Nonmonotonic Energy Dependence of Net-Proton Number Fluctuations

Nonmonotonic variation with collision energy (sqrt[s_{NN}]) of the moments of the net-baryon number distribution in heavy-ion collisions, related to the correlation length and the susceptibilities of the system, is suggested as a signature for the quantum chromodynamics critical point. We report the first evidence of a nonmonotonic variation in the kurtosis times variance of the net-proton number (proxy for net-baryon number) distribution as a function of sqrt[s_{NN}] with 3.1  σ significance for head-on (central) gold-on-gold (Au+Au) collisions measured solenoidal tracker at Relativistic Heavy Ion Collider. Data in noncentral Au+Au collisions and models of heavy-ion collisions without a critical point show a monotonic variation as a function of sqrt[s_{NN}].

Palladin isoforms 3 and 4 regulate cancer-associated fibroblast pro-tumor functions in pancreatic ductal adenocarcinoma

Pancreatic Ductal Adenocarcinoma (PDAC) has a five-year survival under 10%. Treatment is compromised due to a fibrotic-like stromal remodeling process, known as desmoplasia, which limits therapeutic perfusion, supports tumor progression, and establishes an immunosuppressive microenvironment. These processes are driven by cancer-associated fibroblasts (CAFs), functionally activated through transforming growth factor beta1 (TGFβ1). CAFs produce a topographically aligned extracellular matrix (ECM) that correlates with reduced overall survival. Paradoxically, ablation of CAF populations results in a more aggressive disease, suggesting CAFs can also restrain PDAC progression. Thus, unraveling the mechanism(s) underlying CAF functions could lead to therapies that reinstate the tumor-suppressive features of the pancreatic stroma. CAF activation involves the f-actin organizing protein palladin. CAFs express two palladin isoforms (iso3 and iso4) which are up-regulated in response to TGFβ1. However, the roles of iso3 and iso4 in CAF functions remain elusive. Using a CAF-derived ECM model, we uncovered that iso3/iso4 are required to sustain TGFβ1-dependent CAF activation, secrete immunosuppressive cytokines, and produce a pro-tumoral ECM. Findings demonstrate a novel role for CAF palladin and suggest that iso3/iso4 regulate both redundant and specific tumor-supportive desmoplastic functions. This study highlights the therapeutic potential of targeting CAFs to restore fibroblastic anti-tumor activity in the pancreatic microenvironment.

Yoga could reduce the burden and symptoms of atrial fibrillation as well as medication related side effects and the complications with cardiac ablation

Background

Atrial fibrillation (AF) is a common cardiac arrhythmia that affects around three million people worldwide. Thromboembolic stroke, myocardial ischemia and congestive heart failure with significant financial burden are bad outcomes of AF. It is associated with significant morbidity and is also an independent risk factor for mortality. The treatment of AF and its associated complications increases healthcare resource utilization and contributes to increasing costs of healthcare, particularly costs associated with recurrent hospitalization.

Methods

538 patients of atrial fibrillation are enrolled in our multicentric study from 2012 to 2017 that brought to light the therapeutic impact a noninvasive, medication-free intervention has on a costly disease.The unique approach of this study involved patients serving as their own controls; for the first 12 weeks, patients continued standard AF medical or catheter ablation therapy, followed by 16 weeks of 30-min alternate day yoga sessions (Savasana / Sun Salution Yoga Posture, Ujjayi Breath and Anulom –Vilom Pranayam). Patients were also encouraged to practice yoga at home on a daily basis.We divided into two group Yoga and Non Yoga and compared the data after 16 weeks of training.

Results

Yoga training reduced symptomatic AF episodes (14.8±4 vs. 8.2±3.2, p<0.005), symptomatic non-AF episodes (12.8±2.8 vs. 9.2±2.2; p<0.004), asymptomatic AF episodes (2.4±0.4 vs. 1.3±0.20; p<0.005), and depression and anxiety (p<0.005) used Goldberg anxiety score 2.5 fold improved as compared to non yoga group while improving, QoL parameters including physical functioning, vitality, social functioning, and mental health as assessed using the SF-36 (p=0.017, p<0.001, p<0.001, p=0.019, and p<0.003, respectively). There were significant decreases in heart rate and systolic (11±3 mmhg) and diastolic (6±2 mmhg) blood pressure after yoga training (p<0.002). This may directly result in decreased hospitalization (38% in yoga vs 16% in non yoga group) and healthcare costs reduction in yoga group. Yoga is also an intervention free from medication-related side effects or the complications observed with cardiac ablation.

Conclusions

The primary outcome was a composite of the reductions in symptomatic AF, symptomatic non-AF, and asymptomatic AF episodes as recorded by a diary and correlated with a non-looping event monitor with low cost. Strikingly, the results validate the ability of yoga practice to reduce patient-reported AF symptoms. It also demonstrated a statistically significant impact on quality of life (QoL), mental health, physical functioning, depression, and anxiety with avoid of side effects of medication or ablation.

Funding Acknowledgement

Type of funding source: None

Tuberculosis Transmission or Mortality Among Persons Living with HIV, USA, 2011-2016

BACKGROUND

Persons living with HIV are more likely to have tuberculosis (TB) disease attributed to recent transmission (RT) and to die during TB treatment than persons without HIV. We examined factors associated with RT or mortality among TB/HIV patients.

METHODS

Using National TB Surveillance System data from 2011 to 2016, we calculated multivariable adjusted odds ratios (aOR) with 99% confidence intervals (CI) to estimate associations between patient characteristics and RT or mortality. Mortality analyses were restricted to 2011-2014 to allow sufficient time for reporting outcomes.

RESULTS

TB disease was attributed to RT in 491 (20%) of 2415 TB/HIV patients. RT was more likely among those reporting homelessness (aOR, 2.6; CI, 2.0, 3.5) or substance use (aOR,1.6; CI, 1.2, 2.1) and among blacks (aOR,1.8; CI, 1.2, 2.8) and Hispanics (aOR, 1.8; CI, 1.1, 2.9); RT was less likely among non-US-born persons (aOR, 0.2; CI, 0.2, 0.3). The proportion who died during TB treatment was higher among persons with HIV than without (8.6% versus 5.2%; p < 0.0001). Among 2273 TB/HIV patients, 195 died during TB treatment. Age ≥ 65 years (aOR, 5.3; CI, 2.4, 11.6), 45-64 years (aOR, 2.2; CI, 1.4, 3.4), and having another medical risk factor for TB (aOR, 3.3; CI, 1.8, 6.2) were associated with death; directly observed treatment (DOT) for TB was protective (aOR, 0.5; CI, 0.2, 1.0).

CONCLUSIONS

Among TB/HIV patients, blacks, Hispanics, and those reporting homelessness or substance use should be prioritized for interventions that decrease TB transmission. Improved adherence to treatment through DOT was associated with decreased mortality, but additional interventions are needed to reduce mortality among older patients and those TB/HIV patients with another medical risk factor for TB.

Maternal risk factors for childhood malnutrition in Pakistan: demographic health survey 2012-13

Background

In Pakistan, this is a catastrophe for 44% children combating with stunted growth; the third highest percentage of stunted children in the world and further 1 million children are underweight. Fifteen percent of children are wasted and half of them are anemic, and almost one-third of the children have iron deficiency anemia. The study aimed to collate all contributing factors that have been reported in the PDHS-2012-13 survey for child malnutrition.

Methods

Pakistan Demographic and Health Survey, 2012-13 data was used (n = 1967). Forty five factors were extracted from PDHS 2012-13 and factor analysis was performed to reduce these factors into similar potential factors by using principle component (PC) decomposition. Malnutrition status of children of age &lt; 5 years was assessed by using three indices: height-for-age, weight-for-height, and weight for age. To examine the associations between derived factors and childhood malnutrition, binary logistic regression was used.

Results

About 43% of under-five children are stunted, 26.9% are underweight and 12.6% are wasted. Multivariate adjusted results showed mothers who belong to poor quintile (OR: 1.50, p-value 0.02), who afraid of husband all the time (OR: 1.36, p-value 0.02), who had &gt; 4 children (OR: 1.47, p-value &lt;0.01), and who used tobacco (OR: 1.80, p-value 0.02) were more likely to have stunted children. However, mothers who had no education (OR: 1.82, p-value&lt;0.01), who were poor dweller (OR: 1.55, p-value 0.03), who used unprotected water (OR: 1.62, p-value&lt;0.01), mothers who had younger age at birth (OR: 1.37, p-value 0.02) were more likely have underweight children.

Conclusions

Maternal socio-demographics and environmental factors were more significantly associated with child malnutrition. This study will enable the public health professionals' workforce tier at a national level to gain expertise and formulate better planning in order to improve child health in Pakistan.

Key messages

This study will enable the public health professionals’ workforce tier to achieve gains in child health in Pakistan. Study findings may help to improved and to initiate evidence-based guidelines for maternal and child health.

0423 Older Age Modifies the Association Between Combined Sleep Disordered Breathing and Sleep Duration with Neurocognitive Decline in Hispanic/Latino Adults

Introduction

We aimed to determine if age or sex modifies associations between sleep-disordered breathing (SDB), sleep duration and severe phenotypes of combined SDB/sleep duration with 7-year neurocognitive change (NC) in a diverse sample of U.S. Hispanic/Latinos.

Methods

We analyzed data of 5,235 adults 50-80 years of age from SOL-INCA, an ancillary to the Hispanic Community Health Study/Study of Latinos that determines the risk factors for NC. The main outcome was NC after a mean follow-up of 7-years on measures of memory (SEVLT sum and SEVLT recall), language (word fluency), processing speed (DSS) and a cognitive impairment screener. We evaluated the effect of baseline SDB (AHI ≥ 15), sleepiness (Epworth Sleepiness Scale, ESS ≥ 10), self-reported sleep duration (i.e. &lt;6 hours, 6-9 hours, ≥ 9 hours), age and sex on NC. Survey linear regression models with interaction terms were used to examine the relationship between SDB, sleep duration, combinations of SDB and sleep duration phenotypes and NC. Depression, vascular risk, sleep medication, and study site were entered into all models as covariates.

Results

Overall, the mean age was 56.0 years, 54.8% females, 62.2% completed high school, 17.3% had SDB, 6.6% had short sleep,and 14.8% had long sleep. Sleep duration and SDB were not associated with NC. There was a significant interaction between agexSDB+sleep duration on delayed recall (F10,599= 2.40, p=0.01) and processing speed (F10,597= 2.55, p=0.01). Combined SDB + short sleep was associated with decline in processing speed (β=-0.6, 95% CI= [-1.2, -0.1], and combined SDB+long sleep was associated with decline in verbal memory (β=-0.9, 95% CI=[-1.7, -0.2] in adults aged ≥ 65 years. There was no association in participants aged &lt;65 years and no sex differences.

Conclusion

Age, but not sex, modified the association between SDB and sleep duration with decline on processing speed and verbal memory. Sleep interventions tailored for older adults may be useful in slowing or preventing neurocognitive decline.

Support

This work is supported by National Institute on Aging (R01AG048642, RF1AG054548, R01AG061022, and R21AG056952).

First Measurement of Λ_{c} Baryon Production in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the first measurement of the charmed baryon Λ_{c}^{±} production at midrapidity (|y|<1) in Au+Au collisions at sqrt[s_{NN}]=200  GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider. The Λ_{c}/D^{0} [denoting (Λ_{c}^{+}+Λ_{c}^{-})/(D^{0}+D[over ¯]^{0})] yield ratio is measured to be 1.08±0.16  (stat)±0.26  (sys) in the 0%-20% most central Au+Au collisions for the transverse momentum (p_{T}) range 3<p_{T}<6  GeV/c. This is significantly larger than the pythia model calculations for p+p collisions. The measured Λ_{c}/D^{0} ratio, as a function of p_{T} and collision centrality, is comparable to the baryon-to-meson ratios for light and strange hadrons in Au+Au collisions. Model calculations including coalescence hadronization for charmed baryon and meson formation reproduce the features of our measured Λ_{c}/D^{0} ratio.

Understanding the genetic relationships between Indonesian bambara groundnut landraces and investigating their origins

A total of 170 bambara groundnut (Vigna subterranea) accessions were evaluated using both simple sequence repeat (SSR) and single nucleotide polymorphism (SNP) markers generated using genotyping-by-sequencing (GbS), of which 56 accessions were collected from West and East Java. Principal coordinate analysis (PCoA), population structure, and cluster analysis suggest that the East Java accessions could be a result of the introduction of selected West Java accessions. In addition, the current Indonesian accessions were likely introduced from Southern Africa, which would have produced a very marked founding effect such that these accessions present only a fraction of the genetic variability that exists within this species.

Association of obesity measures and multimorbidity in Pakistan: findings from the IMPACT study

OBJECTIVE

Obesity is a major factor leading to multimorbidity. However, the relative importance of obesity measures, including body mass index (BMI), body fat percentage (BF%) and visceral fat (VF), in relation to multimorbidity has not been extensively studied in Asia. Therefore, the objective of this study was to examine the relation of these measures of obesity with multimorbidity in a representative community sample in Pakistan.

STUDY DESIGN

This is a community-based cross-sectional study.

METHODS

This study was conducted among residents of Gulshan town, Karachi, Pakistan. Data on healthy individuals and individuals with chronic conditions were recorded. All self-reported chronic conditions were further assessed by physical examination, medical history of the participants and laboratory findings. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses of BMI, BF% and VF as predictors of obesity were used to examine the association with multimorbidity.

RESULTS

A total of 1500 participants (738 men and 762 women) were recruited, with a median age of 54.5 years. Multivariate logistic regression showed a significant association of BMI (odds ratio [OR] = 1.28, 95% confidence interval [CI] = 1.00-1.81, P-value 0.049) and BF% (OR = 2.28, 95% CI = 1.50-3.45, P-value <0.001) with multimorbidity. However, the ROC analysis for BMI, BF% and VF showed very similar results, even when the analysis was stratified by gender. In this exploratory analysis, increasing age and female gender were significantly associated with multimorbidity compared with their counterparts.

CONCLUSIONS

Adult populations with high BF% levels carry a higher risk of multimorbidity than those with high BMI scores. In a population with differing metabolic characteristics, BMI might be less precise than direct adiposity measurements. Additional studies are needed to confirm the potential use of measuring the anatomical location and metabolic characteristics of lean and fat mass to identify risk of diseases.

First Observation of the Directed Flow of D^{0} and D^{0}[over ¯] in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report the first measurement of rapidity-odd directed flow (v_{1}) for D^{0} and D^{0}[over ¯] mesons at midrapidity (|y|<0.8) in Au+Au collisions at sqrt[s_{NN}]=200  GeV using the STAR detector at the Relativistic Heavy Ion Collider. In 10-80% Au+Au collisions, the slope of the v_{1} rapidity dependence (dv_{1}/dy), averaged over D^{0} and D^{0}[over ¯] mesons, is -0.080±0.017(stat)±0.016(syst) for transverse momentum p_{T} above 1.5  GeV/c. The absolute value of D^{0} meson dv_{1}/dy is about 25 times larger than that for charged kaons, with 3.4σ significance. These data give a unique insight into the initial tilt of the produced matter, and offer constraints on the geometric and transport parameters of the hot QCD medium created in relativistic heavy-ion collisions.