Rasch analysis of the pre-sleep arousal scale in patients with acute insomnia disorder.

BACKGROUND: Hyperarousal plays an essential role in the initiation and maintenance of insomnia, highlighting the need for a tool that measure the hyperarousal state during the early course of insomnia. Pre-sleep Arousal Scale (PSAS) is a self-report questionnaire to evaluate subjective pre-sleep arousal of insomnia. The aim of this study was to examine the psychometric properties of the PSAS among patients with acute insomnia disorder (AID) using Rasch analysis. METHODS: Totally 170 patients with AID from 31 public hospitals in China were recruited and completed the test. The psychometric properties of the PSAS were tested using Rasch analysis by Winsteps v5.4.1.0, including unidimensionality, local item independence, item fit, category diagnostics, reliability, item-person maps and differential item functioning (DIF) by age and gender. RESULTS: According to Rasch analysis, somatic and cognitive subscales were unidimensional and basically demonstrated good item-fit statistics. 4-point Likert scale may be more appropriate for PSAS. All items have a good reliability and separation. No gender and age bias were detected for the scale. However, the person arousal level is not well matched to item difficulty. CONCLUSION: The present study further reveals appropriate psychometric properties of the PSAS in patients with AID and provides suggestions for refinements and supplements to the PSAS.

Targeting Aquaporin-3 Attenuates Skin Inflammation in Rosacea.

Rosacea is a common inflammatory skin disorder mediated by the dysregulation of both keratinocytes and T cells. Here, we report that aquaporin 3 (AQP3), a channel protein that mediates the transport of water/glycerol, was highly expressed in the epidermis and CD4+ T cells of both rosacea patients and experimental mice. Specifically, AQP3 deletion blocked the development of rosacea-like skin inflammation in model mice with LL37-induced rosacea-like disease. We also present mechanistic evidence showing that AQP3 was essential to the activation of NF-κB signaling and subsequent production of disease-characteristic chemokines in keratinocytes. Moreover, we show that AQP3 was upregulated during T cell differentiation and promotes helper T (Th) 17 differentiation possibly via the activation of STAT3 signaling. Our findings reveal that AQP3-mediated activation of NF-κB in keratinocytes and activation of STAT3 in CD4+ T cells acted synergistically and contributed to the inflammation in rosacea.

Clinical Features and Risk Factors for Nasal Rosacea: A Hospital-Based Retrospective Study.

INTRODUCTION: At present, some studies have reported that nasal rosacea may be an independent disease, but phenotypic characteristics and risk factors for nasal rosacea remain unknown. This study aimed to clarify the clinical features and explore the risk factors for nasal rosacea. METHODS: A hospital-based retrospective study was conducted, including 1615 rosacea patients and 1501 healthy individuals. The patients were divided into three groups based on the involved areas of the lesions (non-nasal, intermediate and nasal rosacea group). Their demographic data and clinical features were obtained from patients' medical records, and risk factors of nasal rosacea were analyzed. RESULTS: There were 927 (57.4%), 647 (40.1%) and 41 (2.5%) cases in the non-nasal, intermediate and nasal rosacea groups, respectively. Of 41 patients with nasal rosacea, all (100.0%) had fixed erythema and 17 cases (41.5%) had phymatous changes. Compared with control group, male gender (adjusted odds ratio [aOR] = 2.39, 95% confidence interval [CI] = 1.14, 4.99), obesity (aOR = 3.19, 95% CI 1.86, 11.79) and alcohol use (aOR = 1.58, 95% CI 1.22, 5.40) were risk factors for nasal rosacea, but these three factors were not risk factors for non-nasal rosacea and intermediate rosacea groups. Among patients with nasal lesions (compared with patients without nasal phymatous changes), family history of rosacea was a risk factor (aOR = 2.12, 95% CI 1.01, 4.46) for nasal phymatous changes and Fitzpatrick IV skin type was a protective factor (aOR = 0.49, 95% CI 0.28, 0.86). CONCLUSION: Nasal rosacea has relatively specific clinical features and independent risk factors, suggesting that it may be a special type of rosacea.