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Ruonan Sun,1,&ast; Shuyuan Zhang,1,&ast; Jiarui Si,2 Liming Zhang,1 Haolun Yang,1 Zheng Ye,1 Xin Xiong2 1West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zheng Ye, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, People’s Republic of China, Email zheng_ye@scu.edu.cn Xin Xiong, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, People’s Republic of China, Tel/Fax +86-28-85503898, Email drxiongxin@scu.edu.cnBackground: Studies have reported correlations between various oral behaviors and painful temporomandibular disorders (TMD), yet comprehensive research on the independent effects of each oral behavior within the general population remains sparse.Objective: This cross-sectional study aimed to investigate the association between painful TMD (PT) and various oral behaviors in general population.Methods: A questionnaire survey was conducted with participants to collect data encompassing demographic characteristics, eight specific oral behaviors, and the 5 major TMD symptoms(5Ts) checklist. Participants were categorized into PT and non-PT (NPT) groups based on their responses to the 5Ts checklist. Those reporting TMJ/facial pain or headaches were assigned to the PT group, while all other participants constituted the NPT group. Both univariate and multivariate logistic regression analyses were employed to evaluate the association between individual oral behavior and the presence of PT, controlling for demographic confounders including age, sex, systemic diseases, and dental treatments history.Results: A total of 441 valid questionnaires were received, including 156 males and 285 females. The prevalence of PT was identified to be 33.33%, with 61.00% of participants engaging in one or more types of oral behaviors. Each oral behavior was more frequently reported in the PT group compared to the NPT group. The univariate logistic regression analysis identified positive correlations between all eight oral behaviors and PT. In the multivariate logistic regression analysis, these associations persisted after adjustment for demographic confounders including age, sex, history of systemic diseases and dental treatments (P< 0.01). The behaviors most strongly associated with PT were “Hold or jut jaw forward/to the side” (OR:4.478), “Hold, tighten or tense muscles without clench” (OR:3.343) and “Hold jaw in rigid or tense position” (OR:3.209).Conclusion: The presence of oral behaviors has significant association with PT. Individuals exhibiting multiple oral behaviors are more likely to experience PT. Additional studies are needed to clarify the effects of reducing oral behaviors on pain-related symptoms.Keywords: oral behaviors, painful temporomandibular disorders, Temporomandibular Joint, general population, cross-sectional study

Frederik Faergemann Lau,1 Signe Bollerup,1 Frederik Engsig,1 Henrik Krarup,2 Lone Hagens Mygind,3 Jesper Bach Hansen,3 Lone Galmstrup Madsen,4,5 Peter Thielsen,6 Ulla Balslev,7 Lars Nørregaard Nielsen,8 Toke S Barfod,9 Mette Rye Clausen,10 Lise Hobolth,11 Alex Lund Laursen,12 Britta Tarp,13 Birgit T Roege,14 Jan Gerstoft,15 Peer Brehm Christensen,16,17 Nina Weis1,5 1Department of Infectious Diseases, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark; 2Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark; 3Department of Medical Gastroenterology, Aalborg University Hospital, Aalborg, Denmark; 4Department of Medical Gastroenterology, Zealand University Hospital, Koege, Denmark; 5Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; 6Department of Gastroenterology, Copenhagen University Hospital-Herlev, Herlev, Denmark; 7Department of Infectious Diseases, Copenhagen University Hospital-Herlev, Herlev, Denmark; 8Department of Lung- and Infectious Diseases, North Zealand Hospital-Hilleroed, Hilleroed, Denmark; 9Department of Internal Medicine and Infectious Diseases, Zealand University Hospital, Roskilde, Denmark; 10Department of Medical Gastroenterology and Hepatology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; 11Department of Gastroenterology, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark; 12Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; 13Diagnostic Center, Silkeborg Regional Hospital, Silkeborg, Denmark; 14Department of Internal Medicine, Kolding Hospital, Kolding, Denmark; 15Department of Infectious Diseases, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; 16Department of Infectious Diseases, Odense University Hospital, Odense, Denmark; 17Clinical Institute, University of Southern Denmark, Odense, DenmarkCorrespondence: Nina Weis, Department of Infectious Diseases, Copenhagen University Hospital – Hvidovre, Kettegaard Alle 30, Hvidovre, DK-2650, Denmark, Tel +45 3862 3514, Email nina.weis@regionh.dkObjective: Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB) are conflicting. Our objective was to address the rate of IHD in patients with CHB compared with individuals without CHB (control-persons) from the general population.Study Design and Setting: We conducted a cohort study of prospectively obtained data from Danish nationwide registries. We produced cumulative incidence curves and calculated the unadjusted incidence rate ratio (IRR) of IHD in persons with and without CHB. The adjusted association between having CHB and developing IHD was examined using a cause-specific Cox regression model.Results: In total, 6472 persons with CHB and 62,251 age- and sex-matched individuals from the general population were followed for 48,840 and 567,456 person-years, respectively, during which 103 (1,59%) with CHB and 1058 (1,70%) control-persons developed IHD. The crude IRR was 1.13 (95% CI: 0.91– 1.39). CHB did not have a statistically significant effect on the rate of IHD after adjusting for several confounding factors (adjusted hazard ratio: 0.96, 95% CI: 0.76– 1.21).Conclusion: In this nationwide cohort study, we did not find any difference between rate of IHD in persons with CHB in comparison with the general population.Keywords: hepatitis B virus, viral infection, atherosclerosis, coronary heart disease, ischemic heart disease, cardiovascular disease, general population

This study aims to explore the emotional experiences related to the lockdown during the first pandemic wave, analysing the dreams of the Italian population. Through an online survey spread throughout the country, participants completed the Depression Anxiety Stress Scale-21 (DASS-21), the Resilience Scale (RS) and were asked to narrate a dream they had during the lockdown. The dreams were qualitatively analysed through the thematic content analysis. Logistic regression analyses were then conducted to verify the relationship among the categories that emerged and between these categories and the DASS-21 and RS scores. In the dreams 8 categories were identified (Places, Characters, Relationships, Actions, Danger, Death, Processes, and Emotions) composed of specific sub-categories, which seem to compose a sort of narrative structure of the dream. Some sub-categories were found to be predictor of depression and resilience or with exposure to COVID-19. Dreams can be a valid tool both to understand the experiences of the population during the pandemic and to evaluate those at risk of developing distress in clinical practice.

Tatiana Dilla,1 Luís Lizan,2 Silvia Paz,2 Pilar Garrido,3 Cristina Avendaño,4 Juan J Cruz-Hernández,5 Javier Espinosa,6 José A Sacristán1 1Medical Department, Lilly, Madrid, 2Outcomes’10, Jaime I University, Castellón, 3Medical Oncology Department, University Hospital Ramon y Cajal, Madrid, 4Clinical Pharmacology Department, Puerta de Hierro-Majadahonda Hospital, Madrid, 5Salamanca Institute for Biomedical Research, University Hospital of Salamanca, Salamanca, 6Medical Oncology Department, General Hospital Ciudad Real, Ciudad Real, Spain Background: In oncology, establishing the value of new cancer treatments is challenging. A clear definition of the different perspectives regarding the drivers of innovation in oncology is required to enable new cancer treatments to be properly rewarded for the value they create. The aim of this study was to analyze the views of oncologists, health care policy makers, patients, and the general population regarding the value of new cancer treatments. Methods: An exploratory and qualitative study was conducted through structured interviews to assess participants’ attitudes toward cost and outcomes of cancer drugs. First, the participants were asked to indicate the minimum survival benefit that a new treatment should have to be funded by the Spanish National Health System (NHS). Second, the participants were requested to state the highest cost that the NHS could afford for a medication that increases a patient’s quality of life (QoL) by twofold with no changes in survival. The responses were used to calculate incremental cost-effectiveness ratios (ICERs). Results: The minimum improvement in patient survival means that justified inclusions into the NHS were 5.7, 8.2, 9.1, and 10.4 months, which implied different ICERs for oncologists (€106,000/quality-adjusted life year [QALY]), patients (€73,520/QALY), the general population (€66,074/QALY), and health care policy makers (€57,471/QALY), respectively. The costs stated in the QoL-enhancing scenario were €33,167, €30,200, €26,000, and €17,040, which resulted in ICERs of €82,917/QALY for patients, €75,500/QALY for the general population, €65,000/QALY for oncologists, and €42,600/QALY for health care policy makers, respectively. Conclusion: All estimated ICER values were higher than the thresholds previously described in the literature. Oncologists most valued gains in survival, whereas patients assigned a higher monetary value to treatments that enhanced QoL. Health care policy makers were less likely to pay more for therapeutic improvements compared to the remaining participants. Keywords: oncology, cost, cost-effectiveness, cost-effectiveness threshold, ICER, clinically meaningful outcomes, Spain

BACKGROUND The double product (DP), consisting of the systolic blood pressure (SBP) multiplied by the pulse rate (PR), is an index of myocardial oxygen consumption, but its prognostic value in the general population remains unknown. METHODS We recorded health outcomes in 9,937 subjects (median age, 53.2 years; 47.3% women) randomly recruited from 11 populations and enrolled in the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) study. We obtained the SBP, PR, and DP for these subjects as determined through 24-hour ambulatory monitoring. RESULTS Over a median period of 11.0 years, 1,388 of the 9,937 study subjects died, of whom 536 and 794, respectively, died of cardiovascular (CV) and non-CV causes, and a further 1,161, 658, 494, and 465 subjects, respectively, experienced a CV, cardiac, coronary, or cerebrovascular event. In multivariate-adjusted Cox models, not including SBP and PR, DP predicted total, CV, and non-CV mortality (standardized hazard ratio [HR], ≥ 1.10; P ≤ 0.02), and all CV, cardiac, coronary, and stroke events (HR, ≥ 1.21; P < 0.0001). For CV mortality (HR, 1.34 vs. 1.30; P = 0.71) and coronary events (1.28 vs. 1.21; P = 0.26), SBP and the DP were equally predictive. As compared with DP, SBP was a stronger predictor of all CV events (1.39 vs. 1.27; P = 0.002) and stroke (1.61 vs. 1.36; P < 0.0001), and a slightly stronger predictor of cardiac events (1.32 vs. 1.22; P = 0.06). In fully adjusted models, including both SBP and PR, the predictive value of DP disappeared for fatal endpoints (P ≥ 0.07), coronary events (P = 0.06), and stroke (P = 0.12), or DP was even inversely associated with the risk of all CV and cardiac events (both P ≤ 0.01). CONCLUSION In the general population, we did not observe DP to add to risk stratification over and beyond SBP and PR. [ABSTRACT FROM AUTHOR]

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The present paper investigates a possible association between components of negative effectivity and alcohol habits in an ethnically and linguistically homogenous nationwide sample of non-institutionalized adults (N = 8096). Negative affectivity was assessed employing the Hopkins Symptom Check List (HCSL; Derogatis et al. (1974) Behavioural Science, 19, 1-15). A weak, positive, bivariate correlation between manifest anxiety and use of alcohol was found. Phobic anxiety, depression and somatizing were negatively correlated with alcohol habits. Sociodemographic variables such as age, level of education and family income were more strongly associated with use of alcohol than self-reported negative affect. Controlled for the sociodemographic variables in logistic regression analyses, manifest anxiety and somatizing were still significantly related to alcohol habits. [ABSTRACT FROM AUTHOR]

Study Objectives: Research points to impaired cognitive performance in sleep clinic patients with obstructive sleep apnea (OSA). However, inconsistent findings from various epidemiologic studies make this relationship less generalizable. The current study investigated the association between OSA and functional outcome measures, such as cognition, daytime sleepiness, and quality of life, in a Korean general population sample., Methods: A total of 1492 participants from the Korean Genome and Epidemiology Study (KoGES) were included in the analyses. The presence of OSA measured by overnight polysomnography (PSG) was defined by apnea-hypopnea index (AHI) >5. Cognitive performance was determined with scores from a comprehensive neuropsychological battery. Excessive daytime sleepiness and quality of life were additionally measured through subjective reports., Results: After adjusting for various demographic and medical characteristics, OSA was independently associated with lower performance in the Digit Symbol Test (52.73 ± 17.08 vs. 58.72 ± 18.03, OSA vs. not, p = .02). Hypoxia measures were not related to cognitive performance. OSA was associated with higher odds of displaying excessive daytime sleepiness (odds ratio = 1.72, 95% CI: 1.05-2.80), but there was no significant relationship between OSA and quality of life., Conclusions: Cognition was unexpectedly unaffected overall. However, OSA was associated with impairment in a multidomain test that taps skills generally associated with frontal lobe function. The results suggest that research on protective and adaptive brain mechanisms to OSA stress can provide unique insights into the brain-sleep interface. As the study runs longitudinally, it will enable future studies on the impact of OSA on cognitive decline., (© Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.)