0556 Sex-Specific Relationship Between Anxiety and Autonomic Nervous System Dysfunction in Obstructive Sleep Apnea

Introduction

Cardiovascular co-morbidities in obstructive sleep apnea (OSA) are hard to treat, perhaps due to autonomic nervous system (ANS) dysfunction. In OSA, intermittent hypoxia and poor tissue oxygen perfusion damage endothelial and nervous tissue, potentially underlying the dysfunction. Moreover, OSA is strongly associated with anxiety, which is independently associated with ANS dysfunction. We assessed sex-specific relationships between anxiety and cardiovascular markers of ANS dysfunction in OSA.

Methods

We studied people diagnosed with OSA and healthy controls. We collected 5 minutes of wakeful resting ECG, continuous non-invasive blood pressure, and respiration data. We calculated heart rate (HR), heart rate variability (HRV; sympathetic-vagal balance related to brainstem ANS output), mean arterial blood pressure (MAP), beat-to-beat MAP variability (BPV; related to peripheral autonomic function) and breathing rate (BR). We analyzed these measures with a multivariate regression model of anxiety symptoms (generalized anxiety disorder; GAD-7 scores), sex, and group (OSA vs. control), age/BMI/AHI covariates, and Bonferroni-corrected post-hoc comparisons (p≤0.05).

Results

We analyzed 64 subjects (32 OSA: AHI [mean±SEM] 24±4events/hour, 12 female, age 52±21years, BMI 33±2kg/m2; 32 control: 19 female, age 46±2; BMI 26±1). We observed significant main effects of anxiety, BMI, AHI, sex on HRV, but only group on BPV; post-hoc comparisons revealed high BPV only in OSA females. Secondary analyses included classifying by anxiety symptoms (GAD-7≥5), showing only OSA females with anxiety had higher BPV. Males showed higher HRV. AHI and anxiety were positively correlated with HRV in OSA males. AHI was negatively correlated with BR in OSA females.

Conclusion

We observed higher anxiety associated with higher BPV in OSA, especially in females. Unexpectedly, BR was lower in OSA females; longer breaths may have led to the greater BPV. Higher HRV in males complicated by OSA severity and anxiety could be related to higher sympathetic tone. The slightly older control group may have influenced the findings. Overall, our findings suggest anxiety in OSA is associated with peripheral and centrally-mediated autonomic dysfunction, but in a sex-specific manner.

Support

National Institutes of Health R56-NR-017435 and RO1-HL-135562.

Mutations in growth hormone gene affect stability of protein structure leading to reduced growth, reproduction, and milk production in crossbred cattle-an insight

The GH has a multifaceted role in growth, reproduction, and milk production. Nonsynonymous mutations identified as L153V were observed from GH1 (L) to GH2 (V) with higher genotypic frequency for GH1 being 0.87. GH2 (V) allele was identified as a rare allele and the population followed Hardy-Weinberg equilibrium. LL homozygote variant had significantly better growth, reproduction, and expected milk production at different ages in crossbred (CB) males. Reports are scanty explaining the molecular mechanism of how individuals with LV genotype were phenotypically inferior to that of wild-type LL. In the present study, it was explored that GH peptide with LV heterozygotes of GH gene, were observed to have reduced structural stability thermodynamically and thus functionally leads to reduced economic traits in CB animals. The fact was first time reported and confirmed through genomic analysis, bioinformatics, and later confirmed through immunohistochemistry. Differential expression analysis of the GH gene with respect to other genes in the hypothalamus-pituitary growth axis of CB cattle was also studied to have a complete insight of the GH gene.

Corrigendum to "Dietary administration of Nexrutine inhibits rat liver tumorigenesis and induces apoptotic cell death in human hepatocellular carcinoma cells". [Toxicol. Rep. 2 (2014) (November) 1-11]

[This corrects the article DOI: 10.1016/j.toxrep.2014.11.006.].

Tuning of Magnetic Activity in Spin-Filter Josephson Junctions Towards Spin-Triplet Transport

The study of superconductor-ferromagnet interfaces has generated great interest in the last decades, leading to the observation of spin-aligned triplet supercurrents and 0-π transitions in Josephson junctions where two superconductors are separated by an itinerant ferromagnet. Recently, spin-filter Josephson junctions with ferromagnetic barriers have shown unique transport properties, when compared to standard metallic ferromagnetic junctions, due to the intrinsically nondissipative nature of the tunneling process. Here we present the first extensive characterization of spin polarized Josephson junctions down to 0.3 K, and the first evidence of an incomplete 0-π transition in highly spin polarized tunnel ferromagnetic junctions. Experimental data are consistent with a progressive enhancement of the magnetic activity with the increase of the barrier thickness, as neatly captured by the simplest theoretical approach including a nonuniform exchange field. For very long junctions, unconventional magnetic activity of the barrier points to the presence of spin-triplet correlations.

Measurement of the Effective Weak Mixing Angle in pp[over ¯]→Z/γ^{*}→ℓ^{+}ℓ^{-} Events

We present a measurement of the effective weak mixing angle parameter sin^{2}θ_{eff}^{ℓ} in pp[over ¯]→Z/γ^{*}→μ^{+}μ^{-} events at a center-of-mass energy of 1.96 TeV, collected by the D0 detector at the Fermilab Tevatron Collider and corresponding to 8.6  fb^{-1} of integrated luminosity. The measured value of sin^{2}θ_{eff}^{ℓ}[μμ]=0.23016±0.00064 is further combined with the result from the D0 measurement in pp[over ¯]→Z/γ^{*}→e^{+}e^{-} events, resulting in sin^{2}θ_{eff}^{ℓ}[comb]=0.23095±0.00040. This combined result is the most precise measurement from a single experiment at a hadron collider and is the most precise determination using the coupling of the Z/γ^{*} to light quarks.

Spin-flop and magnetodielectric reversal in Yb substituted GdMnO3

The evolution of various spin structures in Yb doped GdMnO₃ distorted orthorhombic perovskite system was investigated from their magnetic, dielectric and magnetodielectric characteristics. The Gd_1-x Yb _x MnO₃ (0  ⩽  x  ⩽  0.15) revealed an enhanced magnetodielectric coupling when their magnetic structure is guided from ab to the bc-cycloidal spin structure upon Yb doping. The compounds exhibit magnetic field and temperature controlled spin-flop from c to a-axis. Additionally, magnetodielectric reversal is observed for the x  =  0.1 sample which depends on both magnetic field and temperature. The resultant correlation between magnetic and electric orderings is discussed in the frame of symmetric and antisymmetric exchange interaction models. These findings provide further insight in understanding the magnetoelectric materials and importantly show a way to tune the magnetic and magnetodielectric properties towards better application potential.

Customization of biliopancreatic limb length to modulate and sustain antidiabetic effect of gastric bypass surgery

Although Roux-en-Y Gastric Bypass (RYGB) remains the most effective treatment for obesity and type 2 diabetes (T2D), many patients fail to achieve remission, or relapse. Increasing intestinal limb lengths of RYGB may improve outcomes, but the mechanistic basis for this remains unclear. We hypothesize biliopancreatic (BP) limb length modulates the antidiabetic effect of RYGB. Rats underwent RYGB with a 20-cm (RYGB-20cm) or 40-cm (RYGB-40cm) BP limb and were compared with control animals. After 2 and 4 wk, portal and systemic blood was sampled during intestinal glucose infusion. Portosystemic gradient was used to calculate intestinal glucose utilization (G_util), absorption (G_absorp), and hormone secretion. Intestinal morphology and gene expression were assessed. At 2 wk, G_absorp progressively decreased with increasing BP limb length; this pattern persisted at 4 wk. G_util increased ≈70% in both RYGB-20cm and -40cm groups at 2 wk. At 4 wk, G_util progressively increased with limb length. Furthermore, Roux limb weight, and expression of hexokinase and preproglucagon, exhibited a similar progressive increase. At 4 wk, glucagon-like peptide-1 and -2 levels were higher after RYGB-40cm, with associated increased secretion. We conclude that BP limb length modulates multiple antidiabetic mechanisms, analogous to the dose-response relationship of a drug. Early postoperatively, a longer BP limb reduces G_absorp. Later, G_util, Roux limb hypertrophy, hormone secretion, and hormone levels are increased with longer BP limb. Sustained high incretin levels may prevent weight regain and T2D relapse. These data provide the basis for customizing BP limb length according to patient characteristics and desired metabolic effect. NEW & NOTEWORTHY Biliopancreatic limb length in gastric bypass modulates multiple antidiabetic mechanisms, analogous to the dose-response relationship of a drug. With a longer biliopancreatic limb, Roux limb hypertrophy, increased glucose utilization, reduced glucose absorption, and sustained high incretin levels may prevent weight regain and diabetes relapse.

Combined Forward-Backward Asymmetry Measurements in Top-Antitop Quark Production at the Tevatron

The CDF and D0 experiments at the Fermilab Tevatron have measured the asymmetry between yields of forward- and backward-produced top and antitop quarks based on their rapidity difference and the asymmetry between their decay leptons. These measurements use the full data sets collected in proton-antiproton collisions at a center-of-mass energy of sqrt[s]=1.96  TeV. We report the results of combinations of the inclusive asymmetries and their differential dependencies on relevant kinematic quantities. The combined inclusive asymmetry is A_{FB}^{tt[over ¯]}=0.128±0.025. The combined inclusive and differential asymmetries are consistent with recent standard model predictions.

Identification of factors associated with treatment refractoriness of oral lesions in pemphigus vulgaris

BACKGROUND

The oral mucosal lesions of patients with pemphigus vulgaris are known to show more treatment refractoriness than skin lesions.

OBJECTIVES

To identify which clinical and laboratory parameters may indicate treatment refractoriness of oral lesions in pemphigus vulgaris.

METHODS

This was a prospective study of 50 adults with pemphigus vulgaris and oral lesions; patients were given treatment appropriate for overall disease severity. Treatment refractoriness was defined arbitrarily as less than 75% reduction in oral objective Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) after treatment for 6 months.

RESULTS

Of 46 patients who completed the study, 17 (37%) were treatment refractory whereas 29 (63%) were treatment responsive. At baseline, the treatment refractory group had a significantly longer mean duration of disease (P = 0·02) and mean duration of oral lesions (P = 0·01), a higher percentage of lesions in the retromolar trigone (P = 0·05) and on the occlusion line along the buccal mucosa (P = 0·04), a higher percentage of deep/crateriform ulcers (P < 0·001) and erosions with a lichenoid hue (P < 0·001). Herpes simplex virus (HSV) DNA positivity, assessed by polymerase chain reaction in oral tissue scrapings (P = 0·02), was also significantly higher in the treatment refractory group. No other factors we tested for were statistically significant.

CONCLUSIONS

Treatment refractoriness of oral lesions was significantly associated with duration of disease/oral lesions; specific morphology and location of oral lesions; and the presence of HSV DNA in the oral cavity. These factors may forewarn the treating physician about a refractory course of oral lesions that may help with counselling patients.

Tailoring of magnetic orderings in Fe substituted GdMnO3 bulk samples towards room temperature

The evolution of various magnetic ordering has been studied for the orthorhombic perovskite GdMn_1-x Fe _x O₃ (0  ⩽  x  ⩽  0.7) system to obtain its comprehensive magnetic phase diagram. We observed that the substitution of Fe in GdMnO₃ increases the antiferromagnetic Neel temperature (T _N) from 40 K to above 400 K and importantly induces a spin-reorientation transition (T _SR) for x  ⩾  0.4. These transitions are close to room temperature at x  =  0.5 and then gradually separated at a higher x value. The static orbital ordering induced by the Jahn-Teller distortion seems to play an important role in changing the T _N. The variations of spin-reorientation ordering along with the competition between the magnetic orderings as a function of the composition were discussed with respect to antisymmetric exchange interactions and Mn³⁺ single-ion anisotropy in detail. In addition, the correlation between structural and magnetic properties suggests that the subtle structural change at composition x  =  0.4 may affect the magnetic ordering. The observed tunable T _SR and T _N in GdMn_1-x Fe _x O₃ could add a practical value for these compositions in fields like spintronics and sensors.

Insulin secretion and action in North Indian women during pregnancy

AIM

The relative roles(s) of impaired insulin secretion vs. insulin resistance in the development of gestational diabetes mellitus depend upon multiple risk factors and diagnostic criteria. Here, we explored their relative contribution to gestational diabetes as defined by the WHO 1999 (GDM1999) and adapted WHO 2013 (GDM2013) criteria, excluding the 1-h glucose value, in a high-risk Indian population from Punjab.

METHODS

Insulin secretion (HOMA2-B) and insulin action (HOMA2-IR) were assessed in 4665 Indian women with or without gestational diabetes defined by the GDM1999 or adapted GDM2013 criteria.

RESULTS

Gestational diabetes defined using both criteria was associated with decreased insulin secretion compared with pregnant women with normal glucose tolerance. Women with gestational diabetes defined by the adapted GDM2013, but not GDM1999 criteria, were more insulin resistant than pregnant women with normal glucose tolerance, and furthermore displayed lower insulin secretion than GDM1999 women. Urban habitat, illiteracy, high age and low BMI were independently associated with reduced insulin secretion, whereas Sikh religion, increasing age and BMI, as well as a family history of diabetes were independently associated with increased insulin resistance.

CONCLUSIONS

Gestational diabetes risk factors influence insulin secretion and action in North Indian women in a differential manner. Gestational diabetes classified using the adapted GDM2013 compared with GDM1999 criteria is associated with more severe impairments of insulin secretion and action.

Undergraduate medical students’ interest in specialising in Family Medicine at the University of the Free State, 2014

Background: There is a large demand for Family Medicine specialists, yet not enough medical students specialise in this field. This study investigated the interest of undergraduate medical students at the University of the Free State in pursuing a career in Family Medicine, factors associated with this interest, and their opinion of Family Medicine as a specialty. Methods: In this prospective cross-sectional study, anonymous, self-reporting questionnaires, available in English and Afrikaans, were distributed to first- to fifth-year undergraduates. Data were collected on demographic variables and interest in Family Medicine and other disciplines. The students had to rate the likelihood of them selecting 15 different specialties as a future career according to a five-point Likert scale. Opinions concerning Family Medicine were tested with a yes/no response as to the agreement to five statements. Results: Fifth-year students were excluded due to poor response rate (13.6%). The response rate for the first- to fourth-year groups was 86.4%. Interest in Family Medicine decreased from first to third year (22.4, 21.2 and 14.0%, respectively), but increased again in the fourth year (23.3%). Females and speakers of African languages showed the most interest in this field. Medical students, especially first years, generally had poor knowledge regarding Family Medicine. Conclusion: Family Medicine is not a preferred specialty in any of the four year groups, and students had insufficient knowledge of the field. Family Medicine should be introduced earlier into the medical curriculum. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1317977