The Muller F element (4.2 Mb, ~80 protein-coding genes) is an unusual autosome of Drosophila melanogaster; it is mostly heterochromatic with a low recombination rate. To investigate how these properties impact the evolution of repeats and genes, we manually improved the sequence and annotated the genes on the D. erecta, D. mojavensis, and D. grimshawi F elements and euchromatic domains from the Muller D element. We find that F elements have greater transposon density (25–50%) than euchromatic reference regions (3–11%). Among the F elements, D. grimshawi has the lowest transposon density (particularly DINE-1: 2% vs. 11–27%). F element genes have larger coding spans, more coding exons, larger introns, and lower codon bias. Comparison of the Effective Number of Codons with the Codon Adaptation Index shows that, in contrast to the other species, codon bias in D. grimshawi F element genes can be attributed primarily to selection instead of mutational biases, suggesting that density and types of transposons affect the degree of local heterochromatin formation. F element genes have lower estimated DNA melting temperatures than D element genes, potentially facilitating transcription through heterochromatin. Most F element genes (~90%) have remained on that element, but the F element has smaller syntenic blocks than genome averages (3.4–3.6 vs. 8.4–8.8 genes per block), indicating greater rates of inversion despite lower rates of recombination. Overall, the F element has maintained characteristics that are distinct from other autosomes in the Drosophila lineage, illuminating the constraints imposed by a heterochromatic milieu.
Study Objectives: The majority of adolescents with chronic insomnia have physical health or psychiatric comorbidities; insomnia is also associated with greater negative daytime symptoms (e.g., depressive symptoms) and reduced overall health-related quality of life (HRQOL). However, to date, there has been limited attention to treatment of insomnia in this population. The purpose of this study was to determine the preliminary efficacy of a brief cognitive behavioral therapy for insomnia (CBT-I) intervention on sleep, psychological symptoms, and HRQOL outcomes in adolescents with insomnia and co-occurring physical or psychiatric comorbidities. Methods: We conducted a single arm pilot trial in which 40 youth (mean age = 14.93, standard deviation = 1.89) with insomnia and physical or psychiatric comorbidities (e.g., depression, chronic pain, anxiety, gastrointestinal problems) received CBT-I in four individual treatment sessions over 4 to 6 w. Adolescents completed 7 days of wrist actigraphy and self-report measures of insomnia, sleep quality and behaviors, psychological symptoms, and HRQOL outcomes at pretreatment, immediate posttreatment, and 3-mo follow-up. Results: CBT-I was associated with improvements in self-reported measures of sleep including insomnia symptoms, sleep quality, sleep hygiene, pre-sleep arousal, and sleep onset latency. Psychological symptoms and HRQOL also improved. Effects were generally sustained at 3-mo follow-up. Conclusions: CBT-I may be efficacious for adolescents with co-occurring physical and mental health comorbidities; future randomized controlled trials are needed to test the effect of CBT-I on sleep, psychological symptoms, and HRQOL and to evaluate maintenance of treatment effects over longer time periods. Keywords: adolescents, chronic pain, cognitive behavioral therapy, depression, health-related quality of life, insomnia, intervention, sleep I NTRO DUCTI O NInsomnia, characterized by difficulties falling asleep or staying asleep, affects 10% of the adolescent population.1 Adolescents with insomnia commonly have comorbid medical and psychiatric disorders, such as depression, anxiety, and chronic pain.2 More recent conceptualizations of insomnia consider it to be a transdiagnostic contributor to the multiple causal factors that underlie medical and psychiatric conditions.3 Insomnia may contribute to the onset, maintenance, and recurrence of these symptoms. For example, insomnia may precede the onset of major depressive episodes and sleep disruption may lead to physical health disorders such as chronic pain.4,5 There is a large evidence base supporting the efficacy of cognitive behavioral therapy for insomnia (CBT-I) among adults with a diverse range of comorbid physical and psychiatric conditions. In contrast, CBT-I is still in early stages of development within child and adolescent populations.There have been a handful of randomized controlled trials of CBT-I in children and adolescents, showing benefit on improving sleep outcomes.7-9 However, most of these trials and existing...
Study Objectives: This aim of this study was to evaluate oral health and oral health-related quality of life (OHRQoL) in children with obstructive sleep apnea (OSA). Methods: This cross-sectional study involved 31 children who had baseline polysomnography studies and in whom a diagnosis of OSA was made by a sleep physician. They were evaluated against 36 control patients who, based on parent responses to the Pediatric Sleep Questionnaire, were at very low risk for having sleep problems. The mean age of the cohort was 12.3 ± 2.7 years. The oral health status was examined clinically and recorded using caries and periodontal indices. OHRQoL was measured using the Child Oral Health Impact Profile (COHIP) questionnaires. Results: Children with OSA had significantly worsened oral health compared to control patients as evidenced by more caries (15.2 and 3.2, respectively; P < .001) and more periodontitis. Periodontitis severity was measured by the presence of bleeding on probing, (87% versus 30%, P < .001) and higher number of sites with abnormally deep periodontal probing depths (2.7 versus 0.3, P < .001). The COHIP scores were significantly higher among children with OSA compared to control patients, (29.7 versus 11.8, P < .001) consistent with poorer OHRQoL. Conclusions: This study suggests that in children OSA may have a significant association with poorer oral health when compared to control patients without sleep problems, and that their oral health status may have a negative effect on their quality of life. Increased awareness regarding the oral health effects of sleep-disordered breathing in the medical and dental community is needed.
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