Cortisol Awakening Reaction and Anxiety in Depressed Coronary Artery Disease Patients

Disturbances of HPA axis functioning as represented by cortisol awakening reaction (CAR) belong to the mediating pathways linking psychosocial distress and cardiovascular risk. Both depression and anxiety have been confirmed as independent risk factors for coronary artery disease (CAD). However, data on anxiety and cortisol output in CAD patients are scarce. Based on previous data, we hypothesized that anxiety would be associated with higher cortisol output and a more pronounced morning increase in moderately depressed CAD patients. 77 patients (60 y, 79% male) underwent saliva sampling (+0, +30, +45, +60 min after awakening, midday and late-night sample). Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS) and patients were grouped into anxious versus non anxious subjects based upon the recommended score (≥11). A repeated measures ANOVA yielded a significant time and quadratic time effect referring to the typical CAR. Anxious patients showed a significantly steeper 30 min increase, higher AUCi, lower waking and late-night cortisol levels. The steeper cortisol increase in the anxious group is in line with previous data and may be interpreted as a biological substrate of affect regulation. The lower basal and late-night levels coupled with greater AUCi mirror a more dynamic reactivity pattern compared to depressed subjects without anxiety.

Changes in Snacking Patterns during COVID-19 Lockdown in Adults from Mumbai City, India

Mumbai was one of the 1st cities in India to go into total lockdown in March 2020. The lockdown was expected to have an influence on eating habits specially the snacking patterns. The main objective of this study was to access the change in snacking patterns of participants living in Mumbai city, India during lockdown. Data was collected in 256 Mumbai residents (60 males, 196 females) using Google forms. Information regarding number of meals consumed, meals at which snacks were consumed, change in snacking pattern, reasons for increase or decrease in snacking, and type of snacks consumed during lockdown as compared to before lock was collected. Around 20% reported a decrease, 31% reported no change and 49% reported an increase in snack consumption during lockdown. Participants consumed higher number of meals during lockdown (p<0.05). Significantly higher percentage of participants did not consume store brought snacks during lockdown (30.9% vs 13.7%) (p<0.05). Significantly higher percentage of participants consumed snacks at mid-evening (50.4% vs 33.6%), late evening (48% vs 32%) and late night (32% vs 16.8%) during lockdown as compared to before lockdown (p<0.05). Significantly change in lemon-water (57.8% vs 43.4%), coffee (47.3% vs 40.6%) and carbonated beverages (14.8% vs 23.4%) was observed during lockdown as compared to before lockdown (p<0.05). Significant increase in nuts (74.2% vs 65.6%), instant noodles (69.5% vs 60.9%) and biscuits (78.5% vs 68%) was observed during lockdown as compared to before lockdown (p<0.05). Significant decrease in South Indian (61.75 vs 69.1%), Frankie (32.8% vs 51.6%), bhel (50.4% vs 69.1%), Chinese bhel (21.5% vs 35.5%) and usal (32% vs 40.2%) was observed during lockdown as compared to before lockdown (p<0.05). To conclude, snacks were consumed at more number of meals during lockdown in comparison to before lockdown. A change in type of snacks consumed was observed during lockdown. Ready and easy to eat snacks such as nuts, instant noodles and biscuits showed an increase whereas snacks that require elaborate cooking procedure showed a decrease in consumption. With partial lockdown still persisting in many parts of the country and many still working from home it is imperative to circulate more accurate information on appropriate snacking habits.

The co-construction of campaign argumentation on U.S.A. late-night talk shows

This study shows that when presidential candidates visit, late-night talk show discourse is argumentative, and that this argumentation is co-constructed by the host and the candidate. Through their questions, hosts implicitly invoke arguments by casting doubt on the candidate’s presidential bid. By treating the host’s questions as critical questions expressing skepticism whether people should vote for the candidate, politicians prototypically use two types of argument schemes to defend their case. First, to argue that their policy proposals are needed, candidates use complex problem-solving argumentation. Second, to maintain that they have the skills and character to succeed as president, candidates use symptomatic argumentation. In their response, candidates also deal with other critical questions belonging to the argument scheme invoked through the host’s question. Which critical questions of that argument scheme the candidate addresses in addition to the one posed by the host depends on the type of question the host has asked.

640 Cannabis abuse and syncope

Aims Cannabis (marijuana) is the most consumed drug worldwide, counting roughly 200 million users in 2019 (4% of the global population). Once illegal in most of the world countries, cannabis is now legal for medical and recreational use in several states. During the last 20 years, we have observed a growing decriminalization wave parallel with an increase number of consumers: it is therefore mandatory not only for the cardiologists but for every physician to be aware of marijuana potential cardiovascular adverse health effects. With this paper, we present a case report of cannabis induced 16 s implantable loop recorder (ILR) recorded asystole from hypervagotonia in a 24-year-old heavy marijuana consumer. We focus on the infrequently reported association between syncope and chronic marijuana use and we try to explain the underlying mechanisms against the background of the current literature. Methods and results A 24-year-old presented to the emergency department sent by her cardiologist because of a recent finding of a 16 s asystole on the ILR she implanted 7 months before for recurrent syncopes. She openly declared that she is a heavy marijuana user (at least 5 cannabis-cigarette per day, not mixed up with tobacco, for no less than 12 years). She had a history of at least two spontaneous atypical syncopal episodes and a multitude of pre-syncopal episodes. Before being hospitalized, she underwent several diagnostic tests excluding a neurological etiology and, upon outpatient regimen, she begun a cardiology evaluation which lead to the ILR implantation. While watching TV at late night, the second prodrome-less syncopal episode occurred and a 16-s asystole was found on the ILR. During hospitalization, the patient was closely monitored and we evaluated basic autonomic function tests, carotid sinus massage, echocardiography, exercise stress test, and 24 h telemetry. Following the results of the exams, we considered a heart conduction system anomaly unlikely. Finally, the patient underwent a toxicological and a psychiatric evaluation, where she strongly expressed not wanting to abandon cannabis abuse. After a collective discussion with the heart team, syncope unit, electrophysiologists, and toxicologist, we decided to implant a dual chamber pacemaker with a rate response algorithm due to the high risk of trauma of the syncopal episodes. Conclusions Cannabis cardiovascular effects are not well known; among these we find ischaemic episodes, tachyarrhythmias, symptomatic sinus bradycardia, sinus arrest, and ventricular asystole. In the light of the poor literature, we believe that cannabis may produce opposite adverse effects depending on the duration of the habit. Acute administration increases sympathetic tone and reduces parasympathetic tone; conversely, with chronic intake an opposite effect is observed: repetitive dosing decreases sympathetic activity and increases parasympathetic activity. Physicians should be aware of the effects that cannabis produces upon the cardiovascular system: this could avoid expensive, prolonged hospitalizations, and needless diagnostic tests.

Assessment of scale of hazards due to pool fire for a fossil fired power plant in India

Hazards for a fossil fired power plant located at coastal Gujarat in India have been assessed. The trajectory and spread of the plume from tanks of fossil fired power plant were predicted using existing models named Carter, Mills, Briggs and Zonato during winter and summer seasons with low and high wind speeds observed in day and night hours. Results show that wide areas of habitation and human settlement to the northeast of the site may be potentially under hazards due to southwesterly and southerly winds during summer. Plume heights and widths are found high in the morning hours or late night when wind speeds are low. As wind speed increases around noon, low plume heights and widths are obtained. Length scales become low at low wind speeds and vice-versa. Lethal doses of thermal radiation beyond radial distance of 70 m are within the tolerable limit under hazardous condition.

Sap Flow and Water Consumption of Captain Cook Tree [Cascabela thevetia (l.) Lippold].

A two-year field study documented the diurnal and nocturnal sap flow rates and water consumption of young (YCC), adult (ACC) and mature (MCC) Captain Cook trees [Cascabela thevetia (L.) Lippold] that were invading a riparian habitat in northern Queensland. For comparison, two native trees [black tea tree (Melaleuca bracteata F. Muell.) and Moreton Bay ash (Corymbia tessellaris (F.Muell.) K.D.Hill & L.A.S.Johnson)] growing in association with Captain Cook tree were also monitored. Sap flow measurements were grouped into eight timeframes per day (early morning, late morning, early afternoon, late afternoon, early night, late night, early dawn and late dawn). Significant interactions in sap flow rate occurred between plant types, timeframes, and months. The magnitude of sap flow rate was Moreton Bay ash>YCC>ACC>black tea tree>MCC. Maximum sap flow rates tended to occur during early (1-3 pm) to mid-afternoon (4-6 pm) for all age groups of Captain Cook tree and the two native trees. Diurnal sap flow rates were significantly greater than nocturnal, and on a monthly basis sap flow rates were highest over the spring to autumn period (September-May) and lowest during winter (June–August). Significant differences in water consumption also occurred between species and months. Water consumption peak time varied between plant types with most plants peaking in January except for MCC and Moreton Bay ash trees for which peak water consumption occurred in June and July respectively. Water consumption was high across all seasons except winter. The magnitude of water consumption was Moreton Bay ash>black tea tree>YCC>ACC>MCC trees. Moreton Bay ash registered maximal monthly water consumption (4700 L) compared with minimal consumption by MCC trees (55 L). On average, Captain Cook trees used 99% and 72% less water than Moreton Bay ash and black tea trees respectively. The significantly lower water consumption by Captain Cook trees compared with Moreton Bay ash and black tea trees may be offset by high population densities. Results also suggest that knowledge of optimal sap flow timeframes may be advantageous in exploring optimal timing for application of control operations related to management of Captain Cook trees.

Impact of Light at Night Is Phase Dependent: A Study on Migratory Redheaded Bunting (Emberiza bruniceps)

Artificial light at night (LAN) alters the physiology and behavior of an organism; however, very little is known about phase-dependent effects of LAN, particularly, in night migratory songbirds. Therefore, in this study, we investigated whether the effects of LAN on daily activity and photoperiodic responses in the Palearctic Indian migratory songbird, redheaded buntings (Emberiza bruniceps), is dependent on the different phases of the night. Male buntings maintained under short photoperiod (8L:16D; L = 100 lux, D &lt; 0.1 lux) in individual activity cages were exposed to LAN (2 lux) for 6 weeks either in 4 h bin given at the different phases of 16 h night (early, mid, or late at ZT 08–12, ZT 14–18, or ZT 20–24, respectively; n = 9 each group) or throughout 16 h night (all night light, n = 6, ZT 08–24, the time of lights ON was considered as Zeitgeber time 0, ZT 0). A group (n = 6) with no LAN served as control. The results showed that LAN at the different phases of night induced differential effects as shown by an intense activity during the night, altered melatonin and temperature rhythms, and showed an increase in body mass and body fattening, food intake, and gonadal size. Midnight light exposure has a greater impact on migration and reproduction linked phenotypes, which is similar to the ones that received light throughout the night. The highlights of this study are that (i) LAN impacts day-night activity behavior, (ii) its continuity with the day alters the perception of day length, (iii) birds showed differential sensitivity to LAN in a phase-dependent manner, (iv) the direction of placing LAN affects the daily responses, e.g., LAN in the early night was “accepted” as extended dusk but the late night was considered as early dawn, and (v) midnight LAN was most effective and induced similar responses as continuous LAN. Overall, LAN induces long day responses in short days and shows differential sensitivity of the different phases of the night toward the light. This information may be valuable in adopting a part-night lighting approach to help reduce the physiological burden, such as early migration and reproduction, of artificial lighting on the nocturnal migrants.

Late-night noise hazards and the Tokyo Metropolitan Government's countermeasures in the 1960s

In 1960s Tokyo, late-night noise became a source of annoyance for urban-dwellers in residential areas. The problem was primarily due to young people who congregated around small food establishments eating and drinking. The situation led to the Tokyo Metropolitan Government to attempt to remove such small businesses through the 1969 Environmental Pollution Prevention Ordinance. However, the section of the ordinance dealing with late-night noise hazards was diluted by the political parties, who supported the interests of such businesses, hence failing to satisfy local residents who were victims of the problem.