Associations between Sleep Problems and Anxiety in Youth

Most of us are able to recall sleepless nights during periods of heightened anxiety, and the associations between sleep and anxiety are sufficiently well established to be acknowledged in the DSM-IV (American Psychiatric Association, 1994). Indeed, sleeprelated difficulties are included in the diagnostic criteria for posttraumatic stress disorder, acute stress disorder and generalized anxiety disorder. In contrast to the wealth of literature highlighting associations between sleep problems and anxiety in adults, less is known about these associations in children and adolescents. It is important to understand associations between disorders as there is evidence to suggest that co-occurring difficulties may result in greater impairment than those occurring alone. For example, a study focusing upon depression found that individuals with co-occurring disorders were more likely to demonstrate suicidal behaviour as compared to those with pure depression (Rohde et al., 1991). Furthermore, focusing upon children is important as various difficulties, including anxiety, may appear early in life and persist into adulthood (Kim- Cohen et al., 2003). This article summarises some key findings with regards to the associations between sleep problems and anxiety in youth and proposes possible clinical implications of this research

Assessing capacity to engage in healthcare to improve the patient experience through health information technology

Patient engagement is viewed as a means to improve patient care, increase population health, and decrease health care costs. Efforts to improve engagement are prevalent across healthcare, particularly through health information technology (HIT) tools such as patient portals. However, we know that not all patients have the same ability to engage, leading to potential disparities. We present the Engagement Capacity Framework and suggest that examining capacity for engagement would improve our ability to address currently unmeasured factors that facilitate engagement. The objective was to examine factors that influence an individual’s capacity for engagement through HIT. We administered a paper survey to patients seen for care in a Family Medicine Clinic at a large Academic Medical Center, measuring potential components of the Engagement Capacity Framework. 142 patients completed the survey. Respondents reported high self-efficacy, high resilience, and good or better quality of life. Most were willing to use the Internet. Almost 30% of respondents did not use a patient portal and 37% of these respondents were very or somewhat unwilling to use a portal. We observed significant positive correlations (p \u3e 0.05) between portal use and searching for health information online, using email and owning technology. For those who did not use a portal we asked about willingness to use a portal; portal willingness was positively correlated with willingness to use the Internet (p \u3c 0.01). Our findings emphasize the importance of assessing capacity for engagement in order to target interventions to those most in need, connecting them to necessary resources to allow more full participation in their care. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len

Low copper levels measured in the aortic wall of New Zealand patients with non-syndromic ascending thoracic aortic aneurysm

OBJECTIVES: Studies in animals have shown causal relationships between copper (Cu) deficiency and the development of thoracic aortic aneurysms (TAAs) [1, 2]. Cu deficiency is widespread in New Zealand (NZ) soils; the high soil pH from the use of lime fertilizers reduces the bioavailability of Cu for grazing animals and growing plants; this, in turn, reduces Cu availability in the NZ human food chain. Our study is a pilot study to explore associations between Cu and TAA. We measured Cu levels in aneurysmal aortic tissues in patients undergoing Bentall procedures and non-aneurysmal aortic tissue from coronary artery bypass graft patients. METHODS: Aortic samples were collected from 2 groups of patients during elective open-heart surgery over 4 months between November 2017 and February 2018. The groups were a TAA group, patients with non-syndromic aortic aneurysm and without the bicuspid aortic valve or known infectious or inflammatory condition (ANEURYSM; n = 13), and a control coronary artery bypass graft group (CONTROL; n = 44). Standardized digested dry tissue weighed samples were analysed from both groups. Tissue extraction of trace elements was carried out using HCl-H2O2 digestion and a highly sensitive analytical technique, inductively coupled plasma mass spectrometry-used to measure elemental concentrations. RESULTS: Cu concentration (mean ± SD) was significantly lower in ANEURYSM (3.34 ± 0.16 µg/g) when compared to the CONTROL group tissues (4.33 ± 0.20 µg/g) (dry weight; mean ± SD; Student's t-test, P < 0.05). Over 46% of the Aneurysm patients were Maori and live in a geographically Cu-deficient NZ territory. CONCLUSIONS: Cu deficiency may play a role in the development or progression of non-syndromic ascending aortic aneurysms in NZ. Maori patients are more at risk as they commonly live in rural NZ, dependent on locally grown nutritional sources. Further studies are required to confirm this exciting finding and to establish cause and effect relationship

The Direct and Ecological Costs of an Ant-Plant Symbiosis

How strong is selection for cheating in mutualisms? The answer depends on the type and magnitude of the costs of the mutualism. Here we investigated the direct and ecological costs of plant defense by ants in the association between Cordia nodosa, a myrmecophytic plant, and Allomerus octoarticulatus, a phytoecious ant. Cordia nodosa trees produce food and housing to reward ants that protect them against herbivores. For nearly 1 year, we manipulated the presence of A. octoarticulatus ants and most insect herbivores on C. nodosa in a full-factorial experiment. Ants increased plant growth when herbivores were present but decreased plant growth when herbivores were absent, indicating that hosting ants can be costly to plants. However, we did not detect a cost to ant colonies of defending host plants against herbivores. Although this asymmetry in costs suggests that the plants may be under stronger selection than the ants to cheat by withholding investment in their partner, the costs to C. nodosa are probably at least partly ecological, arising because ants tend scale insects on their host plants. We argue that ecological costs should favor resistance or traits other than cheating and thus that neither partner may face much temptation to cheat.Organismic and Evolutionary Biolog

Effects of dietary protein and fiber at breakfast on appetite, ad libitum energy intake at lunch, and neural responses to visual food stimuli in overweight adults

Increasing either protein or fiber at mealtimes has relatively modest effects on ingestive behavior. Whether protein and fiber have additive or interactive effects on ingestive behavior is not known. Fifteen overweight adults (5 female, 10 male; BMI: 27.1 ± 0.2 kg/m²; aged 26 ± 1 year) consumed four breakfast meals in a randomized crossover manner (normal protein (12 g) + normal fiber (2 g), normal protein (12 g) + high fiber (8 g), high protein (25 g) + normal fiber (2 g), high protein (25 g) + high fiber (8 g)). The amount of protein and fiber consumed at breakfast did not influence postprandial appetite or ad libitum energy intake at lunch. In the fasting-state, visual food stimuli elicited significant responses in the bilateral insula and amygdala and left orbitofrontal cortex. Contrary to our hypotheses, postprandial right insula responses were lower after consuming normal protein vs. high protein breakfasts. Postprandial responses in other a priori brain regions were not significantly influenced by protein or fiber intake at breakfast. In conclusion, these data do not support increasing dietary protein and fiber at breakfast as effective strategies for modulating neural reward processing and acute ingestive behavior in overweight adults.R01 MH102224 - NIMH NIH HHS; UL1 TR001108 - NCATS NIH HHS; UL1TR001108 - NCATS NIH HH

Promoting Teamwork in Translational Medical Teams: Insights and Recommendations from Science and Practice

Translational medical teams are transdisciplinary, highly collaborative, and operate within dynamic environments to solve time-sensitive and complex problems. These teams are tasked with turning observations in the laboratory and clinic into effective interventions that improve the health of individuals and the public. The nature of the problems they seek to solve requires coordination among clinicians, scientists, and experts from various scientific disciplines. Characteristically, translational medical teams have complex compositions, structure, and pluralistic goals, which pose significant challenges and barriers to enacting effective teamwork, compromising team performance. Given these challenges, it is imperative to glean insights from teams research and the science of team science on how to execute efficacious teamwork. Consequently, the purpose of this paper is to discuss specific teamwork processes (i.e., trust, communication, self-correction, backup behavior, shared mental models, and conflict management) that are critical to translational medical team performance and offer mechanisms to better equip such teams. Utilizing a theoretical framework of transdisciplinary teamwork adapted from the science of team science and tailored to translational medical teams, we describe each of these processes, their relation to translational medical team outcomes, and how they can be leveraged to improve teamwork. Such a discussion aims to provide practical guidance for conceptualizing and enhancing teamwork in translational medical teams

Detection of Helium in the Atmosphere of the Exo-Neptune HAT-P-11b

The helium absorption triplet at a wavelength of 10,833 \AA\ has been proposed as a way to probe the escaping atmospheres of exoplanets. Recently this feature was detected for the first time using Hubble Space Telescope (HST) WFC3 observations of the hot Jupiter WASP-107b. We use similar HST/WFC3 observations to detect helium in the atmosphere of the hot Neptune HAT-P-11b at the $4\sigma$ confidence level. We compare our observations to a grid of 1D models of hydrodynamic escape to constrain the thermospheric temperatures and mass loss rate. We find that our data are best fit by models with high mass loss rates of $\dot{M} \approx 10^{9}$ - $10^{11}$ g s$^{-1}$. Although we do not detect the planetary wind directly, our data are consistent with the prediction that HAT-P-11b is experiencing hydrodynamic atmospheric escape. Nevertheless, the mass loss rate is low enough that the planet has only lost up to a few percent of its mass over its history, leaving its bulk composition largely unaffected. This matches the expectation from population statistics, which indicate that close-in planets with radii greater than 2 R$_{\oplus}$ form and retain H/He-dominated atmospheres. We also confirm the independent detection of helium in HAT-P-11b obtained with the CARMENES instrument, making this the first exoplanet with the detection of the same signature of photoevaporation from both ground- and space-based facilities.Comment: 12 pages, 9 figures, accepted for publication in ApJ

Therapeutic Monoclonal Antibodies to Prevent Tuberculosis Infection

Mycobacteria tuberculosis (Mtb) is a major cause of human morbidity and mortality. Transmission occurs through inhalation of aerosolized Mtb and the initial infection is believed to occur primarily in the alveolar macrophage, although Mtb can infect other cells residing in the lung including dendritic cells, pneumocytes and M cells. Several molecules derived from Mtb are involved in the attachment of the organism to host receptors (opsonic and non-opsonic), which have been reasonably well elucidated. However, a complete understanding of how Mtb attaches to the host and the relative importance of each mechanism on the outcome of infection remains elusive. We hypothesize that protection from infection is possible by blocking the critical initial surface interactions of the organism with the host cell using specific monoclonal antibodies (mAbs). To develop effective mAbs, the outermost layers of Mtb, the capsule and outer membrane, were isolated and characterized by protein gel and LC/MS/MS. Approximately 1000 different proteins were identified in the isolations, of which ~25% were unique to one of the two fractions. The capsule or outer membrane preparations were used as antigens to immunize CD1 mice for up to 12 weeks to generate antibodies via traditional hybridoma generation. Antibodies were screened, selected and characterized by their ability to bind whole cell Mtb by ELISA, demonstration of unique heavy chain variable region sequence and binding specificity by Western Blot. Of approximately 1500 screened hybridomas, 30 lead mAbs have been isolated with specificity to various targets. Preliminary results suggest several of the lead mAb candidates are able to prevent Mtb-induced macrophage cell death in vitro. Future studies will attempt to confirm efficacy in vivo after aerosolized infection in mice with mAb-coated Mtb or parenteral administration of mAb(s). Targets of functional mAbs will be determined and these antigens could serve as viable candidates for vaccine development

A New N-terminal Recognition Domain in Caveolin-1 Interacts with Sterol Carrier Protein-2 (SCP-2)

Although plasma membrane domains, such as caveolae, provide an organizing principle for signaling pathways and cholesterol homeostasis in the cell, relatively little is known regarding specific mechanisms, whereby intracellular lipid-binding proteins are targeted to caveolae. Therefore, the interaction between caveolin-1 and sterol carrier protein-2 (SCP-2), a protein that binds and transfers both cholesterol and signaling lipids (e.g., phosphatidylinositides and sphingolipids), was examined by yeast two-hybrid, in vitro binding and fluorescence resonance energy transfer (FRET) analyses. Results of the in vivo and in vitro assays identified for the first time the N-terminal amino acids (aa) 1−32 amphipathic α helix of SCP-2 functionally interacted with caveolin-1. This interaction was independent of the classic caveolin-1 scaffolding domain, in which many signaling proteins interact. Instead, SCP-2 bound caveolin-1 through a new domain identified in the N-terminal domain of caveolin-1 between aa 34−40. Modeling studies suggested that electrostatic interactions between the SCP-2 N-terminal aa 1−32 amphipathic α-helical domain (cationic, positively charged face) and the caveolin-1 N-terminal aa 33−59 α helix (anionic, negatively charged face) may significantly contribute to this interaction. These findings provide new insights on how SCP-2 enhances cholesterol retention within the cell as well as regulates the distribution of signaling lipids, such as phosphoinositides and sphingolipids, at plasma membrane caveolae