24-hour Day Research Articles

Modelling and performance evaluation of a novel passive thermoelectric system based on radiative cooling and solar heating for 24-hour power-generation

Harvesting energy from the sun and ultracold outer space for electricity generation is green access to green energy and helps reduce carbon dioxide emissions. However, current work on passive electricity generation is restrained to daytime or nighttime. In this paper, we propose a passive thermoelectric system that produces continuous electric power during a full 24-hour day - even in winter. The thermoelectric output is maintained and amplified by integrating radiative cooling and solar heating. The utterly passive system consists of a thermoelectric generator (TEG), a radiative cooling film, and a greenhouse cavity. Radiative cooling is used to cool the sky-facing end of the TEG below ambient temperature without the need for fuel. Meanwhile, the solar-heating-based greenhouse is used to heat the hot end of the TEG to enhance the temperature difference between the cold and hot ends and, thus, the output. An energy balance model that considers the varying solar radiation is developed to determine the temperature difference between the TEG ends and system output. The accuracy of the evaluation model is first confirmed by the good agreement between the modelled performance of the system and the experimentally measured data. Afterwards, the effects of radiative cooler, solar absorption rate, and cloud cover on the system performance are studied. Finally, the seasonal and locational performance of the system in China is evaluated. Results indicate that the proposed passive TEG system that integrates radiative cooling and solar heating can produce 24-hour continuous and impregnable output. Therefore, the proposed system in this work may help the development of passive electricity generation.

Soundscape planning for mixed use urban communities

Mixed use urban communities with a variety of retail, dining, entertainment, commercial, and residential occupants on one building or within several blocks of each other often bring a vitality to cities and towns. Careful planning and design are needed for the different uses to maintain sonic compatibility with each other over a 24-hour day. There are acoustical challenges in measuring amplified entertainment sounds due to the rapid succession of individual notes and words in pieces of music or trains of speech. Sounds of vehicles with straight pipes revving engines as they drive through a main street is another acoustical challenge. The enclosed walls of glass, metal and masonry of high-rise building create sound reflections and reverberation similar to what occurs in closed rooms reducing the decay of sounds with distance. Soundscape measurements, computer model studies of urban sound flows, implementing acoustical strategies as part of a design and planning process and addressing the challenges of rapidly time varying sounds measured by LAeq’s are among the methods that are often implemented to address these issues. A case study of acoustical design for a revitalizing urban area is presented with its challenges, design processes, and initial strategies discussed.

The Feel4Diabetes intervention: effectiveness on 24-hour physical behaviour composition in families at risk for diabetes development.

The Feel4Diabetes project conducted a 2-year intervention aiming to encourage healthy behaviours in families in six European countries. Within this paper, the intervention effect was evaluated after the first intervention year on 24-hour physical behaviour composition in Belgian families at risk for type 2 diabetes. Parents' and children's levels of physical activity (PA) and sedentary behaviour (SB) were objectively measured and sleep duration was self-reported. Valid data were obtained in 82 children (mean age: 8.2 ± 0.84; 50.0% boys) and 72 parents (mean age: 40.1 ± 5.5; 27.8% fathers). Data were analysed using a compositional data approach, and mixed models were used to take clustering into account. Results showed that for children, the mean baseline composition of the 24-hour day in sleep, SB, light and moderate-to-vigorous PA for the intervention group was (11 hours 18 minutes; 6 hours 33 minutes; 5 hours 02 minutes, 1 hour 08 minutes) and for the control group (11 hours 18 minutes; 6 hours 35 minutes; 5 hours 04 minutes; 1 hour 06 minutes), respectively. For parents, the mean baseline composition was for the intervention group (8 hours 12 minutes; 9 hours 36 minutes; 5 hours 43 minutes; 27 minutes) and for the control group (8 hours 00 minute; 9 hours 00 minute; 6 hours 27 minutes; 33 minutes). No significant intervention effects were found on 24-hour physical behaviour composition of either parents or children (p = 0.19 and p = 0.21, respectively). A relatively small study population and a poor attendance rate among parents could maybe explain the lack of effectiveness. More effective strategies are needed to retain vulnerable families in interventions. Furthermore, future approaches to improve the 24-hour physical behaviour composition should maybe focus more specifically on PA, SB and sleep, and involve teachers, children and parents in the design of the intervention. Trial registration: NCT02393872 in ClinicalTrials.gov.

Expression of coffee florigen CaFT1 reveals a sustained floral induction window associated with asynchronous flowering in tropical perennials

The behavior of florigen(s) and environment-influenced regulatory pathways that control floral initiation in tropical perennials species with complex phenological cycles is poorly understood. Understanding the mechanisms underlying this process is important for food production in the face of climate change, thus, we used Coffea sp. L. (Rubiaceae) as a model to explore this issue. Homologs of FLOWERING LOCUS T (CaFT1) and environment-related regulators CONSTANS (CaCO), PHYTOCHROME INTERACTING FACTOR 4 (CaPIF4) and FLOWERING LOCUS C (CaFLC) were retrieved from coffee genomes and identified through phylogenetic analysis. Overexpression of CaFT1 in Arabidopsis caused early-flowering phenotype and yeast two hybrid studies indicated CaFT1 binding to bZIP floral regulator FD, which suggests that CaFT1 is a coffee florigen. Expression of CaFT1 and other floral regulators, together with carbohydrate analysis, were evaluated over one year using three contrasting genotypes, two C. arabica cultivars and C. canephora. All genotypes showed active and variable CaFT1 transcription from February until October, indicating the potential window for floral induction that reached a maximum in the cold period of June. CaCO expression, as expected, varied over a 24-hour day period and monthly with day length, whereas expression of temperature-responsive homologs, CaFLC and CaPIF4, did not correlate with temperature changes nor CaFT1 expression, suggesting alternative FT regulatory pathways in coffee. Based on our results, we suggest a continuum of floral induction that allows different starting points for floral activation, which explains developmental asynchronicity and prolonged anthesis events in tropical perennial species.

Your best day: An interactive app to translate how time reallocations within a 24-hour day are associated with health measures.

Reallocations of time between daily activities such as sleep, sedentary behavior and physical activity are differentially associated with markers of physical, mental and social health. An individual's most desirable allocation of time may differ depending on which outcomes they value most, with these outcomes potentially competing with each other for reallocations. We aimed to develop an interactive app that translates how self-selected time reallocations are associated with multiple health measures. We used data from the Australian Child Health CheckPoint study (n = 1685, 48% female, 11-12 y), with time spent in daily activities derived from a validated 24-h recall instrument, %body fat from bioelectric impedance, psychosocial health from the Pediatric Quality of Life Inventory and academic performance (writing) from national standardized tests. We created a user-interface to the compositional isotemporal substitution model with interactive sliders that can be manipulated to self-select time reallocations between activities. The time-use composition was significantly associated with body fat percentage (F = 2.66, P < .001), psychosocial health (F = 4.02, P < .001), and academic performance (F = 2.76, P < .001). Dragging the sliders on the app shows how self-selected time reallocations are associated with the health measures. For example, reallocating 60 minutes from screen time to physical activity was associated with -0.8 [95% CI -1.0 to -0.5] %body fat, +1.9 [1.4 to 2.5] psychosocial score and +4.5 [1.8 to 7.2] academic performance. Our app allows the health associations of time reallocations to be compared against each other. Interactive interfaces provide flexibility in selecting which time reallocations to investigate, and may transform how research findings are disseminated.

ALCOHOL CONSUMPTION AND PHYSICAL ACTIVITY, SEDENTARY, AND SLEEP BEHAVIORS IN UNIVERSITY STUDENTS

PURPOSE: Excessive alcohol intake has been associated with negative health outcomes, but it is unclear if alcohol consumption is related to the different behaviors (moderate to vigorous physical activity (MVPA), sedentary behavior (SED), and total sleep duration) that make up a 24-hour day in university students. The purpose of the study was to examine the associations between alcohol consumption and self-reported MVPA, SED, and sleep in university students. METHODS: University students (n=660, 20.3±1.6 yr, 80% female) completed an online survey to assess demographics, total alcohol consumption per week, Greek Life membership, sleep duration (min/day) via Pittsburgh Sleep Quality Index, SED (min/day) via Sedentary Behavior Questionnaire, and MVPA (min/day) via Leisure Time Physical Activity Questionnaire. Multiple linear regression was used to examine associations between different alcohol consumption categories (Moderate = Females 1-7 drinks per week, Males 1-14 drinks per week; Heavy = Females > 7 drinks per week, Males > 14 drinks per week) with MVPA, SED, and sleep behaviors adjusting for possible confounding factors (sex, race/ethnicity, BMI, and Greek Life membership). RESULTS: Moderate (β=6.9, p=0.10) and heavy alcohol drinkers (β=6.4, p=0.21) self-reported higher MVPA compared to university students that do not consume alcohol (trend p =0.02). Moderate (β=20.5, p=0.29) and heavy (β=41.5, p=0.27) alcohol drinkers self-reported higher SED compared non-drinkers, although these differences were not statistically significant (trend p=0.17). Moderate (β=0.5, p=0.94) and heavy (β=-5.8 p=0.61) alcohol drinkers had sleep times that were similar to those who reported not consuming alcohol (trend p=0.78). CONCLUSIONS: In this university student sample, alcohol drinkers reported participating in 6-7 additional minutes of MVPA per day than students that reportedly do not drink alcohol. However, only moderate drinkers had statistically significant higher values. While this analysis controlled for several potential confounders, other unmeasured differences between drinkers and non-drinkers may account for the higher MVPA observed among drinkers. Alternatively, alcohol drinking among university students may be a marker for greater engagement in social activities that incorporate MVPA.

Reallocating Time Between Sleep, Sedentary Time, And Physical Activity On Quality Of Life In Cancer Survivors

PURPOSE: Increasing time in moderate-vigorous physical activity (MVPA) and reducing time in sedentary behaviors (SB) can improve quality of life (QOL) in cancer survivors (CS). However, these behaviors only account for a small portion of the day, neglecting other important health behaviors like sleep and light PA. When examining the effects of these behaviors on QOL, it is important to account for their interdependent nature within the confines of the 24-hour day (i.e., you must decrease time in one activity to increase time in another). This study examined the effect of reallocating time between sleep, SB, light PA and MVPA on QOL in a mixed sample of CS. METHODS: A cross-sectional evaluation of adult CS within five-years of completing active cancer treatment(s). Participants concurrently wore the activPAL™ accelerometer to measure SB, light PA and MVPA, and the Actiwatch-2 to measure sleep duration for 7-days, 24-hours per day. QOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G). FACT-G scores range from 0-108, a difference of 4 points is considered clinically meaningful, and higher scores indicate better QOL. Isotemporal substitution methods in linear regression models were used to examine the effect of 30-minute time reallocations on total QOL. RESULTS: Participants (N=73) were M=53±13 years old, mostly female (75.7%), and diagnosed with colorectal (33.8%) breast (29.7%), leukemia/lymphoma (9.5%), or other (27.0%) cancer. Average QOL score was 87.0±15.3 (range = 41-107). No time reallocations were statistically significant, however, clinically meaningful associations (i.e., lower QOL) were observed for reallocating 30 minutes from MVPA to sleep (-4.42), SB (-4.32), or light PA (-5.06). CONCLUSION: Findings suggest that moving time away from MVPA may negatively impact QOL but did not reach statistical significance. These findings are congruent with previous literature which has established the important role of MVPA for QOL in CS. Future studies should evaluate reallocating time among a sample of survivors presenting with poor versus good QOL to guide intervention development.

Abstract 079: Long-term Circadian Disruption Via Food Availability Leads To Kidney Damage

Circadian disruption (CD) is a risk factor in cardiovascular disease although we know little about its effects on the kidney. Previous work from our group showed that short-term CD in mice by restricting food availability to the daytime is sufficient to invert diurnal blood pressure rhythms yet kidney excretory function remained aligned with the light-dark cycle. Thus, we hypothesize that long-term CD will result in kidney damage. After putting C57BL/6 mice on a regular 12:12 light:dark cycle were placed on an inactive time-restricted feeding (iTRF, 12h food access during the day/lights on) or ad libitum feeding protocol for 8 weeks. During the final week, male and female iTRF mice ate significantly less during the 24-hour day compared to ad lib feeding (male iTRF 6.1±1.4g/day vs. ad lib 9.1±0.9g/day, p&lt;.0001, n=9 for both groups; female iTRF 6.4 ±0.7 g/day, vs. ad lib 8.3±1.5g/day, p&lt;0.01, n=9 and 8, respectively). Both sexes had an inversion in their diurnal water intake rhythms but maintained normal diurnal urinary water excretion. Aldosterone (aldo) and endothelin-1 (ET-1) contribute to circadian timing of sodium transport systems in the collecting duct. While male iTRF mice maintained their diurnal rhythm of aldosterone excretion (2.0±1.4ng/hr in light, p=0.06; 7.8±3.1ng/hr in dark, p=0.37, n=6), female iTRF mice lost their diurnal rhythm (4.4±2.7ng/hr in light, p=0.85; 4.4±3.1ng/hr in dark, p=0.11, n=6). Male mice with iTRF had significantly lower ET-1 excretion, but maintained the diurnal variation. In contrast, female iTRF mice demonstrated an inverted ET-1 excretion pattern (18.5±6.3ng/hr in light vs. 7.3±2.9ng/hr in dark, p=0.03, n=3) compared to ad lib fed mice (18.9±2.1ng/hr in light vs. 33.7±5.6ng/hr in dark, p=0.01, n=3). Picrosirus red staining of kidneys revealed a striking increase in glomerular and interstitial fibrosis in iTRF male mice as compared to their ad lib counterparts. In contrast, iTRF female mice appeared to be completely protected from increased fibrosis. These results support our hypothesis that long-term CD due to timing of food intake exacerbates kidney damage. However, females were protected against renal fibrosis, perhaps due in part to an ability to better modulate kidney rhythms in response to food timing.

미국의 총액결제시스템 비교연구

Purpose The aim of this study is to compare the real-time gross system in America. Comparative analysis of precedent research, features and operational polices between Fedwire and FedNow was performed for research purposes. Design/Methodology/Approach The paper is organized as follows. In Section , the necessity and purpose of research this paper is outlined. In Section , outlines previous research in domestic and foreign literature and the development process the real-time gross system in America. Section contains a comparative explain of the operational polices ofthe central bank. payment liquidity, services resilience and payment reserves. Section contains a comparative analysis competitiveness evaluation including fees, legal stability, services accessibility, account methods and feedback between Fedwire and FedNow. Section summarizes and suggests that the payment system have more efficience, accuracy, and security with the remaining conclusions. Findings Fedwire Funds Service is a real-time gross settlement system that enables participants to initiate fund transfers that are immediate, final, and irrevocable once processed. The Fedwire Funds Service business day begins at 9:00 p.m. eastern time (ET) on the preceding calendar day and ends at 7:00 p.m. ET, Monday through Friday, excluding designated holidays. The FedNow Service will be designed to maintain uninterrupted 24x7x365 processing with security features to support payment integrity and data security. The service will have a 24-hour business day each day of the week, including weekends and holidays.Write the Findings of you research here. Research Implications In this paper, I would like to suggest the necessity of converting Korea’s current deferred-netting system to the real-time gross system.

Audit of in-hospital mortality by age and time-of-day among patients presenting to a low-resource Ugandan hospital

Introduction: Admission to hospital outside of normal working hours is consistently associated with poorer patient outcomes. Our aim was to determine the association of patients’ age and time of presentation to a low-resource Ugandan hospital with admission rate and in-hospital mortality.Method: Prospective observational non-interventional audit in the emergency and outpatient departments of Kitovu Hospital in Uganda, a low-resource sub-Saharan hospital. Data on age, sex, time of admission was collected from all non-pregnant patients during 2020 and 2021, and outcomes analysed.Results: Out of 17,133 patients who presented to the hospital 189 died in hospital (1.1% of all presentations and 7.9% of all admissions); 46 (24.3%) patients died within 24 hours of arrival (0.3% of all presentations and 1.9% of all admissions). Deaths within 24 hours of arrival in hospital were more likely in the very young and the old, and in those who presented at night and on the weekend.Conclusion: As many in-hospital deaths occur shortly after arrival, resuscitation skills are needed even in low-resource settings for as much of the 24-hour day as possible.

Use of a Real-Time Locating System to Assess Internal Medicine Resident Location and Movement in the Hospital

The patient-physician clinical encounter is the cornerstone of medical training, yet residents spend as little as 12% of their time in direct patient contact. To use a real-time locating system (RTLS) to characterize intern work experiences in the hospital, understand factors associated with time spent at patients' bedsides, and inform future interventions to increase time spent with patients. This cross-sectional study was conducted from July 1, 2018, to June 30, 2019 (ie, the academic year 2018-2019). Internal medicine residents from postgraduate year 1 (interns) at an academic medical center wore an infrared badge that recorded location and duration (eg, patient room, ward hall, physician workroom). Data were analyzed from September 1, 2020, to August 30, 2021. Main outcome was time (in minutes) at the bedside; the unit of analysis was a 24-hour intern day or interval of time within the day (eg, rounding period). Descriptive statistics are reported overall, by intern, and for 5 clinical service categories. Multilevel modeling assessed the association of intern, service, and calendar time with time spent at the bedside. Data from 43 of 52 interns (82.7%) encompassing 95 275 hours of observations were included for analyses. Twenty-six interns (60.5%) were women. Interns were detected for a mean (SD) of 722.8 (194.4) minutes per 24-hour period; 13.4% of this time was spent in patient rooms (mean [SD] time, 96.8 [57.2] minutes) and 33.3% in physician workrooms (mean [SD] time, 240.9 [228.8] minutes). Mean percentage of time at the bedside during a 24-hour period varied among interns from 8.8% to 18.3%. Mean (SD) percentage of time at the bedside varied by service for the 24-hour period from 11.7% (6.6%) for nononcology subspecialties to 15.4% (6.0%) for oncology, and during rounds from 8.0% (12.4%) for nononcology subspecialties to 26.5% (12.1%) for oncology. In multilevel modeling, the individual intern accounted for 8.1% of overall variance in time spent at the bedside during a 24-hour period, and service accounted for 18.0% of variance during rounds. The findings of this cross-sectional study support previous evidence suggesting that interns spend only a small proportion of time with hospitalized patients. The differences in time spent in patients' rooms among interns and during rounds constitute an opportunity to design interventions that bring trainees back to the bedside.

Effect of position on intracranial pressure and compliance: a cross-sectional study including 101 patients.

A better understanding of the effect of position on intracranial pressure (ICP) and compliance is important for the development of treatment strategies that can restore normal cerebrospinal fluid (CSF) dynamics. There is limited knowledge on the effect of position on intracranial compliance. In this cross-sectional study the authors tested the association of pulse amplitude (PA) with position and the day/night cycle. Additionally, they describe the postural ICP and PA changes of patients with "normal" ICP dynamics. This single-center retrospective study included patients with suspected and/or confirmed CSF dynamics abnormalities who had been examined with elective 24-hour ICP monitoring between October 2017 and September 2019. Patients had been enrolled in a short exercise battery including four positions: supine, lumbar puncture position in the left lateral decubitus position, sitting, and standing. Each position was maintained for 2 minutes, and mean ICP and PA were calculated for each position. The 24-hour day and night median ICP and PA data were also collected. Linear regression models were used to test the correlation of PA with position and day/night cycle. All linear regressions were corrected for confounders. The postural ICP monitoring results of patients without obvious ICP dynamics abnormality were summarized. One hundred one patients (24 males and 77 females) with a mean age of 39 ± 13years (mean ± standard deviation) were included in the study. The adjusted linear regression models demonstrated a significant association of ICP with position and day/night cycle, with upright (sitting and standing) and day ICP values lower than supine and night ICP values. The adjusted linear regression model was also significant for the association of PA with position and day/night cycle, with upright and day PA values higher than supine and night PA results. These associations were confirmed for patients with and without shunts. Patients without clear ICP dynamics abnormality had tighter control of their postural ICP changes than the other patients; however, the difference among groups was not statistically significant. This is the largest study investigating the effect of postural changes on intracranial compliance. The results of this study suggest that PA, as well as ICP, is significantly associated with posture, increasing in upright positions compared to that while supine. Further studies will be needed to investigate the mechanism behind this association.

EFFECTS OF SGLT-2 INHIBITORS ON 24H AMBULATORY BLOOD PRESSURE IN PATIENTS WITH TYPE 2 DIABETIC AND HYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Objective: To analyze the effects of different types of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on 24-hour ambulatory blood pressure in patients with type 2 diabetes mellitus and hypertension. Design and method: In the meta-analysis, The PubMed, Web of science, and Cochrane Library were searched for relevant literature, and the references obtained from these sources were retrieved from inception till December 2020. The inclusion and exclusion criteria were formulated in accordance with the requirements of Cochrane systematic review. A total of 1354 articles were retrieved, 592 duplicate articles were excluded, 372 articles were excluded after reading the title and abstract, 87 articles were excluded from non-randomized control and irrelevant outcome indicators, and 7 studies with 2343 patients were finally included. Use RevMan5.3 software to compare the changes in 24-hour ambulatory blood pressure, day and night blood pressure of patients with type 2 diabetes and hypertension before and after treatment with different types and doses of SGLT2i. Results: A total of four types of SGLT-2i were evaluated in the application of patients with type 2 diabetes and hypertension. The result showed that compared with placebo,SGLT2i could reduce the 24-hour systolic blood pressure of patients with type 2 diabetes and hypertension by 4.36mmHg (95%CI -5.92--2.79,p &lt; 0.001),among which the antihypertensive effects of empagliflozin, canagliflozin, dapagliflozin and ertugliflozin were -4.59mmHg, -3.74mmHg, -5.06mmHg, -3.64mmHg, respectively; similarly, the 24-hour dynamic diastolic blood pressure decreased by 2.20mmHg (95%CI -2.74, -1.65,p &lt; 0.001), among which the antihypertensive effects of empagliflozin, canagliflozin, dapagliflozin and ertugliflozin were -2.38mmHg, -1.22mmHg, -2.00mmHg,- 2.69mmHg, respectively. At the same time, the systolic and diastolic blood pressure during the day and night decreased significantly. Conclusions: his meta-analysis shows that SGLT2i can have beneficial effects on the cardiovascular system by reducing 24-hour ambulatory blood pressure in patients with type 2 diabetes and hypertension, other than reducing blood sugar. Therefore, for patients with type 2 diabetes and hypertension, SGLT2i may be the best hypoglycemic choice.

0136 Firefighter Sleep Behavior and Psychomotor Vigilance Compared to Biomathematical Predictions of Performance

Abstract Introduction Firefighters work a demanding 24-hour job in which fatigue may compromise safety. Biomathematical fatigue modeling software applications, like the Sleep, Activity, Fatigue, and Task Effectiveness Fatigue Avoidance Scheduling Tool (SAFTE-FAST) could be adapted to serve as a fatigue mitigation tool for firefighting operations. SAFTE-FAST predicts task effectiveness using objective work and sleep data. Model predictions of effectiveness (Predicted Effectiveness) have not been previously compared against actual Psychomotor Vigilance Task (PVT) speed (Actual Effectiveness) in a firefighter population. Methods Total sleep time across the 24-hour day (TST24) was monitored continuously throughout a 2-week study period in firefighters working 24-hour shifts using a sleep-tracking actigraphy device (Zulu Watch, Institutes for Behavior Resources). Speed on an 8-minute PVT was assessed daily on on-shift and off-shift days. Mean speeds &amp;gt;2 standard deviations above the grand distribution were excluded. SAFTE-FAST calculated Predicted Effectiveness (PVT Speed [1/Reaction Time] expressed as a % of individual optimum performance) from objective sleep and work data. Actual Effectiveness was computed as a percentage of the median of an individual’s top 10% fastest PVT Speeds. Paired samples t-test explored differences between on-shift and off-shift PVT Speed and TST24. Linear regression explored correlation of Predicted Effectiveness to Actual Effectiveness across 5% Effectiveness bins. Results Two hundred twenty (N=220) firefighters provided sleep, work, and PVT data for 1-2 weeks (Mean: 8; Range: 1-15 days) between 9/2020 to 8/2021. On-shift days accounted for 37% of study days (M: 3; R: 0-10 on-shift days). PVT Speed and TST24 were not significantly different between on-shift (Speed: 2.43±0.47; TST24: 404±163 minutes) and off-shift days (Speed: 2.44±0.48; TST24: 396±156 min; all p&amp;gt;0.1). Linear regression across 5% SAFTE prediction bins revealed significant correlations between SAFTE Predicted Effectiveness and PVT Actual Effectiveness (R2=0.861, p&amp;lt;.001). Conclusion Firefighters averaged less than 7 hours of sleep per 24-hour period whether on or off-shift. Average PVT speed was similar to performance from chronically-sleep-deprived or alcohol-impaired individuals. SAFTE-FAST Predicted Effectiveness and PVT Actual Effectiveness were distributed similarly across 5% bins. While preliminary, these findings suggest that firefighters may suffer from chronic sleep debt and impaired psychomotor vigilance that can be predicted using biomathematical modelling. Support (If Any) N/A

0816 Chronic insomnia secondary to severe nocturnal visual hallucinations in Charles Bonnet syndrome; a challenging case to manage

Abstract Introduction Over 1 million Americans are blind. Charles Bonnet syndrome (CBS), a parallel to phantom limb syndrome and also known as release hallucinations, describes visual hallucinations in patients with severe visual loss and blindness. The prevalence of release hallucinations, though likely underreported, is believed to be 12 to 20% of visually impaired persons. Report of Cases: A 45-year-old male with past medical history of migraines presented to the hospital with what was determined to be a ruptured pituitary macroadenoma and as a result, lost complete visual function including pupillary reflexes. The patient subsequently experienced both simple and complex release hallucinations and was eventually diagnosed with Charles Bonnet syndrome. Most disturbing to the patient was the simple release hallucinations which was described as a bright white light in a honeycomb lattice predominately in his right visual field which lasted for hours. This phantom light was not consistently associated with any other symptoms and could occur at any time throughout the 24-hour day. Nocturnal symptoms occurred approximately 50% of nights and caused severe onset/maintenance insomnia and insufficient sleep duration. The patient tried therapy in addition to proper sleep hygiene without relief. He was trialed on several medications and the only one able to alleviate all but the worst of the phantom light was diazepam. The GABA-A receptor agonist finally allowed the patient an opportunity to sleep. His insomnia was then treated with once nightly temazepam, in addition to as needed diazepam. Approximately nine years after losing his vision, he was transitioned from temazepam to the tricyclic antidepressant amitriptyline, which offered improved relief from the phantom lights causing his insomnia. The patient continues to utilize once nightly amitriptyline with diazepam for breakthrough symptoms, though he still suffers significant impairment due to the phantom lights of his Charles Bonnet syndrome. Conclusion Treatment of Charles Bonnet syndrome is multifactorial and includes maintaining optimal eye care, stimulating senses, psychosocial therapy, and pharmacotherapy. Insomnia from release hallucinations remains difficult to manage, though GABA-A receptor agonists have shown some relief. Case reports of atypical antipsychotics and antidepressants, including melperone and agomelatine respectively, have demonstrated ability to improve release hallucinations. Support (If Any) Charles Bonnet Syndrome FAQs. Charles Bonnet Syndrome Foundation (Australia). https://www.charlesbonnetsyndrome.org/index.php/cbs/faq. Accessed December 15, 2021.Hsu HC, Huang YS, Fan WX, Chen TC. Charles Bonnet Syndrome (CBS): Successful Treatment of Visual Hallucinations Due to Vision Loss with Agomelatine in Three Cases. European Psychiatry. 2017;41(S1):S172-S172. doi:10.1016/j.eurpsy.2017.01.2065Pelak VS. Visual release hallucinations (Charles Bonnet syndrome). UpToDate. Waltham, MA: UpToDate; June 7, 2016; https://www.uptodate.com/contents/visual-release-hallucinations-charles-bonnet-syndrome.

Final 24-hour Drain Output and Postoperative Day Are Poor Indicators for Appropriate Drain Removal.

Background:Drains are used in plastic surgery to remove excess fluid while ameliorating complications. However, there is a paucity of evidence supporting guiding parameters on when to discontinue a drain. The aim of our study was to determine whether two of the most common parameters, drain volume 24 hours before removal or postoperative day, are valid indicators for drain removal.Methods:A retrospective chart review was conducted for surgical operations performed by our division between July 2014 and May 2019. Of the 1308 patients, 616 had a drain and a complete record. Demographics, medical history, operative time, antibiotic use, anatomic site, donor/recipient, and complication type were recorded. Complications were defined as events that deviated from expected postoperative course or required pharmacological/procedural intervention. T-test and Chi square were used to analyze data.Results:In total, 544 patients were in the no complication group, and 72 were in the complication group. The complication group patients had drains removed later than patients in the no complication group (15.7 days versus 12.5 days, P = 0.0003) and had similar final 24-hour drain volumes versus patients in the no complication group (16.7 mL versus 18.8 mL, P = 0.2548). The complication group had more operations on the pelvis (11% versus 2.1%; P = 0.000017) or thigh (8.5% versus 3.4%; P = 0.029).Conclusions:Our data suggest neither postoperative day nor 24-hour volume before drain removal are valid indicators for removal. Late removal correlates with more complications; however, persisting output leading to later removal may be predictive of an impending complication rather than delays in drain removal causing the complication.

How are combinations of physical activity, sedentary behaviour and sleep related to cognitive function in older adults? A systematic review.

The relationships between cognitive function and each of physical activity, sleep and sedentary behaviour in older adults are well documented. However, these three "time use" behaviours are co-dependent parts of the 24-hour day (spending time in one leaves less time for the others), and their best balance for cognitive function in older adults is still largely unknown. This systematic review summarises the existing evidence on the associations between combinations of two or more time-use behaviours and cognitive function in older adults. Embase, Pubmed, PsycInfo, Medline and Emcare databases were searched in March 2020 and updated in May 2021, returning a total of 25,289 papers for screening. A total of 23 studies were included in the synthesis, spanning >23,000 participants (mean age 71years). Findings support previous evidence that spending more time in physical activity and limiting sedentary behaviour is broadly associated with better cognitive outcomes in older adults. Higher proportions of moderate-vigorous physical activity in the day were most frequently associated with better cognitive function. Some evidence suggests that certain types of sedentary behaviour may be positively associated with cognitive function, such as reading or computer use. Sleep duration appears to share an inverted U-shaped relationship with cognition, as too much or too little sleep is negatively associated with cognitive function. This review highlights considerable heterogeneity in methodological and statistical approaches, and encourages a more standardised, transparent approach to capturing important daily behaviours in older adults. Investigating all three time-use behaviours together against cognitive function using suitable statistical methodology is strongly recommended to further our understanding of optimal 24-hour time use for brain function in aging.

The Impact of Universal Mental Health Screening on Pediatric Emergency Department Flow.

Assess the impact of universal mental health screening with MyHEARTSMAP on emergency department (ED) flow, an important aspect of feasibility. We hypothesized that the difference in departmental level ED length of stay (LOS) for screening and matched nonscreening days is less than 30 minutes. We conducted a 2-center, retrospective cohort study between December 2017 and June 2019. At each center, random mental health screening days were assigned over the course of 15 consecutive months. We matched each 24-hour screening day to a unique nonscreening day based on: location (Center 1 or Center 2); day type (weekday: Monday-Thursday or weekend: Friday-Sunday); date (±28 days); and 24-hour volume (±15 patients). We collected retrospective patient flow data, including LOS, across all ED visits to determine the difference in departmental level median LOS between matched screening and nonscreening days. There was not a statistically significant difference in departmental LOS between screening and nonscreening days. Overall, the difference in departmental LOS was -4.0 minutes (95% confidence interval, -9.8, 1.8) for screening days compared to nonscreening days, with a difference of -2.0 minutes (-9.0, 4.9) at Center 1 and -6.0 minutes (-15.4, 3.4) at Center 2. Our findings show that universal mental health screening with MyHEARTSMAP can be implemented without a significant impact of ED LOS.

A C2-symmetric state in the AAA+ KaiC hexamer coordinates structural and functional modes within a molecular clock

Cyanobacteria generate circadian rhythms via a molecular clock that keeps track of time post-translationally. At the center of this clock is the hexameric AAA+ protein KaiC, which undergoes a cycle of autophosphorylation in its C-terminal domain (CII) that governs binding of the other clock proteins, KaiA and KaiB, at its N-terminal domain (CI) over the course of the 24-hour day. KaiA promotes autophosphorylation by interacting with C-terminal loops of KaiC, known as A-loops, until KaiA is sequestered by KaiB, which cooperatively binds the CI domain during the evening.

Chronotherapy of Early Colon Cancer: Advantage of Morning Dose Schedules.

Colon adenomas with proliferating mutant cells may progress to invasive carcinomas. Proliferation of cells in human colorectal tissue is circadian, greater in the interval 4 to 12 hours after midnight than 16 to 24 hours after midnight. We have tested the hypothesis that chemotherapy administered during the time of greater cell proliferation will be more effective than chemotherapy administered during the time of lesser proliferation. An agent-based computer model of cell proliferation in colon crypts was calibrated with measurements of cell numbers in human biopsy specimens. It was used to simulate cytotoxic chemotherapy of an early stage of colon cancer, adenomas with about 20% of mutant cells. Chemotherapy doses were scheduled at different 4-hour intervals during the 24-hour day, and repeated at weekly intervals. Chemotherapy administered at 4 to 8 hours after midnight cured mutant cells in 100% of 50 trials with an average time to cure of 7.82 days (s.e.m. = 0.99). In contrast, chemotherapy administered at 20 to 24 hours after midnight cured only 18% of 50 trials, with the average time to cure of 23.51 days (s.e.m. = 2.42). These simulation results suggest that clinical chemotherapy of early colon cancer may be more effective when given in the morning than later in the day.