Using an extended theory of planned behaviour to investigate sleep impaired driving

Metabotropic Glutamate Receptors of Subtype 5 (mGluR5) and Sleep Homeostasis: Effects of Gene Knock-out and of Selective Negative Allosteric Modulation on EEG, Behavioral and Molecular Variables in Mice

In order to be able to take preventative measures early in life against the development of atherosclerosis, it is important to evaluate profiles of subclinical atherosclerosis, especially among young adults. We screened plasma homocysteine levels, highly sensitive C-reactive protein levels and carotid intima-media thickness in young and elderly adults. Among both young and elderly adults, plasma homocysteine and highly sensitive C-reactive protein were significantly lower in females than in males. Highly sensitive C-reactive protein was significantly lower in young adults than in elderly adults, and homocysteine was lower (but not significantly) in young adults than in elderly adults. Among young adults, mean carotid intima-media thickness was lower (but not significantly) in females than in males. Among elderly adults, mean carotid intima-media thickness was significantly lower in females than in males. Among both males and females, mean carotid intima-media thickness was significantly higher in elderly adults than in young adults. These results demonstrate basic profiles of atherosclerosis markers in young and elderly Japanese adults. Further study is needed to evaluate measures developed for application in early adulthood to prevent atherosclerosis.

Human behavior is organized into 24-hour cycles that are typically composed of about 16 hours of wakefulness and about 8 hours of sleep. Sleep is an essential behavior and is critical for maintaining normal adaptive waking behavior. Both sleep and wake are initiated and maintained by separate and specific neural systems. The sleep-wake cycle is a function of 2 processes--a homeostatic drive for sleep that increases throughout the waking day and an opposing circadian influence that promotes wakefulness centered in the suprachiasmatic nucleus (SCN). A better understanding of the basis for sleep can help treatment and direct research about sleep.

The compensatory reserve is defined as the physiological capacity to compensate for reductions in central blood volume. It is measured by a machine learning algorithm, called CRI, which analyzes continuous changes in the features of a photoplethysmographic signal obtained by finger pulse oximetry. The purpose of this study was 2‐fold. First, we examined the effect of healthy aging on compensatory reserve during normothermic and heat stress conditions. Second, we examined the effect of rapid saline infusion during heat stress on compensatory reserve. Eleven young (6 males/5 females; mean ± SD: age, 25 ± 4 years; height, 165 ± 6 cm; weight, 63 ± 9 kg) and ten aged (4 males/6 females; age, 69 ± 4 years; height, 165 ± 9 cm; weight, 68 ± 9 kg) adults were exposed to central hypovolemia via 15 and 30 mmHg of lower‐body negative pressure (LBNP) under normothermic and heat stress (increase in core temperature of 1.5°C) conditions. Approximately 10 min after the heat stress LBNP challenge, warm saline was rapidly infused (15 ml/kg in ~6 min) while subjects remained hyperthermic. Absolute CRI values (Table) range between 0 and 1, where 0 represents little to no reserve for cardiovascular compensation and 1 represents maximal physiological reserve to compensate for central hypovolemia. Under normothermic conditions, an age × LBNP level interaction was observed (P<0.01). Relative to baseline, CRI was reduced during 15 mmHg LBNP in young (P<0.01) but not aged (P=0.21) adults. During 30 mmHg LBNP, CRI was reduced in both groups (P≤0.01). During whole‐body passive heat stress, CRI was lower relative to normothermic baseline in both groups (P<0.01). During subsequent LBNP, CRI was further reduced in young adults during 15 and 30 mmHg (P<0.01). In aged adults, CRI was further reduced at 30 mmHg during heating (P=0.06), but not at 15mmHg (P=0.27). Relative to heat stress, rapid saline infusion did not affect CRI in young (P=0.47) or aged (P=0.99) adults. These results demonstrate that CRI responses at low levels of central hypovolemia (i.e. 15 mmHg ≈ 250 ml) differ between young and aged adults under normothermic and heat stress conditions. Furthermore, CRI is unaffected by rapid saline infusion performed under heat stress conditions in both young and aged adults.Support or Funding InformationFunded by the Department of Defense (W81XWH‐12‐1‐0152). CRI responses in young and aged adults. Normothermic baseline LBNP15 LBNP30 Heat stress LBNP15 LBNP30 Infusion Young 0.88±0.06 0.77±0.11* 0.53±0.17* 0.43±0.27* 0.31±0.20† 0.18±0.13† 0.40±0.18 Aged 0.84±0.20 0.79±0.21 0.67±0.24* 0.45±0.20* 0.40±0.20 0.35±0.23† 0.41±0.15 Values are mean ± SD. different from baseline at P≤0.05; different from heat stress at P≤0.06.

Perception of Nutrition in Adults with Sickle Cell Disease: Concept Elicitation of Nutritional Status and the Mini Nutrition Assessment

Background and Purpose: Postural-suprapostural task is defined as achievement of a motor or cognitive task performed simultaneously with successful postural control. Due to limited attentional resource, appropriate task prioritization is required for better performance during postural-suprapostural task, especially in elderly adults, who may have decreased attentional capacity and impaired attentional allocation. However, research on the suitable strategy of task prioritization (posture-first (PF) vs. supraposture-first (SF)) in younger and older adults is limited and lacks direct neural evidences. The purpose of this study was to investigate the effects of task-priority strategies on postural-suprapostural performance and its related cortical activity in younger and older populations. Methods: Sixteen younger healthy and sixteen elderly healthy adults were recruited in this study. Each participant was requested to perform a force-matching precision grip task (suprapostural task) while maintaining balance on a stabilometer (postural task) with postural task or suprapostural task as the first-priority task. Both behavioral and cortical data, including task accuracy (postural error and force-matching error), postural ApEn (approximate entropy), reaction time of precision-grip, and event-related potentials (ERPs), including P1, N1, and P2 amplitudes, were recorded. Results and Discussions: With SF strategy, less postural error was found in both younger and older groups. Furthermore, smaller force-matching error and larger postural ApEn were observed under the SF condition in the older group. ERP results revealed a task priority-dependent N1 response, which was smaller in the SF condition, indicating that SF is an efficient strategy for postural-suprapostural control. In addition, besides N1 and P2 waves, P1 positivity was observed only in the older adults, implying more facilitation of sensory processing was invested in the initial preparation phase of postural-suprapostural performance for older adults. Conclusion: SF strategy may be the adequate strategy for both healthy younger and older adults, with better postural-suprapostural accuracy and more efficient attentional allocation than PF strategy. Further study is needed to be confident in this conclusion for patients with neurological disease, such as Parkinson’s disease. Significance and Contribution: The study not only provided an optimal task-priority strategy for healthy adults, especially older adults, to increase their movement quality of postural-suprapostural task, but also gain a better insight to neural correlates of concurrent postural and motor-suprapostural tasks.

In view of my finding that dreams are the precursors of waking life, its blueprint in fact, dreaming and waking must be seen as an interdependent unit. Both are equivalent occurrences with the dream being the primary aspect. This interdependent relationship can best be compared with Einstein’s famous formula of E=mc 2 where E stands for the dream and mc 2 for waking life. For mystics, both states are solipsistic projections . The world is not an objective reality. To argue that it is a permanent and shared experience is based on a double premise . We can’t have the sleeper’s point of view and that of the waking individual at one and the same time. In other words, just as dreams come and go, the waking world disappears as we go to sleep and resurfaces as we wake. Clearly, the world, like our dreams is a cerebral projection . Karl Pribram agrees when he sees the brain as a holographic machine that projects the universe as we wake , in the same way as a holographic plate projects its images in 3D outwards when a laser light strikes it. He states: “ The rules of quantum mechanics apply all the way through to our psychological processes, to what’s going on in the nervous system – then we have an explanation perhaps, certainly we have a parallel to the kind of experiences that people have called spiritual experiences”. The precursor of the holographic plate ‘containing the world’ may be found in a poem by the mystic Shabistari who writes: “Know that the world is a mirror from head to foot, in every atom are a hundred blazing suns”… And as in quantum mechanics, this projection is characterised by ‘omnipresence’ much as it is described in Hindu mysticism: “In the Heaven of Indra, there is said to be a network of pearls so arranged that if you look at one, you see all others reflected in it. In the same way, each object in the world is not merely itself, but involves every other object, and in fact, is every other object”. All this is only possible because we are ‘suspended’ in an all-pervasive medium: CONSCIOUSNESS. Indeed consciousness is the sine qua non of existence. It is therefore the prime factor in any theory of existence. It is in fact that which lends reality to all there is. This is in perfect agreement with quantum mechanics, which states that ‘energy’, typified by an interactive dualism, only ‘coalesces’ to matter as we focus on it. In short, the world cannot exist as such, but only unfolds in a living medium, the mind - in consciousness . In turn, the necessity of a living matrix for the ‘creation’ of the universe underpins the argument that the world only exists while we are awake. It also demonstrates how right Chuang Tzu was when he said: “I and the universe are one”, and such oneness is not just a theoretical unit, but a living whole . In a theory where the world is an objective reality, consciousness emerges from complex computations among neurons. (Hameroff) But the medically induced NDE of Pam Reynolds that was observed by twenty staff assigned to Dr. Spetzler’s operation on Pam and is recorded in detail, demonstrates in incontrovertible terms that consciousness exists outside the brain , and is in fact the fundament of existence . It also demonstrates that consciousness is non-intermittent and hence the only entity that can claim reality status. In fact as E, the creative energy that in quantum mechanics is typified by an interactive dualism, where photons and particles are an ‘hermaphroditic emulsion’ of potentialities, where unitive E is better described as ‘not two’ than as ‘one’, we understand at once that mc 2 , the material expression of E, is never pure matter, but also energy, and ultimately a form of consciousness. Such toppling of our antiquated western perceptions is rocking the foundations of our science. Clearly, a massive paradigm shift is under foot. East and West are moving closer together, paving the way for a new worldview and a new kind of spirituality. In that climate the dream and its function as a messenger will gradually be saved from confusion and underestimation. Indeed, like Hermes, it will eventually be recognised as the messenger of life’s most fundamental information. Instead of being dismissed as Prospero’s vacuous wisps of smoke, it will be recognised, once again, as the DNA of life on earth.

Emotional information rapidly captures our attention and also often invokes automatic response tendencies, whereby positive information motivates approach, while negative information encourages avoidance. However, many circumstances require the need to override or inhibit these automatic responses. Control over responses to emotional information remains largely intact in late life, in spite of age-related declines in cognitive control and inhibition of responses to non-emotional information. The goal of this behavioral study was to understand how the aging process influences emotional response inhibition for positive and negative information in older adults. We examined emotional response inhibition in 36 healthy older adults (ages 60–89) and 44 younger adults (ages 18–22) using an emotional Go/No-Go task presenting happy (positive), fearful (negative), and neutral faces. In both younger and older adults, happy faces produced more approach-related behavior (i.e., fewer misses), while fearful faces produced more avoidance-related behavior, in keeping with theories of approach/avoidance-motivated responses. Calculation of speed/accuracy trade-offs between response times and false alarm rates revealed that younger and older adults both favored speed at the expense of accuracy, most robustly within blocks with fearful faces. However, there was no indication that the strength of the speed/accuracy trade-off differed between younger and older adults. The key finding was that although younger adults were faster to respond to all types of faces, older adults had greater emotional response inhibition (i.e., fewer false alarms). Moreover, younger adults were particularly prone to false alarms for happy faces. This is the first study to directly test effects of aging on emotional response inhibition. Complementing previous literature in the domains of attention and memory, these results provide new evidence that in the domain of response inhibition older adults may more effectively employ emotion regulatory ability, albeit on a slower time course, compared to younger adults. Older adults’ enhanced adaptive emotion regulation strategies may facilitate resistance to emotional distraction. The present study extends the literature of emotional response inhibition in younger adulthood into late life, and in doing so further elucidates how cognitive aging interacts with affective control processes.

The need for sleep, the so-called sleep pressure, increases continuously during wakefulness and decreases during sleep again, in particular during intense deep sleep (Borbely, 1982). This sleep homeostatic process is mediated by the increase and degradation of adenosine in frontal brain structures (Porkka-Heiskanen, 2013). At the behavioural level, it is commonly mirrored in declines of performance under high sleep pressure (Cajochen, Blatter, & Wallach, 2004). 
\n Adenosine is degraded by adenosine deaminase (ADA) (Landolt, 2008). Due to a polymorphism (rs73598374), ADA activity differs inter-individually. Lower ADA activity in G/A- compared to G/G-allele carriers (Battistuzzi, Iudicone, Santolamazza, & Petrucci, 1981)has been associated with a trait-like higher sleep pressure level, indicated by deeper sleep and worse vigilance performance (Bachmann et al., 2012).
\n However, the impact of sleep pressure on several sleep and waking functions depends on circadian phase (Dijk & Franken, 2005): It is potentiated during the night while counteracted during daytime by circadian wake promoting mechanisms. Also, the influence of sleep pressure on neuro-behavioral performance depends on cognitive domain (Van Dongen, Baynard, Maislin, & Dinges, 2004). Performance relying on the frontal lobes, such as executive aspects of working memory (WM), has been suggested to be particularly vulnerable to high sleep pressure (Harrison & Horne, 2000).
\n In a multi-methodological approach we compared thus circadian variations in sleep and in a set of waking functions according to the ADA-genotype. To capture both circadian variations and their interaction with sleep pressure, we compared two 40-h conditions, in which sleep pressure was either kept low by multiple napping (low sleep pressure) or accumulated during sleep deprivation (high sleep pressure). Nap sleep electroencephalographic (EEG) activity, vigilance, WM performance and underlying blood oxygen level-dependent (BOLD) activity was assessed in regular time intervals.
\n Vigilance and WM performance was worse during high as compared to low sleep pressure, particularly during the night. Specifically in executive aspects of WM, sleep pressure-dependent performance modulations were evident in G/A- but not in G/G-allele carriers (Reichert, Maire, Gabel, Viola, et al., 2014). WM performance of G/A-allele carriers benefited during napping in particular from rapid eye movement (REM) sleep duration (Reichert, Maire, Gabel, Hofstetter, et al., 2014). At times of high circadian wake promotion G/A-allele carriers showed a reduced sleep ability, indicating changes of circadian arousal promotion in response to lower ADA activity. Accordingly, we observed at a cerebral level during high circadian sleep promotion, that G/A-allele carriers showed more corti-cal compensatory mechanisms during WM performance to cope with high sleep pressure at night.
\n Overall, the data suggest that the impact of sleep pressure on performance, whether state- or trait-like, is modulated by circadian mechanisms. These mechanisms contribute to a differential resistance or vulnerability to sleep deprivation according to cognitive domain.
\nReferences
\nBachmann, V., Klaus, F., Bodenmann, S., Schafer, N., Brugger, P., Huber, S., . . . Landolt, H. P. (2012). Cerebral Cortex, 22(4), 962-970. doi: bhr173 [pii]10.1093/cercor/bhr173
\nBorbely, A. A. (1982). A two process model of sleep regulation. Hum Neurobiol, 1(3), 195-204. 
\nCajochen, C., Blatter, K., & Wallach, D. (2004). Psychologica Belgica, 44(1/2), 59-80. 
\nDijk, D. J., & Franken, P. (2005). In R. T. Kryger MH, Dement WC (Ed.), Principles and Practice of Sleep Medicine (pp. 418-435). Philadelphia: Elsevier Saunders.
\nHarrison, Y., & Horne, J. A. (2000). J Exp Psychol Appl, 6(3), 236-249. 
\nLandolt, H. P. (2008). Biochem Pharmacol, 75(11), 2070-2079. doi: 10.1016/j.bcp.2008.02.024S0006-2952(08)00104-4 [pii]
\nPorkka-Heiskanen, T. (2013). Curr Opin Neurobiol, 23(5), 799-805. doi: 10.1016/j.conb.2013.02.010
\nReichert, C. F., Maire, M., Gabel, V., Hofstetter, M., Viola, A. U., Kolodyazhniy, V., . . . Schmidt, C. (2014). PLoS One, 9(12), e113734. doi: 10.1371/journal.pone.0113734
\nReichert, C. F., Maire, M., Gabel, V., Viola, A. U., Kolodyazhniy, V., Strobel, W., . . . Schmidt, C. (2014). J Biol Rhythms, 92(2), 119-130. 
\nVan Dongen, H. P., Baynard, M. D., Maislin, G., & Dinges, D. F. (2004). Sleep, 27(3), 423-433. 
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This study compared the doses of sugammadex needed for rapid recovery from deep neuromuscular blockade (NMB) between young and elderly adults. Twenty-two young (20-40yrs) and 22 elderly (≥70yrs) adults were enrolled, and deep NMB of 1-2 post-tetanic counts was maintained with rocuronium intraoperatively. Predetermined doses of sugammadex were given at the end of surgery starting at 4.0mg/kg for the first patient of each group. Doses were decreased or increased in following patients by 0.5mg/kg, depending on the 'success' or 'failure' of rapid recovery in the preceding patient. 'Success' was defined as adequate recovery (train-of-four ratio 0.9) within 2min. after sugammadex administration. The median (range) of ages was 29 (20-40) and 73 (70-84)yrs for the young and elderly adults, respectively. Doses of sugammadex facilitating adequate recovery from deep NMB within 2min. in each patient population with 50% and 95% probability were defined as ED50 and ED95 , respectively. The ED50 estimated by the Dixon's method was significantly higher in the elderly compared to young adults [4.2±0.4mg/kg versus 3.3±0.3mg/kg, p<0.001]. The ED50 (83% CI) estimated by isotonic regression was 4.5 (4.2-5.0)mg/kg in elderly adults and 3.3 (3.2-3.4)mg/kg in young adults. The ED95 (95% CI) estimated by isotonic regression was 5.4 (4.9-5.5)mg/kg and 4.4 (3.9-4.5)mg/kg in the elderly and young adults, respectively. In conclusion, dose adjustments of sugammadex should be considered when rapid recovery from deep NMB is needed in elderly adults.

Objective To analyze the vitamin D status among apparently healthy younger and elder adults in Beijing based on liquid chromatography tandem mass spectrometry. Methods This is an observational study. Participants included 287 apparently healthy young adults(143 males and 144 females) with an average of (32.2±6.9) years old(19-44 years). At the same time 198 middle- and elder-aged adults were recruited [90 males, 108 females, (55.6±7.6) years], and fasting blood samples were collected and serum were isolated. They measured 25-hydroxyvitamin D (25OHD: 25OHD2 and 25OHD3) using liquid chromatography tandem mass spectrometry method. Vitamin D with deficiency, insufficiency, sufficiency and intoxication was categorized as 25OHD <20 ng/ml, 20-30 ng/ml, 30-150 ng/ml, and ≥150 ng/ml, respectively. ALT, Ca, P, Cr, Glu, TG, TC and iPTH wereanalyzed using automatic analyzers.Statistical analysis was performed using SPSS17.0. Results The median 25OHD level in the total studied younger adults was 16.0[2.5%-97.5%: (6.1-29.0) ng/ml] which didn′t show significant difference with that of middle- and elder-aged adults. Younger males had significant higher level of 25OHD than females [17.9(8.3-32.3) ng/ml vs. 14.4(5.4-26.4) ng/ml, Z= -4.238, P<0.01]. Of the total younger subjects, the rate of vitamin D with deficiency (<20 ng/ml), insufficiency (20-30 ng/ml) and sufficiency (≥30 ng/ml) was 72.8%, 25.1%, 2.1%, respectively, while that of middle- and elder-aged adults was 76.3%, 21.2%, 2.5% respectively, and that of younger males was 65.0%, 30.8%, 4.2%, respectively while that of younger females was 80.6%, 19.4%, 0%, respectively. Younger females had significantly higher rate of 25OHD deficiency (χ2=31.766, P<0.01). With adjusting sex, age and BMI, serum iPTH (r= -0.264, P<0.01) was significantly negatively correlated with 25OHD while Cr (r=0.221, P<0.01) showed significantly positively correlation with 25OHD. Conclusion Vitamin D deficiency is prevalent in both younger and elder adults in Beijing, especially in younger females. (Chin J Lab Med, 2017, 40: 689-692) Key words: Vitamin D; Nutritional status; Tandem mass spectrometry; Chromatography, liquid; Young adult; Aged

Functional Assessment in Younger and Older Adults with Sickle Cell Disease

The impact of standing desks within the school classroom on sedentary behaviour, physical activity, health and development

Attempts were made to isolate Clostridium difficile from a total of 431 fecal specimens from 149 young and 213 elderly healthy adults, and 69 elderly adults with cerebrovascular disease but no gastrointestinal disease. C difficile was isolated from 49 specimens, and the frequency of isolation was 15.4% in healthy young adults, 7.0% in healthy elderly adults, and 15.9% in elderly adults with cerebrovascular disease. Thirty-four (about 70%) of the 49 C. difficile strains isolated produced cytotoxin which was neutralized by Clostridium sordellii antitoxin in vitro; in both young and elderly adults approximately 30% of the C. difficile isolates were nontoxigenic. The mean concentration of C. difficile in feces was 10(4.1)/g in young adults and 10(4.6)/g in elderly adults, with a range of 10(2.0) to 10(6.9)/g. Antibody against C. difficile toxin was found in most of the sera obtained from young adults carrying toxigenic C. difficile, but not in sera of elderly adults, no matter how abundant was toxigenic C. difficile in the feces.

Using a lifespan approach, the authors investigated developmental features of the control of ballistic aiming arm movements by manipulating movement complexity, response uncertainty, and the use of precues. Four different age groups of participants (6- and 9-year-old boys and girls and 24- and 73-year- old men and women, 20 participants in each age group) performed 7 types of rapid aiming arm movements on the surface of a digitizer. Their movement characteristics such as movement velocity, normalized jerk, relative timing, movement linearity, and intersegment intervals were profiled. Analyses of variance with repeated measures were conducted on age and task effects in varying movement complexity (Study 1), response uncertainty (Study 2), and precue use (Study 3) conditions. Young children and senior adults had slower, more variant, less smooth, and less linear arm movements than older children and young adults. Increasing the number of movement segments resulted in slower and more variant responses. Movement accuracy demands or response uncertainty interacted with age so that the 6- and 74-year-old participants had poorer performances but responded similarly to the varying treatments. Even though older children and young adults had better performances than young children and senior adults, their arm movement performance declined when response uncertainty increased. The analyses suggested that young children's and senior adults' performances are poorer because less of their movement is under central control, and they therefore use on-line adjustments. In addition, older children and young adults use a valid precue more effectively to prepare for subsequent movements than do young children and senior adults, suggesting that older children and young adults are more capable of organizing motor responses than arc young children and senior adults.