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      The need to promote sleep health in public health agendas across the globe

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          Abstract

          Healthy sleep is essential for physical and mental health, and social wellbeing; however, across the globe, and particularly in developing countries, national public health agendas rarely consider sleep health. Sleep should be promoted as an essential pillar of health, equivalent to nutrition and physical activity. To improve sleep health across the globe, a focus on education and awareness, research, and targeted public health policies are needed. We recommend developing sleep health educational programmes and awareness campaigns; increasing, standardising, and centralising data on sleep quantity and quality in every country across the globe; and developing and implementing sleep health policies across sectors of society. Efforts are needed to ensure equity and inclusivity for all people, particularly those who are most socially and economically vulnerable, and historically excluded.

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          Impact of COVID-19 Pandemic on Mental Health in the General Population: A Systematic Review

          Highlights • The Coronavirus disease 2019 (COVID-19) pandemic has resulted in unprecedented hazards to mental health globally. • Relatively high rates of anxiety, depression, post-traumatic stress disorder, psychological distress, and stress were reported in the general population during the COVID-19 pandemic in eight countries. • Common risk factors associated with mental distress during the COVID-19 pandemic include female gender, younger age group (≤40 years), presence of chronic/psychiatric illnesses, unemployment, student status, and frequent exposure to social media/news concerning COVID-19. • Mitigation of COVID-19 induced psychological distress requires government intervention and individual efforts.
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            Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic

            (2021)
            Background Before 2020, mental disorders were leading causes of the global health-related burden, with depressive and anxiety disorders being leading contributors to this burden. The emergence of the COVID-19 pandemic has created an environment where many determinants of poor mental health are exacerbated. The need for up-to-date information on the mental health impacts of COVID-19 in a way that informs health system responses is imperative. In this study, we aimed to quantify the impact of the COVID-19 pandemic on the prevalence and burden of major depressive disorder and anxiety disorders globally in 2020. Methods We conducted a systematic review of data reporting the prevalence of major depressive disorder and anxiety disorders during the COVID-19 pandemic and published between Jan 1, 2020, and Jan 29, 2021. We searched PubMed, Google Scholar, preprint servers, grey literature sources, and consulted experts. Eligible studies reported prevalence of depressive or anxiety disorders that were representative of the general population during the COVID-19 pandemic and had a pre-pandemic baseline. We used the assembled data in a meta-regression to estimate change in the prevalence of major depressive disorder and anxiety disorders between pre-pandemic and mid-pandemic (using periods as defined by each study) via COVID-19 impact indicators (human mobility, daily SARS-CoV-2 infection rate, and daily excess mortality rate). We then used this model to estimate the change from pre-pandemic prevalence (estimated using Disease Modelling Meta-Regression version 2.1 [known as DisMod-MR 2.1]) by age, sex, and location. We used final prevalence estimates and disability weights to estimate years lived with disability and disability-adjusted life-years (DALYs) for major depressive disorder and anxiety disorders. Findings We identified 5683 unique data sources, of which 48 met inclusion criteria (46 studies met criteria for major depressive disorder and 27 for anxiety disorders). Two COVID-19 impact indicators, specifically daily SARS-CoV-2 infection rates and reductions in human mobility, were associated with increased prevalence of major depressive disorder (regression coefficient [ B ] 0·9 [95% uncertainty interval 0·1 to 1·8; p=0·029] for human mobility, 18·1 [7·9 to 28·3; p=0·0005] for daily SARS-CoV-2 infection) and anxiety disorders (0·9 [0·1 to 1·7; p=0·022] and 13·8 [10·7 to 17·0; p<0·0001]. Females were affected more by the pandemic than males ( B 0·1 [0·1 to 0·2; p=0·0001] for major depressive disorder, 0·1 [0·1 to 0·2; p=0·0001] for anxiety disorders) and younger age groups were more affected than older age groups (−0·007 [–0·009 to −0·006; p=0·0001] for major depressive disorder, −0·003 [–0·005 to −0·002; p=0·0001] for anxiety disorders). We estimated that the locations hit hardest by the pandemic in 2020, as measured with decreased human mobility and daily SARS-CoV-2 infection rate, had the greatest increases in prevalence of major depressive disorder and anxiety disorders. We estimated an additional 53·2 million (44·8 to 62·9) cases of major depressive disorder globally (an increase of 27·6% [25·1 to 30·3]) due to the COVID-19 pandemic, such that the total prevalence was 3152·9 cases (2722·5 to 3654·5) per 100 000 population. We also estimated an additional 76·2 million (64·3 to 90·6) cases of anxiety disorders globally (an increase of 25·6% [23·2 to 28·0]), such that the total prevalence was 4802·4 cases (4108·2 to 5588·6) per 100 000 population. Altogether, major depressive disorder caused 49·4 million (33·6 to 68·7) DALYs and anxiety disorders caused 44·5 million (30·2 to 62·5) DALYs globally in 2020. Interpretation This pandemic has created an increased urgency to strengthen mental health systems in most countries. Mitigation strategies could incorporate ways to promote mental wellbeing and target determinants of poor mental health and interventions to treat those with a mental disorder. Taking no action to address the burden of major depressive disorder and anxiety disorders should not be an option. Funding Queensland Health, National Health and Medical Research Council, and the Bill and Melinda Gates Foundation.
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              Roles of the immune system in cancer: from tumor initiation to metastatic progression

              In this review, Gonzelez et al. provide an update of recent accomplishments, unifying concepts, and futures challenges to study tumor-associated immune cells, with an emphasis on metastatic carcinomas. The presence of inflammatory immune cells in human tumors raises a fundamental question in oncology: How do cancer cells avoid the destruction by immune attack? In principle, tumor development can be controlled by cytotoxic innate and adaptive immune cells; however, as the tumor develops from neoplastic tissue to clinically detectable tumors, cancer cells evolve different mechanisms that mimic peripheral immune tolerance in order to avoid tumoricidal attack. Here, we provide an update of recent accomplishments, unifying concepts, and future challenges to study tumor-associated immune cells, with an emphasis on metastatic carcinomas.
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                Author and article information

                Contributors
                Journal
                101699003
                46113
                Lancet Public Health
                Lancet Public Health
                The Lancet. Public health
                2468-2667
                17 November 2023
                October 2023
                22 November 2023
                : 8
                : 10
                : e820-e826
                Affiliations
                Miami Veterans Affairs, Healthcare System, Miami, FL, USA
                Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami, Miami, FL, USA
                Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
                Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
                Clinical Neurophysiology Unit, School of Medicine, Cairo University Hospitals, Cairo, Egypt
                Department of Neurology, Inselspital, University of Bern, Bern, Switzerland
                Center for Sleep and Circadian Science, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
                Department of Sleep Medicine, Peking University People’s Hospital, Beijing, China
                Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
                Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
                Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
                Department of Psychology, and CERVO Brain Research Center, Université Laval, Quebec City, QC, Canada
                Sleep Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
                Psychobiology Department, Sleep Medicine Division, Universidade Federal de São Paulo, São Paulo, Brazil
                Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
                Health Futures Institute, Murdoch University, Perth, WA, Australia
                Division of Sleep Medicine, Center for Circadian and Sleep Medicine, Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
                Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC, USA
                Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
                Author notes
                [*]

                Contributed equally

                [†]

                Contributed equally

                Contributors

                DCL and AN as equal first authors contributed to the literature search, figures development, study design, data collection, data analysis, data interpretation, writing, reviewing, and editing. LA, CLAB, DJB, FH, BH, CMM, AIP, DP, and VKS contributed to the study design, data interpretation, writing, reviewing, and editing. YAM contributed to the study design, data collection, data analysis, data interpretation of the global school-based student health survey (GSHS) data, writing, reviewing and editing. CLJ, PCZ, and PRE as equal senior authors closely supervised the literature search, figure concepts, content structure, analysing and interpreting data, writing, reviewing, and editing.

                Correspondence to: Dr Chandra L Jackson, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC 27709, USA chandra.jackson@ 123456nih.gov
                Article
                NIHMS1939014
                10.1016/S2468-2667(23)00182-2
                10664020
                37777291
                b556797d-01b6-46e4-b014-c5ef8e406cc6

                This is an Open Access article under the CC BY-NC-ND 4.0 license.

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