Associations of sleep and circadian phenotypes with COVID-19 susceptibility and hospitalization: an observational cohort study based on the UK Biobank and a two-sample Mendelian randomization study

Study Objectives Sleep and circadian phenotypes are associated with several diseases. The present study aimed to investigate whether sleep and circadian phenotypes were causally linked with coronavirus disease 2019 (COVID-19)-related outcomes. Methods Habitual sleep duration, insomnia, excessive daytime sleepiness, daytime napping, and chronotype were selected as exposures. Key outcomes included positivity and hospitalization for COVID-19. In the observation cohort study, multivariable risk ratios (RRs) and their 95% confidence intervals (CIs) were calculated. Two-sample Mendelian randomization (MR) analyses were conducted to estimate the causal effects of the significant findings in the observation analyses. Beta values and the corresponding 95% CIs were calculated and compared using the inverse variance weighting, weighted median, and MR-Egger methods. Results In the UK Biobank cohort study, both often excessive daytime sleepiness and sometimes daytime napping were associated with hospitalized COVID-19 (excessive daytime sleepiness [often vs. never]: RR=1.24, 95% CI=1.02-1.5; daytime napping [sometimes vs. never]: RR=1.12, 95% CI=1.02-1.22). In addition, sometimes daytime napping was also associated with an increased risk of COVID-19 susceptibility (sometimes vs. never: RR= 1.04, 95% CI=1.01-1.28). In the MR analyses, excessive daytime sleepiness was found to increase the risk of hospitalized COVID-19 (MR IVW method: OR = 4.53, 95% CI = 1.04-19.82), whereas little evidence supported a causal link between daytime napping and COVID-19 outcomes. Conclusions Observational and genetic evidence supports a potential causal link between excessive daytime sleepiness and an increased risk of COVID-19 hospitalization, suggesting that interventions targeting excessive daytime sleepiness symptoms might decrease severe COVID-19 rate.

Novel Insight into the Mechanisms of the Bidirectional Relationship between Diabetes and Periodontitis

Periodontitis and diabetes are two major global health problems despite their prevalence being significantly underreported and underestimated. Both epidemiological and intervention studies show a bidirectional relationship between periodontitis and diabetes. The hypothesis of a potential causal link between the two diseases is corroborated by recent studies in experimental animals that identified mechanisms whereby periodontitis and diabetes can adversely affect each other. Herein, we will review clinical data on the existence of a two-way relationship between periodontitis and diabetes and discuss possible mechanistic interactions in both directions, focusing in particular on new data highlighting the importance of the host response. Moreover, we will address the hypothesis that trained immunity may represent the unifying mechanism explaining the intertwined association between diabetes and periodontitis. Achieving a better mechanistic insight on clustering of infectious, inflammatory, and metabolic diseases may provide new therapeutic options to reduce the risk of diabetes and diabetes-associated comorbidities.

Does Social Medical Insurance Achieve a Poverty Reduction Effect in China?

This paper aims to explore the impact of social medical insurance (SMI) on poverty reduction (PR) in China. Considering the time-varying characteristics of factors, this paper uses the bootstrap Granger full sample causality and subsample rolling window model to find the relationship between SMI and PR. The results highlight that in some periods, there is a bidirectional causal link between SMI and PR. Influenced by the medical insurance reform and medication measures. Social medical insurance does not have a positive impact on poverty reduction in some periods. These results are supported by the Utility Maximization Model of Insurance Consumption, which highlights that individuals make utility maximization choices when choosing insurance. The effect of medical insurance on poverty alleviation depends on whether an individual's investment in medical insurance can maximize its utility. If the proportion of social medical insurance reimbursement is too low, individuals will give up buying social medical insurance. Thus, the anti-poverty effect of social medical insurance is difficult to achieve. Therefore, authorities need to pay attention to specific contexts and social medical insurance policies and further improve the social medical insurance system to promote the realization of the anti-poverty of social medical insurance.

The Impact of Climate Variability and Change on Food Security in Sub-Saharan Africa: Perspective from Panel Data Analysis

This study investigates the relationship between climate variables such as rainfall amount, temperature, and carbon dioxide (CO2) emission and the triple dimension of food security (availability, accessibility, and utilization) in a panel of 25 sub-Saharan African countries from 1985 to 2018. After testing for cross-sectional dependence, unit root and cointegration, the study estimated the pool mean group (PMG) panel autoregressive distributed lag (ARDL). The empirical outcome revealed that rainfall had a significantly positive effect on food availability, accessibility, and utilization in the long run. In contrast, temperature was harmful to food availability and accessibility and had no impact on food utilization. Lastly, CO2 emission positively impacted food availability and accessibility but did not affect food utilization. The study took a step further by integrating some additional variables and performed the panel fully modified ordinary least squares (FMOLS) and dynamic ordinary least squares (DOLS) regression to ensure the robustness of the preceding PMG results. The control variables yielded meaningful results in most cases, so did the FMOLS and DOLS regression. The Granger causality test was conducted to determine the causal link, if any, among the variables. There was evidence of a short-run causal relationship between food availability and CO2 emission. Food accessibility exhibited a causal association with temperature, whereas food utilization was strongly connected with temperature. CO2 emission was linked to rainfall. Lastly, a bidirectional causal link was found between rainfall and temperature. Recommendations to the national, sub-regional, and regional policymakers are addressed and discussed.

How Does Climate Change Affect Rice Production in Thailand? Assessing the Role of Financial Development

The study aims to examine the impacts of climate change (CC) and financial development (FD) on rice production (RP) in Thailand from the period 1969 to 2016 by using the ARDL and VECM framework. The empirical results revealed that in the long- run (LR) and short-run (SR) there is a reduction in rice production as temperature increase. The carbon dioxide (CO2) positively affects rice production in the (LR), while this connection is negative in the SR. The empirical results further confirmed that in the LR and SR domestic credit provided by the financial sector positively and significantly improved rice production, while domestic credit to private sector by banks negatively affect rice production. The important input factors including cultivated area, fertilizers use and labor force positively and significantly contributed to rice production in both LR and SR. The LR causal link of all variables with rice production is validated. The SR causal association is unidirectional among temperature, CO2 emissions, financial development, labor force and rice production. Additionally, the IRF and VDM outcomes also confirm that both climate change and socioeconomic development are crucial for rice production in Thailand. The study offers important policy implications to improve rice production with the help of improved financial system and climate controls.

The default network is causally linked to creative thinking

Creative thinking represents a major evolutionary mechanism that greatly contributed to the rapid advancement of the human species. The ability to produce novel and useful ideas, or original thinking, is thought to correlate well with unexpected, synchronous activation of several large-scale, dispersed cortical networks, such as the default network (DN). Despite a vast amount of correlative evidence, a causal link between default network and creativity has yet to be demonstrated. Surgeries for resection of brain tumors that lie in proximity to speech related areas are performed while the patient is awake to map the exposed cortical surface for language functions. Such operations provide a unique opportunity to explore human behavior while disrupting a focal cortical area via focal electrical stimulation. We used a novel paradigm of individualized direct cortical stimulation to examine the association between creative thinking and the DN. Preoperative resting-state fMRI was used to map the DN in individual patients. A cortical area identified as a DN node (study) or outside the DN (controls) was stimulated while the participants performed an alternate-uses-task (AUT). This task measures divergent thinking through the number and originality of different uses provided for an everyday object. Baseline AUT performance in the operating room was positively correlated with DN integrity. Direct cortical stimulation at the DN node resulted in decreased ability to produce alternate uses, but not in the originality of uses produced. Stimulation in areas that when used as network seed regions produced a network similar to the canonical DN was associated with reduction of creative fluency. Stimulation of areas that did not produce a default-like network (controls) did not alter creative thinking. This is the first study to causally link the DN and creative thinking.

Causal Link in Killing with Abstinence

It is not heresy to say that the causation that revolves around the criminal law is the one that links the cause to the causative, so it appears as a link between two poles, which is an essential axis to achieve the responsibility of the offender or not, and one of the pillars of the crime, and according to this case, factors may occur that affect the communication between The conduct and the occurrence of the result, whether prior, contemporaneous, or subsequent to determine the responsibility of the offender. And just as a crime may occur in the affirmative, it may occur in a negative way, which is achieved by the availability of conditions, and all of this is within the limits of a principle imposed on the legislator, the obligation that there is no crime or punishment except on the basis of a law, and this is within what it means that there is no crime without material behavior, to find that the legislator sometimes decomposes to criminalizing acts A broad and broad criminalization to show precisely and precisely what is the behavior, and even at the judicial level. For all of this, the researcher concluded that the legislator should be aware of the seriousness of the matter, and stipulate the crime of murder by abstaining and emptying it in a clear legislative text.

Reading Between the Stars: Understanding the Effects of Online Customer Reviews on Product Demand

Problem definition: Many studies have examined quantitative customer reviews (i.e., star ratings) and found them to be a reliable source of information that has a positive effect on product demand. Yet the effect of qualitative customer reviews (i.e., text reviews) on demand has been less thoroughly studied, and it is not known whether (or how) the sentiment expressed in text reviews moderates the influence of star ratings on product demand. We are therefore led to examine how the interplay between review sentiment and star ratings affects product demand. Academic/practical relevance: Consumer perceptions of product quality and how they are shared via customer reviews are of extreme relevance to the firm, but we still do not understand how product demand is affected by the quantitative and qualitative aspects of customer reviews. Our paper seeks to fill this critical gap in the literature by analyzing star ratings, the sentiment of customer reviews, and their interaction. Methodology: Using 2002–2013 data for the U.S. automobile market, we investigate empirically the impact of star ratings and review sentiment on product demand. Thus, we estimate an aggregated multinomial choice model after performing a machine learning–based sentiment analysis on the entire corpus of customer reviews included in our sample. We take advantage of a quasi-exogenous shock to establish a causal link between online reviews and product demand. Results: We find robust empirical evidence that (i) review sentiment and star ratings both have a decreasingly positive effect on product demand and (ii) the effect (on demand) of their interaction suggests that the two components of reviews are complements. Positive sentiments in text reviews increase the positive effect of ratings when the effect of ratings is decidedly positive while they also compensate for the tendency of consumers to discount extremely high star ratings. Managerial implications: The firm should pay greater attention to quantitative and qualitative customer reviews to better understand how consumers perceive the quality of its offerings.

Is COVID-19 multisystem inflammatory syndrome a new variant of Kawasaki Disease?

Objectives: In this systematic review, we aimed to evaluate the clinical features, therapeutic options, and outcomes of children with multisystem inflammatory syndrome in children (MIS-C) and to investigate whether MIS-C is a new variant of Kawasaki disease. Materials and methods: Adhering to PRISMA principles, we searched for eligible studies between December 2019 and June 2020 through the following databases: PubMed, ISI Web of Science, SCOPUS, and Science Direct. Studies including original data of patients aged <21 years with MIS-C and descriptions of clinical signs, laboratory or radiological investigations were selected. Results: A total of 84 studies were identified, for which 48 were eligible for full screening and only 13 studies (n=657) met our inclusion criteria. More than 70% of patients with MIS-C tested positive for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). The most common symptoms were gastrointestinal (80 to 100%) and most patients presented with fever for >4 days. Mucocutaneous manifestations are similar to Kawasaki disease presented in up to 64% in some studies. Almost all patients had significant elevations in inflammatory markers, and up to 50 to 100% had elevated troponin suggesting myocardial damage. Intravenous immunoglobulin (IVIG) was administered to 60% of patients in 12 studies and 80 to 100% in five studies. Steroids were administered to 10 to 95% of patients. The overall mortality rate was 0.9%. Conclusion: The temporal association between novel coronavirus disease 2019 (COVID-19) onset and Kawasaki-like disease and MIS-C suggests a causal link. Both syndromes have similar cascades of symptoms and hyperinflammation, which likely explain their response to the same immunomodulatory agents. However, it is unclear yet why some children appear more susceptible to develop MIS-C.