Search

Introduction Sleep disruption has profound effects on immune function. Many adolescents do not get adequate amounts of sleep each night, and chronic sleep disturbance has been associated with increased risk of several inflammatory diseases. However, the relationship between sleep disturbances and inflammation during adolescence is not well understood. In this study, we examined the relationship between specific features of sleep disruption and cytokine levels in adolescents. Methods A total of 88 adolescents (18.36 ± 0.51 years, 56.8% female) completed the Pittsburgh Sleep Quality Index (PSQI), a self-reported questionnaire used to assess subjective sleep quality over a 1-month time period. Blood plasma samples were obtained for each participant at the same timepoint to measure levels of pro-inflammatory cytokines (Interleukin (IL)-6, IL-8, tumor-necrosis factor (TNF)-alpha, and interferon (IFN)-gamma), anti-inflammatory cytokine (IL-10), and C-reactive protein (CRP). Samples were assayed using a Meso Scale Discovery multiplex immunoassay. Linear regression models were used to test the effect of PSQI sleep latency, duration, efficiency, quality, disturbance, and total score on each cytokine level, while covarying for sex and body mass index. We corrected for multiple comparisons using a False Discovery Rate (FDR) correction. Results Overall, disruption in sleep was associated with distinct cytokine differences. Worse sleep, reflected by the PSQI total score and greater sleep disturbance, was associated with lower IL-6 levels (p=0.013, p=0.015, respectively), however theses associations were attenuated to a trend after FDR correction (q=0.083, q=0.092, respectively). Longer sleep latency was also associated with lower IL-6 (p=0.028), and IFN (p=0.016) levels, however these effects were also attenuated after FDR correction (q=0.138, q=0.094, respectively). Reduced sleep efficiency was associated with higher TNF (q=0.046) and CRP (q=0.021) levels. Conclusion Our findings show that different components of sleep disruption have varying effects on cytokine release, resulting in an overall blunted immune response. This underscores the significant impact of sleep disturbances on perturbing immune function during this critical developmental period. Support (If Any)

Introduction The 22q11.2 locus contains genes critical for brain development. Individuals with copy number variations (i.e. a deletion or duplication; CNV) at this locus have greatly increased risk of developmental neuropsychiatric disorders, as well as immune dysfunction and sleep problems. However, it remains unknown if sleep disturbance and immune dysfunction are related to each other in this population, as they are in typically developing individuals. Methods We examined the relationship between self-reported sleep disturbance and blood cytokine levels in 22q11.2 deletion (22qDel; n= 40, Mage = 17.5±8.4 years, 45% males) and duplication (22qDup; n=28, Mage =16.8±12.9 years, 45% males) carriers. Blood plasma samples were obtained to measure interlukein-6 (IL-6), interlukein-10 (IL-10), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF) and interferon-gamma (IFN) using a MesoScale Discovery multiplex immunoassay. We also measured levels of C-reactive protein (CRP) using an ELISA. Subjects were classified as either good or poor sleepers based on the sleep disturbance score on the Structured Interview of Psychosis-Risk Symptoms (SIPS). Linear regression models were used to test the effect of sleep disturbance, subject group (22qDel vs. 22qDup), and a group-by-sleep interaction on each cytokine level while controlling age, sex, body mass index, and collection time. We corrected for multiple comparisons using False Discovery Rate (FDR) correction. Results Overall, 22qDup carriers had higher levels of IL-8 (q0.18). There was a group-by-sleep interaction for IL-8 (p=0.013), TNF (p=0.048), and IFN (p=0.034) such that sleep disturbance had a greater effect on cytokine levels in the 22qDel group, but only the interaction for IL-8 survived as a trend towards significance after FDR correction (q=0.076). Conclusion Our findings suggest that poor sleep may contribute to immune dysfunction in 22q11.2 CNV carriers. Further, there may be differential impacts of sleep on immune function, depending on gene dosage at the 22q11.2 locus. Future research in larger samples is required to determine if immune disruption and sleep problems are related to elevated psychiatric symptoms in 22q11.2 CNV carriers. Support (If Any) RO1MH085953; U01MH10171

Background and Hypothesis: Marion County suffers from stark racial disparities in infant mortality rate (IMR) with black babies experiencing an IMR of 11.6 and white babies 4.5, to culminate at a state average of 7.3. Since 2016, WeCare Indiana has worked to reduce the IMR in Central Indiana by connecting pregnant, post-partum, and childbearing age women with Community Health Workers (CHW) and community organizations that help with areas including but not limited to baby supplies, housing, and food insecurity. The goal of this research was to identify factors that promote changes in behaviors in WeCare clients as well as barriers to behavior modification in relation to the five pillars of the WeCare program: food insecurity, mental health, smoking, breastfeeding, and safe sleep. Experimental Design or Project Methods: Qualitative analysis of unstructured CHW follow-up notes from 2016 to 2018 of 1775 WeCare clients from mostly 13 highest risk zip codes for IM in Central Indiana was completed using keyword searches and clustering narrative entries into themes associated with the apriori areas of behavioral change. Results: Several key influencers of behavioral change were identified: (1) CHW dissemination of eligibility information about WIC, (2) CHW referral of clients to behavioral health resources, and (3) Pack n Play resources bundled with Safe Sleep class. Persistent barriers to positive behavioral change included: (1) lack of transportation to food resources, (2) unmanaged stress propagating substance use and smoking, (3) employment interfering with breastfeeding, and (4) lack of Safe Sleep education for all caretakers. Conclusion and Potential Impact: Next steps include sharing qualitative findings with CHW to reinforce positive behavioral change as well as investigating solutions for the barriers that prevent change within the five pillars of WeCare Indiana. Data from this study will be used to help interpret the calculated behavioral change scores relative to baseline measures that were found from quantitative analysis.

Correlational research has shown that lower social standing is associated with poorer health, but it is unknown if this association is causal. Two experiments tested whether randomly assigned low subjective social status would promote ruminative coping, a mechanism leading to the development of poor health outcomes. Participants were college females, split about evenly between Blacks and Whites. Experiment 1 (N = 39) found those imagining themselves at the bottom (vs. top) of a social ladder showed more ruminative coping using rater-assessed responses. Experiment 2 (N = 42) replicated these results, extended them with a self-report outcome measure, and demonstrated that negative affect did not mediate between subjective social status and ruminative coping. Across both experiments, race/ethnicity had no effect.

Unlike Taiwan's Patent Law, which expressly permits parallel importation, and the Trademark Law, where parallel imports have been held permissible by Taiwan courts, Taiwan's Copyright Law, after amendment in 1993, basically forbids parallel imports (articles 87(4) and 87-1). This enactment essentially creates a new distribution right for copyright owners. Since then, parallel imported copyright products have been treated as unlawful copies. Distributors of those parallel imports in Taiwan are therefore subject to both civil and criminal penalties. This article starts by covering the rules that govern parallel imports in Taiwan, their impacts on Taiwan's copyright market and assesses the role Taiwan's international trade policy played in view of its Copyright Law legislation. It also analyses the adverse effects of this ban on parallel imports on Taiwan's trade with other countries. As Taiwan joined the World Trade Organization (WTO) in 2009, it is concluded that the ban on parallel imports may be challenged by other WTO members as an unlawful trade barrier. The existing ban under articles 87(4) and 87-1 of Taiwan's Copyright Law does not properly address the parallel imports issues or serve the objectives of Taiwan's Copyright Law. Fair-use application on a case-by-case basis should be a more adequate approach.

The American College of Cardiology/American Heart Association guidelines for acute myocardial infarction related to process of care aim to decrease morbidity and mortality and provide a standard of care for patients with acute myocardial infarction (AMI). Currently, there are limited data comparing adherence between centers providing fibrinolytic therapy alone and those that provide percutaneous coronary intervention (PCI). Reported compliance with AMI performance measures was analyzed using data from the United States Department of Health and Human Services Hospital Compare Web site from 2007, including aspirin administration, β-blocker administration, angiotensin-converting enzyme or angiotensin receptor blocking agents, and smoking cessation counseling. Adherence to all reported measurements was significantly higher (P < 0.0001) in hospitals that reported PCI capability, compared with hospitals that reported only fibrinolytic use in AMI patients.