Abstract RELATIONSHIPS BETWEEN CUMULATIVE CHILDHOOD ADVERSITY AND SLEEP HEALTH: DOES VIGILANCE FOR THREAT PLAY A ROLE?

Exposure to childhood adversity in the home may be related to poorer sleep, even in samples without sleep disorders or psychiatric illness. Sleep health is a construct that considers dimensions of both nighttime and daytime sleep (i.e., regularity, satisfaction, alertness, timing, efficiency, duration). This study examined the relationship between cumulative childhood adversity (i.e., a sum of different types of adversities) and sleep health, as well as mediators and moderators of this relationship, including vigilance for threat, childhood SES, community adversities, body mass index, and symptoms of depression, anxiety, and PTSD in a sample of 540 healthy undergraduates aged 18-28 years old (50% female; 29% non-white). Online surveys assessed childhood adversity before age 18 and current sleep, mood, vigilance for threat, and health. Survey sleep health was measured using the “RUSATED” scale (Buysse, 2014). A subsample (n=114) completed a laboratory protocol that measured behavioral and physiological vigilance for threat, and a weeklong sleep protocol (actigraphy and daily diaries). Primary analyses examined a second-order latent factor of sleep health that combined survey, actigraphy, and diary measures of the six sleep health dimensions. Supplemental analyses examined the total sleep health score on the RUSATED survey, as well as total scores when RUSATED cut-offs for each sleep dimension were applied to actigraphy and diary data. Structural equation modeling (with bootstrapping for mediation models) and linear regressions were used to examine the relationship between childhood adversity and sleep health. Overall, 52% of the sample reported one or more childhood adversities. Childhood adversity was related to poorer latent sleep health and survey-reported RUSATED sleep health total score after adjustment for sociodemographic, health, and psychosocial covariates. Mediation and moderation hypotheses were largely unsupported, with two exceptions: PTSD partially mediated the relationship between childhood adversity and diary-derived sleep health total score, and low childhood SES moderated the relationship between adversity and survey sleep health total score, but this interaction was not probed as less than 5% of participants reported low SES. The sleep health construct may provide a nuanced way to study sleep patterns and ultimately guide intervention efforts that may mitigate downstream risk of poor health outcomes

POLETOWN NEIGHBORHOOD COUNCIL, a voluntary unincorporated association

Corporation as a site for construction of an assembly plant. The plaintiffs, a neighborhood association and several individual residents of the affected area, brought suit in Wayne Circuit Court to challenge the project on a number of grounds, not all of which have been argued to this Court. Defendants' motions for summary judgment were denied pending trial on a single question of fact: whether, under 1980 PA 87; M.C.L. § 213.51 et seq ; M.S.A. § 8.265(1) et seq, the city abused its discretion in determining that condemnation of plaintiffs' property was necessary to complete the project

Quantification of silver nanoparticle uptake and distribution within individual human macrophages by FIB/SEM slice and view

Background Quantification of nanoparticle (NP) uptake in cells or tissues is very important for safety assessment. Often, electron microscopy based approaches are used for this purpose, which allow imaging at very high resolution. However, precise quantification of NP numbers in cells and tissues remains challenging. The aim of this study was to present a novel approach, that combines precise quantification of NPs in individual cells together with high resolution imaging of their intracellular distribution based on focused ion beam/ scanning electron microscopy (FIB/SEM) slice and view approaches. Results We quantified cellular uptake of 75 nm diameter citrate stabilized silver NPs (Ag 75 Cit) into an individual human macrophage derived from monocytic THP-1 cells using a FIB/SEM slice and view approach. Cells were treated with 10 μg/ml for 24 h. We investigated a single cell and found in total 3138 ± 722 silver NPs inside this cell. Most of the silver NPs were located in large agglomerates, only a few were found in clusters of fewer than five NPs. Furthermore, we cross-checked our results by using inductively coupled plasma mass spectrometry and could confirm the FIB/SEM results. Conclusions Our approach based on FIB/SEM slice and view is currently the only one that allows the quantification of the absolute dose of silver NPs in individual cells and at the same time to assess their intracellular distribution at high resolution. We therefore propose to use FIB/SEM slice and view to systematically analyse the cellular uptake of various NPs as a function of size, concentration and incubation time.TU Berlin, Open-Access-Mittel - 201

Parents’ Readiness to Change Affects BMI Reduction Outcomes in Adolescents with Polycystic Ovary Syndrome

Evidence supports the importance of parental involvement for youth’s ability to manage weight. This study utilized the stages of change (SOC) model to assess readiness to change weight control behaviors as well as the predictive value of SOC in determining BMI outcomes in forty adolescent-parent dyads (mean adolescent age = 15 ± 1.84 (13–20), BMI = 37 ± 8.60; 70% white) participating in a weight management intervention for adolescent females with polycystic ovary syndrome (PCOS). Adolescents and parents completed a questionnaire assessing their SOC for the following four weight control domains: increasing dietary portion control, increasing fruit and vegetable consumption, decreasing dietary fat, and increasing usual physical activity. Linear regression analyses indicated that adolescent change in total SOC from baseline to treatment completion was not predictive of adolescent change in BMI from baseline to treatment completion. However, parent change in total SOC from baseline to treatment completion was predictive of adolescent change in BMI, (t(24) = 2.15, p=0.043). Findings support future research which carefully assesses adolescent and parent SOC and potentially develops interventions targeting adolescent and parental readiness to adopt healthy lifestyle goals

The SAMe-TT2R2 score and quality of anticoagulation in atrial fibrillation: a simple aid to decision-making on who is suitable (or not) for vitamin K antagonists

International audienc

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction