Dual endothelin receptor antagonism increases resting energy expenditure in people with increased adiposity

Increased adiposity is associated with dysregulation of the endothelin system, both of which increase the risk of cardiovascular disease (CVD). Preclinical data indicate that endothelin dysregulation also reduces resting energy expenditure (REE). The objective was to test the hypothesis that endothelin receptor antagonism will increase REE in people with obesity compared with healthy weight individuals. Using a double blind, placebo-controlled, crossover design, 32 participants [healthy weight (HW): n = 16, BMI: 21.3 ± 2.8 kg/m2, age: 26 ± 7 yr and overweight/obese (OB): n = 16, BMI: 33.5 ± 9.5 kg/m2, age: 31 ± 6 yr] were randomized to receive either 125 mg of bosentan (ETA/B antagonism) or placebo twice per day for 3 days. Breath-by-breath gas exchange data were collected and REE was assessed by indirect calorimetry. Venous blood samples were analyzed for concentrations of endothelin-1 (ET-1). Treatment with bosentan increased plasma ET-1 in both OB and HW groups. Within the OB group, the changes in absolute REE (PLA: -77.6 ± 127.6 vs. BOS: 72.2 ± 146.6 kcal/day; P = 0.046). The change in REE was not different following either treatment in the HW group. Overall, absolute plasma concentrations of ET-1 following treatment with bosentan were significantly associated with kcal/day of fat (r = 0.488, P = 0.005), percentage of fat utilization (r = 0.415, P = 0.020), and inversely associated with the percentage of carbohydrates (r = -0.419, P = 0.019), and respiratory exchange ratio (r = -0.407, P = 0.023). Taken together, these results suggest that modulation of the endothelin system may represent a novel therapeutic approach to increase both resting metabolism and caloric expenditure, and reduce CVD risk in people with increased adiposity.NEW & NOTEWORTHY Findings from our current translational investigation demonstrate that dual endothelin A/B receptor antagonism increases total REE in overweight/obese individuals. These results suggest that modulation of the endothelin system may represent a novel therapeutic target to increase both resting metabolism and caloric expenditure, enhance weight loss, and reduce CVD risk in seemingly healthy individuals with elevated adiposity.

The importance of personality traits for predicting clinical clerkship grades and USMLE scores

Background: Important aspects of medical school success are thought to rely on non-cognitive attributes such as personality traits. Methods: In a sample of medical students who completed their 3rd-year clerkships, the current study examined the impact of personality traits on performance on four measures of 3rd-year clerkship grades and United States Medical Licensing Examination (USMLE) Step 2CK (Clinical Knowledge) scores. Results: We found that specific personality traits, including conscientiousness, achievement-striving, morality, and self-efficacy predicted multiple outcome measures, including Step 2CK performance. However, while we observed a clear link between personality and success during the 3rd year, we also found that Step 1 scores, not specific or grouped personality traits, best predicted all measures of clerkship performance except clerkship evaluations and, as expected, best predicted Step 2CK performance. Additionally, we created a composite personality profile for our sample by averaging the high and low scores of the Big Five personality trait scales and their subscales. However, this personality composite, which included the traits agreeableness, cooperation, Conscientiousness, and cautiousness, did not predict any of our outcome measures. Conclusions: These findings indicate that personality traits individually and in combination predict 3rd year medical school success, especially when performance may rely less on intellectual prowess, and more on personality factors. Importantly, however, Step 1 scores were usually much better predictors not only of Step 2CK and shelf exam performance, but even overall clerkship grades and Objective Structured Clinical Examination (OSCE) performance. We hope these results can be used to help clerkship directors and faculty understand that personality factors impact medical school performance and that they should be considered when evaluating the more non-cognitive aspects of student achievement.

Endothelin receptor blockade blunts the pressor response to acute stress in men and women with obesity

Obesity is associated with dysregulation of the endothelin system. In individuals with obesity, an exaggerated pressor response to acute stress is accompanied by increased circulating endothelin-1 (ET-1). The impact of combined endothelin A/B receptor (ET_A/B) antagonism on the stress-induced pressor response in overweight/obese (OB) individuals is unknown. The objective of this study is to test the hypothesis that treatment with an ET_A/B antagonist (bosentan) would reduce the stress-induced pressor response and arterial stiffness in overweight/obese compared with normal weight (NW) individuals. Forty participants [normal weight (NW): n = 20, body mass index (BMI): 21.7 ± 2.4 kg/m² and overweight/obese (OB): n = 20, BMI: 33.8 ± 8.2 kg/m²] were randomized to placebo or 125 mg of bosentan twice a day (250 mg total) for 3 days. Hemodynamics were assessed before, during, and after a cold pressor test (CPT). Endothelin-1 was assessed at baseline and immediately after CPT. Following a washout period, the same protocol was repeated with the opposite treatment. The change from baseline in mean arterial pressure (MAP) during CPT following bosentan was significantly lower (P = 0.039) in the OB group than in the NW group (OB: 28 ± 12 vs. NW: 34 ± 15 mmHg). These results suggest that ET_A/B antagonism favorably blunts the pressor response to acute stress in overweight/obese individuals.NEW & NOTEWORTHY Findings from our current translational investigation demonstrate that dual endothelin A/B receptor antagonism blunts the pressor response to acute stress in overweight/obese individuals. These results suggest that modulation of the endothelin system may represent a novel therapeutic target to reduce cardiovascular disease (CVD) risk by blunting the stress response in overweight/obese individuals.

Smoking cessation reduces systemic inflammation and circulating endothelin-1

Smoking increases systemic inflammation and circulating endothelin-1 (ET-1), both of which contribute to an elevated risk of cardiovascular disease (CVD). The present study sought to test the hypothesis that a 12-week smoking cessation intervention would contribute to a long-term reduction in circulating ET-1, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). 30 individuals participated in a 12-week evidence-based smoking cessation program at Augusta University. Serum cotinine, plasma inflammatory cytokines, and plasma ET-1 were determined at baseline, immediately after the 12-week cessation program (end of treatment, EOT), and 12-months (12M) following the cessation program. Serum cotinine was significantly reduced (p < 0.001) at EOT and 12M following the smoking cessation program. Compared to BL (7.0 ± 1.6 pg/mL), TNF-α was significantly reduced at EOT (6.3 ± 1.5 pg/mL, p = 0.001) and 12M (5.2 ± 2.7 pg/mL, p < 0.001). ET-1 was significantly lower at EOT (1.9 ± 0.6 pg/mL, p = 0.013) and at 12M (2.0 ± 0.8 pg/mL, p = 0.091) following smoking cessation compared with BL (2.3 ± 0.6 pg/mL). BL concentrations of cotinine were significantly associated with basal ET-1 (r = 0.449, p = 0.013) and the change in cotinine at 12M following smoking cessation was significantly associated with the change in plasma ET-1 at 12M (r = 0.457, p = 0.011). Findings from the present pilot investigation demonstrate that a 12-week smoking cessation program reduces circulating concentrations of ET-1 and TNF-α for at least a year. The reduction in serum cotinine was associated with the decrease in circulating ET-1. The attenuation in ET-1 and inflammation may in part, contribute to the lower risk of CVD that is observed with smoking cessation.

Germline ATM variants predispose to melanoma: a joint analysis across the GenoMEL and MelaNostrum consortia

PURPOSE

Ataxia-Telangiectasia Mutated (ATM) has been implicated in the risk of several cancers, but establishing a causal relationship is often challenging. Although ATM single-nucleotide polymorphisms have been linked to melanoma, few functional alleles have been identified. Therefore, ATM impact on melanoma predisposition is unclear.

METHODS

From 22 American, Australian, and European sites, we collected 2,104 familial, multiple primary (MPM), and sporadic melanoma cases who underwent ATM genotyping via panel, exome, or genome sequencing, and compared the allele frequency (AF) of selected ATM variants classified as loss-of-function (LOF) and variants of uncertain significance (VUS) between this cohort and the gnomAD non-Finnish European (NFE) data set.

RESULTS

LOF variants were more represented in our study cohort than in gnomAD NFE, both in all (AF = 0.005 and 0.002, OR = 2.6, 95% CI = 1.56-4.11, p < 0.01), and familial + MPM cases (AF = 0.0054 and 0.002, OR = 2.97, p < 0.01). Similarly, VUS were enriched in all (AF = 0.046 and 0.033, OR = 1.41, 95% CI = 1.6-5.09, p < 0.01) and familial + MPM cases (AF = 0.053 and 0.033, OR = 1.63, p < 0.01). In a case-control comparison of two centers that provided 1,446 controls, LOF and VUS were enriched in familial + MPM cases (p = 0.027, p = 0.018).

CONCLUSION

This study, describing the largest multicenter melanoma cohort investigated for ATM germline variants, supports the role of ATM as a melanoma predisposition gene, with LOF variants suggesting a moderate-risk.

Attraction Effects for Verbal Gender and Number Are Similar but Not Identical: Self-Paced Reading Evidence From Modern Standard Arabic

Previous work on the comprehension of agreement has shown that incorrectly inflected verbs do not trigger responses typically seen with fully ungrammatical verbs when the preceding sentential context furnishes a possibly matching distractor noun (i.e., agreement attraction). We report eight studies, three being direct replications, designed to assess the degree of similarity of these errors in the comprehension of subject-verb agreement along the dimensions of grammatical gender and number in Modern Standard Arabic. A meta-analysis of the results demonstrate the presence of agreement attraction effects in reading comprehension for gender and number on verbs. Moreover, the meta-analysis demonstrates that these two features do not behave identically: gender effects are larger and occur later relative to number attraction effects. These results challenge models of agreement that predict agreement features to be equipotent and show that real-time models of agreement require modifications in the form of cue-weighting in order to account for these differential results.

Does sleep protect memories against interference? A failure to replicate

Across a broad spectrum of memory tasks, retention is superior following a night of sleep compared to a day of wake. However, this result alone does not clarify whether sleep merely slows the forgetting that would otherwise occur as a result of information processing during wakefulness, or whether sleep actually consolidates memories, protecting them from subsequent retroactive interference. Two influential studies suggested that sleep protects memories against the subsequent retroactive interference that occurs when participants learn new yet overlapping information (interference learning). In these studies, interference learning was much less detrimental to memory following a night of sleep compared to a day of wakefulness, an indication that sleep supports this important aspect of memory consolidation. In the current replication study, we repeated the protocol of and, additionally, we examined the impact of intrinsic motivation on performance in sleep and wake participants. We were unable to replicate the finding that sleep protects memories against retroactive interference, with the detrimental effects of interference learning being essentially the same in wake and sleep participants. We also found that while intrinsic motivation benefitted task acquisition it was not a modulator of sleep-wake differences in memory processing. Although we cannot accept the null hypothesis that sleep has no role to play in reducing the negative impact of interference, the findings draw into question prior evidence for sleep’s role in protecting memories against interference. Moreover, the current study highlights the importance of replicating key findings in the study of sleep’s impact on memory processing before drawing strong conclusions that set the direction of future research.

Comparing the Effects of Sleep and Rest on Memory Consolidation

INTRODUCTION

There is ample evidence that overnight sleep and daytime naps benefit memory retention, compared to comparable amounts of active wakefulness. Yet recent evidence also suggests that a period of post-training rest (eg, quiet wakefulness with eyes closed) provides a similar memory benefit compared to wake. However, the relative benefits of sleep vs quiet waking rest on memory remain poorly understood. Here, we assessed the extent to which sleep provides a unique memory benefit, above and beyond that conferred by quiet waking rest.

METHODS

In a sample of healthy undergraduate students (N=83), we tested the effect of 30 mins of post-learning sleep, rest, or active wake on concept learning (dot pattern classification) and declarative memory (word pair associates) across a 4-hr daytime training-retest interval.

RESULTS AND CONCLUSIONS

Contrary to our hypotheses, we found no differences in performance between the three conditions for either task. The findings are interpreted with reference to methodological considerations including the length of the experimental interval, the nature of the tasks used, and challenges inherent in creating experimental conditions that can be executed by participants.

Whole body vibration elicits differential immune and metabolic responses in obese and normal weight individuals

Traditional aerobic exercise reduces the risk of developing chronic diseases by inducing immune, metabolic, and myokine responses. Following traditional exercise, both the magnitude and time-course of these beneficial responses are different between obese compared to normal weight individuals. Although obesity may affect the ability to engage in traditional exercise, whole body vibration (WBV) has emerged as a more tolerable form of exercise . The impact of WBV on immune, metabolic, and myokine responses as well as differences between normal weight and obese individuals, however, is unknown.

Purpose

To determine if WBV elicits differential magnitudes and time-courses of immune, metabolic, and myokine responses between obese and normal weight individuals.

Methods

21 participants [Obese (OB): n = 11, Age: 33 ± 4 y, percent body fat (%BF): 39.1 ± 2.4% & Normal weight (NW) n = 10, Age: 28 ± 8 y, %BF: 17.4 ± 2.1%] engaged in 10 cycles of WBV exercise [1 cycle = 1 min of vibration followed by 30 s of rest]. Blood samples were collected pre-WBV (PRE), immediately (POST), 3 h (3H), and 24 h (24H) post-WBV and analyzed for leukocytes, insulin, glucose, and myokines (IL-6, decorin, myostatin).

Results

The peak (3H) percent change in neutrophil counts (OB: 13.9 ± 17.4 vs. NW: 47.2 ± 6.2%Δ; p = 0.007) was different between groups. The percent change in neutrophil percentages was increased in NW (POST: -1.6 ± 2.0 vs. 3H: 13.0 ± 7.2%Δ, p = 0.019) but not OB (p > 0.05). HOMA β-cell function was increased at 24H (PRE: 83.4 ± 5.4 vs. 24H: 131.0 ± 14.1%; p = 0.013) in NW and was not altered in OB (p > 0.05). PRE IL-6 was greater in OB compared to NW (OB: 2.7 ± 0.6 vs. NW: 0.6 ± 0.1 pg/mL; p = 0.011); however, the percent change from PRE to peak (3H) was greater in NW (OB: 148.1 ± 47.9 vs. NW: 1277.9 ± 597.6 %Δ; p = 0.035). Creatine kinase, decorin, and myostatin were not significantly altered in either group (p > 0.05).

Conclusion

Taken together, these data suggest that acute whole body vibration elicits favorable immune, metabolic, and myokine responses and that these responses differ between obese and normal weight individuals.

Adequacy of Daily Fluid Intake Volume Can Be Identified From Urinary Frequency and Perceived Thirst in Healthy Adults

Objective: Achieving and maintaining an optimal level of hydration has significant implications for both acute and chronic health, yet many hydration assessments are not feasible for the general public. Urinary frequency (UF) is a reliable method to self-assess hydration status in healthy individuals, and thirst can provide additional sensory information on adequacy of daily fluid intake volume (DFI). However, threshold values for these indices to detect optimal hydration have not been determined. In this study, we sought to determine threshold values for 24-hour UF and perceived thirst that could accurately distinguish between optimal and suboptimal hydration states.Methods: Thirty-two healthy adults (age 22 ± 3 years, body mass index 24.9 ± 4.1 kg/m²) collected urine over 24 hours on four separate occasions, where UF was recorded as well as thirst at each void using a numbered perceptual scale. Using urine osmolality as the criterion standard, all samples were either classified as representing an optimal (≤500 mOsm·kg^-1) or suboptimal hydration status (>500 mOsm·kg^-1).Results: A 24-hour UF ≤6 was able to detect suboptimal hydration with good accuracy (area under the curve [AUC] 0.815) and a 24-hour average perceived thirst rating > 3 ("a little thirsty") could detect it with reasonable accuracy (AUC 0.725). In addition, a UF ≤4 had a considerably higher positive likelihood ratio to detect suboptimal hydration versus a UF ≤6 (9.03 versus 2.18, respectively).Conclusions: These analyses suggest that individuals with a 24-hour UF ≤6 or perceiving themselves to be, on average, "a little thirsty" throughout the day are likely to be suboptimally hydrated and thus underconsuming an adequate DFI.

Endothelial Dysfunction in Cystic Fibrosis: Role of Oxidative Stress

Oxidative stress and vascular endothelial dysfunction are established characteristics of cystic fibrosis (CF). Oxidative stress may contribute to vascular dysfunction via inhibition of nitric oxide (NO) bioavailability. Purpose. To determine if ingestion of a single antioxidant cocktail (AOC) improves vascular endothelial function in patients with CF. Methods. In 18 patients with CF (age 8-39 y), brachial artery flow-mediated dilation (FMD) was assessed using a Doppler ultrasound prior to and two hours following either an AOC (n = 18; 1,000 mg vitamin C, 600 IU vitamin E, and 600 mg α-lipoic acid) or a placebo (n = 9). In a subgroup of patients (n = 9), changes in serum concentrations of α-tocopherol and lipid hydroperoxide (LOOH) were assessed following AOC and placebo. Results. A significant (p = 0.032) increase in FMD was observed following AOC (Δ1.9 ± 3.3%), compared to no change following placebo (Δ - 0.8 ± 1.9%). Moreover, compared with placebo, AOC prevented the decrease in α-tocopherol (Δ0.48 ± 2.91 vs. -1.98 ± 2.32 μM, p = 0.024) and tended to decrease LOOH (Δ - 0.2 ± 0.1 vs. 0.1 ± 0.1 μM, p = 0.063). Conclusions. These data demonstrate that ingestion of an antioxidant cocktail can improve vascular endothelial function and improve oxidative stress in patients with CF, providing evidence that oxidative stress is a key contributor to vascular endothelial dysfunction in CF.

Tetrahydrobiopterin improves endothelial function in patients with cystic fibrosis

Cystic fibrosis (CF) is a genetic disorder associated with vascular endothelial dysfunction. Nitric oxide (NO) plays a major role in maintaining vascular function, and tetrahydrobiopterin (BH4) is a critical determinant of NO bioavailability. Thus the purpose of this study was to investigate the effects of oral administration of BH4 on endothelial function in patients with CF. Twenty-nine patients with CF (18 ± 8 yr old) and 29 healthy matched controls were recruited. Patients with CF participated in a randomized trial where they received a 5 mg/kg dose of oral BH4 (BH4-5; n = 17) or a 20 mg/kg dose of oral BH4 (BH4-20; n = 12). On a separate visit, a subset of patients from each group was retested following a placebo (PLC; n = 9). Brachial artery flow-mediated dilation (FMD) was used to evaluate vascular endothelial function, and a plasma sample was obtained before and 3 h after treatment. Cultured endothelial cells were treated with plasma to assess NO bioavailability. Baseline FMD was lower in patients compared with controls (5.7 ± 3.4 vs. 8.4 ± 3.5%, respectively, P = 0.005). No change in FMD was observed following PLC or BH4-5 (∆FMD: -0.8 ± 1.9% and -0.5 ± 2.5%; P = 0.273 and 0.132, respectively). Treatment with BH4-20, however, resulted in significant improvements in FMD (∆FMD: 1.1 ± 1.4%) compared with BH4-5 ( P = 0.023) and PLC ( P = 0.017). Moreover, BH4-20 significantly decreased endothelial cell superoxide production and increased NO production. These data suggest that a single oral dose of BH4 at 20 mg/kg improves vascular endothelial function in patients with CF, likely via increased endothelial NO synthase coupling. These findings support the hypothesis that loss of BH4 bioactivity contributes, in part, to endothelial dysfunction in patients with CF. NEW & NOTEWORTHY For the first time, the present study documents that a single dose of oral BH4 can improve vascular endothelial function in patients with cystic fibrosis (CF), and our in vitro data suggest this is via decreasing uncoupled nitric oxide. These data provide insight into the important role of BH4 bioactivity in vascular dysfunction and provide the foundation for further investigation into the chronic effects of BH4 treatment in patients with CF.

Sildenafil improves vascular endothelial function in patients with cystic fibrosis

Cystic fibrosis (CF), characterized by defective CFTR function, is associated with multiple systemic complications, including vascular dysfunction. Sildenafil, a phosphodiesterase type 5 inhibitor, not only enhances nitric oxide (NO) metabolism but has been shown to improve CFTR functionality as well. Thus, sildenafil has been proposed as a therapy to improve vascular health in CF; however, its potential therapeutic role has yet to be determined. We sought to investigate the effect of sildenafil on endothelial function in patients with CF. Patients with CF completed a randomized, double-blind, placebo-controlled, crossover study with an acute dose of sildenafil (50 mg) or placebo followed by a 4-wk open-label extension with sildenafil (20 mg/day). Flow-mediated dilation (FMD) was used to evaluate endothelial function before and after treatments. In addition, phosphorylated endothelial NO synthase (pNOS3) and total NOS3 protein expression was determined from endothelial cells that were exposed to plasma from the patients before and after 4 wk of sildenafil treatment. No changes ( P ≥ 0.110) in endothelial function were observed after the acute dose of sildenafil. However, FMD significantly ( P = 0.029) increased after 4 wk of treatment (∆FMD: 1.5 ± 2.2%). Moreover, pNOS3 protein expression significantly ( P = 0.013) increased after 4 wk of treatment (∆pNOS3: 0.31 ± 0.39 arbitrary units) and was associated ( r = 0.593, P = 0.033) with the change in FMD. These data suggest that 4 wk of sildenafil treatment can improve vascular endothelial function in patients with CF, likely through an increase in NOS3 phosphorylation. NEW & NOTEWORTHY Findings from the present study demonstrate, for the first time, significant improvement of endothelial function in patients with cystic fibrosis treated with sildenafil that is associated with greater phosphorylation of endothelial nitric oxide synthase. These results support the use of sildenafil as a potential novel therapy for this patient population.

The effect of passive heat stress on distress andself-control in male smokers and non-smokers

In the current study, we tested the effects of core body temperature increases (e.g. heat stress) on affect, self-reported physical discomfort, and subsequent self-control in male smokers and nonsmokers using a novel passive heat stress paradigm, within a distress tolerance framework. Twenty-eight men (14 smokers), completed both heat stress and control sessions in randomized order. Results revealed that increases in core body temperature were associated with increased anxiety, irritability, and body discomfort as well as decreased happiness, with stronger effects for smokers. Smokers and nonsmokers both evidenced less self-control during the heat session and did not differ on this measure, nor on a measure of interoceptive sensitivity. The current study indicates that heat stress is a viable method for studying distress tolerance in men, and suggests the value in examining dynamic changes in self-control as a function of distress. Implications will be discussed for distress tolerance in general and smokers in specific.

Exercise testing in patients with cystic fibrosis-importance of ventilatory parameters

BACKGROUND

Ventilatory parameters obtained during exercise predict survival in several chronic diseases; however, long-term changes in exercise ventilatory parameters in patients with cystic fibrosis (CF) have yet to be examined and potential differences between sexes in CF are unknown.

PURPOSE

We sought to examine the change in exercise ventilatory parameters over time in patients with CF and determine if the change is different between sexes.

METHODS

Exercise capacity (VO₂ peak) and exercise ventilatory parameters (V_E/VO₂ peak, V_E/VCO₂ peak, and V_E/VCO₂ slope) were determined from a maximal cardio-pulmonary test on a cycle ergometer on two visits separated by 39 ± 16 months in 20 patients with CF (10 female, 10 male).

RESULTS

No differences between sexes were observed at visit 1 (all p > 0.05). Overall, exercise ventilatory parameters significantly (p < 0.05) deteriorated between visits, with no change (p > 0.05) in VO₂ peak. Moreover, compared to males, female patients exhibited greater deteriorations in V_E/VO₂ peak (p = 0.001), V_E/VCO₂ peak (p = 0.002), and V_E/VCO₂ slope (p = 0.016) between visits.

CONCLUSIONS

These data in patients with CF indicate that exercise ventilatory parameters decline over time despite no change in VO₂ peak, and female patients exhibit a more rapid deterioration compared to males.

Scopolamine does not impact declarative and motor memory consolidation across a night of sleep or a day of wakefulness

It has been proposed that normal waking levels of acetylcholine (ACH) are important for initial memory acquisition, and that decreased ACH is critical for memory consolidation. Sleep is thought to benefit memory consolidation in part due to the predominance of low ACH levels observed during non-rapid eye movement sleep. Here we examined whether sleep and ACH suppression with the cholinergic antagonist scopolamine impact declarative and motor memory consolidation across a night of sleep or a day of wakefulness. Eighty-seven participants trained on a declarative and motor memory task in the morning or evening. Following training, participants were administered a scopolamine (0.4 mg) or placebo capsule. Participants were retested on the tasks 12 h later after a day of wake or a night of sleep. Reducing ACH levels with scopolamine provided no consolidation benefit for either task. Additionally, we found that sleep had a pronounced beneficial effect for declarative, but not motor memory consolidation. Lastly, in an exploratory analysis of the relationship between motivation and memory performance, we found that indices of intrinsic motivation were associated with improved memory acquisition and consolidation. Our findings show that reducing ACH levels after memory acquisition has no impact on the consolidation of declarative or motor memories. Additionally, sleep benefitted declarative memory but not motor memory consolidation, which highlights the interesting, though uncommon, finding that performance on some tasks might not benefit from sleep. Interestingly, the future study of intrinsic motivation may be warranted given its relationship to memory acquisition and consolidation. These findings add to our understanding of how sleep and acetylcholine impact memory consolidation, and may provide some insight about the role of ACH in memory disorders such as Alzheimer's disease.

Obesity, but not hypohydration, mediates changes in mental task load during passive heating in females

Background

The independent effects of hypohydration and hyperthermia on cognition and mood is unclear since the two stresses often confound each other. Further, it is unknown if obese individuals have the same impairments during hyperthermia and hypohydration that is often observed in non-obese individuals.

Methods

The current study was designed to assess the independent and combined effects of mild hypohydration and hyperthermia on cognition, mood, and mental task load in obese and non-obese females. Twenty-one healthy females participated in two passive heating trials, wherein they were either euhydrated or hypohydrated prior to and throughout passive heating. Cognition (ImPACT), mental task load (NASA-TLX), and mood (Brunel Mood Scale; BRUMS) were measured before and after a 1.0 °C increase in core temperature (T_C).

Results

After a 1.0 °C T_C elevation, hypohydration resulted in greater (p < 0.05) body mass loss (-1.14 ± 0.48 vs -0.58 ± 0.48 kg; hypohydrated and euhydrated, respectively) and elevation in serum osmolality (292 ± 4 vs 282 ± 3 mOsm; p < 0.05) versus euhydration. Hypohydration, independent of hyperthermia, did not affect mental task load or mood (p > 0.05). Hyperthermia, regardless of hydration status, impaired (∼5 A.U) measures of memory-based cognition (verbal and visual memory), and increased mental task load, while worsening mood (p < 0.05). Interestingly, obese individuals had increased mental task load while hyperthermic compared to the non-obese individuals (p < 0.05) even while euhydrated. Hypohydration did not exacerbate any heat-related effects on cognition between obese and non-obese females (p > 0.05).

Conclusion

These data indicate that hyperthermia independently impairs memory-based aspects of cognitive performance, mental task load, and leads to a negative mood state. Mild hypohydration did not exacerbate the effects of hyperthermia. However, obese individuals had increased mental task load during hyperthermia.

Beneficial effects of a daytime nap on verbal memory in adolescents

This study aimed to examine the sleep-dependent memory consolidation of verbal declarative memory in Chinese adolescents in a naturalistic experimental setting. Thirty-nine healthy boarding school students (ages 15-18, 70% female) were randomized to either a one-hour afternoon nap or wake group between the baseline and the retest sessions of three verbal declarative memory tasks: a Prose Stories Recall task, a Word Pair Associates task, and Rey Auditory Verbal Learning Test. Results showed that the nap group performed better than the no-nap group on both the Prose Stories Recall task and the Word Pair Associates task, but not on list learning. Our findings suggest that napping is beneficial to verbal declarative memory in adolescents, providing ecologically-valid empirical support for the sleep-dependent memory consolidation hypothesis using a napping paradigm in participants' naturalistic habitat. Our results demonstrate the potential importance of napping as a practical mnemonic intervention/compensatory strategy for student populations.

Oral NaHCO3 Activates a Splenic Anti-Inflammatory Pathway: Evidence That Cholinergic Signals Are Transmitted via Mesothelial Cells

We tested the hypothesis that oral NaHCO₃ intake stimulates splenic anti-inflammatory pathways. Following oral NaHCO₃ loading, macrophage polarization was shifted from predominantly M1 (inflammatory) to M2 (regulatory) phenotypes, and FOXP3⁺CD4⁺ T-lymphocytes increased in the spleen, blood, and kidneys of rats. Similar anti-inflammatory changes in macrophage polarization were observed in the blood of human subjects following NaHCO₃ ingestion. Surprisingly, we found that gentle manipulation to visualize the spleen at midline during surgical laparotomy (sham splenectomy) was sufficient to abolish the response in rats and resulted in hypertrophy/hyperplasia of the capsular mesothelial cells. Thin collagenous connections lined by mesothelial cells were found to connect to the capsular mesothelium. Mesothelial cells in these connections stained positive for the pan-neuronal marker PGP9.5 and acetylcholine esterase and contained many ultrastructural elements, which visually resembled neuronal structures. Both disruption of the fragile mesothelial connections or transection of the vagal nerves resulted in the loss of capsular mesothelial acetylcholine esterase staining and reduced splenic mass. Our data indicate that oral NaHCO₃ activates a splenic anti-inflammatory pathway and provides evidence that the signals that mediate this response are transmitted to the spleen via a novel neuronal-like function of mesothelial cells.

The Relative Impact of Sleep and Circadian Drive on Motor Skill Acquisition and Memory Consolidation

Study Objectives

Sleep during the biological night facilitates memory consolidation. Here we determined the impact of sleep and wake on motor skill learning (acquisition) and subsequent off-line skill improvement (memory consolidation), independent of circadian phase, and compared this to the impact of the endogenous circadian system, independent of whether sleep occurred during the biological night or day.

Methods

Participants completed two 8-day sleep laboratory visits, adhering on one visit to a circadian aligned ("normal") sleep schedule for the full duration of the protocol, and on the other to a circadian misaligned (12-hour inverted) schedule, with alignment during the first 3 days, a 12-hour 'slam shift' on Day 4, followed by circadian misalignment during the last 4 days of the protocol. Participants were repeatedly trained and tested on different versions of the finger-tapping motor sequence task across each visit.

Results

Sleep facilitated offline memory consolidation regardless of whether it occurred during the biological day or night, while circadian phase had no significant impact. These sleep-related benefits remained after accounting for general motor speed, measured in the absence of learning. In addition, motor skill acquisition was facilitated when the training session followed shortly after sleep, without significant impact of circadian phase (biological morning vs. evening). This effect was largely driven by heightened acquisition in participants who slept during the day and were trained shortly thereafter, that is, when acquisition occurred during the biological evening. These benefits were also retained after controlling for general motor speed.

Conclusions

Sleep benefits both the acquisition and consolidation of motor skill regardless of whether they occur during the biological day or night. After controlling for general motor speed, a critical adjustment that few studies perform, these sleep benefits remain intact. Our findings have clear implications for night shift workers who obtain their sleep during the day.

Spot Sample Urine Specific Gravity Does Not Accurately Represent Small Decreases in Plasma Volume in Resting Healthy Males

BACKGROUND

Urine specific gravity (U_SG) is often used to assess hydration status, particularly around athletic competition, but it is unknown whether high U_SG is indicative of plasma volume (PV) reduction (i.e., hypohydration). We tested the hypothesis that if high U_SG is reflective of reduced PV, subsequent fluid ingestion would increase PV.

PURPOSE

The purpose of this study was to examine 24-hour changes in U_SG and PV in individuals presenting with high and low spot U_SG.

METHODS

Nineteen healthy males were provided food and water over 24 hours with a total water volume of 35 ml·kg^-1 body mass. Absolute PV and blood volume (BV), measured using the CO-rebreathe technique, along with U_SG were measured before and after a 24-hour intervention period. Based on a preintervention morning spot U_SG, subjects were post hoc assigned to groups according to U_SG (≤1.020 or >1.020; low and high U_SG, respectively).

RESULTS

Despite presenting with an elevated spot U_SG (1.026 ± 0.004), subsequent fluid ingestion over 24 hours did not lead to changes (∆) in PV (-75 ± 234 ml) or BV (-156 ± 370 ml) in the high U_SG group (p > 0.05). However, a spot U_SG after the 24-hour intervention in this group decreased (p = 0.018) to a level indicating improved hydration status (1.017 ± 0.007). In the low U_SG group, there were no changes in PV (-39 ± 274 ml), BV (-82 ± 396 ml), or U_SG (0.003 ± 0.007) over the 24-hour fluid intervention (all p > 0.05).

CONCLUSIONS

Despite a high preintervention U_SG and subsequent decrease after 24-hour fluid intake, measures of PV and BV were not indicative of this seemingly improved hydration status. This suggests that a highly concentrated spot sample U_SG and subsequent changes are not accurately representative of PV or BV.

A single bout of maximal exercise improves lung function in patients with cystic fibrosis

BACKGROUND

Responses to a single bout of exercise may provide critical information for maximizing improvements in pulmonary function following exercise training in cystic fibrosis (CF). We sought to determine if acute maximal exercise improves pulmonary function in patients with CF.

METHODS

Thirty-three patients with CF completed a comprehensive assessment of pulmonary function to determine forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and lung clearance index (LCI) prior to and immediately following maximal aerobic exercise on a cycle ergometer.

RESULTS

Following exercise, FVC (∆0.08±0.14L) and FEV₁ (∆0.06±0.15L) increased, while LCI decreased (∆-0.71±0.93) (all p<0.05). Changes in FEV₁ (%predicted) were associated with peak work (r=0.40, p=0.02) and peak pulmonary ventilation (r=0.45, p=0.01).

CONCLUSIONS

A single bout of maximal exercise acutely improves pulmonary function in patients with CF and improvements may be related to peak work and peak pulmonary ventilation.

Effect of hypohydration on postsynaptic cutaneous vasodilation and sweating in healthy men

Hypohydration decreases cutaneous vasodilation and sweating during heat stress, but it is unknown if these decrements are from postsynaptic (i.e., sweat gland/blood vessel) alterations. The purpose of this study was to determine if hypohydration affects postsynaptic cutaneous vasodilation and sweating responses. Twelve healthy men participated in euhydrated (EU) and hypohydrated (HY) trials, with hypohydration induced via fluid restriction and passive heat stress. Changes in cutaneous vascular conductance (CVC; %max) in response to incremental intradermal infusion of the endothelium-independent vasodilator sodium nitroprusside (SNP) and the endothelium-dependent vasodilator methacholine chloride (MCh) were assessed by laser Doppler flowmetry. Local sweat rate (LSR) was simultaneously assessed at the MCh site via ventilated capsule. At the end of the last dose, maximal CVC was elicited by delivering a maximal dose of SNP (5 × 10−2 M) for 30 min to both sites with simultaneous local heating (~44°C) at the SNP site. The concentration of drug needed to elicit 50% of the maximal response (log EC50) was compared between hydration conditions. The percent body mass loss was greater with HY vs. EU (−2.2 ± 0.7 vs. −0.1 ± 0.7%, P < 0.001). Log EC50 of endothelium-dependent CVC was lower with EU (−3.62 ± 0.22) vs. HY (−2.93 ± 0.08; P = 0.044). Hypohydration did not significantly alter endothelium-independent CVC or LSR (both P > 0.05). In conclusion, hypohydration attenuated endothelium-dependent CVC but did not affect endothelium-independent CVC or LSR responses. These data suggest that reductions in skin blood flow accompanying hypohydration can be partially attributed to altered postsynaptic function.

TET2 binds the androgen receptor and loss is associated with prostate cancer

Genetic alterations associated with prostate cancer (PCa) may be identified by sequencing metastatic tumour genomes to identify molecular markers at this lethal stage of disease. Previously, we characterized somatic alterations in metastatic tumours in the methylcytosine dioxygenase ten-eleven translocation 2 (TET2), which is altered in 5-15% of myeloid, kidney, colon and PCas. Genome-wide association studies previously identified non-coding risk variants associated with PCa and melanoma. We perform fine-mapping of PCa risk across TET2 using genotypes from the PEGASUS case-control cohort and identify six new risk variants in introns 1 and 2. Oligonucleotides containing two risk variants are bound by the transcription factor octamer-binding protein 1 (Oct1/POU2F1) and TET2 and Oct1 expression are positively correlated in prostate tumours. TET2 is expressed in normal prostate tissue and reduced in a subset of tumours from the Cancer Genome Atlas (TCGA). Small interfering RNA-mediated TET2 knockdown (KD) increases LNCaP cell proliferation, migration and wound healing, verifying loss drives a cancer phenotype. Endogenous TET2 bound the androgen receptor (AR) and AR-coactivator proteins in LNCaP cell extracts, and TET2 KD increases prostate-specific antigen (KLK3/PSA) expression. Published data reveal TET2 binding sites and hydroxymethylcytosine proximal to KLK3. A gene co-expression network identified using TCGA prostate tumour RNA-sequencing identifies co-regulated cancer genes associated with 2-oxoglutarate (2-OG) and succinate metabolism, including TET2, lysine demethylase (KDM) KDM6A, BRCA1-associated BAP1, and citric acid cycle enzymes IDH1/2, SDHA/B, and FH. The co-expression signature is conserved across 31 TCGA cancers suggesting a putative role for TET2 as an energy sensor (of 2-OG) that modifies aspects of androgen-AR signalling. Decreased TET2 mRNA expression in TCGA PCa tumours is strongly associated with reduced patient survival, indicating reduced expression in tumours may be an informative biomarker of disease progression and perhaps metastatic disease.

Effect of hypohydration on thermoregulatory responses in men with low and high body fat exercising in the heat

It is unclear whether men with low body fat (LO-BF) have impaired thermoregulation during exercise heat stress compared with those with high body fat (HI-BF) when euhydration (EU) is maintained. Furthermore, in LO-BF individuals, hypohydration (HY) impairs thermoregulatory responses during exercise heat stress, but it is unknown whether this occurs in HI-BF counterparts. The purpose of this study was to test the hypotheses that men with HI-BF have impaired thermoregulatory responses to exercise heat stress and that HY further exacerbates these impairments vs. LO-BF. Men with LO-BF [ n = 11, body mass (BM) 73.9 ± 8.5 kg, BF% 13.6 ± 3.8] and HI-BF ( n = 9, BM 89.6 ± 6.9 kg, BF% 30.2 ± 4.1), in a randomized crossover design, performed 60 min of upright cycling in a hot environment (40.3 ± 0.4°C, relative humidity 32.5 ± 1.9%) at a metabolic heat production rate of 6 W/kg BM and finished exercise either euhydrated (EU; 0.3 ± 1.2 vs. 0.3 ± 0.9% BM loss) or HY (−2.5 ± 1.1 vs. −1.7 ± 1.5% BM loss). Changes in rectal temperature (ΔTrec), local sweat rate (ΔLSR), and cutaneous vascular conductance (ΔCVC; %max) were measured throughout. When EU, LO-BF and HI-BF had similar CVC and LSR responses ( P > 0.05); however, LO-BF had a lower ΔTrec vs. HI-BF (0.92 ± 0.35 vs. 1.31 ± 0.32°C, P = 0.021). Compared with EU, HY increased end-exercise ΔTrec in LO-BF (0.47 ± 0.37°C, P < 0.01) but not in HI-BF (−0.06 ± 0.29°C, P > 0.05). HY, compared with EU, did not affect ΔLSR and ΔCVC in either group ( P > 0.05). We conclude that, when euhydrated, men with HI-BF have a greater increase in Trec vs. LO-BF but similar CVC and LSR. HY exacerbates increases in Trec in LO-BF but not HI-BF.

NEW & NOTEWORTHY This is the first known investigation to compare thermoregulatory responses to exercise heat stress between men with high and low body fat (BF) in a physiologically uncompensable environment while simultaneously examining the confounding influence of hydration status. Both groups demonstrated similar sweating and cutaneous vasodilatory responses when euhydrated, despite vast differences in rectal temperature. Furthermore, in contrast to low BF, individuals with high BF demonstrated similar increases in core body temperature when either euhydrated or hypohydrated.

Revisiting the cost of carnivory in mammals

Predator-prey relationships play a key role in the evolution and ecology of carnivores. An understanding of predator-prey relationships and how this differs across species and environments provides information on how carnivorous strategies have evolved and how they may change in response to environmental change. We aim to determine how mammals overcame the challenges of living within the marine environment; specifically, how this altered predator-prey body mass relationships relative to terrestrial mammals. Using predator and prey mass data collected from the literature, we applied phylogenetic piecewise regressions to investigate the relationship between predator and prey size across carnivorous mammals (51 terrestrial and 56 marine mammals). We demonstrate that carnivorous mammals have four broad dietary groups: small marine carnivores (< 11 000 kg) and small terrestrial carnivores (< 11 kg) feed on prey less than 5 kg and 2 kg, respectively. On average, large marine carnivores (> 11 000 kg) feed on prey equal to 0.01% of the carnivore's body size, compared to 45% or greater in large terrestrial carnivores (> 11 kg). We propose that differences in prey availability, and the relative ease of processing large prey in the terrestrial environment and small prey in marine environment, have led to the evolution of these novel foraging behaviours. Our results provide important insights into the selection pressures that may have been faced by early marine mammals and ultimately led to the evolution of a range of feeding strategies and predatory behaviours.

Effects of obesity and mild hypohydration on local sweating and cutaneous vascular responses during passive heat stress in females

The purpose of this study was to evaluate the effect of obesity and mild hypohydration on local sweating (LSR) and cutaneous vascular conductance (CVC) responses during passive heat stress in females. Thirteen obese (age, 24 ± 4 years; 45.4% ± 5.2% body fat) and 12 nonobese (age, 22 ± 2 years; 25.1% ± 3.9% body fat) females were passively heated (1.0 °C rectal temperature increase) while either euhydrated (EUHY) or mildly hypohydrated (HYPO; via fluid restriction). Chest and forearm LSR (ventilated capsule) and CVC (Laser Doppler flowmetry) onset, sensitivity, and plateau/steady state were recorded as mean body temperature increased (ΔTb). Participants began trials EUHY (urine specific gravity, Usg = 1.009 ± 0.006) or HYPO (Usg = 1.025 ± 0.004; p < 0.05), and remained EUHY or HYPO. Independent of obesity, HYPO decreased sweat sensitivity at the chest (HYPO = 0.79 ± 0.35, EUHY = 0.95 ± 0.39 Δmg·min(-1)·cm(-2)/°C ΔTb) and forearm (HYPO = 0.82 ± 0.39, EUHY = 1.06 ± 0.34 Δmg·min(-1)·cm(-2)/°C ΔTb); forearm LSR plateau was also decreased (HYPO = 0.66 ± 0.19, EUHY = 0.78 ± 0.23 mg·min(-1)·cm(-2); all p < 0.05). Overall, obese females had lower chest-sweat sensitivity (0.72 ± 0.35 vs. 1.01 ± 0.33 Δmg·min(-1)·cm(-2)/°C ΔTb) and plateau (0.55 ± 0.27 vs. 0.80 ± 0.25 mg·min(-1)·cm(-2); p < 0.05). While hypohydrated, obese females had a lower chest LSR (p < 0.05) versus nonobese females midway (0.45 ± 0.26 vs. 0.73 ± 0.23 mg·min(-1)·cm(-2)) and at the end (0.53 ± 0.27 vs. 0.81 ± 0.24 mg·min(-1)·cm(-2)) of heating. Furthermore, HYPO (relative to the EUHY trials) led to a greater decrease in CVC sensitivity in obese (-28 ± 27 Δ% maximal CVC/°C ΔTb) versus nonobese females (+9.2 ± 33 Δ% maximal CVC/°C ΔTb; p < 0.05). In conclusion, mild hypohydration impairs females' sweating responses during passive heat stress, and this effect is exacerbated when obese.

Effect of passive heat stress on arterial stiffness in smokers versus non-smokers

In non-smokers, passive heat stress increases shear stress and vasodilation, decreasing arterial stiffness. Smokers, who reportedly have arterial dysfunction, may have similar improvements in arterial stiffness with passive heat stress. Therefore, we examined the effects of an acute bout of whole-body passive heat stress on arterial stiffness in smokers vs. non-smokers. Thirteen smokers (8.8 ± 5.5 [median = 6] cigarettes per day for > 4 years) and 13 non-smokers matched for age, mass, height, and exercise habits (27 ± 8 years; 78.8 ± 15.4 kg; 177.6 ± 6.7 cm) were passively heated to 1.5 °C core temperature (T C) increase. At baseline and each 0.5 °C T C increase, peripheral (pPWV) and central pulse wave velocity (cPWV) were measured via Doppler ultrasound. No differences existed between smokers and non-smokers for any variables (all p >  .05), except cPWV slightly increased from baseline (526.7 ± 81.7 cm · s(-1)) to 1.5 °C ΔT C (579.7 ± 69.8 cm · s(-1); p < 0.005), suggesting heat stress acutely increased central arterial stiffness. pPWV did not change with heating (grand mean: baseline = 691.9 ± 92.9 cm · s(-1); 1.5 °C ΔT C = 691.9 ± 79.5 cm · s(-1); p > 0.05). Changes in cPWV and pPWV during heating correlated (p < 0.05) with baseline PWV in smokers (cPWV: r = -0.59; pPWV: r = -0.62) and non-smokers (cPWV: r = -0.45; pPWV: r = -0.77). Independent of smoking status, baseline stiffness appears to mediate the magnitude of heating-induced changes in arterial stiffness.

Physiologic and Perceptual Responses to Cold-Shower Cooling After Exercise-Induced Hyperthermia

CONTEXT

Exercise conducted in hot, humid environments increases the risk for exertional heat stroke (EHS). The current recommended treatment of EHS is cold-water immersion; however, limitations may require the use of alternative resources such as a cold shower (CS) or dousing with a hose to cool EHS patients.

OBJECTIVE

To investigate the cooling effectiveness of a CS after exercise-induced hyperthermia.

DESIGN

Randomized, crossover controlled study.

SETTING

Environmental chamber (temperature = 33.4°C ± 2.1°C; relative humidity = 27.1% ± 1.4%).

PATIENTS OR OTHER PARTICIPANTS

Seventeen participants (10 male, 7 female; height = 1.75 ± 0.07 m, body mass = 70.4 ± 8.7 kg, body surface area = 1.85 ± 0.13 m(2), age range = 19-35 years) volunteered.

INTERVENTION(S)

On 2 occasions, participants completed matched-intensity volitional exercise on an ergometer or treadmill to elevate rectal temperature to ≥39°C or until participant fatigue prevented continuation (reaching at least 38.5°C). They were then either treated with a CS (20.8°C ± 0.80°C) or seated in the chamber (control [CON] condition) for 15 minutes.

MAIN OUTCOME MEASURE(S)

Rectal temperature, calculated cooling rate, heart rate, and perceptual measures (thermal sensation and perceived muscle pain).

RESULTS

The rectal temperature (P = .98), heart rate (P = .85), thermal sensation (P = .69), and muscle pain (P = .31) were not different during exercise for the CS and CON trials (P > .05). Overall, the cooling rate was faster during CS (0.07°C/min ± 0.03°C/min) than during CON (0.04°C/min ± 0.03°C/min; t16 = 2.77, P = .01). Heart-rate changes were greater during CS (45 ± 20 beats per minute) compared with CON (27 ± 10 beats per minute; t16 = 3.32, P = .004). Thermal sensation was reduced to a greater extent with CS than with CON (F3,45 = 41.12, P < .001).

CONCLUSIONS

Although the CS facilitated cooling rates faster than no treatment, clinicians should continue to advocate for accepted cooling modalities and use CS only if no other validated means of cooling are available.