BackgroundDespite implications of sleep disturbances in Alzheimer’s disease (AD) pathophysiology (e.g. cerebral amyloid accumulation, atrophy in AD‐pathology sensitive brain regions); contradictory findings on sleep/neuropathology relationships at preclinical‐AD stage exist, possibly due to sex‐differences and/or methodological disparities and inconsistencies in sleep evaluation. We sought to address this conundrum using self‐reported versus actigraphy‐based data, to explore sex differences associated with amyloid load and MRI whole brain/sub‐regional volumetric indices, among asymptomatic older adults.MethodSex‐stratified analysis of CHARIOT:PRO SubStudy baseline data (519 cognitively‐unimpaired participants: 60–85 years) was performed, using a‐priori confounder‐adjusted multivariable regression models, aimed at assessing the effect‐modifying role of sex on associations of sleep quality measures (objective: 7‐day actigraphy, subjective: Pittsburg‐Sleep‐Quality‐Index questionnaire) with (i) Brain amyloid pathology status (positive/negative), (ii) volumetric‐MRI whole brain, (iii) hippocampal and (iv) frontal regions. Bivariate correlation analysis compared self‐reported and actigraphy sleep measures.Result49.1% of the participants were amyloid‐positive and more likely to report poor sleep. Only 5% of the cohort accurately estimated their overall sleep quality and were more likely to be younger (mean±SD: 69.1 ± 6.4), compared to inaccurate‐reporters (underestimated‐sleepQ: 72.7±5.5; overestimated‐sleepQ: mean 71.3±5.30; F (2, 336) = 5.18, P < 0.01). Women were more likely to underestimate their sleep quality compared to men (χ2 (2, 336) = 9.32, P < 0.01). Indeed, actigraphy revealed higher odds of insufficient sleep duration (OR, 1.75, 95% CI [1.13‐2.70]) and sleep efficiency impairments (OR, 4.36, 95% CI [1.47‐12.90] in men compared to women. Effect modification on associations of neurodegeneration indices and global sleep quality by sex revealed better self‐reported sleep quality specifically for women with larger hippocampal volumes (β:1.07e‐03;CI:2.48e‐04,1.89e‐03) and larger whole brain volumes (β:1.02e‐05;CI:3.06e‐06,1.74e‐05). Similarly, associations with amyloid pathology status showed worse actigraphy‐ascertained sleep efficiency for amyloid‐positive men (β:−1.44;CI:−2.79,−0.08).ConclusionActigraphy‐derived sleep quality metrices proved useful (compared to self‐reports) in differentiating sex dichotomies related to amyloid status and brain volumetric measures, emphasizing the importance of accounting for sex/gender divergence in subjective reporting, when exploring relationships between sleep quality and AD neuropathology. Further studies are warranted, extending upon these observations to explore potential predictive value for cognitive and functional trajectories from pre‐symptomatic stages.

Background: The clinical outcomes of distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP) patients have been generally investigated. However, postoperative hematological changes after distal pancreatectomy with or without splenectomy are poorly understood. Methods: Information from patients undergoing distal pancreatectomy (DP) between January 2014 and June 2019 at a single institution was reviewed. A linear mixed-effect model was used to compare dynamic hematological changes between different groups. Results: In total, 302 patients who underwent DP were enrolled. In the long term, most postoperative hematological parameters remained significantly higher than preoperative levels in the DPS group, while postoperative lymphocyte, monocyte, basophil, and platelet levels returned to preoperative levels in the SPDP group. All postoperative hematological parameters except for red blood cell count and serum hemoglobulin level were significantly higher in the DPS group than in the SPDP group. There were no significant differences in hematological changes between the splenic vessel preservation (SVP) and Warshaw technique (WT) groups. Conclusions: Postoperative hematological changes were significantly different between the DPS and SPDP groups. Compared to DPS, SPDP reduced abnormal hematological changes caused by splenectomy. SVP and WT were comparable in terms of postoperative hematological changes.

Background: The clinical outcomes of patients who received distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP) have been generally investigated. However, postoperative hematological changes after distal pancreatectomy with or without splenectomy are poorly understood.Methods: Information from patients undergoing distal pancreatectomy (DP) between January 2014 and June 2019 at a single institution was reviewed. A linear mixed-effects model was used to compare dynamic hematological changes between different groups.Results: A total of 302 patients who underwent DP were enrolled. In the long term, most postoperative hematological parameters remained significantly higher than preoperative levels in the DPS group, while postoperative lymphocyte, monocyte, basophil, and platelet levels returned to preoperative levels in the SPDP group. All postoperative hematological parameters except for red blood cell count and serum hemoglobulin level were significantly higher in the DPS group than in the SPDP group. There were no significant differences in hematological changes between the splenic vessel preservation (SVP) and Warshaw technique (WT) groups.Conclusions: Postoperative hematological changes were significantly different between the DPS and SPDP groups. Compared to DPS, SPDP reduced abnormal hematological changes caused by splenectomy. SVP and WT were comparable in terms of postoperative hematological changes.