Gaze differences in processing pictures with emotional content

The International Affective Picture System (IAPS) is a set of standardized emotionally evocative color photographs developed by NIMH Center for Emotion and Attention at the University of Florida. It contains more than 900 emotional pictures indexed by emotional valence, arousal and dominance. However, when IAPS pictures were used in studying emotions with the event-related potentials, the results have shown a great deal of variation and inconsistency. In this research arousal and dominance of pictures were controlled while emotional valence was manipulated as 3 categories, pleasant, neutral and unpleasant pictures. Two experiments were conducted with an eye-tracker in order to determine to what the participants turn their gaze. Participants were 25 psychology students with normal vision. Every participant saw all pictures in color and same pictures in black/white version. This makes 200 analyzed units for color pictures and 200 for black and white pictures. Every picture was divided into figure and ground. Considering that perception can be influenced by color, edges, luminosity and contrast and since all those factors are collapsed on the pictures in IAPS, we compared color pictures with same black and white pictures. In first eye-tracking IAPS research we analyzed 12 emotional pictures and showed that participants have higher number of fixations for ground on neutral and unpleasant pictures and for figure on pleasant pictures. Second experiment was conducted with 4 sets of emotional complementary pictures (pleasant/unpleasant) which differ only on the content in the figure area and it was shown that participants were more focused on the figure area than on the ground area. Future ERP (event related potential) research with IAPS pictures should take into consideration these findings and to either choose pictures with blank ground or adjust pictures in the way that ground is blank. For the following experiments suggestion is to put emotional content in the figure area and to use different non complementary pictures to see if there is difference between different emotional categories.     

The relationship between epicardial adipose tissue and coronary artery stenosis by sex and menopausal status in patients with suspected angina

Background

Evidence suggests that epicardial adipose tissue (EAT) is closely related to coronary artery stenosis (CAS). However, sexual dimorphism may be present in adipose tissue, and its influence on CAS between men and women is controversial. We assessed the relationship between EAT and CAS by sex and menopausal status in patients with suspected angina.

Methods

Six hundred twenty-eight consecutive patients (men/women n?=?257/371; mean age = 59.9?±?10.2?years) who had chest pain for angina and underwent coronary angiography were included. CAS was defined as >?50% luminal narrowing of at least one epicardial coronary artery. EAT thickness was measured by transthoracic echocardiography.

Results

Of the 628 patients, 52.1% (n?=?134) of men and 35.3% (n?=?131) of women had CAS. The mean EAT thickness was not different between men and women and was larger in patients with CAS (8.04?±?2.39 vs 6.58?±?1.88?mm, P?<?0.001). EAT thickness was independently associated with CAS in both sexes (P?<?0.001). The odds ratio (OR) of EAT for the presence of CAS was higher in men (OR?=?1.43, 95% confidence interval [CI] 1.21–1.69) than in women (OR?=?1.24, 95% CI 1.10–1.40). EAT thickness was larger in postmenopausal women than in premenopausal women (7.59?±?2.25 vs 5.80?±?1.57?mm, P?<?0.001) and was independently related with CAS (OR?=?1.24, 95% CI 1.09–1.41). This was not the case in premenopausal women.

Conclusion

In patients with suspected angina, an increase in EAT thickness was independently related to the presence of CAS in both men and women, with it being stronger in men. According to menopausal status in women, EAT thickness is significantly associated with CAS only in postmenopausal women.

     

Weight loss and regain in obese individuals: a link with adipose tissue metabolism indices?

This study was performed to examine whether changes in subcutaneous adipose tissue (SCAT) metabolism indices after weight loss were related to the magnitude of weight regain. Nine men and ten premenopausal women whose body mass index ranged from 30 to 42 kg/m², 35–48 years old, were studied before and after a 15-week weight loss program, as well as at a 17–22-month follow-up period. Although body composition was evaluated at all study periods, abdominal and femoral SCAT-lipoprotein lipase (LPL) and hormone-sensitive lipase (HSL) activities, and α2- and β-adrenoceptors (ARs) were measured before and after weight loss, exclusively. Although the SCAT-LPL activity did not change after weight loss in men, it tended to decrease in the femoral depot of women (p?=?0.06). SCAT-HSL activity remained unchanged after weight reduction in men, while the post-weight loss lipase activity tended to be higher in both regions of women (p?=?0.06). Although the post-weight loss number of β-ARs was higher irrespective of the fat depot (0.001?<?p?<?0.05), the number of α2-ARs was increased in the femoral (p?<?0.05), but not in the abdominal SCAT (p?=?0.08) after weight reduction, in men. Neither the α2- nor the β-AR density changed after weight reduction, in women. Abdominal SCAT-LPL activity after weight reduction was negatively related to weight regain indices, in women (?0.65?<?Rhô?<??0.75; 0.01?<?p?<?0.05). Both the post-weight loss abdominal SCAT α2-AR density and the α2-/β-AR balance were positively associated with weight regain indices, in men (0.69?<?Rhô?<?0.88; 0.01?<?p?<?0.05). These results suggest that selected SCAT metabolism indices could predict failure to weight loss maintenance, in both genders.     

Diurnal emotional reactivity: Ultradian changes at neural and behavioral levels in men

The aim of this study was to examine the ultradian dynamic of emotional processing in men. Event-related potentials were recorded while participants watched different sets of unpleasant and neutral pictures every 15?min for 3?h. Emotional feelings induced by unpleasant pictures were also assessed with self-rating scales at the end of each picture set. Whereas brain processing of neutral pictures remained stable over time, a late positive component elicited by unpleasant pictures presented ultradian oscillations varying between 65 and 110?min in 77% of the participants, mainly in the right centro-posterior area. Ultradian rhythms were also observed for values self-rating the intensity of unpleasant feelings. Correlative analyses performed between brain and behavioral ultradian oscillations indicated that these rhythms follow a temporal opposite pattern. For the first time, these results raise questions regarding the modulating role of ultradian oscillations when the brain computes the significance of unpleasant stimuli and produces the final emotional feelings. Overall, these findings open new perspectives on the temporal regulation of emotional reactivity in healthy individuals and in those with affective disorders.     

Affective pictures processing is reflected by an increased long-distance EEG connectivity

Analysis of affective picture processing by means of EEG has invaded the literature. The methodology of event-related EEG coherence is one of the essential methods used to analyze functional connectivity. The aims of the present study are to find out the long range EEG connectivity changes in perception of different affective pictures and analyze gender differences in these long range connected networks. EEGs of 28 healthy subjects (14 female) were recorded at 32 locations. The participants passively viewed emotional pictures (IAPS, unpleasant, pleasant, neutral). The long-distance intra-hemispheric event-related coherence was analyzed for delta (1–3.5 Hz), theta (4–7.5 Hz), and alpha (8–13 Hz) frequency ranges for F₃–T₇, F₄–T₈, F₃–TP₇, F₄–TP₈, F₃–P₃, F₄–P₄, F₃–O₁, F₄–O₂, C₃–O₁, C₄–O₂ electrode pairs. Unpleasant pictures elicited significantly higher delta coherence values than neutral pictures (p < 0.05), over fronto-parietal, fronto-occipital, and centro-occipital electrode pairs. Furthermore, unpleasant pictures elicited higher theta coherence values than pleasant (p < 0.05) and neutral pictures (p < 0.05). The present study showed that female subjects had higher delta (p < 0.05) and theta (p < 0.05) coherence values than male subjects. This difference was observed more for emotional pictures than for neutral pictures. This study showed that the brain connectivity was higher during emotional pictures than neutral pictures. Females had higher connectivity between different parts of the brain than males during emotional processes. According to these results, we may comment that increased valence and arousal caused increased brain activity. It seems that not just single sources but functional networks were also activated during perception of emotional pictures.     

The impact of a delayed sleep–wake schedule on depression is greater in women – A web-based cross-sectional study in Japanese young adults

Sleep-related problems, such as symptoms of insomnia, daytime sleepiness, shorter sleep duration, or a delayed sleep–wake schedule, are known to be risk factors for depression. In general, depression is more prevalent in women than in men, but sleep-related problems do not necessarily show similar gender predominance. Hence, it can be speculated that the impact of sleep-related problems on the development process of depression differs between genders; however, so far, few studies have focused on this issue. The aim of this study was to clarify gender differences in the rates of depression of people with the above sleep-related problems, and to examine gender differences in factors associated with depression in Japanese young adults. A web-based questionnaire survey comprising assessments of demographic variables, sleep-related variables (bed time, wake time, sleep onset latency, frequency of difficulty in initiating sleep and that in maintaining sleep, i.e. symptom components of insomnia, and daytime sleepiness), and the 12-item version of the Center for Epidemiologic Studies Depression Scale was administered to 2502 participants (males:females?=?1144:1358, age range?=?19–25 years). Female predominance in the rate of depression was observed only in subjects with a delayed sleep–wake schedule (χ²₍₁₎?=?15.44, p?<?0.001). In men, daytime sleepiness and difficulty in initiating sleep were significantly associated with depression (odds ratio [OR]?=?2.39, 95% confidence interval [CI]?=?[1.69, 3.39], p?<?0.001; OR?=?3.50, 95% CI?=?[2.29, 5.35], p?<?0.001, respectively), whereas in women, significant associations were found between depression and a delayed sleep–wake schedule (OR?=?1.75, 95% CI?=?[1.28, 2.39], p?<?0.001), daytime sleepiness (OR?=?2.13, 95% CI?=?[1.60, 2.85], p?<?0.001), and difficulty in initiating sleep (OR?=?4.37, 95% CI?=?[3.17, 6.03], p?<?0.001). These results indicate that in younger generations, the impact of a delayed sleep–wake schedule on the development of depression is greater in women; specifically, women are vulnerable to depression when they have an eveningness-type lifestyle, which is possibly attributable to the female-specific intrinsic earlier and shorter circadian rhythm. These results suggest the necessity of gender-based approaches to treating sleep-related problems for alleviating or preventing depressive symptoms in young adults.     

Differences in circadian patterns between rural and urban populations: An epidemiological study in countryside

The physiological pattern of the sleep–wake cycle is influenced by external synchronizing agents such as light and social patterns, creating variations in each individual’s preferred active and sleep periods. Because of the demands of a 24-h working society, it may be imperative for many people to adapt their sleep patterns (physiologically) to their daily activities. Therefore, we analyzed the difference in sleep patterns and chronobiological parameters between an essentially rural farming and urban small-town populations. We studied 5942 subjects (women, 67.1%, N?=?3985; mean age, 44.3?±?13.1 years), from which the chronotype, circadian sleep pattern, and period of light exposure were collected using the Munich Chronotype Questionnaire (MCTQ). A structured questionnaire was also made for collection of social and demographic information. Compared with the urban population (N?=?3427, 57.7%), the rural population (N?=?2515, 42.3%) presented a more predominantly early sleep pattern, as determined by the mid-sleep phase (rural: 2.26?±?1.16; urban: 3.15?±?1.55; t-test, p?<?0.001). We also found less social jetlag (rural: 0.32; urban: 0.55; Mann–Whitney U test, p?<?0.001) and higher light-exposure (rural: 9.55?±?2.31; urban: 8.46?±?2.85; t test, p?<?0.001) in the rural population. Additionally, the rural population presented a higher prevalence of psychiatric disorders (rural: 156, 6.20%; urban: 165, 4.80%; Chi-square, p?<?0.05), and a lower prevalence of metabolic diseases (rural: 143, 5.70%; urban: 225, 6.60%; Chi-square, p?<?0.05). The significant difference in sleep parameters, chronotype, and light exposure between groups remained after multivariate regression analysis (r^2?=?0.41, F?=?297.19, p?<?0.001, β?=?1.208). In this study, there was a significant difference between the rural and urban populations in natural light exposure and sleeping patterns. Because of agricultural work schedules, rural populations spend considerable time outside that is an obligation related to work schedules. Our results emphasize the idea that latitude may not be the main factor influencing individual circadian habits. Rather, circadian physiology adapts to differences in exposure to light (natural and artificial) as well as social and work schedules.     

Paced QRS morphology predicts incident left ventricular systolic dysfunction and atrial fibrillation

Background

The prognostic significance of paced QRS complex morphology on surface ECG remains unclear. This study aimed to assess long-term outcomes associated with variations in the paced QRS complex.

Metabolic endotoxaemia related inflammation is associated with hypogonadism in overweight men

Background

Obesity is associated with both impaired testosterone production and a chronic state of low grade inflammation. Previously it was believed that this inflammation was mediated by a decline in the immunosuppressive action of testosterone. However, more recently an alternative hypothesis (GELDING theory) has suggested that inflammation originating from the passage of intestinal bacteria into the circulation (metabolic endotoxaemia) may actually be the cause of impaired testicular function in obese men. The aim of this study is to investigate if metabolic endotoxaemia, as quantified by serum Lipopolysaccharide Binding Protein (LBP), is associated with impaired testicular endocrine function.

Methods

A total of 50 men aged between 21 and 50 years (mean 35.1?±?6.8 years) were assessed for adiposity (BMI, waist circumference and % body fat using bio-impedance), inflammatory status (serum CRP, IL-1β, IL-6, TNFα and LBP) and testicular endocrine function (serum testosterone, estradiol, AMH, LH and FSH). Statistical analysis was performed using Pearson correlation analysis, with log transformation of data where appropriate, and multi-variate regression.

Results

Overall increasing adiposity (% body fat) was positively associated with metabolic endotoxaemia (LBP, r?=?0.366, p?=?0.009) and inflammation (CRP r?=?0.531, p?<?0.001; IL-6 r?=?0.463, p?=?0.001), while also being negatively correlated with serum testosterone (r?=??0.403, p?=?0.004). Serum testosterone levels were significantly negatively correlated with inflammation (CRP r?=??0.471, p?=?0.001; IL-6 r?=??0.516, p?<?0.001) and endotoxaemia (LBP) after adjusting for serum LH levels (p?=??0.317, p?=?0.03). Furthermore, serum IL-6 was negatively associated with AMH levels (r?=??0.324, p?=?0.023), with a negative trend between LBP and AMH also approaching significance (r?=??0.267, p?=?0.064).

Conclusions

Obesity and its associated metabolic endotoxaemia helps initiate a pro-inflammatory state characterised by raised serum IL-6 levels, which in turn is correlated with impairment of both Leydig (testosterone) and Sertoli cell function (AMH). These results open up the potential for new treatments of obesity related male hypogonadism that focus on preventing the endotoxaemia associated chronic inflammatory state.

     

Power of counter movement jumps with external load – coherence of three assessment methods

Background

The purpose of this study was to evaluate the coherence between three different methods assessing the power driven from a counter movement jump (CMJ); the Powertimer 300-series contact mat (C-mat), the MuscleLab 4010 infrared mat (IR-mat) and the MuscleLab 4010 linear encoder (M-encoder), and to evaluate the test-retest reliability of the M-encoder.

Methods

Twenty-two males and 29 female, elite athletes performed two test sessions with three days in between. Each test session included counter movement jumps (CMJ) performed on a Smith-machine with external loads of 40 kg. Jump height and flight time were assessed with C-mat and IR-mat, and power was additionally assessed with C-mat. Variables analyzed from the M-encoder were average power (AP), average force (AV), average velocity (AV), and distance (D).

Results

The results from the C-mat were systematically higher than the ones obtained from the M-encoder and IR-mat. The correlation between the C-mat, M-encoder and the IR-mat was strong (r_p?=?0.95-0.98). The results showed a high test-retest reliability for all indices assessed with the M-encoder, AP (r_p?=?0.97, p?<?0.001; TE%?=?3.9%), AF (r_p?=?0.99, p?<?0.001; TE%?=?1.4%). Furthermore, the AV had high values (r_p?=?0.94, p?<?0.001; TE%?=?2.9%) as well as D (r_p?=?0.87, p?<?0.001; TE%?=?5.4%).

Conclusion

It is important to use the same equipment in both pre- and post-testing, since all three methods were reliable, coherent but not interchangeable to each other.

     

Comparative Hair Trace Element Profile in the Population of Sakhalin and Taiwan Pacific Islands

The objective of the current study is to perform a comparative analysis of hair trace element content in 393 apparently healthy adults living in Taipei, Taiwan, Republic of China (94 women and 46 men) and Yuzhno-Sakhalinsk, Sakhalin, Russia (186 women and 67 men). The obtained data indicate that Yuzhno-Sakhalinsk inhabitants were characterized by significantly higher hair Co, Cr, Mn, and V levels, exceeding the respective Taipei values by a factor of 3, 2, 7, and 5, respectively (all p?<?0.001). Hair Cu, Fe, and Si levels were also higher in examinees from Yuzhno-Sakhalinsk than those from Taipei by 10% (p?=?0.001), 61% (p?<?0.001), and 68% (p?<?0.001), respectively. It is notable that the only essential element, being significantly higher (+?30%; p?<?0.001) in Taipei inhabitants, is selenium. Yuzhno-Sakhalinsk inhabitants were characterized by 60% higher levels of hair Sn, and nearly two- and threefold higher scalp hair content of Be and Cd in comparison to Taipei values, respectively (all p?<?0.001). Oppositely, the examinees from Taipei had 14% (p?=?0.040) and 47% (p?=?0.001) higher levels of hair As and Hg as compared to Yuzhno-Sakhalinsk inhabitants. Further analysis demonstrated that men from both Yuzhno-Sakhalinsk and Taipei were characterized by significantly higher hair Mn, As, and Pb levels in comparison to women. The intensive development of heavy industry in Yuzhno-Sakhalinsk may result in increased metal emissions, whereas fish consumption may result in elevation of hair Hg, As, and Se levels in Taiwan inhabitants.     

Different contribution of extent of myocardial injury to left ventricular systolic and diastolic function in early reperfused acute myocardial infarction

Background

We sought to investigate the influence of the extent of myocardial injury on left ventricular (LV) systolic and diastolic function in patients after reperfused acute myocardial infarction (AMI).

Methods

Thirty-eight reperfused AMI patients underwent cardiac magnetic resonance (CMR) imaging after percutaneous coronary revascularization. The extent of myocardial edema and scarring were assessed by T2 weighted imaging and late gadolinium enhancement (LGE) imaging, respectively. Within a day of CMR, echocardiography was done. Using 2D speckle tracking analysis, LV longitudinal, circumferential strain, and twist were measured.

Results

Extent of LGE were significantly correlated with LV systolic functional indices such as ejection fraction (r?=?-0.57, p?<?0.001), regional wall motion score index (r?=?0.52, p?=?0.001), and global longitudinal strain (r?=?0.56, p?<?0.001). The diastolic functional indices significantly correlated with age (r?=?-0.64, p?<?0.001), LV twist (r?=?-0.39, p?=?0.02), average non-infarcted myocardial circumferential strain (r?=?-0.52, p?=?0.001), and LV end-diastolic wall stress index (r?=?-0.47, p?=?0.003 with e’) but not or weakly with extent of LGE. In multivariate analysis, age and non-infarcted myocardial circumferential strain independently correlated with diastolic functional indices rather than extent of injury.

Conclusions

In patients with timely reperfused AMI, not only extent of myocardial injury but also age and non-infarcted myocardial function were more significantly related to LV chamber diastolic function.     

Stability and Fragmentation of the Activity Rhythm Across the Sleep-Wake Cycle: The Importance of Age,Lifestyle, and Mental Health

The rhythms of activity across the 24-h sleep-wake cycle, determined in part by the circadian clock, change with aging. Few large-scale studies measured the activity rhythm objectively in the general population. The present population-based study in middle-aged and elderly persons evaluated how activity rhythms change with age, and additionally investigated sociodemographics, mental health, lifestyle, and sleep characteristics as determinants of rhythms of activity. Activity rhythms were measured objectively with actigraphy. Recordings of at least 96?h (138?±?14?h, mean?±?SD) were collected from 1734 people (age: 62?±?9.4?yrs) participating in the Rotterdam Study. Activity rhythms were quantified by calculating interdaily stability, i.e., the stability of the rhythm over days, and intradaily variability, i.e., the fragmentation of the rhythm relative to its 24-h amplitude. We assessed age, gender, presence of a partner, employment, cognitive functioning, depressive symptoms, body mass index (BMI), coffee use, alcohol use, and smoking as determinants. The results indicate that older age is associated with a more stable 24-h activity profile (β?=?0.07, p?=?0.02), but also with a more fragmented distribution of periods of activity and inactivity (β?=?0.20, p?<?0.001). Having more depressive symptoms was related to less stable (β?=??0.07, p?=?0.005) and more fragmented (β?=?0.10, p?<?0.001) rhythms. A high BMI and smoking were also associated with less stable rhythms (BMI: β?=??0.11, p?<?0.001; smoking: β?=??0.11, p?<?0.001) and more fragmented rhythms (BMI: β?=?0.09, p?<?0.001; smoking: β?=?0.11, p?<?0.001). We conclude that with older age the 24-h activity rhythm becomes more rigid, whereas the ability to maintain either an active or inactive state for a longer period of time is compromised. Both characteristics appear to be important for major health issues in old age.     

Validity of the Japanese version of the Munich ChronoType Questionnaire

To assess circadian preference with a score, the Morningness-Eveningness Questionnaire (MEQ) has been used for more than 3 decades now. More recently, the Munich ChronoType Questionnaire (MCTQ) was developed: it asks for sleep-wake behavior on work and free days and uses the midpoint of sleep on free days (MSF), corrected for sleep debt accumulated during the work week as an indicator of chronotype (MSF_sc). In this study, we developed a Japanese version of the MCTQ by using a translation/back-translation approach including an examination of its semantic validity. In a subsequent questionnaire survey, 450 adult men and women completed the Japanese versions of the MCTQ and MEQ. Results showed that MEQ scores were significantly negatively correlated with mid-sleep parameters assessed by the MCTQ, on both, work and free days, as well as with the chronotype measure MSF_sc (r?=??0.580 to ?0.652, all p?<?0.001). As in the original German version, the strongest correlation was observed between MEQ score and MSF. A physiological validation study using dim light melatonin onset as a circadian phase marker (N?=?37) showed a high correlation between chronotype as assessed with the MSF_sc (r?=?0.542, p?<?0.001), and less so for MEQ score (r?=??0.402, p?=?0.055). These results demonstrate the validity of the Japanese MCTQ and provide further support of the adequacy of the MCTQ as a chronotype measure.     

Predictive factors for biochemical pregnancy in intracytoplasmic sperm injection cycles

The aim of this study was to investigate which factors contribute to the incidence of biochemical pregnancy (BP) in intracytoplasmic sperm injection (ICSI) cycles. This cohort study included cycles performed from June 2010 to September 2016 in a private, university-affiliated IVF centre. Cycles were split into four groups, depending on the pregnancy outcomes: Clinical Pregnancy (CP, n?=?903), Biochemical Pregnancy (BP, n?=?55), Miscarriage (MI, n?=?142) and Negative Pregnancy (NP, n?=?2034). The effects of ovarian stimulation, laboratory data and seminal parameters on pregnancy outcomes were evaluated using adjusted general linear models. Discriminant analyses were conducted to construct a model for pregnancy prediction and to establish cut-offs for BP. The total sperm count (p?=?0.035), total and progressive sperm motility (p?=?0.001 and p?=?0.023, respectively), total motile sperm count (TMSC, p?=?0.029) and the endometrial thickness (p?<?0.001) were lower among BP group cycles. Lower rates of high-quality cleavage-stage embryos were observed in the BP group compared to CP and MI groups (p?<?0.001). In discriminant analyses, cut-offs for BP prediction were established for the following factors: endometrial thickness < 11?mm, sperm motility < 55.5% and total dose of follicle-stimulating hormone (FSH)> 2400 IU. The incidence of biochemical pregnancy was four times higher when the aforementioned factors did not meet the defined cut-offs. The combination of suboptimal endometrial development and poor seminal and embryo quality contribute to an increased incidence of biochemical pregnancy in ICSI cycles.     

Sleep-Wake Cycle of Adolescents in Côte d'Ivoire: Influence of Age,Gender, Religion and Occupation

The human sleep-wake cycle is characterized by significant individual differences. Those differences in the sleep-wake cycle are partially heritable but are also influenced by environmental factors like the light/dark cycle or social habits. In this study we analyse for the first time the sleep-wake rhythm of adolescent pupils and working adolescents in a less industrialised country in West Africa near the equator. The aim of this study was to explore the sleep wake cycle in this geographical region, using Côte d'Ivoire as an example. Data collection took place between 2nd of March and 10th of June 2009. 588 adolescents (338 girls, 250 boys) between 10 and 15 years (mean?±?SD: 12.72?±?1.63) participated in this study. We collected data on the religion of the participants (Christian (N?=?159), Muslim (N?=?352), other/no religion (N?=?77)) and their occupation. Participants were either pupils attending school (N?=?336) or adolescents that were already working (N?=?252) and not attending school. The interviewer filled in the questionnaire. We found significant effects of age (p?<?0.001), gender (p?<?0.001), occupation (p?=?0.002), religion (p?<?0.001) and region (p?<?0.001). The midpoint of sleep was on average 1:26 (SD: 00:30) on weekdays and 1:37 (SD: 00:42) on weekend days. There are significant differences between weekdays and weekend days, but these were only small. Sleep duration suggests that adolescents in Côte d'Ivoire may gain sufficient sleep during week and weekend days, and thus, may live more in accordance with their own biological clock than adolescents in the northern hemisphere. In contrast, the data can be interpreted that adolescents live in a permanent ‘jetlag’. Factors may be the more continuous light/dark cycle in the tropics, low amount of ambient light and less electricity.     

Tobacco Smoke Exposure During Pregnancy Increases Maternal Blood Lead Levels Affecting Neonate Birth Weight

To assess the effect of lead exposure from cigarette smoke on fetal growth, blood lead concentrations were measured using inductively coupled plasma mass spectrometry in 150 healthy pregnant women. Mean lead concentrations in plasma and whole blood were significantly higher in the smoking group compared with the nonsmoking group in each trimester of pregnancy (p?<?0.001). Logistic regression analysis showed the highest impact of the number of cigarettes smoked per day for serum lead concentration (β?=?0.238; p?<?0.05), while in whole blood, it was duration of smoking before conception (β?=?0.297; p?<?0.001). Birth weight of the smoking mothers' infants was significantly lower (mean?±?SEM, 3,192?±?50.8 and 3,569?±?49.6 g, respectively; p?<?0.001) and negatively correlated with lead levels in plasma (r?=??0.38; p?<?0.001) and in whole blood (r?=??0.27; p?<?0.001). Therefore, it is suggested that smoking during pregnancy increases lead concentrations in maternal blood. Fetal exposure to low doses of lead in utero may be a serious risk factor causing lower birth weight.     

Impact of type 2 diabetes mellitus on short- and long-term mortality after coronary artery bypass surgery

Background

Type 2 diabetes mellitus (DM) is a frequent co-morbidity among patients undergoing coronary artery bypass grafting (CABG) surgery. The aim of this study was to evaluate the impact of DM on the early- and long-term outcomes of patients who underwent isolated CABG.

Methods

We performed an observational cohort study in a large tertiary medical center over a period of 11 years. All data from patients who had undergone isolated CABG surgery between 2004 and 2014 were obtained from our departmental database. The study population included 2766 patients who were divided into two groups: Group I (1553 non-diabetic patients), and Group II (1213 patients suffering from type 2 DM). Group II patients were then divided into two subgroups: subgroup IIA (981 patients treated with oral antihyperglycemic medications) and subgroup IIB (232 insulin-treated patients with or without additional oral antihyperglycemic drugs). In-hospital, 1-, 3-, 5- and 10-year mortality outcome variables were evaluated. Mean follow-up was 97?±?41 months.

Results

In-hospital mortality was similar between Group I and Group II patients (1.87% vs. 2.31%, p?=?0.422) and between the subgroups IIA and IIB (2.14% vs. 3.02%, p?=?0.464). Long-term mortality (1, 3, 5 and 10 years) was higher in Group II (DM type 2) compared with Group I (non-diabetic patients) (5.3% vs. 3.6%, p?=?0.038; 9.3% vs. 5.6%, p?<?0.001; 15.3% vs. 9.3%, p?<?0.001 and 47.3% vs. 29.6% p?<?0.001). Kaplan–Meier analysis demonstrated that all-cause mortality was higher in Group II compared with Group I (p?<?0.001) and in subgroup IIB compared with subgroup IIA (p?=?0.001). Multivariable analysis showed that DM increased the mortality hazard by twofold, and among diabetic patients, insulin treatment increased the mortality hazard by twofold.

Conclusions

Diabetic and non-diabetic patients have similar in-hospital mortality rates. Survival rates of diabetic patients start to deteriorate 3 year after surgery. Type 2 DM is an independent predictor for long-term mortality after isolated CABG surgery. Mortality is even higher when the diabetes treatment strategy included insulin.

     

Bullying,sleep/wake patterns and subjective sleep disorders: Findings from a cross-sectional survey

The aim of this study was to explore: (a) sleep patterns and disorders possibly associated with adolescent bullying profiles (pure bully, pure victim, bully/victim and neutral) and (b) the effect of sleep on psychosocial problems (externalized and internalized) related to bullying. The sample consisted of 1422 students aged 10–18 (mean?=?14.3, SD?=?2.7; 57% male) from five socioeconomically diverse schools in France. Bullying profiles were obtained using the revised Bully–Victim Questionnaire. Subjective sleep disorders were assessed using the Athens Insomnia Scale. School-week and weekend sleep/wake patterns were recorded. Internalizing problems were investigated using a Perceived Social Disintegration Scale and a Psychological Distress Scale. Externalizing behaviors were assessed using a General Aggressiveness Scale and an Antisocial Behavior Scale. These questionnaires were administered during individual interviews at school. After controlling for effects of gender and age, victims of bullying showed significantly more subjective sleep disturbances than the pure-bully or neutral groups (p?<?0.001). Bullies’ sleep schedules were more irregular (p?<?0.001 for bedtime irregularity and p<0.01 for wake-up time irregularity) and their sleep duration was shorter than their schoolmates (p?<?0.001 for the school week and p?<?0.05 for the weekend). There was an effect of sleep on psychosocial problems related to bullying, and our results indicate that sleep has a moderating effect on aggression in bullies (p?<?0.001). This would suggest a higher vulnerability of bullies to sleep deprivation. These results show differences in sleep problems and patterns in school-bullying profiles. Findings of this study open up new perspectives for understanding and preventing bullying in schools, with implications for research and clinical applications.