Amygdala Changes in Chronic Insomnia and Their Association with Sleep and Anxiety Symptoms: Insight from Shape Analysis.

Affective disorders, such as anxiety and depression, are common comorbidities associated with chronic insomnia disorder (CID). However, the underlying neural mechanisms of these comorbidities are still not clear. The present study is aimed at investigating structural changes in the amygdala of CID patients using surface-based shape analysis. A total of 65 medication-naive patients with CID and 55 healthy controls (HCs) matched for age, sex, and years of education were enrolled in this study and were subjected to structural magnetic resonance imaging (MRI). The Oxford Centre for Functional MRI of the Brain (FMRIB) created an Integrated Registration and Segmentation Tool (FIRST) that was employed in this study to assess the volumetric and surface alterations in patients with CID. Shape correlations between the amygdala and clinical features were also analyzed. Atrophic changes in the amygdala were observed at the local level, not for the entire amygdala volume. The left atrophic changes in the amygdala were in the superficial and basolateral nuclei while right atrophic changes were in the basolateral nuclei in CID patients. Insomnia severity was associated with the centromedial right amygdala while anxiety was linked with the basolateral nuclei. These findings indicate localized amygdala atrophy in CID. Separate amygdala regions are associated with insomnia and anxiety in CID. This evidence helps elucidate the neural mechanisms underlying the bidirectional relationship between insomnia and anxiety.

Evaluation of a novel flushing protocol for a peripherally inserted central catheter (PICC) in the neurological intensive care unit: A prospective randomized study.

Background: Peripherally inserted central catheters (PICCs) are increasingly used in critical care units. Venous arterial blood management protection (VAMP) for PICCs could decrease the rate of blockage of PICCs. We investigated whether a novel flushing method for PICCs could decrease the risk of venous thromboembolism (VT) and catheter-associated bloodstream infections (CABSIs) compared to the traditional flushing method. Methods: In this prospective randomized study, we evaluated 360 patients with PICCs who were admitted to our neurological intensive care unit from March 2012 to February 201 4. The patients were randomized into the experimental group (n= 186) and the control group (n= 174). The VAMP-system flushing method was used in the experimental group whereas in the control group the PICCs were flushed with a 10 ml syringe of saline. Baseline clinical information, blockage rate of PICCs, occurrence of VT and CABSIs and average time for flushing (seconds per flushing time) were compared and analysed. Results: The occurrence of CABSIs and average time for flushing were statistically lower in the experimental group. The rate of blockage of PICCs, proportion of male subjects, age of subjects, APACHE II score and length of stay in hospital showed no significant differences between the two groups. Conclusion: This study showed that the VAMP-system flushing method is simple to use and may be more beneficial for patients with a PICC; it may also lower the risk of CABSIs.

A phase I, dose-escalation trial evaluating the safety and efficacy of emulsified isoflurane in healthy human volunteers.

BACKGROUND: This first-in-human volunteer phase I clinical trial aimed to evaluate the safety, tolerability, and anesthesia efficacy of emulsified isoflurane (EI), an intravenously injectable formulation of isoflurane. METHODS: Seventy-eight healthy volunteers were recruited in this open-label, single-bolus, dose-escalation, phase I trial and were allocated into 16 cohorts. Each volunteer received a single bolus injection of EI. The dose started with 0.3 mg/kg (for isoflurane) and was planned to end with 64.6 mg/kg. Postdose vital signs, physical examination, laboratory tests, chest radiograph, 12-lead electrocardiogram, and development of any adverse event were closely monitored as safety measurements. Effectiveness in producing sedation/anesthesia was assessed by Modified Observer's Assessment of Alertness/Sedation and Bispectral Index. RESULTS: The dose escalation ended as planned. The most common adverse events associated with EI were injection pain (77 of 78, 98.7%) and transient tachycardia (22 of 78, 25.6%). Only at high doses (≥38.3 mg/kg) did EI cause transient hypotension (5 of 78, 6.4%) or apnea (11 of 78, 14.1%), but all the affected volunteers recovered uneventfully. Fast onset of unconsciousness (typically 40 s after injection) was developed in all volunteers receiving doses of 22.6 mg/kg or greater. Waking-up time and depression in Modified Observer's Assessment of Alertness/Sedation correlated well with EI dose. None of the postdose tests revealed any abnormal result. CONCLUSIONS: EI is safe for intravenous injection in human volunteers in the dose range of 0.3 to 64.6 mg/kg. At doses of 22.6 mg/kg or higher, EI produced rapid onset of unconsciousness in all volunteers followed by fast, predictable, and complete recovery.

The relationship between physical activity and subjective well-being in Chinese university students: the mediating roles of perceived health, social support and self-esteem.

Purpose: The intent of this paper is to understand the effect of Physical Activity on university students' Subjective Well-being and to explore whether Perceived Health, Social Support, and Self-esteem play roles as mediating variables. Methods: Self-reported data from 404 college students (147 males and 257 females) were analyzed using structural equation modeling (SEM). The relationships between the study variables were tested by mediation models and 5,000 bootstrap samples using AMOS version 24. Results: (1) The six hypotheses were supported in the measurement model in the results (P < 0.05). Physical Activity was related to Social Support, Perceived Health, and to Self-esteem; Social Support, Perceived Health, and Self-esteem were all related to Subjective Well-being. However, the direct positive effect of Physical Activity gradually decreased in the order of Self-esteem, Social Support, and Perceived Health. The direct effect of Perceived Health, Social Support, and Self-esteem on Subjective Well-being also decreased sequentially. (2) In the Structural Equation Model (χ2 = 825.451, p < 0.001, df = 455, CMIN/df = 1.814, CFI = 0.942, RMSEA = 0.045), the three hypotheses of mediation were supported (P < 0.05), showing positive indirect effects between Physical Activity and Subjective Well-being. Of the three mediating effects, Social Support and Self-esteem were not different, and the mediating effect of Perceived Health showed the largest impact. This indicates that Social Support, Perceived Health, and Self-esteem mediate the effects of Physical Activity, and Subjective Well-being regulation has positive indirect effects. Conclusion: This study demonstrates the importance of meeting the needs of Social Support, Perceived Health, and Self-esteem when designing interventions to promote college students' sports participation to enhance Subjective Well-being.

[Effect of single doses of HX0507 on QTc intervals in healthy people: a phase I safety and tolerability study].

OBJECTIVE: To assess the effect of HX0507 on QTc interval in healthy people in a phase I safety and tolerability study. METHODS: Eighty healthy people were randomly assigned to one of the 13 dosage groups. Standard 12-lead ECGs data were collected before and after HX0507, a water soluble prodrug of propofol, was given intravenously to the participants (at 33 time points). The QT interval values were corrected for heart rate using Fridericia's formula (QTcF = QT/RR(0.33)) and Bazett's formula (QTcB=QT/RR(0.5)). The primary target variable was baseline-adjusted changes in QTcF (deltaQTcF). RESULTS: Prolongation of QT interval was induced by HX0507 administered at an anticipated clinical dosage (3 mg/kg) or at a stronger dosage (8 mg/kg) and above. The mean deltaQTcF ranged from 5.61 ms to 32.24 ms, with an upper limit of 90% CI ranging from 10.30 ms to 53.90 ms. There was a linear correlation between HX0507 dosage and its effect on QT interval. Eight types of ECG-related adverse events were detected in 32 subjects. CONCLUSION: Single administration of HX0507 induces dose-related QT prolongation.

The Development of a Model to Predict Sports Participation among College Students in Central China.

This study applies the theory of planned behavior (TPB) and self-determination theory (SDT) to predict the sports participation and exercise intentions of college students in Central China by considering the mediating roles of attitudes, subjective norms, and perceived behavioral control. Structural equation modeling (SEM) was used to analyze self-reported data from 294 college students (144 males and 150 females). The relationship between the research variables was tested by the mediation model and Bootstrap 5000 sampling using AMOS version 24. The results show that the direct effects of attitudes and perceived behavioral control on motor intention and motor participation are significant in the model. The satisfaction of the three psychological needs had a positive indirect effect on motor participation through attitudes; competence and autonomy had a positive indirect effect on motor participation mediated through subjective norms; however, only competence had a positive indirect effect on motor mediated through perceived behavioral control. In conclusion, this research demonstrates the importance of meeting these three basic psychological needs when designing intervention measures to promote college students' sports participation.

Circ_0072995 Promotes Cell Carcinogenesis via Up-Regulating miR-149-5p-Mediated SHMT2 in Breast Cancer.

BACKGROUND: Circ_0072995 is a novel identified circRNA and has been identified to involve in the metastasis of breast cancer. However, the detailed function and mechanism of circ_0072995 in the biological property of breast cancer cell remain vague. MATERIALS AND METHODS: The expression of circ_0072995, microRNA (miR)-149-5p and serine hydroxymethyltransferase 2 (SHMT2) mRNA was detected using quantitative real-time polymerase chain reaction. Western blot was used to detect the protein levels of SHMT2, hexokinase-2 (HK-2), lactate dehydrogenase a chain (LDHA), and glucose transporter 1 (GLUT1). Cell proliferation, apoptosis, migration, and invasion were analyzed using cell counting kit-8 assay, flow cytometry, caspase-3 activity analysis, cell adhesion assay and transwell assay, respectively. Glucose metabolism was calculated by measuring glucose uptake, lactate production, and adenosine triphosphate (ATP) levels. The interaction between miR-149-5p and circ_0072995 or SHMT2 was confirmed by dual-luciferase reporter assay. In vivo tumorigenesis was performed using the murine xenograft model. RESULTS: Circ_0072995 and SHMT2 were up-regulated in breast cancer tissues and cell lines, and knockdown of circ_0072995 or SHMT2 suppressed cell malignant properties and anaerobic glycolysis; importantly, SHMT2 overexpression attenuated the anticancer action of circ_0072995 knockdown in breast cancer. Besides, we also found circ_0072995 directly targeted miR-149-5p, thereby regulating its downstream gene SHMT2 by competitively binding to miR-149-5p. Additionally, xenograft analysis showed circ_0072995 silencing suppressed tumor growth via regulating SHMT2 and miR-149-5p in vivo. CONCLUSION: This study demonstrated that circ_0072995 promoted cell malignant phenotypes and anaerobic glycolysis in breast cancer via up-regulating SHMT2 through sponging miR-149-5p, indicating a promising molecular target for breast cancer treatment.