Sleeping More Hours Per Day Than Working Can Prevent New-Onset Diabetes.

Objectives: We expressed the combined effect by the ratio of daily sleep time to daily work time. The aim of this study was to discussed the predictive ability of daily sleep hours/work hours (SH/WH) ratio for diabetes risk. Methods: Cox proportional hazards regression was used to calculate the hazard ratios (HRs) of new-onset diabetes. Restricted cubic spline analyses were performed to visualize the influence trend of SH/WH ratio and diabetes risk. Results: The RCS model revealed a non-linear and L-shaped correlation between SH/WH ratio and diabetes risk. Compared with the participates with SH/WH ratio <1, those with a ratio ≥1 had a lower risk of developing diabetes. The multivariable adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of new-onset diabetes in Q2, Q3, Q4 and Q5 groups compared with Q1 group were 0.82 (0.57, 1.19), 1.05 (0.69, 1.59), 0.57 (0.36, 0.91), 0.66 (0.42, 1.06). The Kaplan-Meier curve showed that Q4 group had lower cumulative incidence. Conclusion: Sleeping longer than working (SH/WH ratio ≥1) can reduce risk for developing diabetes. A minimal risk observed at 1.10-<1.37 (the fourth quintile) of SH/WH ratio.

Comparative effectiveness and acceptability of psychotherapies for late-life depression: A systematic review and network meta-analysis.

BACKGROUND: The purpose of this systematic review and network meta-analysis is to compare the effectiveness and acceptability of psychotherapies for late-life depression. METHODS: We searched PubMed, Embase, PsycINFO, CINAHL, The Cochrane Library, China National Knowledge Infrastructure, WANFANG database, and Chinese Biomedicine literature (CBM) for randomized controlled trials (RCTs) from their respective inception dates to March 30, 2022. Comparative effectiveness and acceptability of these psychological interventions were evaluated by conducting standard pairwise meta-analyses and network meta-analyses. A battery of analyses and assessments, such as the risk of bias and certainty of the evidence were performed. RESULTS: A total of 68 studies with 4550 participants on six psychotherapies compared with two control groups were included in the final analysis. Notably, there were no statistically significant differences between behavioral activation therapy, cognitive behavior therapy (CBT), cognitive therapy, life review therapy, mindfulness, and combined psychotherapy. Compared with the non-active control group, six psychological interventions were statistically effective in reducing depression symptoms (standardized mean differences (SMDs) range, -1.08 to -0.73). While, only CBT, life review therapy, mindfulness, and combined psychotherapy were more effective than the active control group (SMDs range, -0.85 to -0.74). Life review therapy was ranked as the best option according to effectiveness and acceptability, while behavioral activation therapy was the worst by acceptability. The certainty of the evidence was mostly rated as low to very low. CONCLUSIONS: Despite the scarcity of high-quality evidence, all six psychotherapies were effective for late-life depression, and life review therapy seemed to be the best choice in terms of effectiveness and acceptability. The findings of our review could provide policymakers and service commissioners with evidence-based practice for making decisions among different psychotherapies.

Adrenal crisis mainly manifested as recurrent syncope secondary to tislelizumab: a case report and literature review.

As an immune checkpoint inhibitor (ICI), tislelizumab is an anti-programmed cell death protein 1 (PD-1) drug. With the extensive application of ICIs, there is an ever-increasing proportion of immune-related adverse events (irAEs) in clinical settings, some of which may even be life-threatening. Herein, we present a patient with tislelizumab-induced adrenal crisis. The main clinical manifestation was recurrent syncope accompanied by high-grade fever. Timely identification and hormone replacement therapy helped the patient overcome the crisis well. Finally, the patient discontinued tislelizumab and switched to antibody-drug conjugate (ADC) therapy. We report this case to improve our understanding of this situation, identify this kind of disease, and prevent adrenal crisis in time. Eventually, limiting toxicities reduces the interruption of immunotherapy. Since irAEs are multisystem damage with more non-specific symptoms, except for oncologists, general practitioners who endorse the need for taking a holistic approach to the patient should play a vital role in the management of cancer treatment.