A pathogenic cycle between insomnia and cognitive arousal fuels perinatal depression: exploring the roles of nocturnal cognitive arousal and perinatal-focused rumination

STUDY OBJECTIVES: Depression is among the most prevalent perinatal complications, yet modifiable risk factors remain elusive. Over half of perinatal women endorse clinical insomnia symptoms, which are etiologically implicated in depression in nonperinatal samples. Yet, prospective data on perinatal insomnia and depression are mixed. We sought to clarify temporal associations of insomnia and depression during peripartum, and to investigate cognitive arousal as a potential mechanism facilitating this relationship. METHODS: Seventy pregnant women completed sociodemographic information and baseline sleep and mood symptoms between gestational weeks 25 and 30. Beginning at gestational week 30, participants completed 17 weekly online surveys assessing insomnia, depression, and three cognitive arousal indices (nocturnal cognitive arousal, perseverative thinking, and perinatal-focused rumination). Mixed effects models were conducted to test hypotheses. RESULTS: Women were at risk for depression when experiencing insomnia (odds ratio [OR] = 2.36, 95% confidence interval [CI] = 1.28 to 4.35), nocturnal cognitive arousal (OR = 3.05, 95% CI = 1.60 to 5.79), perinatal-focused rumination (OR = 2.05, 95% CI = 1.11 to 3.79), and perseverative thinking (OR = 7.48, 95% CI = 3.90 to 14.32). Prospective analyses revealed bidirectional effects between insomnia and cognitive arousal, and both predicted future depression. Nocturnal cognitive arousal mediated 23-43% of the effect of insomnia on depression. Insomnia mediated 12%-18% of the effect of nocturnal cognitive arousal on depression. A similar pattern was observed with perinatal-focused rumination. Depression did not predict insomnia. CONCLUSION: Nocturnal cognitive arousal, including ruminating on perinatal concerns while trying to fall asleep, fuels insomnia. In turn, lying awake at night provides an opportunity for nocturnal cognitive arousal. This cycle feeds perinatal depression. Daytime cognitive arousal may indirectly disrupt sleep as perseverating during the day persists into the night

Nocturnal insomnia symptoms and stress-induced cognitive intrusions in risk for depression: A 2-year prospective study

Nearly half of US adults endorse insomnia symptoms. Sleep problems increase risk for depression during stress, but the mechanisms are unclear. During high stress, individuals having difficulty falling or staying asleep may be vulnerable to cognitive intrusions after stressful events, given that the inability to sleep creates a period of unstructured and socially isolated time in bed. We investigated the unique and combined effects of insomnia symptoms and stress-induced cognitive intrusions on risk for incident depression. 1126 non-depressed US adults with no history of DSM-5 insomnia disorder completed 3 annual web-based surveys on sleep, stress, and depression. We examined whether nocturnal insomnia symptoms and stress-induced cognitive intrusions predicted depression 1y and 2y later. Finally, we compared depression-risk across four groups: non-perseverators with good sleep, non-perseverators with insomnia symptoms, perseverators with good sleep, and perseverators with insomnia symptoms. Insomnia symptoms (β = .10-.13, p \u3c .001) and cognitive intrusions (β = .19-.20, p \u3c .001) predicted depression severity 1y and 2y later. Depression incidence across 2 years was 6.2%. Perseverators with insomnia had the highest rates of depression (13.0%), whereas good sleeping non-perseverators had the lowest rates (3.3%, Relative Risk = 3.94). Perseverators with sleep latency \u3e30 m reported greater depression than good sleeping perseverators (t = 2.09, p \u3c .04). Cognitive intrusions following stress creates a depressogenic mindset, and nocturnal wakefulness may augment the effects of cognitive arousal on depression development. Poor sleepers may be especially vulnerable to cognitive intrusions when having difficulty initiating sleep. As treatable behaviors, nighttime wakefulness and cognitive arousal may be targeted to reduce risk for depression in poor sleepers

Hilbert Lattice Equations

There are five known classes of lattice equations that hold in every infinite dimensional Hilbert space underlying quantum systems: generalised orthoarguesian, Mayet's E_A, Godowski, Mayet-Godowski, and Mayet's E equations. We obtain a result which opens a possibility that the first two classes coincide. We devise new algorithms to generate Mayet-Godowski equations that allow us to prove that the fourth class properly includes the third. An open problem related to the last class is answered. Finally, we show some new results on the Godowski lattices characterising the third class of equations.Comment: 24 pages, 3 figure

CLERK is a novel receptor kinase required for sensing of root-active CLE peptides in <i>Arabidopsis</i>.

CLAVATA3/EMBRYO SURROUNDING REGION (CLE) peptides are secreted endogenous plant ligands that are sensed by receptor kinases (RKs) to convey environmental and developmental inputs. Typically, this involves an RK with narrow ligand specificity that signals together with a more promiscuous co-receptor. For most CLEs, biologically relevant (co-)receptors are unknown. The dimer of the receptor-like protein CLAVATA 2 (CLV2) and the pseudokinase CORYNE (CRN) conditions perception of so-called root-active CLE peptides, the exogenous application of which suppresses root growth by preventing protophloem formation in the meristem. &lt;i&gt;clv2&lt;/i&gt; as well as &lt;i&gt;crn&lt;/i&gt; null mutants are resistant to root-active CLE peptides, possibly because CLV2-CRN promotes expression of their cognate receptors. Here, we have identified the &lt;i&gt;CLE-RESISTANT RECEPTOR KINASE&lt;/i&gt; ( &lt;i&gt;CLERK&lt;/i&gt; ) gene, which is required for full sensing of root-active CLE peptides in early developing protophloem. CLERK protein can be replaced by its close homologs, SENESCENCE-ASSOCIATED RECEPTOR-LIKE KINASE (SARK) and NSP-INTERACTING KINASE 1 (NIK1). Yet neither CLERK nor NIK1 ectodomains interact biochemically with described CLE receptor ectodomains. Consistently, &lt;i&gt;CLERK&lt;/i&gt; also acts genetically independently of &lt;i&gt;CLV2-CRN&lt;/i&gt; We, thus, have discovered a novel hub for redundant CLE sensing in the root

Type-Decomposition of a Pseudo-Effect Algebra

The theory of direct decomposition of a centrally orthocomplete effect algebra into direct summands of various types utilizes the notion of a type-determining (TD) set. A pseudo-effect algebra (PEA) is a (possibly) noncommutative version of an effect algebra. In this article we develop the basic theory of centrally orthocomplete PEAs, generalize the notion of a TD set to PEAs, and show that TD sets induce decompositions of centrally orthocomplete PEAs into direct summands.Comment: 18 page

Arabidopsis SABRE and CLASP interact to stabilize cell division plane orientation and planar polarity

The orientation of cell division and the coordination of cell polarity within the plane of the tissue layer (planar polarity) contribute to shape diverse multicellular organisms. The root of Arabidopsis thaliana displays regularly oriented cell divisions, cell elongation and planar polarity providing a plant model system to study these processes. Here we report that the SABRE protein, which shares similarity with proteins of unknown function throughout eukaryotes, has important roles in orienting cell division and planar polarity. SABRE localizes at the plasma membrane, endomembranes, mitotic spindle and cell plate. SABRE stabilizes the orientation of CLASP-labelled preprophase band microtubules predicting the cell division plane, and of cortical microtubules driving cell elongation. During planar polarity establishment, sabre is epistatic to clasp at directing polar membrane domains of Rho-of-plant GTPases. Our findings mechanistically link SABRE to CLASP-dependent microtubule organization, shedding new light on the function of SABRE-related proteins in eukaryotes

Kochen-Specker Sets and Generalized Orthoarguesian Equations

Every set (finite or infinite) of quantum vectors (states) satisfies generalized orthoarguesian equations ($n$OA). We consider two 3-dim Kochen-Specker (KS) sets of vectors and show how each of them should be represented by means of a Hasse diagram---a lattice, an algebra of subspaces of a Hilbert space--that contains rays and planes determined by the vectors so as to satisfy $n$OA. That also shows why they cannot be represented by a special kind of Hasse diagram called a Greechie diagram, as has been erroneously done in the literature. One of the KS sets (Peres') is an example of a lattice in which 6OA pass and 7OA fails, and that closes an open question of whether the 7oa class of lattices properly contains the 6oa class. This result is important because it provides additional evidence that our previously given proof of noa =< (n+1)oa can be extended to proper inclusion noa < (n+1)oa and that nOA form an infinite sequence of successively stronger equations.Comment: 16 pages and 5 figure

Sleep to Reduce Incident Depression Effectively (STRIDE): study protocol for a randomized controlled trial comparing stepped-care cognitive-behavioral therapy for insomnia versus sleep education control to prevent major depression

BACKGROUND: Prevention of major depressive disorder (MDD) is a public health priority. Strategies targeting individuals at elevated risk for MDD may guide effective preventive care. Insomnia is a reliable precursor to depression, preceding half of all incident and relapse cases. Thus, insomnia may serve as a useful entry point for preventing MDD. Cognitive-behavioral therapy for insomnia (CBT-I) is recommended as the first-line treatment for insomnia, but widespread implementation is limited by a shortage of trained specialists. Innovative stepped-care approaches rooted in primary care can increase access to CBT-I and reduce rates of MDD. METHODS/DESIGN: We propose a large-scale stepped-care clinical trial in the primary care setting that utilizes a sequential, multiple assignment, randomized trial (SMART) design to determine the effectiveness of dCBT-I alone and in combination with clinician-led CBT-I for insomnia and the prevention of MDD incidence and relapse. Specifically, our care model uses digital CBT-I (dCBT-I) as a first-line intervention to increase care access and reduce the need for specialist resources. Our proposal also adds clinician-led CBT-I for patients who do not remit with first-line intervention and need a more personalized approach from specialty care. We will evaluate negative repetitive thinking as a potential treatment mechanism by which dCBT-I and CBT-I benefit insomnia and depression outcomes. DISCUSSION: This project will test a highly scalable model of sleep care in a large primary care system to determine the potential for wide dissemination and implementation to address the high volume of population need for safe and effective insomnia treatment and associated prevention of depression. TRIAL REGISTRATION: ClinicalTrials.gov NCT03322774. Registered on October 26, 2017

A geometrical origin for the covariant entropy bound

Causal diamond-shaped subsets of space-time are naturally associated with operator algebras in quantum field theory, and they are also related to the Bousso covariant entropy bound. In this work we argue that the net of these causal sets to which are assigned the local operator algebras of quantum theories should be taken to be non orthomodular if there is some lowest scale for the description of space-time as a manifold. This geometry can be related to a reduction in the degrees of freedom of the holographic type under certain natural conditions for the local algebras. A non orthomodular net of causal sets that implements the cutoff in a covariant manner is constructed. It gives an explanation, in a simple example, of the non positive expansion condition for light-sheet selection in the covariant entropy bound. It also suggests a different covariant formulation of entropy bound.Comment: 20 pages, 8 figures, final versio