Tulane University

The transition to college is associated with increased sleep difficulties. Everyday discrimination is an important social determinant of sleep difficulties, and this study examined associations between precollege exposures to everyday discrimination and sleep during the first year of college. The study also considers the mediating role of daily sleep quality. Using a combination of longitudinal surveys and daily diaries, the extent to which precollege exposures to everyday discrimination collected in the fall semester predicted sleep difficulties in the spring semester of students' first year in college was investigated in a sample of 628 diverse college students (mean age = 18.54 years). Sleep difficulties included self-reported sleep onset-related disturbance and daytime dysfunction. Precollege exposures to everyday discrimination were associated with higher levels of daytime dysfunction (but not with sleep disturbance) in the spring semester. Precollege exposures to everyday discrimination were also associated with lower mean levels of daily sleep quality across 14 days; in turn, lower daily sleep quality contributed to higher levels of daytime dysfunction in the spring. Although precollege exposures to everyday discrimination were associated with higher variability in daily sleep quality, variability in daily sleep quality was not associated with sleep difficulties in the spring. Precollege exposures to everyday discrimination were associated with sleep difficulties in the first year of college, and these sleep concerns are explained by daily-level sleep processes. Targeting daily sleep quality may be an important health lever to improve first-year college students' sleep problems and their transition to college. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

BackgroundBrepocitinib is a first-in-class, oral, selective TYK2–JAK1 inhibitor that blocks cytokine signaling, which has been implicated in dermatomyositis.MethodsIn this phase 3, double-blind, randomized, placebo-controlled trial, adults with dermatomyositis were assigned in a 1:1:1 ratio to receive once-daily oral brepocitinib at a dose of 30 mg, brepocitinib at a dose of 15 mg, or placebo for 52 weeks. Standard therapies were continued, and glucocorticoids were tapered. The primary end point was the Total Improvement Score, a validated composite myositis index (with scores ranging from 0 to 100 and higher scores indicating greater improvement) at week 52. Key secondary end points, including skin disease activity, glucocorticoid tapering, and physical function, were tested in a multiplicity-controlled sequence.ResultsA total of 241 patients underwent randomization: 81 to receive brepocitinib 30 mg, 81 to receive brepocitinib 15 mg, and 79 to receive placebo. At week 52, the mean Total Improvement Score was 46.5, 37.5, and 31.2, respectively (difference with brepocitinib 30 mg vs. placebo, 15.3; 95% confidence interval [CI], 6.7 to 24.0; P<0.001; difference with brepocitinib 15 mg vs. placebo, 6.3; 95% CI, −2.4 to 14.9). Brepocitinib 30 mg was superior to placebo across all nine key secondary end points, including skin disease activity, systemic glucocorticoid tapering, and functional disability, with improvements observed as early as week 4. Serious infections were more frequent in the brepocitinib 30-mg group than in the placebo group (10% vs. 1%). No deaths occurred during the trial.ConclusionsIn adults with dermatomyositis that was resistant to previous therapy, the use of brepocitinib at a dose of 30 mg (but not at a dose of 15 mg) resulted in significant benefits with respect to a composite myositis index, skin disease severity, glucocorticoid tapering, and functional disability. (Funded by Priovant Therapeutics; ClinicalTrials.gov number, NCT05437263.)

The purpose of this study was to investigate the impact of demographic, psychological, and social factors on self-reported recovery after anterior cruciate ligament (ACL) reconstruction (ACLR). Psychological and social factors would be associated with lower patient-reported outcome scores (PROMS) after ACLR. Case series. Level 4. Retrospective review was conducted of patients who underwent ACLR at a single institution. Recovery was measured by using the PROMIS 10 SF Global Health Physical score, Lysholm Knee score, International Knee Documentation Committee (IKDC) score, and Knee Outcome Survey (KOS) scores. Multivariable linear regression models were developed to predict 6-month PROMIS 10 SF Global Health Physical, Lysholm Knee, IKDC, and KOS scores. Sociodemographic, surgical, and preoperative PROMS with variance inflation factors >5 were removed to minimize collinearity. A total of 67 patients who underwent ACLR between December 2013 to August 2023 were included in this study, with a mean age of 31.1 ± 10.3 years. Smoking history was consistently associated with lower 6-month IKDC (β = -33.5 [-54.0, -13.0], P = 0.002), KOS (β = -35.6 [-42.3, -18.4], P < 0.001), and Lysholm (β = -27.6 [-45.1, -10.0], P = 0.004) scores. White race was associated with lower Lysholm scores (β = -8.0 [-13.1, -3.0], P = 0.003). Higher preoperative PROMIS mental health scores were associated with higher KOS (β = 0.4 [0.1, 0.6], P = 0.01). Patients with Medicaid reported higher KOS scores (β = 7.2 [2.4, 12.0], P = 0.004). Several psychosocial and demographic factors may influence recovery after ACL reconstruction. In our study, smoking predicted worse outcomes, while having Medicaid insurance was unexpectedly linked to better self-reported recovery. White race predicted worse outcomes. Mental health findings were contradictory, with high preoperative PROMIS mental health scores, representing current mental health, and a history of depression potentially associated with improved outcomes. Identifying psychological and social factors preoperatively can help clinicians better understand which patients may be at risk for lower self-reported outcomes.