population without AS (RR, 2.04; 95% CI, 1.28 to 3.25, P = .003; heterogeneity: I2 = 72.6%, P = .003). The pooled results of 5 studies, which provided the International Index of Erectile Function (IIEF) score, demonstrated that patients with AS had significantly lower values in the IIEF erectile function domain as compared with the healthy control subjects (SMD, −0.60; 95% CI, −0.80 to −0.41; P &lt; .001; heterogeneity: I2 = 34.4%, P = .192). Additionally, the other domain of the IIEF also showed lower values when compared with the general population without AS (P &lt; .05).

Clinical Implications
The present meta-analysis provides evidence of the management of ED in men with AS.

Strengths and Limitations
This is the first meta-analysis to provide the prevalence of ED in AS patients and to demonstrate that AS is a risk factor for ED. However, the results after pooling the included studies showed significant heterogeneity.

Conclusion
Our meta-analysis demonstrated the high prevalence of ED in men with AS and that AS is a potential risk factor for ED.
0001 Effect of Time-Restricted Eating on Actigraphy-Derived Sleep Parameters
Authors: Duan Daisy , Pham Luu , Jun Jonathan , Turkson-Ocran Ruth-Alma , Pilla Scott , Clark Jeanne , Maruthur Nisa 
Published: May 2023

Abstract

Introduction
Time-restricted eating (TRE) is an emerging dietary intervention for weight loss. Sleep can be influenced by timing of food intake. Nevertheless, the impact of TRE on sleep patterns remains under-explored. The Time-Restricted Intake of Meals (TRIM) study was a parallel-arm, controlled feeding trial in 41 adults with obesity and prediabetes or untreated diabetes, randomized to TRE (8am-6pm) or usual eating pattern (UEP; 8am-12am) for 12 weeks, where the primary outcome was weight change. We hypothesized that TRE would cause changes in sleep/wake patterns.

Methods
This was a post-hoc analysis of TRIM using wrist actigraphy data obtained at baseline and week-12. We applied an objective process to determine sleep parameters after sleep estimation (Cole-Kripke) from actigraphy data. We analyzed 6 days/nights of recordings for each participant at each timepoint. Outcomes were sleep duration defined by mean total sleep time per 24-hour period (TST), sleep timing measured by mid-sleep time, sleep onset/offset, and sleep continuity. We used paired t-tests or Wilcoxon signed rank tests to compare data between baseline and week-12 within intervention arms and Mann-Whitney U tests or Wilcoxon signed rank tests to compare changes between intervention arms.

Results
38 participants (20 UEP; 18 TRE) with adequate actigraphy data (mean age 60 years, 92% female, and 92% Black) were analyzed. Baseline TST (mean□SD) was 394□90 minutes and 386□81 minutes for UEP and TRE, respectively. Week-12 TST was 397□92 minutes and 444□95 minutes for UEP and TRE, respectively. Compared to UEP, TRE increased TST by 55 minutes (p=0.03). TRE shifted mid-sleep time to 44 minutes earlier, from 3:24am to 2:40am (p=0.01), while UEP maintained the same mid-sleep time at 3:15am. Sleep onset shifted from a median of 12:22am to 11:52pm in TRE (p=0.03) while it remained stable in UEP (p=0.97). There were no differences in sleep offset and sleep continuity within and between intervention arms.

Conclusion
Sleep behaviors were different by treatment arm with increased total sleep time and earlier sleep onset in TRE participants. TRE may have ancillary consequences on sleep, which could have clinical implications for sleep regulation.

Support (if any)
AHA SFRN 17SFRN33590069 K23DK133690
0004 Using Apple Watch to predict circadian phase in night shift workers
Authors: Cheng Philip , Walch Olivia , Hannay Kevin , Roth Thomas , Drake Christopher 
Published: May 2023

Abstract

Introduction
A critical obstacle for circadian medicine is the lack of feasibility in measuring circadian phase in the clinic. Existing tools such as assessment of dim light melatonin onset (DLMO) are too resource intensive, especially in populations with extreme circadian disruption such as night shift workers. Recent studies have demonstrated the validity and feasibility of estimating circadian phase via mathematical modeling data collected with wearable technology. However, these studies have mostly relied on research grade devices (e.g., actigraphs) that have limited scalability. In this work, we validate the use of a consumer wearable (the Apple Watch) to predict DLMO in a population of night shift workers.

Methods
A sample of 21 fixed-night shift workers wore an Apple Watch for two weeks before completing DLMO in the lab. DLMO was assessed via hourly salivary melatonin samples collected in dim light (&lt; 10 lux) for a period of 24 hours. Activity data was used as input into the Hannay model of the circadian clock to produce a predicted DLMO, which was then compared to in-lab DLMO.

Results
Model predictions of DLMO showed high correlation with in-lab DLMO, with a Lin’s concordance correlation coefficient (CCC) of 0.81, with a mean absolute error (MAE) of 2.10. This was comparable to the previously published validation using research grade actigraphy (CCC = 0.70; MAE = 2.88).

Conclusion
This study is the first to provide evidence suggesting that estimates of circadian phase using the Apple Watch have comparable validity with research grade actigraphy. These results have significant implications for the scalability of circadian medicine, particularly as consumer-based wearable technology is already commonplace. Apple Watches are also the most common consumer-based wearable device. Future research should extend findings to other wearable devices, especially devices at a lower price-point to increase accessibility.

Support (if any)
Support for this study was provided from the American Academy of Sleep Medicine Foundation (245-SR-21) awarded to Dr. Philip Cheng.
0006 Circadian Misalignment Increases the Impact of Visceral Adiposity on Metabolic Syndrome Burden in Adolescents
Authors: Morales-Ghinaglia Natasha , He Fan , Liao Jason , Calhoun Susan , Vgontzas Alexandros , Bixler Edward , Liao Duanping , Fernandez-Mendoza Julio 
Published: May 2023

Abstract

Introduction
Although insufficient sleep is a known risk factor for metabolic syndrome (MetS), the circadian timing of sleep is also involved in cardiac and metabolic regulation. As a result, circadian misalignment of the sleep-wake cycle, which is highly prevalent in adolescents, may independently impact the burden of MetS in youth.

Methods
We analyzed data from 277 population-based randomly-selected adolescents from the Penn State Child Cohort (median 16 years; 47% female; 21% racial/ethnic minority) who had at least 5 nights of at-home actigraphy (ACT), an in-lab 9-h polysomnography (PSG) and an in-lab dual-energy X-ray absorptiometry (DEXA) scan. Two ACT-measured metrics of circadian misalignment were examined as effect modifiers: sleep midpoint (SM), the intra-individual mean midpoint of the sleep period, and sleep regularity (SR), the intra-individual standard deviation of sleep midpoint. DEXA-measured visceral adipose tissue (VAT) was the primary predictor. A continuous MetS score (i.e., sum of the age and sex adjusted z-scores of waist circumference, blood pressure, HOMA-IR, triglycerides, and HDL cholesterol) was the primary outcome. Linear regression models tested SM and SR as effect modifiers of the association of VAT with MetS, while accounting for sex, race/ethnicity, age, ACT-sleep duration, ACT-sleep variability, and PSG-apnea/hypopnea index.

Results
A significant interaction was found between VAT and SR on MetS (p-interaction=0.05), while not between VAT and SM (p-interaction=0.15). Among adolescents with high sleep irregularity (≥ 45 minutes; n=164), each standard deviation increase in VAT was associated with 2.4 (0.2) standard deviations increase in MetS (p&lt; 0.01), while this association was weaker among adolescents with low sleep irregularity [&lt; 45 minutes; n=113; β=1.7 (0.3), p&lt; 0.01].

Conclusion
An irregular circadian timing of sleep may further increase the impact of visceral adiposity on MetS burden in adolescents. Sleep irregularity, independent of sleep apnea and insufficient sleep, may contribute to the development of cardiometabolic sequelae associated with central obesity.

Support (if any)
National Institutes of Health (R01HL136587, UL1TR000127) and American Heart Association (23PRE1011962)
0013 Rebels Without a (Sleep Timing) Cause: Circadian Misalignment Does Not Predict Risky Behavior in Adolescents
Authors: Kamhout Sarah , Pilling Mason , Johnson Lauren , Wright Isabella , Duraccio Kara 
Published: May 2023

Abstract

Introduction
Previous studies have shown that sleep impairments may contribute to a variety of problems in adolescents, including behavioral dysregulation. As current research explores the specific mechanisms behind sleep’s influence on risk-taking behaviors, circadian misalignment may be particularly important to consider. Previous studies suggest that adolescents experiencing greater circadian misalignment are more likely to use illicit substances and to be involved in motor vehicle accidents. However, most studies on sleep and adolescent risk-taking only use self-report measures of sleep or focus on sleep duration. This study used gold-standard physiological methods to further examine the relationship between risk-taking behaviors and circadian misalignment in adolescents.

Methods
Fifty healthy adolescents (ages 14-18, 58% female; 94% white) came to the lab for a six-hour appointment in a dim-light room (lux &lt; 5). Every 30 minutes, participants provided saliva samples to measure salivary dim-light melatonin onset (DLMO). Circadian misalignment was defined as the timing of melatonin onset subtracted from average bedtimes noted in participant sleep diaries completed on the previous 10 nights; higher estimates reflect lower circadian misalignment. During each DLMO appointment, participants also completed the Youth Risk Behavior Survey (YRBS) to evaluate levels of risk-taking behaviors

Results
We conducted multiple regression analyses to examine circadian misalignment as a predictor of risky car behavior, risky substance abuse, violence, suicide, and sexual behaviors. We hypothesized that circadian misalignment would be associated with higher levels of all risky behaviors. However, we found no significant relationship between circadian misalignment and risky car (p=.712), substance use (p=.693), violence (p=.317), suicide (p=.259), or sexual behaviors (p=.427).

Conclusion
While our results did not support our hypothesis that circadian misalignment is positively associated with risk-taking behaviors in youth, our use of gold-standard methods to assess circadian misalignment adds robustness to existing literature and raises questions over what aspects of sleep are most associated with previously identified increases in risk-taking behaviors. Future studies can utilize this methodology to further clarify the relationship between risky behaviors and circadian misalignment.

Support (if any)
0014 Sleep Desert = More Dessert? Circadian Misalignment Predicts Greater Sugar Consumption in Adolescents
Authors: Lee Lindsey , Wright Isabella , Kamhout Sarah , Duraccio Kara 
Published: May 2023

Abstract

Introduction
As adolescent sleep duration and quality is declining, obesity rates are also increasing. Previous studies suggest a connection between sleep behaviors and obesity, with sleep’s relationship with dietary intake emerging as a primary mechanism. Circadian misalignment may be particularly important to consider in this context due to its previously observed effects on reward processing and snack selection. This study examined the relationship between circadian misalignment and dietary intake among adolescents.

Methods
Fifty healthy adolescents (14-18, 58% female, 94% white) participated in an 11-day procedure. On day one, participants’ height, weight, and Body Mass Index (BMI) were measured. For the next ten days, participants maintained a sleep diary and completed three 24-hour dietary recalls on randomized days. On the eleventh day, participants came to the lab for a six-hour appointment in a dim-light room (lux &lt; 5). Every 30 minutes, participants provided saliva samples to measure dim-light melatonin onset (DLMO). To measure circadian misalignment, the timing of melatonin onset was subtracted from average bedtime noted in the sleep diaries; lower values suggest greater misalignment.

Results
We conducted multiple regression analyses to examine circadian misalignment as a predictor of average kcal, protein, fat, and sugar consumption. We hypothesized that circadian misalignment would be a positive predictor of greater kcal, fat, and sugar intake but a negative predictor of less protein intake. However, circadian phase did not significantly predict average kcal (F(1, 42) = 1.37, p = .25, R2 = .03, β = -.18, b = -102.86), fat F(1,42) =.001, p=.97, R2=.00, β=-.01, b=-.17), or protein (F(1,42) =.59, p=.45, R2=.01, β=-.12, b=-2.75) consumption. Circadian misalignment did significantly predict average sugar intake, with greater misalignment predicting less sugar intake F(1,42) =4.27, p=.04, R 2 =.09, β=-.30, b=-13.77.

Conclusion
Although adolescents’ circadian misalignment does not predict kcal, protein, or fat consumption, it does predict sugar consumption. Adolescents whose sleep is not aligned with their intrinsic circadian rhythm may be at greater risk for consuming more sugar, which may ultimately increase obesity risk. These findings add to the literature on the potential relationship between sleep and obesity as moderated by dietary intake.

Support (if any)
0015 A circadian-informed lighting intervention markedly accelerates circadian adjustment to a night shift-work schedule
Authors: Guyett Alisha , Lovato Nicole , Manners Jack , Stuart Nicole , Lechat Bastien , Lack Leon , Kemps Eva , Banks Siobhan , Dorrian Jill , Vakulin Andrew , Adams Robert , Eckert Danny , Catcheside Peter , Scott Hannah 
Published: May 2023

Abstract

Introduction
Night shift-work results in misalignment between circadian timing and the sleep/wake schedule, negatively impacting sleep and performance. In encapsulated environments (e.g., submarines), the lack of strong daily solar lighting cues may impair circadian entrainment to the night shift-work schedule. This study designed and tested a circadian-informed lighting strategy to promote faster circadian phase delays to adjust to night shift-work compared to standard lighting.

Methods
Nineteen healthy sleepers (12 males/7 females, mean±SD aged 28.7±10.4 years) underwent two separate 8-day experimental conditions (circadian-informed lighting versus standard lighting). After a baseline sleep from 22:00 – 07:00 (day 1) and salivary dim light melatonin onset assessment ([DLMO], day 2), participants undertook simulated night shift-work (00:00 - 08:00) and slept during the day (10:00 - 19:00) for days 3-7 followed by a post-DLMO assessment on day 8. Ingestible capsules collected core body temperature (CBT) continuously throughout days 2-8, and cosine curve fitting was applied to estimate the timing of each daily temperature minima. The standard lighting condition mimicked current lighting on submarines (largely dim, blue-depleted light), while the circadian-informed lighting administered bright, blue-enriched and dim, blue-depleted lighting at times estimated to facilitate rapid circadian delay. The magnitude of daily CBT minima changes and the delay in pre- vs. post-DLMO were compared across conditions.

Results
There were significant day-by-condition interactions on CBT minima timing and DLMO timing (both p&lt; 0.001). After 4 days of simulated night-shift work there was a mean [95%CI] 4.5 [3.4 to 5.7] hour greater delay in CBT minima and a 4.6 [3.6 to 5.6] hour greater delay in DLMO timing compared to standard lighting, equating to 3.6 and 2.4-fold faster delays in DLMO and CBT minima timing shifts, respectively.

Conclusion
Circadian-informed lighting substantially accelerates circadian re-adjustment to night shift-work. Lighting interventions could usefully improve sleep, performance, and safety in shift-workers.

Support (if any)
This research is supported by the Commonwealth of Australia as represented by the Defence Science and Technology Group of the Department of Defence through the Research Network for Undersea Decision Superiority (research agreement number: 9334), with additional financial support from Flinders University and lighting provision support from REDARC.
0017 Obstructive sleep apnea is associated with altered circadian rhythms in systolic blood pressure at rest and during exercise
Authors: Thosar Saurabh , Bowles Nicole , Butler Matthew , McHill Andrew , Emens Jonathan , Shea Steven 
Published: May 2023

Abstract

Introduction
Obstructive sleep apnea (OSA) is associated with an increased risk for major adverse cardiovascular events (MACE), such as sudden cardiac death. MACE is more frequent in the morning in the general population but more frequent in the middle of the night in people with OSA. Whether these differences are associated with changes in circadian rhythms of blood pressure regulation is unknown. We tested if circadian rhythms in systolic blood pressure (SBP) during rested wakefulness and in response to a standardized mild exercise are disturbed in people with OSA compared to healthy controls (HC).

Methods
We studied 39 participants (HC [n=25, age 52.8±7.8 {mean±SD} years], (OSA [n=14, 50.6±6.6 years]) during ten identical recurring 5-h 20-min behavioral cycles in dim light and in an environment free of time cues. SBP was measured in the supine position during rested wakefulness followed by while seated at rest and during mild-intensity (heart rate at 50% heart rate reserve using the Karvonen formula) exercise on a static cycle ergometer. Circadian phases were determined relative to the dim-light melatonin onset. We performed mixed-model cosinor analyses to test whether the groups differed in their SBP rhythms during rested wakefulness and in their BP responses to exercise.

Results
Melatonin levels or phases relative to clock time were not different between groups (p=0.17), suggesting similar timing of central circadian clock outputs. There was an overall rhythm (p&lt; 0.001) and a trend to group x circadian phase interaction for resting SBP (p=0.10). A separate group analysis showed a significant circadian rhythm in SBP in HC (p&lt; 0.001) with a peak in the evening but no evident circadian rhythm in people with OSA (p=0.17). There was no circadian phase x exercise reactivity interaction between groups, but overall, exercise reactivity of SBP was significantly higher in people with OSA (+4mmHg, p=0.001).

Conclusion
OSA is characterized by a blunted circadian rhythm in resting blood pressure and an exaggerated blood pressure reactivity to exercise. Mechanisms for these rhythm changes should be investigated further.

Support (if any)
Support: NIH F32HL163232, R01HL125893, R01HL163232, R35HL155681, R01HL156948, ULTR00128, Oregon Institute of Occupational Health Sciences.
0019 Assessing Genetic Variation for Effects of Lithium on Circadian Clock Period and Mortality in Fruit Flies
Authors: Fryou Noah , Li Mingjia , Possidente Bernard 
Published: May 2023

Abstract

Introduction
Lithium is the treatment of choice for bipolar disorder, but the mechanism for its therapeutic effect remains unknown, and it has a low threshold for toxic side-effects. Bipolar disorder is cyclical disorder with periodic onsets of illness including depressive and manic episode that vary in cycle length among patients. One of lithium’s well-documented effects- a lengthened circadian clock period- is intriguing since a circadian system abnormality is a potential explanation for the cyclical nature of bipolar disorder. Fruit flies are an efficient model organism for genetic analysis of circadian clock mechanisms, but few Drosophila studies have documented circadian effects of lithium, and none have examined genetic variation.

Methods
We used a random sample of 13 inbred strains from the Drosophila Genetic Resource Panel and three wild-type strains to examine genetic variation for the response of circadian clock period to 20mM LiCl, and its toxicity. Adults were assayed for circadian locomotor activity in constant dark using Drosophila Activity Monitors. Circadian clock period was estimated using chi-squared periodogram.

Results
Among 13 inbred strains examined there is no significant effect of lithium or genetic variation for effects of lithium on circadian period, and only one inbred strain significantly lengthened circadian clock period in response to lithium. There was a significant sex difference in the response to lithium for circadian period, with an increase female and a slight decrease in males, and significant strain variation for sex-differences in circadian response to lithium. There are significant strain differences in mortality in response to lithium. All three wild-type strains significantly increased circadian period in response to lithium and varied in sensitivity to its toxicity.

Conclusion
Results to date suggest that the set of approximately 200 DGRP strains will be useful for investigating genetic variation for lithium toxicity and sex-differences for effects of lithium on circadian clock period. Circadian period in wild-type strains is more responsive to the period-lengthening effects of lithium, suggesting that genetic heterozygosity may play a role in the effects of lithium on circadian clock period.

Support (if any)
Skidmore College Biology Department and Summer Collaborative Research Program.