Detection of phenazepam in impaired driving.

Science.gov (United States)

Kerrigan, Sarah; Mellon, Monica Brady; Hinners, Paige

2013-10-01

Phenazepam is a potent 1,4-benzodiazepine that has gained notoriety among recreational drug users. First synthesized in Ukraine in the 1970s, it is one of the most commonly prescribed benzodiazepines in Russia and other commonwealth of independent state nations, where it is used therapeutically as a prescription drug. Reports of abuse are widespread and several European countries have taken steps to control its use. However, in the USA, phenazepam is not approved for use by the Food and Drug Administration, nor scheduled under the Federal Controlled Substances Act. Phenazepam is widely available on the Internet, and recreational drug users report a potency 10-fold greater than that of nordiazepam. We report a case of a 24-year-old male driver who was apprehended for impaired driving following a two-vehicle crash. The subject exhibited slurred speech and profound psychomotor impairment. Toxicology testing revealed phenazepam at a concentration of 76 ng/mL in blood, with no other drugs detected. This case report not only demonstrates the potential for adverse traffic safety consequences following the misuse of phenazepam, but also highlights the importance of analytical factors such as immunoassay cutoff concentration, cross-reactivity and comprehensive screening using chromatographic-based techniques for impaired driving investigations.

Impact of nocturnal heartburn on quality of life, sleep, and productivity: the SINERGE study.

Science.gov (United States)

Calleja, José Luis; Bixquert, M; Maldonado, J

2007-10-01

The aim of the SINERGE study was to assess the impact of nocturnal heartburn on quality of life, sleep, and productivity. Ambulatory patients >/=18 years old and classified as defined cases of nocturnal heartburn (n=337), nonnocturnal heartburn (n=139), uncontrolled hypertension (n=198), and symptomatic depression (n=104) were included in this cross-sectional study. Information on age, gender, body mass index, and comorbidity was collected and the following validated questionnaires were applied: SF-12, Pittsburgh Sleep Quality Index, and Work Productivity and Activity Impairment questionnaire. The prevalence of primary care consultation for heartburn and nocturnal heartburn was 4.7% and 1.9%, respectively. Health-related quality of life, sleep, and productivity were significantly impaired in patients with frequent nocturnal heartburn symptoms as compared with those of the patients without nocturnal symptoms or patients with hypertension. Nocturnal heartburn poses a considerable burden for the sufferer because of the impact on quality of life, sleep, and daily activities.

Older people with mild cognitive impairment -- their views about assessing driving safety.

Science.gov (United States)

Johnson, David A; Frank, Oliver; Pond, Dimity; Stocks, Nigel

2013-05-01

Driving is important for older people to maintain agency, independence and social connectedness. Little research has been conducted into the views of older people with mild cognitive impairment about who decides if they are safe to drive. This qualitative study investigates the views of older people with mild cognitive impairment about decision making on driving cessation. Participants value their agency; they wanted to decide when they should stop driving themselves. However, they were also prepared to accept their general practitioner's advice when they became unfit to drive. In the interim, they self regulated the timing and distance of their driving to reduce accident risk.

The influence of cognitive impairment with no dementia on driving restriction and cessation in older adults.

Science.gov (United States)

Kowalski, Kristina; Love, Janet; Tuokko, Holly; MacDonald, Stuart; Hultsch, David; Strauss, Esther

2012-11-01

Cognitively impaired older adults may be at increased risk of unsafe driving. Individuals with insight into their own impairments may minimize their risk by restricting or stopping driving. The purpose of this study was to examine the influence of cognitive impairment on driving status and driving habits and intentions. Participants were classified as cognitively impaired, no dementia single (CIND-single), CIND-multiple, or not cognitively impaired (NCI) and compared on their self-reported driving status, habits, and intentions to restrict or quit driving in the future. The groups differed significantly in driving status, but not in whether they restricted their driving or reduced their driving frequency. CIND-multiple group also had significantly higher intention to restrict/stop driving than the NCI group. Reasons for restricting and quitting driving were varied and many individuals reported multiple reasons, both external and internal, for their driving habits and intentions. Regardless of cognitive status, none of the current drivers were seriously thinking of restricting or quitting driving in the next 6 months. It will be important to determine, in future research, how driving practices change over time and what factors influence decisions to restrict or stop driving for people with cognitive impairment. Copyright © 2011. Published by Elsevier Ltd.

77 FR 26049 - Reaching Zero: Actions to Eliminate Substance-Impaired Driving Forum

Science.gov (United States)

2012-05-02

... NATIONAL TRANSPORTATION SAFETY BOARD Reaching Zero: Actions to Eliminate Substance-Impaired Driving Forum The National Transportation Safety Board (NTSB) will convene a Public Forum to address Substance-Impaired Driving which will begin at 8:30 a.m., Tuesday, May 15, 2012. NTSB Chairman Deborah A.P...

EARLY ONSET OF DELINQUENCY AND THE TRAJECTORY OF ALCOHOL-IMPAIRED DRIVING AMONG YOUNG MALES*

Science.gov (United States)

Zhang, Lening; Wieczorek, William F.; Welte, John W.

2011-01-01

Building upon the literature in developmental and life-course criminology, the present study assesses the possible association of age onset of delinquency with the trajectory of alcohol-impaired driving using data collected from the three waves of the Buffalo Longitudinal Survey of Young Men (BLSYM). It is argued that as a unique form of delinquency, alcohol-impaired driving among adolescents may be better understood in a broad context of adolescent delinquency involvement. The study adopts the general approach for the analysis of early onset of delinquency and criminal careers in developmental and life-course criminology and hypothesizes that early onset of delinquency is associated with a higher growth of alcohol-impaired driving over time among adolescents when age onsets of alcohol-impaired driving, drinking, and drug use are controlled. Our analysis with the HLM growth modeling method provides support for the hypothesis. Respondents who had an early start in delinquency were likely to have a faster growth of alcohol-impaired driving over the three waves of BLSYM, which implies that these respondents were likely to have a longer path of alcohol-impaired driving in their transition to adulthood. The implication of this finding is discussed. PMID:21831528

Caffeine antagonism of alcohol-induced driving impairment.

Science.gov (United States)

Liguori, A; Robinson, J H

2001-07-01

The extent to which caffeine antagonizes alcohol-induced impairment of simulated automobile driving at the current lowest legal American limit (0.08% BrAC) was the focus of this study. Fifteen adults swallowed a capsule (0, 200, or 400 mg caffeine) then drank a beverage (0.0 or 0.6 g/kg ethanol) in a within-subject, double-blind, randomized procedure. Forty-five minutes later, participants completed a test battery of subjective effects scales, dynamic posturography, critical flicker fusion (CFF), choice reaction time (CRT), divided attention (Stroop test), and simulated driving. Alcohol alone increased ratings of 'dizzy', 'drug effect', and 'high', slowed CRT and brake latency, and increased body sway. Caffeine alone increased ratings of 'alert' and 'jittery', but did not significantly affect body sway or psychomotor performance. Both caffeine doses comparably counteracted alcohol impairment of brake latency but not CRT or body sway. Brake latency with either alcohol-caffeine combination remained significantly longer than that with placebo. Stroop and CFF performance were unaffected by any drug condition. The results suggest that caffeine may increase alertness and improve reaction time after alcohol use but will not completely counteract alcohol impairment in a driver.

Do Adolescents with Specific Language Impairment Understand Driving Terminology?

Science.gov (United States)

Pandolfe, Jessica M.; Wittke, Kacie; Spaulding, Tammie J.

2016-01-01

Purpose: This study examined if adolescents with specific language impairment (SLI) understand driving vocabulary as well as their typically developing (TD) peers. Method: A total of 16 adolescents with SLI and 16 TD comparison adolescents completed a receptive vocabulary task focused on driving terminology derived from statewide driver's manuals.…

77 FR 72677 - National Impaired Driving Prevention Month, 2012

Science.gov (United States)

2012-12-05

... all of us can work to prevent it, visit www.WhiteHouse.gov/ONDCP and www.NHTSA.gov/Impaired . NOW... Driving Prevention Month reminds us of the importance of celebrating safely. Every year, accidents... or drunk driving, and we rededicate ourselves to preventing it this December and throughout the year...

Nocturnal Eating: Association with Binge Eating, Obesity, and Psychological Distress

Science.gov (United States)

Striegel-Moore, Ruth H.; Rosselli, Francine; Wilson, G. Terence; Perrin, Nancy; Harvey, Kate; DeBar, Lynn

2009-01-01

Objective To examine clinical correlates of nocturnal eating, a core behavioral symptom of night eating syndrome. Method Data from 285 women who had participated in a two-stage screening for binge eating were utilized. Women (n = 41) who reported one or more nocturnal eating episodes in the past 28 days on the Eating Disorder Examination and women who did not report nocturnal eating (n =244) were compared on eating disorder symptomatology, Body Mass Index (BMI), and on measures of psychosocial adjustment. Results Nocturnal eaters were significantly more likely to report binge eating and differed significantly from non-nocturnal eaters (with responses indicating greater disturbance) on weight and shape concern, eating concern, self-esteem, depression, and functional impairment, but not on BMI or dietary restraint. Group differences remained significant in analyses adjusting for binge eating. Conclusions This study confirms the association between nocturnal eating and binge eating previously found in treatment seeking samples yet also suggests that the elevated eating disorder symptoms and decreased psychosocial adjustment observed in nocturnal eaters is not simply a function of binge eating. PMID:19708071

Drug and alcohol-impaired driving among electronic music dance event attendees.

Science.gov (United States)

Furr-Holden, Debra; Voas, Robert B; Kelley-Baker, Tara; Miller, Brenda

2006-10-15

Drug-impaired driving has received increased attention resulting from development of rapid drug-screening procedures used by police and state laws establishing per se limits for drug levels in drivers. Venues that host electronic music dance events (EMDEs) provide a unique opportunity to assess drug-impaired driving among a high proportion of young adult drug users. EMDEs are late-night dance parties marked by a substantial number of young adult attendees and elevated drug involvement. No studies to date have examined drug-impaired driving in a natural environment with active drug and alcohol users. Six EMDEs were sampled in San Diego, California, and Baltimore, Maryland. A random sample of approximately 40 attendees per event were administered surveys about alcohol and other drug (AOD) use and driving status, given breath tests for alcohol, and asked to provide oral fluid samples to test for illicit drug use upon entering and exiting the events. Driving status reduced the level of alcohol use (including abstaining) but the impact on drug-taking was not significant. However, 62% of individuals who reported their intention to drive away from the events were positive for drugs or alcohol upon leaving. This suggests that these events and settings are appropriate ones for developing interventions for reducing risks for young adults.

Navigation skill impairment: Another dimension of the driving difficulties in minimal hepatic encephalopathy.

Science.gov (United States)

Bajaj, Jasmohan S; Hafeezullah, Muhammad; Hoffmann, Raymond G; Varma, Rajiv R; Franco, Jose; Binion, David G; Hammeke, Thomas A; Saeian, Kia

2008-02-01

Patients with minimal hepatic encephalopathy (MHE) have attention, response inhibition, and working memory difficulties that are associated with driving impairment and high motor vehicle accident risk. Navigation is a complex system needed for safe driving that requires functioning working memory and other domains adversely affected by MHE. The aim of this study was to determine the effect of MHE on navigation skills and correlate them with psychometric impairment. Forty-nine nonalcoholic patients with cirrhosis (34 MHE+, 15 MHE-; divided on the basis of a battery of block design, digit symbol, and number connection test A) and 48 age/education-matched controls were included. All patients underwent the psychometric battery and inhibitory control test (ICT) (a test of response inhibition) and driving simulation. Driving simulation consisted of 4 parts: (1) training; (2) driving (outcome being accidents); (3) divided attention (outcome being missed tasks); and (4) navigation, driving along a marked path on a map in a "virtual city" (outcome being illegal turns). Illegal turns were significantly higher in MHE+ (median 1; P = 0.007) compared with MHE-/controls (median 0). Patients who were MHE+ missed more divided attention tasks compared with others (median MHE+ 1, MHE-/controls 0; P = 0.001). Similarly, accidents were higher in patients who were MHE+ (median 2.5; P = 0.004) compared with MHE- (median 1) or controls (median 2). Accidents and illegal turns were significantly correlated (P = 0.001, r = 0.51). ICT impairment was the test most correlated with illegal turns (r = 0.6) and accidents (r = 0.44), although impairment on the other tests were also correlated with illegal turns. Patients positive for MHE have impaired navigation skills on a driving simulator, which is correlated with impairment in response inhibition (ICT) and attention. This navigation difficulty may pose additional driving problems, compounding the pre-existing deleterious effect of attention

Relationship of impaired-driving enforcement intensity to drinking and driving on the roads.

Science.gov (United States)

Fell, James C; Waehrer, Geetha; Voas, Robert B; Auld-Owens, Amy; Carr, Katherine; Pell, Karen

2015-01-01

It is principally the area of enforcement that offers the greatest opportunity for reducing alcohol-impaired driving in the near future. How much of a reduction in drinking and driving would be achieved by how much improvement in enforcement intensity? We developed logistic regression models to explore how enforcement intensity (6 different measures) related to the prevalence of weekend nighttime drivers in the 2007 National Roadside Survey who had been drinking (blood alcohol concentration [BAC] ≥ 0.00 g/dl), who had BACs ≥ 0.05 g/dl, and who were driving with an illegal BAC ≥ 0.08 g/dl. Drivers on the roads in our sample of 30 communities who were exposed to fewer than 228 traffic stops per 10,000 population aged 18 and older had 2.4 times the odds of being BAC positive, 3.6 times the odds of driving with a BAC ≥ 0.05, and 3.8 times the odds of driving with a BAC ≥ 0.08 compared to those drivers on the roads in communities with more than 1,275 traffic stops per 10,000 population. Drivers on the roads in communities with fewer than 3.7 driving under the influence (DUI) arrests per 10,000 population had 2.7 times the odds of BAC-positive drivers on the roads compared to communities with the highest intensity of DUI arrest activity (>38 DUI arrests per 10,000 population). The number of traffic stops and DUI arrests per capita were significantly associated with the odds of drinking and driving on the roads in these communities. This might reflect traffic enforcement visibility. The findings in this study may help law enforcement agencies around the country adjust their traffic enforcement intensity to reduce impaired driving in their community. Copyright © 2014 by the Research Society on Alcoholism.

A guide for statewide impaired-driving task forces.

Science.gov (United States)

2009-09-01

The purpose of the guide is to assist State officials and other stakeholders who are interested in establishing an : Impaired-Driving Statewide Task Force or who are exploring ways to improve their current Task Force. The guide : addresses issues suc...

On-road driving impairments and associated cognitive deficits after stroke.

Science.gov (United States)

Devos, Hannes; Tant, Mark; Akinwuntan, Abiodun E

2014-01-01

Little is known about the critical on-road driving skills that get affected after a stroke. The purpose of this study was to investigate the key on-road driving impairments and their associated cognitive deficits after a stroke. A second aim was to investigate if lateralization of stroke impacts results of the cognitive and on-road driving tests. In this cross-sectional study, 99 participants with a first-ever stroke who were actively driving prior to stroke underwent a cognitive battery and a standardized road test that evaluated 13 specific on-road driving skills. These on-road driving skills were mapped onto an existing, theoretical framework that categorized the on-road items into hierarchic clusters of operational, tactical, visuo-integrative, and mixed driving skills. The total score on the road test and the on-road decision, made by a certified fitness-to-drive expert, decided the main outcome. The critical on-road driving skills predicting the on-road decision were identified using logistic regression analysis. Linear regression analysis was employed to determine the cognitive impairments leading to poor total on-road scores. Analyses were repeated for right- and left-sided strokes. In all, 37 persons scored poorly on the road test. These participants performed worse in all hierarchic clusters of on-road driving. Performances on the operational cluster and the visuo-integrative cluster best predicted on-road decisions (R(2) = 0.60). 'Lane changing' and 'understanding, insight, and quality of traffic participation' were the critical skill deficits leading to poor performance on the road test (R(2) = 0.65). Divided attention was the main determinant of on-road scores in the total group (R(2) = 0.06). Participants with right-sided stroke performed worse on visual field, visual neglect, visual scanning, visuo-constructive skills, and divided attention compared with those with left-sided stroke. Divided attention was the main determinant of total on-road scores

Investigating Simulated Driving Errors in Amnestic Single- and Multiple-Domain Mild Cognitive Impairment.

Science.gov (United States)

Hird, Megan A; Vesely, Kristin A; Fischer, Corinne E; Graham, Simon J; Naglie, Gary; Schweizer, Tom A

2017-01-01

The areas of driving impairment characteristic of mild cognitive impairment (MCI) remain unclear. This study compared the simulated driving performance of 24 individuals with MCI, including amnestic single-domain (sd-MCI, n = 11) and amnestic multiple-domain MCI (md-MCI, n = 13), and 20 age-matched controls. Individuals with MCI committed over twice as many driving errors (20.0 versus 9.9), demonstrated difficulty with lane maintenance, and committed more errors during left turns with traffic compared to healthy controls. Specifically, individuals with md-MCI demonstrated greater driving difficulty compared to healthy controls, relative to those with sd-MCI. Differentiating between different subtypes of MCI may be important when evaluating driving safety.

Digest of impaired driving and selected beverage control laws

Science.gov (United States)

2006-04-01

This digest reports the status of State laws that are concerned with impaired driving offenses and alcoholic beverage control. Unless otherwise indicated, the status of the laws reported is January 1, 2006.

Driving Privileges Facilitate Impaired Driving in Those Youths Who Use Alcohol or Marijuana

Science.gov (United States)

Lewis, Todd F.; Scott Olds, R.; Thombs, Dennis L.; Ding, Kele

2009-01-01

The aim of this study was to determine whether possession of a driver's license increases the risk of impaired driving among adolescents who use alcohol or marijuana. An anonymous questionnaire was administered to secondary school students in northeast Ohio across multiple school districts. Logistic regression analyses revealed that after…

Alcohol effects on simulated driving performance and self-perceptions of impairment in DUI offenders.

Science.gov (United States)

Van Dyke, Nicholas; Fillmore, Mark T

2014-12-01

Drivers with a history of driving under the influence (DUI) of alcohol self-report heightened impulsivity and display reckless driving behaviors as indicated by increased rates of vehicle crashes, moving violations, and traffic tickets. Such poor behavioral self-regulation could also increase sensitivity to the disruptive effects of alcohol on driving performance. The present study examined the degree to which DUI drivers display an increased sensitivity to the acute impairing effects of alcohol on simulated driving performance and overestimate their driving fitness following alcohol consumption. Adult drivers with a history of DUI and a demographically matched group of drivers with no history of DUI (controls) were tested following a 0.65 g/kg alcohol and a placebo. Results indicated that alcohol impaired several measures of driving performance, and there was no difference between DUI offenders and controls in these impairments. However, following alcohol, DUI drivers self-reported a greater ability and willingness to drive compared with controls. These findings indicate that drivers with a history of DUI might perceive themselves as more fit to drive after drinking, which could play an important role in their decisions to drink and drive. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Alcohol-impaired driving and its consequences in the United States: the past 25 years.

Science.gov (United States)

Williams, Allan F

2006-01-01

Progress in dealing with the alcohol-impaired driving problem in the United States during the past 25 years is addressed. Trends in various measures of the problem were tracked and a thorough review of the relevant literature conducted. In the 1980s and continuing into the early 1990s, major decreases occurred in alcohol-impaired driving and its consequences. The contribution of alcohol to fatal crashes dropped by 35-40% during this period. Two primary reasons for the decline appear to be the emergence of citizen activist groups that mobilized public support and attention to the problem, and the proliferation of effective laws. Since about 1995 the alcohol-impaired driving problem has stabilized at a reduced but still quite high level. Highway safety organizations and citizen activist groups have continued to highlight the problem, but its status as a social issue has diminished. We basically know what the primary target groups are, and we know measures that would work to reduce the problem if implemented more fully. We know that political leadership, state task forces, and media advocacy are important ingredients in addressing the problem. It is likely that a resurgence in citizen activism will be necessary to foster these elements and refocus the nation on the unfinished battle against alcohol-impaired driving. Alcohol-impaired driving is still a major problem that needs continuing attention.

Age and visual impairment decrease driving performance as measured on a closed-road circuit.

Science.gov (United States)

Wood, Joanne M

2002-01-01

In this study the effects of visual impairment and age on driving were investigated and related to visual function. Participants were 139 licensed drivers (young, middle-aged, and older participants with normal vision, and older participants with ocular disease). Driving performance was assessed during the daytime on a closed-road driving circuit. Visual performance was assessed using a vision testing battery. Age and visual impairment had a significant detrimental effect on recognition tasks (detection and recognition of signs and hazards), time to complete driving tasks (overall course time, reversing, and maneuvering), maneuvering ability, divided attention, and an overall driving performance index. All vision measures were significantly affected by group membership. A combination of motion sensitivity, useful field of view (UFOV), Pelli-Robson letter contrast sensitivity, and dynamic acuity could predict 50% of the variance in overall driving scores. These results indicate that older drivers with either normal vision or visual impairment had poorer driving performance compared with younger or middle-aged drivers with normal vision. The inclusion of tests such as motion sensitivity and the UFOV significantly improve the predictive power of vision tests for driving performance. Although such measures may not be practical for widespread screening, their application in selected cases should be considered.

Should visually impaired people drive slow motorised vehicles? : Evaluation of driving safety in mobility scooters

NARCIS (Netherlands)

Cordes, Christina; Melis-Dankers, Bart; Heutink, Joost; Brookhuis, Karel; Brouwer, Wiebo

2015-01-01

Background: Mobility scooters may help people with motor impairments maintain independent mobility. However, many users have comorbid disorders that can influence their ability to drive safely. Over the past few years, the media have drawn much attention to mobility scooter safety. Visual disorders

Evaluation of responsible beverage service to reduce impaired driving by 21- to 34-year-old drivers.

Science.gov (United States)

2017-04-01

Despite progress in reducing impaired driving, young adult drivers 21 to 34 remain a particularly high-risk group for : involvement in impaired-driving-related crashes. A number of studies have revealed that approximately half of : intoxicated driver...

A review of national television PSA campaigns for preventing alcohol-impaired driving, 1987-1992.

Science.gov (United States)

DeJong, W; Atkin, C K

1995-01-01

We present a content analysis of 137 public service announcements (PSAs) focused on alcohol-impaired driving that aired nationally on U.S. television between 1987 and 1992. Our findings include the following: 1) Most PSAs were intended to reach an undifferentiated general audience, not necessarily those who are at greatest risk for driving after drinking. 2) Most PSAs were designed to create awareness of the problem of alcohol-impaired driving or to promote individual behavior change. 3) More PSAs were developed on the use of designated drivers than on any other subject. 4) About two-thirds of the PSAs included one or more celebrities who speak directly to the audience. Past media campaigns have tended to ignore the fact that people's behavior is profoundly shaped by their environment, which in turn is shaped by public policy. We recommend that future mass media campaigns against alcohol-impaired driving focus on building support for changes in institutional structures, public policy or law that will motivate, support, and sustain the efforts of individuals to alter their behavior. Television PSAs can play an important but somewhat limited role in support of this effort. Greater emphasis will need to be given instead to media advocacy strategies, including paid radio advertising. We further recommend that the principal organizations concerned about alcohol-impaired driving share their plans and develop a common communications strategy that will advance the public policy agenda proposed by the Surgeon General's Workshop on Drunk Driving.

Occupant and Alcohol-Impaired Driving Deaths in States, 2003-2012

Data.gov (United States)

U.S. Department of Health & Human Services — Alcohol-Impaired Driving Fatalities 2003-2012; All persons killed in crashes involving a driver with BAC >= .08 g/dL. Occupant Fatalities 2003-2012; All occupants...

New Mexico’s comprehensive impaired-driving program : crash data analysis.

Science.gov (United States)

2014-03-01

In late 2004, the National Highway Traffic Safety Administration provided funds through a Cooperative Agreement to the New Mexico Department of Transportation to demonstrate a process for implementing a comprehensive State impaired-driving system. NH...

Evaluation of curriculum to improve health professionals' ability to manage age-related driving impairments.

Science.gov (United States)

Hill, Linda L; Rybar, Jill; Styer, Tara

2013-12-01

As our elderly population increases in proportion with respect to the rest of society, age-related driving impairments are increasing in importance as a public health concern. In this context, health professionals play an important role in identifying impaired drivers. This situation is complicated for two reasons: discussion of driving cessation is a sensitive topic for both health professionals and the elderly, and physicians have limited familiarity with the current American Medical Association (AMA) screening guidelines or mandated reporting laws. To assess curriculum that trains health professionals to increase their awareness, screening, management, and reporting of age-related driving impairments. Between 2009 and September 2011, 47 trainings were delivered to 1202 health professionals. The majority of trainings were seminars or lectures lasting 1h; all were conducted in southern California. The training curriculum was divided into four sections: introduction and background; screening and interpretation; managing outcomes and reporting; and referrals and resources. Videos addressed broaching the topic with patients and counseling on driving cessation. The curriculum was delivered by physicians with the support of public health-trained program staff. Pre- and post-testing was done with 641 of the participants; the majority were physicians. Post-training, participants' confidence in ability to screen increased to 72% and intent to screen increased to 55%. Fully 92% stated they had developed a better understanding of California's mandated reporting laws. Similarly, 92% said they had developed a better understanding of the medical conditions and medications that may impair older adults' ability to drive safely. Furthermore, 91% said mandated-reporting laws helped protect the safety of patients and others, and 59% said it was easier to discuss and justify driving cessation with patients. In-person training of health professionals on age-related driving

Effect of indomethacin on desmopressin resistant nocturnal polyuria and nocturnal enuresis.

Science.gov (United States)

Kamperis, Konstantinos; Rittig, Søren; Bower, Wendy F; Djurhuus, Jens C

2012-11-01

We evaluated the acute effect of indomethacin on renal water and solute handling in children with coexisting monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria, and in healthy controls. A total of 23 subjects were recruited, consisting of 12 children with monosymptomatic nocturnal enuresis and nocturnal polyuria with partial or no response to desmopressin, and 11 age matched controls. Children completed a 48-hour inpatient study protocol consisting of fractional urine collections and blood samples. Sodium and water intake were standardized. During the second night a dose of 50 mg indomethacin was administered orally before bedtime. Diuresis, urine osmolalities, clearances and fractional excretions were calculated for sodium, potassium, urea, osmoles and solute-free water. Renin, angiotensin II, aldosterone and atrial natriuretic peptide were measured in plasma. Prostaglandin E(2) was measured in urine. Indomethacin markedly decreased the nocturnal sodium, urea and osmotic excretion in children with enuresis and controls. The overall effect on nocturnal urine output was inconsistent in the group with enuresis. Subjects in whom nocturnal diuresis was decreased following administration of indomethacin remained dry. Prostaglandin inhibition leads to antidiuresis, reducing the amount of sodium, urea and osmotic excretion in children with monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria. The sodium regulating hormones do not seem to mediate these processes. The overall effect in desmopressin nonresponders with nocturnal polyuria is variable. The extent to which indomethacin can be applied in the treatment of enuresis needs further evaluation. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Driving and off-road impairments underlying failure on road testing in Parkinson's disease.

Science.gov (United States)

Devos, Hannes; Vandenberghe, Wim; Tant, Mark; Akinwuntan, Abiodun E; De Weerdt, Willy; Nieuwboer, Alice; Uc, Ergun Y

2013-12-01

Parkinson's disease (PD) affects driving ability. We aimed to determine the most critical impairments in specific road skills and in clinical characteristics leading to failure on a road test in PD. In this cross-sectional study, certified driving assessment experts evaluated specific driving skills in 104 active, licensed drivers with PD using a standardized, on-road checklist and issued a global decision of pass/fail. Participants also completed an off-road evaluation assessing demographic features, disease characteristics, motor function, vision, and cognition. The most important driving skills and off-road predictors of the pass/fail outcome were identified using multivariate stepwise regression analyses. Eighty-six (65%) passed and 36 (35%) failed the on-road driving evaluation. Persons who failed performed worse on all on-road items. When adjusted for age and gender, poor performances on lateral positioning at low speed, speed adaptations at high speed, and left turning maneuvers yielded the best model that determined the pass/fail decision (R(2) = 0.56). The fail group performed poorer on all motor, visual, and cognitive tests. Measures of visual scanning, motor severity, PD subtype, visual acuity, executive functions, and divided attention were independent predictors of pass/fail decisions in the multivariate model (R(2) = 0.60). Our study demonstrated that failure on a road test in PD is determined by impairments in specific driving skills and associated with deficits in motor, visual, executive, and visuospatial functions. These findings point to specific driving and off-road impairments that can be targeted in multimodal rehabilitation programs for drivers with PD. © 2013 Movement Disorder Society.

Effects of different blood alcohol concentrations and post-alcohol impairment on driving behavior and task performance.

Science.gov (United States)

Liu, Yung-Ching; Ho, Chin Heng

2010-08-01

A study using simulator methodology was conducted to investigate the effects of (1) different blood alcohol concentrations (BAC) of 0, 0.05, 0.08, and 0.10 percent and (2) post-alcohol impairment (where BAC approximately 0%) on driving behavior and subsidiary cognitive task performance. Two driving sessions were investigated, that is, drunk driving and post-alcohol driving, with each requiring approximately 20 min of driving. In addition to driving safely, participants were instructed to perform the critical flicker fusion (CFF) test and completed the NASA-TLX mental workload questionnaire. Eight licensed drivers (6 males, 2 females) participated in this 2 (road complexities) x 2 (simulated driving sessions) x 4 (levels of BAC) within-subjects experiment. The study revealed that higher BAC levels were associated with lower performing driving behavior. The driver's mental workload reached the highest values in the post-alcohol session. In terms of tasks involving divided attention, the traffic sign distance estimation showed significant deterioration with increased BAC levels. The relationship between drunk-driving behavior and alcohol dosage was supported in this study. Noticeably, no significant difference was found between drunk driving and post-alcohol driving, indicating that even in the post-alcohol situation, the impairment still remained significant enough to jeopardize traffic safety as much as it does in the case of drunk driving. In real-life situations, adopting a rest-time strategy to avoid post-alcohol impairment effects may not be the most appropriate solution by drivers; rather, drivers should be given some tests to verify the probability of post-alcohol effects on driving.

3 CFR 8461 - Proclamation 8461 of December 2, 2009. National Impaired Driving Prevention Month, 2009

Science.gov (United States)

2010-01-01

... Traffic Safety Administration is again sponsoring the campaign known as “Drunk Driving. Over the Limit..., we are reminded of the importance of driving free from the influence of alcohol and drugs, and we... Impaired Driving Prevention Month, 2009 8461 Proclamation 8461 Presidential Documents Proclamations...

Sensitivity and validity of psychometric tests for assessing driving impairment: effects of sleep deprivation.

Science.gov (United States)

Jongen, Stefan; Perrier, Joy; Vuurman, Eric F; Ramaekers, Johannes G; Vermeeren, Annemiek

2015-01-01

To assess drug induced driving impairment, initial screening is needed. However, no consensus has been reached about which initial screening tools have to be used. The present study aims to determine the ability of a battery of psychometric tests to detect performance impairing effects of clinically relevant levels of drowsiness as induced by one night of sleep deprivation. Twenty four healthy volunteers participated in a 2-period crossover study in which the highway driving test was conducted twice: once after normal sleep and once after one night of sleep deprivation. The psychometric tests were conducted on 4 occasions: once after normal sleep (at 11 am) and three times during a single night of sleep deprivation (at 1 am, 5 am, and 11 am). On-the-road driving performance was significantly impaired after sleep deprivation, as measured by an increase in Standard Deviation of Lateral Position (SDLP) of 3.1 cm compared to performance after a normal night of sleep. At 5 am, performance in most psychometric tests showed significant impairment. As expected, largest effect sizes were found on performance in the Psychomotor Vigilance Test (PVT). Large effects sizes were also found in the Divided Attention Test (DAT), the Attention Network Test (ANT), and the test for Useful Field of View (UFOV) at 5 and 11 am during sleep deprivation. Effects of sleep deprivation on SDLP correlated significantly with performance changes in the PVT and the DAT, but not with performance changes in the UFOV. From the psychometric tests used in this study, the PVT and DAT seem most promising for initial evaluation of drug impairment based on sensitivity and correlations with driving impairment. Further studies are needed to assess the sensitivity and validity of these psychometric tests after benchmark sedative drug use.

Sensitivity and validity of psychometric tests for assessing driving impairment: effects of sleep deprivation.

Directory of Open Access Journals (Sweden)

Stefan Jongen

Full Text Available To assess drug induced driving impairment, initial screening is needed. However, no consensus has been reached about which initial screening tools have to be used. The present study aims to determine the ability of a battery of psychometric tests to detect performance impairing effects of clinically relevant levels of drowsiness as induced by one night of sleep deprivation.Twenty four healthy volunteers participated in a 2-period crossover study in which the highway driving test was conducted twice: once after normal sleep and once after one night of sleep deprivation. The psychometric tests were conducted on 4 occasions: once after normal sleep (at 11 am and three times during a single night of sleep deprivation (at 1 am, 5 am, and 11 am.On-the-road driving performance was significantly impaired after sleep deprivation, as measured by an increase in Standard Deviation of Lateral Position (SDLP of 3.1 cm compared to performance after a normal night of sleep. At 5 am, performance in most psychometric tests showed significant impairment. As expected, largest effect sizes were found on performance in the Psychomotor Vigilance Test (PVT. Large effects sizes were also found in the Divided Attention Test (DAT, the Attention Network Test (ANT, and the test for Useful Field of View (UFOV at 5 and 11 am during sleep deprivation. Effects of sleep deprivation on SDLP correlated significantly with performance changes in the PVT and the DAT, but not with performance changes in the UFOV.From the psychometric tests used in this study, the PVT and DAT seem most promising for initial evaluation of drug impairment based on sensitivity and correlations with driving impairment. Further studies are needed to assess the sensitivity and validity of these psychometric tests after benchmark sedative drug use.

The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: A literature review.

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Jongen, S; Vuurman, E F P M; Ramaekers, J G; Vermeeren, A

2016-04-01

Laboratory tests assessing driving related skills can be useful as initial screening tools to assess potential drug induced impairment as part of a standardized behavioural assessment. Unfortunately, consensus about which laboratory tests should be included to reliably assess drug induced impairment has not yet been reached. The aim of the present review was to evaluate the sensitivity of laboratory tests to the dose dependent effects of alcohol, as a benchmark, on performance parameters. In total, 179 experimental studies were included. Results show that a cued go/no-go task and a divided attention test with primary tracking and secondary visual search were consistently sensitive to the impairing effects at medium and high blood alcohol concentrations. Driving performance assessed in a simulator was less sensitive to the effects of alcohol as compared to naturalistic, on-the-road driving. In conclusion, replicating results of several potentially useful tests and their predictive validity of actual driving impairment should deserve further research. In addition, driving simulators should be validated and compared head to head to naturalistic driving in order to increase construct validity. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Gender differences and demographic influences in perceived concern for driver safety and support for impaired driving countermeasures.

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Butters, Jennifer; Mann, Robert E; Wickens, Christine M; Boase, Paul

2012-12-01

Driving safety, impaired driving, and legislation to address these concerns remain important issues. It is imperative countermeasures be targeted toward the most appropriate groups. This paper explores the potential relationship between gender and driving attitudes toward safety issues and impaired-driving countermeasures. The data are from the 2007 Impaired Driving Survey commissioned by Transport Canada and Mothers Against Drunk Driving (MADD) Canada. The survey is a, stratified by region, telephone survey of 1,514 Canadian drivers 18years of age and older with a valid driver's license who had driven within the past 30days. The findings illustrate a consistent impact of gender on these issues. Other variables were also identified as relevant factors although less consistently. Current findings suggest that strategies for building support for interventions, or for changing risk perception/concern for risky driving behaviors should be tailored by gender to maximize the potential for behavior change. This information may assist program and policy developers through the identification of more or less receptive target groups. Future research directions are also presented. Copyright © 2012 National Safety Council and Elsevier Ltd. All rights reserved.

Understanding the knowledge and attitudes of commercial drivers in Ghana regarding alcohol impaired driving

Science.gov (United States)

Asiamah, G; Mock, C; Blantari, J

2002-01-01

Objectives: The knowledge and attitudes of commercial drivers in Ghana as regards alcohol impaired driving were investigated. This was done in order to provide information that could subsequently be used to develop antidrunk driving social marketing messages built upon the intrinsic values and motivation of these drivers. Methods: Focus group discussions were held with 43 bus and minibus drivers in the capital city, Accra. A structured discussion guide was used to capture information related to values, risk perceptions, leisure time activities, and attitudes on alcohol impaired driving. Results: The majority of drivers expressed an understanding that drunk driving was a significant risk factor for crashes. There was a significant under-appreciation of the extent of the problem, however. Most believed that it was only rare, extremely intoxicated drivers who were the problem. The drivers also had a minimal understanding of the concept of blood alcohol concentration and related legal limits. Despite these factors, there was widespread support for increased enforcement of existing antidrunk driving laws. Conclusions: In Ghana, commercial drivers understand the basic danger of drunk driving and are motivated to assist in antidrunk driving measures. There are misconceptions and deficits in knowledge that need to be addressed in subsequent educational campaigns. PMID:11928975

The role of visual attention in predicting driving impairment in older adults.

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Hoffman, Lesa; McDowd, Joan M; Atchley, Paul; Dubinsky, Richard

2005-12-01

This study evaluated the role of visual attention (as measured by the DriverScan change detection task and the Useful Field of View Test [UFOV]) in the prediction of driving impairment in 155 adults between the ages of 63 and 87. In contrast to previous research, participants were not oversampled for visual impairment or history of automobile accidents. Although a history of automobile accidents within the past 3 years could not be predicted using any variable, driving performance in a low-fidelity simulator could be significantly predicted by performance in the change detection task and by the divided and selection attention subtests of the UFOV in structural equation models. The sensitivity and specificity of each measure in identifying at-risk drivers were also evaluated with receiver operating characteristic curves.

Contributions of physical and cognitive impairments to self-reported driving difficulty in chronic whiplash-associated disorders.

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Takasaki, Hiroshi; Treleaven, Julia; Johnston, Venerina; Jull, Gwendolen

2013-08-15

Cross-sectional. To conduct a preliminary analysis of the physical, cognitive, and psychological domains contributing to self-reported driving difficulty after adjusting for neck pain, dizziness, and relevant demographics in chronic whiplash-associated disorders (WAD) using hierarchical regression modeling. Pain is a risk factor for car crashes, and dizziness may affect fitness to drive. Both symptoms are common in chronic WAD and difficulty driving is a common complaint in this group. Chronic WAD is often accompanied by physical, cognitive, and psychological impairments. These impairments may contribute to self-reported driving difficulty beyond neck pain, dizziness, and relevant demographics. Forty individuals with chronic WAD participated. Dependent variables were the magnitude of self-reported driving difficulty assessed in the strategic, tactical, and operational levels of the Neck Pain Driving Index. Three models were developed to assess the contributions of independent variables (physical, cognitive, and psychological domains) to each of the 3 dependent variables after adjusting for neck pain intensity, dizziness, and driving demographics. The measures included were: physical domain-range and maximum speed of head rotation, performances during gaze stability, eye-head coordination, and visual dependency tests; cognitive domain-self-reported cognitive symptoms including fatigue and the trail making tests; and psychological domain-general stress, traumatic stress, depression, and fear of neck movements and driving. Symptom duration was relevant to driving difficulty in the strategic and tactical levels. The cognitive domain increased statistical power to estimate the strategic and operational levels (P < 0.1) beyond other contributors. The physical domain increased statistical power to estimate the tactical level (P < 0.1) beyond other contributors. Physical and cognitive impairments independently contributed to self-reported driving difficulty in chronic WAD

Cognitive function and unsafe driving acts during an on-road test among community-dwelling older adults with cognitive impairments.

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Hotta, Ryo; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Nakakubo, Sho; Makino, Keitaro; Shimada, Hiroyuki

2018-02-19

To examine the relationship between cognitive function and unsafe driving acts among community-dwelling older adults with cognitive impairments. Participants (n = 160) were older residents of Obu, Japan, aged ≥65 years with cognitive impairments. They regularly drove and were assessed for the number of unsafe driving acts without adequate verification during an on-road test. We also evaluated cognitive function (attention, executive function and processing speed). Other examined variables included demographics, driving characteristics and visual condition. Participants were classified into two groups according to the number of unsafe driving acts as follows: high group (≥4 unsafe driving acts) and low group (≤3 unsafe driving acts). The high group participants were older in age (P age (r = 0.396, P age group. Processing speed was associated with unsafe driving acts that became worse with increasing age. Future study will be required to longitudinally examine the influence of processing speed on traffic accidents for those with cognitive impairments. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

Predicting Alcohol-Impaired Driving among Spanish Youth with the Theory of Reasoned Action.

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Espada, José P; Griffin, Kenneth W; Gonzálvez, María T; Orgilés, Mireia

2015-06-19

Alcohol consumption is a risk factor for motor vehicle accidents in young drivers. Crashes associated with alcohol consumption typically have greater severity. This study examines the prevalence of driving under the influence among Spanish youth and tests the theory of reasoned action as a model for predicting driving under the influence. Participants included 478 Spanish university students aged 17-26 years. Findings indicated that alcohol was the substance most associated with impaired driving, and was involved in more traffic crashes. Men engage in higher levels of alcohol and other drug use, and perceived less risk in drunk driving (p reasoned action as a predictive model of driving under the influence of alcohol among youth in Spain (p < .001) and can help in the design of prevention programs.

Medication impairing safe driving: knowledge, attitude and behaviour of consumers and patients.

NARCIS (Netherlands)

Vervloet, M.; Dijk, L. van

2007-01-01

Background: Promoting road safety is one of the aims of the Dutch road safety policy. The role of medication impairing safe driving (tranquilizers, sleep medication, tricyclic antidepressants and first generation antihistamines) in traffic accidents is underexposed and not well known. Previous

Impaired Driving Performance as Evidence of a Magnocellular Deficit in Dyslexia and Visual Stress.

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Fisher, Carri; Chekaluk, Eugene; Irwin, Julia

2015-11-01

High comorbidity and an overlap in symptomology have been demonstrated between dyslexia and visual stress. Several researchers have hypothesized an underlying or causal influence that may account for this relationship. The magnocellular theory of dyslexia proposes that a deficit in visuo-temporal processing can explain symptomology for both disorders. If the magnocellular theory holds true, individuals who experience symptomology for these disorders should show impairment on a visuo-temporal task, such as driving. Eighteen male participants formed the sample for this study. Self-report measures assessed dyslexia and visual stress symptomology as well as participant IQ. Participants completed a drive simulation in which errors in response to road signs were measured. Bivariate correlations revealed significant associations between scores on measures of dyslexia and visual stress. Results also demonstrated that self-reported symptomology predicts magnocellular impairment as measured by performance on a driving task. Results from this study suggest that a magnocellular deficit offers a likely explanation for individuals who report high symptomology across both conditions. While conclusions about the impact of these disorders on driving performance should not be derived from this research alone, this study provides a platform for the development of future research, utilizing a clinical population and on-road driving assessment techniques. Copyright © 2015 John Wiley & Sons, Ltd.

Driving impairments in teens and adults with attention-deficit/hyperactivity disorder.

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Barkley, Russell A

2004-06-01

Available research provides compelling evidence that ADHD is associated with significantly increased risks for various adverse outcomes while driving, including increased traffic citations (particularly speeding), motor vehicle crashes for which the driver is at fault, repeated crash occurrences,and more severe crashes as determined from dollar damage and likelihood of bodily injuries from the crash. Not surprisingly, teens and adults with ADHD are more likely to have their licenses suspended and even fully revoked. Research further suggests that these driving risks cannot be accounted for by the comorbid disorders likely to be associated with ADHD, such as ODD, conduct disorder (CD), depression, or anxiety, or by lower than normal levels of intelligence. Recent attempts to study the processes or mechanisms involved in driving in adults with ADHD offer some explanation of how the disorder conveys such increased risks. Driving can be conceptualized usefully as involving at least three or more dimensions or levels, including basic cognitive abilities necessary for driving (operational), actual skills for maneuvering the vehicle in traffic (tactical), and the more executive, goal-directed aspects of driving(strategic). The findings of studies indicate that ADHD interferes with the basic operational components of driving by means of the impairments it produces in attention, resistance to distraction, response inhibition, slower and more variable reaction time, and the capacity to follow rules that may compete with ongoing sensory information. Accumulating evidence also points to a problem in the tactical level of driving, such that those with ADHDrate themselves and are rated by others as employing less safe driving habits during their normal operation of a vehicle than are adults in community control groups. Although this has been more elusive to demonstrate through the use of simple laboratory-based driving simulators. more modern virtual reality driving platforms

The Alabama VIP older driver study rationale and design: examining the relationship between vision impairment and driving using naturalistic driving techniques.

Science.gov (United States)

Owsley, Cynthia; McGwin, Gerald; Antin, Jonathan F; Wood, Joanne M; Elgin, Jennifer

2018-02-07

Older drivers aged ≥70 years old have among the highest rates of motor vehicle collisions (MVC) compared to other age groups. Driving is a highly visual task, and older adults have a high prevalence of vision impairment compared to other ages. Most studies addressing visual risk factors for MVCs by older drivers utilize vehicle accident reports as the primary outcome, an approach with several methodological limitations. Naturalistic driving research methods overcome these challenges and involve installing a high-tech, unobtrusive data acquisition system (DAS) in an older driver's own vehicle. The DAS continuously records multi-channel video of driver and roadway, sensor-based kinematics, GPS location, and presence of nearby objects in front of the vehicle, providing an objective measure of driving exposure. In this naturalistic driving study, the purpose is to examine the relationship between vision and crashes and near-crashes, lane-keeping, turning at intersections, driving performance during secondary tasks demands, and the role of front-seat passengers. An additional aim is to compare results of the on-road driving evaluation by a certified driving rehabilitation specialist to objective indicators of driving performance derived from the naturalistic data. Drivers ≥70 years old are recruited from ophthalmology clinics and a previous population-based study of older drivers, with the goal of recruiting persons with wide ranging visual function. Target samples size is 195 drivers. At a baseline visit, the DAS is installed in the participant's vehicle and a battery of health and functional assessments are administered to the driver including visual-sensory and visual-cognitive tests. The DAS remains installed in the vehicle for six months while the participant goes about his/her normal driving with no imposed study restrictions. After six months, the driver returns for DAS de-installation, repeat vision testing, and an on-road driving evaluation by a certified

Diagnosis of cognitive impairment and the assessment of driving safety: a survey of Canterbury GPs.

Science.gov (United States)

Hoggarth, Petra A

2013-12-13

To assess how GPs in Canterbury determine the driving ability of their older patients with cognitive impairment. A 10-item questionnaire was sent to 514 Canterbury GPs via the mail system of three Primary Health Organisations. GPs could either post or fax back responses anonymously and were also able to add their own comments. 185 GPs returned completed questionnaires (36% response rate). Six of 10 items were rated in the middle of the response range, indicating a middling level of agreement. All but three GPs reported using a cognitive screening test and most talked to their patients about the need to plan for driving cessation. GPs did not frequently report referring for on-road driving assessments and many commented they would appreciate a more structured guideline with specific recommendations. There is room for improvement in the amount of information provided to GPs about how to best assess older patients with cognitive impairment for fitness to drive. Recommendations of specific cognitive screens and a flowchart format would be a valuable addition.

Assessment of memory/attention impairment in children with primary nocturnal enuresis: A voxel-based morphometry study

International Nuclear Information System (INIS)

Yu, Bing; Kong, Fanxing; Peng, Miao; Ma, Hongwei; Liu, Na; Guo, Qiyong

2012-01-01

Aim: Assessment of memory/attention impairment and related exploration of the gray matter differential MR density variations between children with and without primary nocturnal enuresis (PNE) using voxel-based morphometry (VBM) methodology is the aim of the present study. Methods: A total of 75 right-handed PNE children (M/F = 39:36, average age 10.4 ± 1.3 years) and 72 age-matched, right-handed, healthy controls (M/F = 40:32, 10.0 ± 1.2 years) were recruited for the study. First, intelligence tests were performed using the China-Wechsler Intelligence Scale for Children (C-WISC) in both PNE and control children. The full intelligence quotient (FIQ), verbal IQ (VIQ), performance IQ (PIQ), and memory/caution (M/C) factor were measured. Voxel-based morphometry (VBM) was performed using high resolution 3 Tesla T1-weighted MR images, processed using VBM5 in the PNE and control children. Student's t-test or Mann–Whitney U test were performed to analyze the difference in the gray matter density (GMD) between the PNE and control children. Results: The FIQ, VIQ, and PIQ in the PNE group were within the normal range and did not significantly differ from the control group, though the M/C factor was statistically lower in the PNE group. Compared with normal controls, PNE children exhibited lower GMD in the right dorsolateral prefrontal cortex (DLPFC) and the left cerebellum (P < 0.001). Conclusion: Impairment in memory/attention was detected in PNE children, and the structural abnormalities of the right DLPFC and left cerebellum are likely to be implicated in these deficits.

Impaired driving from medical conditions: A 70-year-old man trying to decide if he should continue driving

Science.gov (United States)

Rizzo, Matthew

2012-01-01

Some medical disorders can impair performance, increasing the risk of driving safety errors that can lead to vehicle crashes. The causal pathway often involves a concatenation of factors or events, some of which can be prevented or controlled. Effective interventions can operate before, during, or after a crash occurs at the levels of driver capacity, vehicle and road design, and public policy. A variety of systemic, neurological, psychiatric, and developmental disorders put drivers at potential increased risk of a car crash in the short or long term. Medical diagnosis and age alone are usually insufficient criteria for determining fitness to drive. Strategies are needed for determining what types and levels of reduced function provide a threshold for disqualification in drivers with medical disorders. Evidence of decreased mileage, self-restriction to driving in certain situations, collisions, moving violations, aggressive driving, sleepiness, alcohol abuse, metabolic disorders, and multiple medications may trigger considerations of driver safety. A general framework for evaluating driver fitness relies on a functional evaluation of multiple domains (cognitive, motor, perceptual, and psychiatric) that are important for safe driving and can be applied across many disorders, including conditions that have rarely been studied with respect to driving, and in patients with multiple conditions and medications. Neurocognitive tests, driving simulation, and road tests provide complementary sources of evidence to evaluate driver safety. No single test is sufficient to determine who should drive and who should not. PMID:21364126

Impaired driving from medical conditions: a 70-year-old man trying to decide if he should continue driving.

Science.gov (United States)

Rizzo, Matthew

2011-03-09

Some medical disorders can impair performance, increasing the risk of driving safety errors that can lead to vehicle crashes. The causal pathway often involves a concatenation of factors or events, some of which can be prevented or controlled. Effective interventions can operate before, during, or after a crash occurs at the levels of driver capacity, vehicle and road design, and public policy. A variety of systemic, neurological, psychiatric, and developmental disorders put drivers at potential increased risk of a car crash in the short or long term. Medical diagnosis and age alone are usually insufficient criteria for determining fitness to drive. Strategies are needed for determining what types and levels of reduced function provide a threshold for disqualification in drivers with medical disorders. Evidence of decreased mileage, self-restriction to driving in certain situations, collisions, moving violations, aggressive driving, sleepiness, alcohol abuse, metabolic disorders, and multiple medications may trigger considerations of driver safety. A general framework for evaluating driver fitness relies on a functional evaluation of multiple domains (cognitive, motor, perceptual, and psychiatric) that are important for safe driving and can be applied across many disorders, including conditions that have rarely been studied with respect to driving, and in patients with multiple conditions and medications. Neurocognitive tests, driving simulation, and road tests provide complementary sources of evidence to evaluate driver safety. No single test is sufficient to determine who should drive and who should not.

Persistence of addictive disorders in a first-offender driving while impaired population.

Science.gov (United States)

Lapham, Sandra C; Stout, Robert; Laxton, Georgia; Skipper, Betty J

2011-11-01

We compared the prevalence of alcohol use and other psychiatric disorders in offenders 15 years after a first conviction for driving while impaired with a general population sample. To determine whether high rates of addictive and other psychiatric disorders previously demonstrated in this sample remain disproportionately higher compared with a matched general population sample. Point-in-time cohort study. Pacific Institute for Research and Evaluation, Albuquerque, New Mexico. We interviewed convicted first offenders using the Composite International Diagnostic Interview 15 years after referral to a screening program in Bernalillo County, New Mexico. We calculated rates of diagnoses for non-Hispanic white and Hispanic women (n = 362) and men (n = 220) adjusting for missing data using multiple imputation and compared psychiatric diagnoses with findings from the National Comorbidity Survey Replication by sex and Hispanic ethnicity. Eleven percent of non-Hispanic white women and 12.8% of Hispanic women in the driving while impaired sample reported 12-month alcohol abuse or dependence, compared with 1.0% and 1.8%, respectively, in the National Comorbidity Survey Replication (comparison) sample. Almost 12% of non-Hispanic white men and 17.5% of Hispanic men in the driving while impaired sample reported 12-month alcohol abuse or dependence, compared with to 2.0% and 1.8%, respectively, in the comparison sample. These differences were statistically significant. Rates of drug use disorders and nicotine dependence were also elevated compared with the general population sample, while rates of major depressive disorder and posttraumatic stress disorder were similar. In this sample, high rates of addictive disorders persisted over 10 years among first offenders and greatly exceeded those found in a general population sample.

Clock drawing as a screen for impaired driving in aging and dementia: is it worth the time?

Science.gov (United States)

Manning, Kevin J; Davis, Jennifer D; Papandonatos, George D; Ott, Brian R

2014-02-01

Clock drawing is recommended by medical and transportation authorities as a screening test for unsafe drivers. The objective of the present study was to assess the usefulness of different clock drawing systems as screening measures of driving performance in 122 healthy and cognitively impaired older drivers. Clock drawing was measured using four different scoring systems. Driving outcomes included global ratings of safety and the error rate on a standardized on-road test. Findings revealed that clock drawing was significantly correlated with the driving score on the road test for each of the scoring systems. However, receiver operator curve analyses showed limited clinical utility for clock drawing as a screening instrument for impaired on-road driving performance with the area under the curve ranging from 0.53 to 0.61. Results from this study indicate that clock drawing has limited utility as a solitary screening measure of on-road driving, even when considering a variety of scoring approaches.

Retraining moderately impaired stroke survivors in driving-related visual attention skills.

Science.gov (United States)

Akinwuntan, Abiodun E; Devos, Hannes; Verheyden, Geert; Baten, Guido; Kiekens, Carlotte; Feys, Hilde; De Weerdt, Willy

2010-01-01

Visual inattention is a major cause of road accidents and is a problem commonly experienced after stroke. This study investigated the effects of 2 training programs on performance in the Useful Field of View (UFOV), a validated test of driving-related visual attention skills. Data from 69 first-ever, moderately impaired stroke survivors who participated in a randomized controlled trial (RCT) to determine the effects of simulator training on driving after stroke were analyzed. In addition to regular interventions at a rehabilitation center, participants received 15 hours of either simulator-based driving-related training or non-computer-based cognitive training over 5 weeks. Total percentage reduction in UFOV and performance in divided and selective attention and speed of processing subtests were documented at 6 to 9 weeks (pretraining), 11 to 15 weeks (posttraining), and 6 months post stroke (follow-up). Generalized estimating equation (GEE) model revealed neither group effects nor significant interaction effects of group with time in the UFOV total score and the 3 subtests. However, there were significant within-group improvements from pre- through posttraining to follow-up for all the UFOV parameters. Post-hoc GEE analysis revealed that most improvement in both groups occurred from pre- to posttraining. Both training programs significantly improved visual attention skills of moderately impaired stroke survivors after 15 hours of training and retention of benefit lasted up to 6 months after stroke. Neither of the training programs was better than the other.

Current management of nocturnal enuresis.

Science.gov (United States)

Robson, Wm Lane M

2008-07-01

Nocturnal enuresis is an especially common problem with the potential to have an appreciable negative impact on the emotional health of a child. Our understanding of the pathogenesis continues to improve. A disorder of sleep arousal, a low nocturnal bladder capacity, and nocturnal polyuria are the three factors that interrelate to cause nocturnal enuresis. Constipation is a very common and often unrecognized factor that appreciably affects bladder function. Successful treatment involves interventions that simultaneously improve these factors. Self-esteem improves with any form of therapy and dryness is possible for the majority of children.

Assessment of Driving Safety in Older Adults with Mild Cognitive Impairment.

Science.gov (United States)

Anstey, Kaarin J; Eramudugolla, Ranmalee; Chopra, Sidhant; Price, Jasmine; Wood, Joanne M

2017-01-01

With population aging, drivers with mild cognitive impairment (MCI) are increasing; however, there is little evidence available regarding their safety. We aimed to evaluate risk of unsafe on-road driving performance among older adults with MCI. The study was a cross-sectional observational study, set in Canberra, Australia. Participants were non-demented, current drivers (n = 302) aged 65 to 96 years (M = 75.7, SD = 6.18, 40% female) recruited through the community and primary and tertiary care clinics. Measures included a standardized on-road driving test (ORT), a battery of screening measures designed to evaluate older driver safety (UFOV®, DriveSafe, Multi-D), a neurocognitive test battery, and questionnaires on driving history and behavior. Using Winblad criteria, 57 participants were classified as having MCI and 245 as cognitively normal (CN). While the MCI group had a significantly lower overall safety rating on the ORT (5.61 versus 6.05, p = 0.03), there was a wide range of driving safety scores in the CN and MCI groups. The MCI group performed worse than the CN group on the off-road screening tests. The best fitting model of predictors of ORT performance across the combined sample included age, the Multi-D, and DriveSafe, classifying 90.4% of the sample correctly. Adults with MCI exhibit a similar range of driving ability to CN adults, although on average they scored lower on off-road and on-road assessments. Driving specific tests were more strongly associated with safety ratings than traditional neuropsychological tests.

Getting a good night sleep? The importance of recognizing and treating nocturnal hypokinesia in Parkinson's disease.

Science.gov (United States)

Bhidayasiri, Roongroj; Trenkwalder, Claudia

2018-01-05

When Parkinson's disease (PD) patients are asked about the quality of their sleep, their answers are dominated by difficulties associated with impaired mobility in bed, medically referred to as nocturnal hypokinesia. Nocturnal hypokinesia is symptomatic from the mid-stage of the disease, affecting up to 70% of PD patients, and contributes to poor sleep quality, and increased carer burden. Here we explore four areas of nocturnal hypokinesia that are relevant to clinical practice, namely: manifestations and definition; clinical assessment and objective monitoring; etiologies and contributing factors; and evidence-based therapeutic approaches. In addition, we provide an operational definition of what constitutes nocturnal hypokinesia and outline different methods of assessment, ranging from clinical interviews and rating scales to objective night-time monitoring with inertial sensors. Optimal management of nocturnal hypokinesia in PD begins with recognizing its manifestation by inquiring about cardinal symptoms and contributing factors from, not only patients, but also carers, followed by formal assessment, and the application of individualized evidence-based treatment. Night-time dopaminergic treatment is the primary therapy; however, careful clinical judgment is required to balance the benefits with the potential adverse events related to nocturnal dopaminergic stimulation. Future studies are needed to explore the practicality of home-based objective assessment of nocturnal hypokinesia, new therapeutic options not limited to dopaminergic medications, and non-pharmacologic approaches, including training on compensatory strategies and bedroom adaptations. Copyright © 2018 Elsevier Ltd. All rights reserved.

Nocturnal continuous glucose monitoring

DEFF Research Database (Denmark)

Bay, Christiane; Kristensen, Peter Lommer; Pedersen-Bjergaard, Ulrik

2013-01-01

Abstract Background: A reliable method to detect biochemical nocturnal hypoglycemia is highly needed, especially in patients with recurrent severe hypoglycemia. We evaluated reliability of nocturnal continuous glucose monitoring (CGM) in patients with type 1 diabetes at high risk of severe...

Assessment of memory/attention impairment in children with primary nocturnal enuresis: A voxel-based morphometry study

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Yu, Bing, E-mail: yubing@sj-hospital.org [Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Kong, Fanxing, E-mail: kongfx@sj-hospital.org [Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Peng, Miao, E-mail: pengm@sj-hospital.org [Psychological Outpatient Service, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Ma, Hongwei, E-mail: mahongwei1960@hotmail.com [Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Liu, Na, E-mail: liuna.916@163.com [Department of Radiology, the People' s Hospital of Liaoning Province, Shenyang 110016 (China); Guo, Qiyong, E-mail: guoqy@sj-hospital.org [Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004 (China)

2012-12-15

Aim: Assessment of memory/attention impairment and related exploration of the gray matter differential MR density variations between children with and without primary nocturnal enuresis (PNE) using voxel-based morphometry (VBM) methodology is the aim of the present study. Methods: A total of 75 right-handed PNE children (M/F = 39:36, average age 10.4 ± 1.3 years) and 72 age-matched, right-handed, healthy controls (M/F = 40:32, 10.0 ± 1.2 years) were recruited for the study. First, intelligence tests were performed using the China-Wechsler Intelligence Scale for Children (C-WISC) in both PNE and control children. The full intelligence quotient (FIQ), verbal IQ (VIQ), performance IQ (PIQ), and memory/caution (M/C) factor were measured. Voxel-based morphometry (VBM) was performed using high resolution 3 Tesla T1-weighted MR images, processed using VBM5 in the PNE and control children. Student's t-test or Mann–Whitney U test were performed to analyze the difference in the gray matter density (GMD) between the PNE and control children. Results: The FIQ, VIQ, and PIQ in the PNE group were within the normal range and did not significantly differ from the control group, though the M/C factor was statistically lower in the PNE group. Compared with normal controls, PNE children exhibited lower GMD in the right dorsolateral prefrontal cortex (DLPFC) and the left cerebellum (P < 0.001). Conclusion: Impairment in memory/attention was detected in PNE children, and the structural abnormalities of the right DLPFC and left cerebellum are likely to be implicated in these deficits.

[Pain patients in street traffic. Do analgesics impair driving safety?].

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Sohn, W

2003-06-05

Analgesics--in particular when self-prescribed or taken over the long term--may have a negative effect on safety on the road. This applies not only to vehicle drivers, but also to cyclists and pedestrians. Psychotropic effects of analgesics of all three WHO categories play a major causal role. Impairments may take the form of sleepiness, impaired vision, giddiness, loss of muscular tone or cardiovascular reactions. On the other hand, untreated severe pain has a high risk potential, since it may reduce both cognitive and psychomotoric performance. During the stabilization phase or dose adjustment of opioids, the patient must cautioned not to drive, and particular care must be taken in patients on concomitant or long-term medication or drinking excessive alcohol. In the last resort, the prescription of an analgesic is an individual decision involving both physician and patient.

The effect of dexlansoprazole MR on nocturnal heartburn and GERD-related sleep disturbances in patients with symptomatic GERD.

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Fass, Ronnie; Johnson, David A; Orr, William C; Han, Cong; Mody, Reema; Stern, Kathleen N; Pilmer, Betsy L; Perez, M Claudia

2011-03-01

Nocturnal heartburn and related sleep disturbances are common among patients with gastroesophageal reflux disease (GERD). This study evaluated the efficacy of dexlansoprazole MR 30 mg in relieving nocturnal heartburn and GERD-related sleep disturbances, improving work productivity, and decreasing nocturnal symptom severity in patients with symptomatic GERD. Patients (N=305) with frequent, moderate-to-very severe nocturnal heartburn and associated sleep disturbances were randomized 1:1 in a double-blind fashion to receive dexlansoprazole MR or placebo once daily for 4 weeks. The primary end point was the percentage of nights without heartburn. Secondary end points were the percentage of patients with relief of nocturnal heartburn and of GERD-related sleep disturbances over the last 7 days of treatment. At baseline and week 4/final visit, patients completed questionnaires that assessed sleep quality, work productivity, and the severity and impact of nocturnal GERD symptoms. Dexlansoprazole MR 30 mg (n=152) was superior to placebo (n=153) in median percentage of nights without heartburn (73.1 vs. 35.7%, respectively; Pheartburn and GERD-related sleep disturbances (47.5 vs. 19.6%, 69.7 vs. 47.9%, respectively; Pheartburn, in reducing GERD-related sleep disturbances and the consequent impairments in work productivity, and in improving sleep quality/quality of life.

Prevalence and comorbidity of nocturnal wandering in the U.S. adult general population.

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Pressman, Mark R

2013-01-08

As noted by Ohayon et al., nocturnal wandering (NW) is not synonymous with sleepwalking. NW may also refer to wandering during the night due to epilepsy. Alcohol intoxication can also result in drunken behavior while awake, but this type of cognitive impairment may be undistinguishable from other forms of NW. Dementia and CNS drug effects can also result in NW.

Comparative Effects of an Angiotensin II Receptor Blocker (ARB)/Diuretic vs. ARB/Calcium-Channel Blocker Combination on Uncontrolled Nocturnal Hypertension Evaluated by Information and Communication Technology-Based Nocturnal Home Blood Pressure Monitoring　- The NOCTURNE Study.

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Kario, Kazuomi; Tomitani, Naoko; Kanegae, Hiroshi; Ishii, Hajime; Uchiyama, Kazuaki; Yamagiwa, Kayo; Shiraiwa, Toshihiko; Katsuya, Tomohiro; Yoshida, Tetsuro; Kanda, Kiyomi; Hasegawa, Shinji; Hoshide, Satoshi

2017-06-23

Nocturnal blood pressure (BP) is an independent risk factor of cardiovascular events. The NOCTURNE study, a multicenter, randomized controlled trial (RCT) using our recently developed information and communication technology (ICT) nocturnal home BP monitoring (HBPM) device, was performed to compare the nocturnal HBP-lowering effects of differential ARB-based combination therapies in 411 Japanese patients with nocturnal hypertension (HT).Methods and Results:Patients with nocturnal BP ≥120/70 mmHg at baseline even under ARB therapy (100 mg irbesartan daily) were enrolled. The ARB/CCB combination therapy (irbesartan 100 mg+amlodipine 5 mg) achieved a significantly greater reduction in nocturnal home systolic BP (primary endpoint) than the ARB/diuretic combination (daily irbesartan 100 mg+trichlormethiazide 1 mg) (-14.4 vs. -10.5 mmHg, P<0.0001), independently of urinary sodium excretion and/or nocturnal BP dipping status. However, the change in nocturnal home systolic BP was comparable among the post-hoc subgroups with higher salt sensitivity (diabetes, chronic kidney disease, and elderly patients). This is the first RCT demonstrating the feasibility of clinical assessment of nocturnal BP by ICT-nocturnal HBPM. The ARB/CCB combination was shown to be superior to ARB/diuretic in patients with uncontrolled nocturnal HT independently of sodium intake, despite the similar impact of the 2 combinations in patients with higher salt sensitivity.

Nocturnal Polyuria: Excess of Nocturnal Urine Production, Excess of Definitions-Influence on Renal Function Profile.

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Goessaert, An-Sofie; Walle, Johan Vande; Bosch, Ruud; Hoebeke, Piet; Everaert, Karel

2016-03-01

This study aimed to identify important differences in renal function profile, and potential water and sodium diuresis cutoffs among participants with nocturnal polyuria according to nocturnal polyuria definitions. This post hoc analysis was based on a prospective study in which participants completed a bladder diary, collected urine and provided a blood sample. With an age dependent nocturnal polyuria index greater than 20% to 33% as the referent 4 definitions of nocturnal polyuria were compared, including 1) nocturnal polyuria index greater than 33%, 2) nocturnal urine production greater than 90 ml per hour and 3) greater than 10 ml/kg, and 4) nocturia index greater than 1.5. In 112 male and female participants significant differences in baseline characteristics and bladder diary parameters were found according to definition. Diuresis rate, free water clearance and sodium clearance had similar 24-hour courses in the subgroups with and without polyuria by each definition. The range varied more in the subgroup with vs without polyuria, especially at night for diuresis rate and free water clearance. At night the latter decreased in the polyuria subgroup based on each definition (p polyuria subgroups was found only for urine production greater than 90 ml per hour and polyuria index greater than 20% to 33%. For each definition sodium clearance remained high in the polyuria subgroup, which differed significantly from the no polyuria subgroups (p polyuria by definition. The renal function profile indicating the pathophysiological mechanism of nocturnal polyuria did not seem to be influenced by definition but free water clearance and sodium clearance cutoff sensitivity differed substantially. These results must be confirmed in a larger homogeneous sample. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Nocturnality constrains morphological and functional diversity in the eyes of reef fishes

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Schmitz Lars

2011-11-01

Full Text Available Abstract Background Ambient light levels are often considered to drive the evolution of eye form and function. Diel activity pattern is the main mechanism controlling the visual environment of teleost reef fish, with day-active (diurnal fish active in well-illuminated conditions, whereas night-active (nocturnal fish cope with dim light. Physiological optics predicts several specific evolutionary responses to dim-light vision that should be reflected in visual performance features of the eye. Results We analyzed a large comparative dataset on morphological traits of the eyes in 265 species of teleost reef fish in 43 different families. The eye morphology of nocturnal reef teleosts is characterized by a syndrome that indicates better light sensitivity, including large relative eye size, high optical ratio and large, rounded pupils. Improved dim-light image formation comes at the cost of reduced depth of focus and reduction of potential accommodative lens movement. Diurnal teleost reef fish, released from the stringent functional requirements of dim-light vision have much higher morphological and optical diversity than nocturnal species, with large ranges of optical ratio, depth of focus, and lens accommodation. Conclusions Physical characteristics of the environment are an important factor in the evolution and diversification of the vertebrate eye. Both teleost reef fish and terrestrial amniotes meet the functional requirements of dim-light vision with a similar evolutionary response of morphological and optical modifications. The trade-off between improved dim-light vision and reduced optical diversity may be a key factor in explaining the lower trophic diversity of nocturnal reef teleosts.

Nocturnal Polyuria : Excess of Nocturnal Urine Production, Excess of Definitions-Influence on Renal Function Profile

NARCIS (Netherlands)

Goessaert, An-Sofie; Walle, Johan Vande; Bosch, JLHR; Hoebeke, Piet; Everaert, Karel

2016-01-01

PURPOSE: This study aimed to identify important differences in renal function profile, and potential water and sodium diuresis cutoffs among participants with nocturnal polyuria according to nocturnal polyuria definitions. MATERIALS AND METHODS: This post hoc analysis was based on a prospective

Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development.

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Hill, Catherine Mary; Baya, Ana; Gavlak, Johanna; Carroll, Annette; Heathcote, Kate; Dimitriou, Dagmara; L'Esperance, Veline; Webster, Rebecca; Holloway, John; Virues-Ortega, Javier; Kirkham, Fenella Jane; Bucks, Romola Starr; Hogan, Alexandra Marie

2016-05-01

Physiological adaptation to high altitude hypoxia may be impaired in Andeans with significant European ancestry. The respiratory 'burden' of sleep may challenge adaptation, leading to relative nocturnal hypoxia. Developmental aspects of sleep-related breathing in high-altitude native children have not previously been reported. We aimed to determine the influence of development on diurnal-nocturnal oxyhemoglobin differences in children living at high altitude. This was a cross-sectional, observational study. Seventy-five healthy Bolivian children aged 6 mo to 17 y, native to low altitude (500 m), moderate high altitude (2,500 m), and high altitude (3,700 m) were recruited. Daytime resting pulse oximetry was compared to overnight recordings using Masimo radical oximeters. Genetic ancestry was determined from DNA samples. Children had mixed European/Amerindian ancestry, with no significant differences between altitudes. Sixty-two participants had ≥ 5 h of nocturnal, artifact-free data. As predicted, diurnal mean oxyhemoglobin saturation decreased across altitudes (infants and children, both P sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our observations. © 2016 Associated Professional Sleep Societies, LLC.

Nitroglycerin-mediated, but not flow-mediated vasodilation, is associated with blunted nocturnal blood pressure fall in patients with resistant hypertension.

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Fontes-Guerra, Priscila C A; Cardoso, Claudia R L; Muxfeldt, Elizabeth S; Salles, Gil F

2015-08-01

Endothelial function by flow-mediated (FMD) and nitroglycerin-mediated vasodilations (NMD) was scarcely investigated in resistant hypertension. We aimed to assess the independent correlates of FMD and NMD in resistant hypertensive patients, particularly their associations with ambulatory blood pressures (BP) and nocturnal BP fall patterns. In a cross-sectional study, 280 resistant hypertensive patients performed 24-h ambulatory BP monitoring, carotid-femoral pulse wave velocity, polysomnography, and brachial artery FMD and NMD by high-resolution ultrasonography. Independent correlates of FMD, NMD, and brachial artery diameter (BAD) were assessed by multiple linear and logistic regressions. Median (interquartile range) FMD was 0.75% (-0.6 to +4.4%) and NMD was 11.8% (7.1-18.4%). Baseline BAD and diabetes were independently associated with both FMD and NMD. Older age and prior cardiovascular diseases were associated with altered FMD, whereas higher night-time SBP and lower nocturnal SBP fall were associated with impaired NMD. Moreover, there was a significant gradient of impaired NMD according to blunted nocturnal BP decline patterns. BAD was independently associated with age, sex, BMI, albuminuria, and nocturnal SBP fall. Further adjustments to blood flow velocity, aortic stiffness, plasma aldosterone concentration, and sleep apnea did not change these relationships. NMD, but not FMD, is independently associated with unfavorable night-time BP levels and nondipping patterns, and may be a better cardiovascular risk marker in patients with resistant hypertension. BAD also may provide additional prognostic information.

Nocturnal Hypertension and Attenuated Nocturnal Blood Pressure Dipping is Common in Pediatric Lupus

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Campbell, J. Fallon; Swartz, Sarah J.; Wenderfer, Scott E.

2015-01-01

Hypertension is an important manifestation of systemic lupus erythematosus (SLE) but reports of prevalence vary between 20-70% in published reports of adult and pediatric patients. For both children and adults with SLE, the clinical diagnosis and management of hypertension has traditionally been based on guidelines developed for the general population. In clinical trials, the criteria used for defining participants with hypertension are mostly undefined. As a first step towards formally assessing the blood pressure (BP) patterns of children diagnosed with SLE, 24-hr ambulatory BP monitoring data was analyzed on clinic patients who presented with prehypertension or stage I hypertension. In this pediatric SLE cohort (n=10), 20% met daytime criteria for a diagnosis of hypertension. Patterns of BP elevation varied widely with white coat, masked, isolated systolic, and diastolic nocturnal hypertension all identified. Nocturnal hypertension was detected in 60% and attenuated nocturnal BP dipping in 90% of both hypertensive and normotensive SLE patients. In SLE patients, the median nighttime systolic and diastolic loads were 25% and 15.5% compared with median daily loads of 12.5% and 11.5%. Daytime and nighttime systolic and diastolic BP load and nocturnal dipping was compared to a control population consisting of 85 non-SLE patients under 21 years old with prehypertension or stage 1 hypertension presenting to hypertension clinic. Median systolic BP dipped 5.3 mmHg in SLE patients compared to 11.9 mmHg in non-lupus ( p-value = 0.001). Median diastolic BP dipped 12.9 mmHg versus 18.5 mmHg in non-lupus ( p-value = 0.003). Patterns of BP dysregulation in pediatric SLE merit further exploration. Children with or without SLE displaying prehypertensive or stage 1 casual BP measurements had similar rates of hypertension by ambulatory BP monitoring. However, regardless of BP diagnosis, and independent of kidney involvement, there was an increased proportion with attenuated

Perceptual and Cognitive Impairments and Driving

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Korner-Bitensky, Nicol; Coopersmith, Henry; Mayo, Nancy; Leblanc, Ginette; Kaizer, Franceen

1990-01-01

Perceptual and cognitive disorders that frequently accompany stroke and head injury influence an individual's ability to drive a motor vehicle. Canadian physicians are legally responsible for identifying patients who are potentially unsafe to drive and, if they fail to do so, may be held liable in a civil action suit. The authors review the guidelines for physicians evaluating a patient's fitness to drive after brain injury. They also examine the actions a physician should take when a patient with perceptual and cognitive problems wants to drive. Ultimately, by taking these actions, physicians will help to prevent driving accidents. PMID:21234047

Alanine aminotransferase is associated with an adverse nocturnal blood glucose profile in individuals with normal glucose regulation.

Directory of Open Access Journals (Sweden)

Jian Zhou

Full Text Available OBJECTIVE: Although the association between alanine aminotransferase (ALT levels and risk of type 2 diabetes is well-studied, the effects of slightly increased ALT levels within the normal range on the temporal normal glucose profile remains poorly understood. METHODS: A total of 322 Chinese subjects without impaired glucose tolerance or previous diagnoses of diabetes were recruited for study from 10 hospitals in urban areas across China. All subjects wore a continuous glucose monitoring (CGM system for three consecutive days. The diurnal (06∶00-20∶00 and nocturnal (20∶00-06∶00 mean blood glucose (MBG levels were calculated. Subjects were stratified by ALT quartile level and correlation analyses were performed. RESULTS: The median ALT level was 17 IU/L, and subjects with ALT ≥17 IU/L had higher nocturnal MBG level than those with ALT 0.05. Multivariate stepwise regression analysis of elevated nocturnal MBG identified increased HOMA-IR, elevated ALT levels, and decreased homeostatic model assessment of ß-cell function as independent factors (all, P<0.05. CONCLUSIONS: Mildly elevated ALT levels, within the normal range, are associated with unfavorable nocturnal glucose profiles in Chinese subjects with normal glucose regulation.

Reducing alcohol-impaired driving crashes through the use of social marketing.

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Rothschild, Michael L; Mastin, Beth; Miller, Thomas W

2006-11-01

Over the past decade there has been little decrease in the number of alcohol-related driving fatalities. During this time most interventions have been educational or legal. This paper presents the results of a field experiment that used social marketing to introduce a new ride program into three rural communities. Almost all people in the 21-34-year-old target know that they should not drive while impaired, and most agree it is not a good thing to do, but for many the opportunity to behave properly does not exist. The Road Crew program was developed using new product development techniques and implemented by developing broad coalitions within the communities. A key feature of the program included rides to, between, and home from bars in older luxury vehicles. Results showed a significant shift in riding/driving behavior, especially among 21-34-year olds, a projected 17% decline in alcohol-related crashes in the first year, no increase in drinking behavior, and large savings between the reactive cost of cleaning up after a crash and the proactive cost of avoiding a crash. Programs have become self-sustaining based on fares and tavern contributions, and have become part of the life style in the treatment communities.

Brake response time is significantly impaired after total knee arthroplasty: investigation of performing an emergency stop while driving a car.

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Jordan, Maurice; Hofmann, Ulf-Krister; Rondak, Ina; Götze, Marco; Kluba, Torsten; Ipach, Ingmar

2015-09-01

The objective of this study was to investigate whether total knee arthroplasty (TKA) impairs the ability to perform an emergency stop. An automatic transmission brake simulator was developed to evaluate total brake response time. A prospective repeated-measures design was used. Forty patients (20 left/20 right) were measured 8 days and 6, 12, and 52 wks after surgery. Eight days postoperative total brake response time increased significantly by 30% in right TKA and insignificantly by 2% in left TKA. Brake force significantly decreased by 35% in right TKA and by 25% in left TKA during this period. Baseline values were reached at week 12 in right TKA; the impairment of outcome measures, however, was no longer significant at week 6 compared with preoperative values. Total brake response time and brake force in left TKA fell below baseline values at weeks 6 and 12. Brake force in left TKA was the only outcome measure significantly impaired 8 days postoperatively. This study highlights that categorical statements cannot be provided. This study's findings on automatic transmission driving suggest that right TKA patients may resume driving 6 wks postoperatively. Fitness to drive in left TKA is not fully recovered 8 days postoperatively. If testing is not available, patients should refrain from driving until they return from rehabilitation.

Clinical evaluation of semiautonomous smart wheelchair architecture (Drive-Safe System) with visually impaired individuals.

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Sharma, Vinod; Simpson, Richard C; LoPresti, Edmund F; Schmeler, Mark

2012-01-01

Nonambulatory, visually impaired individuals mostly rely on caregivers for their day-to-day mobility needs. The Drive-Safe System (DSS) is a modular, semiautonomous smart wheelchair system aimed at providing independent mobility to people with visual and mobility impairments. In this project, clinical evaluation of the DSS was performed in a controlled laboratory setting with individuals who have visual impairment but no mobility impairment. Their performance using DSS was compared with their performance using a standard cane for navigation assistance. Participants rated their subjective appraisal of the DSS by using the National Aeronautics and Space Administration-Task Load Index inventory. DSS significantly reduced the number and severity of collisions compared with using a cane alone and without increasing the time required to complete the task. Users rated DSS favorably; they experienced less physical demand when using the DSS, but did not feel any difference in perceived effort, mental demand, and level of frustration when using the DSS alone or along with a cane in comparison with using a cane alone. These findings suggest that the DSS can be a safe, reliable, and easy-to-learn and operate independent mobility solution for visually impaired wheelchair users.

Increased nocturnal blood pressure in enuretic children with polyuria.

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Kruse, Anne; Mahler, Birgitte; Rittig, Soren; Djurhuus, Jens Christian

2009-10-01

We investigated the association between nocturnal blood pressure and urine production in children with enuresis. A total of 39 consecutive children with a mean age of 9.8 years (range 6.2 to 14.9) with monosymptomatic nocturnal enuresis completed a bladder diary, including 2 weeks of basic documentation and 2 with desmopressin titration from 120 to 240 microg sublingually. Arterial blood pressure was measured every 30 minutes during 24 hours and during 4 additional nights using an ambulatory blood pressure monitor. Furthermore, 10 healthy children were recruited into the study who completed a bladder diary for 5 days while measuring arterial blood pressures with documentation of all intake and voided volumes. Patients with nocturnal polyuria had significantly higher nocturnal mean arterial pressure than patients without polyuria and controls (p polyuria than in children without polyuria. There was a significant positive correlation between average nocturnal mean arterial pressure and nocturnal urine volume in the whole study. The association between nocturnal blood pressure and urine volume, and the role of blood pressure should be investigated in a larger group of children with enuresis who have nocturnal polyuria.

Impaired driving simulation in patients with Periodic Limb Movement Disorder and patients with Obstructive Sleep Apnea Syndrome

NARCIS (Netherlands)

Gieteling, Esther W.; Bakker, Marije S.; Hoekema, Aarnoud; Maurits, Natasha M.; Brouwer, Wiebo H.; van der Hoeven, Johannes H.

Background: Excessive daytime sleepiness (EDS) is considered to be responsible for increased collision rate and impaired driving simulator performance in Obstructive Sleep Apnea Syndrome (OSAS) patients. Periodic Limb Movement Disorder (PLMD) patients also frequently report EDS and may also have

Driving competences and neuropsychological factors associated to driving counseling in multiple sclerosis.

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Badenes, Dolors; Garolera, Maite; Casas, Laura; Cejudo-Bolivar, Juan Carlos; de Francisco, Jorge; Zaragoza, Silvia; Calzado, Noemi; Aguilar, Miquel

2014-05-01

Multiple Sclerosis (MS) significantly impacts daily living activities, including car driving. To investigate driving difficulties experienced with MS, we compared 50 MS patients with minor or moderate disability and 50 healthy controls (HC) using computerized driving tests (the ASDE driver test and the Useful Field of View (UFOV) test) and neuropsychological tests. Inclusion criteria included being active drivers. We evaluated whether cognitive deterioration in MS is associated with the results of driving tests by comparing MS patients without cognitive deterioration with HC. The results indicated that the MS patients performed worse than the HCs in attention, information processing, working memory and visuomotor coordination tasks. Furthermore, MS patients with cognitive impairments experienced more difficulties in the driving tests than did the non-impaired MS patients. Motor dysfunction associated with MS also played an important role in this activity. The results of this study suggest that MS should be assessed carefully and that special emphasis should be placed on visuomotor coordination and executive functions because patients with minor motor disability and subtle cognitive impairments can pass measures predictive of driving safety.

The effects of adenotonsillotomy on nocturnal enuresis in snoring children

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Marta Kostrzewa

2017-12-01

Full Text Available Introduction: Nocturnal enuresis is a common problem in the paediatric population. A number of reports indicate that there is a relationship between sleep-disordered breathing in children with tonsillar hypertrophy and nocturnal enuresis. Restoration of nasopharyngeal patency may eliminate nocturnal enuresis. Aim: The aim of the study was to evaluate the incidence of nocturnal enuresis in children snoring due to nasopharyngeal lymphatic tissue hypertrophy as well as to assess the effects of restored upper respiratory patency by means of adenectomy and tonsillectomy on the resolution of nocturnal enuresis in children. Material and methods: The study included 50 children with sleep-disordered breathing qualified for adenectomy, tonsillotomy or adenotonsillotomy (median age 7 years. The control group consisted of 20 healthy children (median age 8 years. Children in the study group were assessed prior to surgical procedure as well as 3 and 6 months after surgery. The presence of sleep-disordered breathing and nocturnal enuresis was determined based on author’s questionnaire completed by parents. Results: The incidence of nocturnal enuresis in children with nasopharyngeal lymphatic tissue hypertrophy was 18% (M:F 17%:19%; p > 0.05. Nocturnal enuresis was still reported in 6% of children 3 months after tonsillotomy. The disorder resolved in all girls and 97% of boys 6 months after procedure. Conclusions: Sleep-disordered breathing in children with nasopharyngeal lymphatic tissue hypertrophy is associated with nocturnal enuresis. Restoration of nasopharyngeal patency in these patients eliminates nocturnal enuresis. Tonsillar hypertrophy causing obstructive breathing should be included in the differential diagnosis of nocturnal enuresis.

On the mechanisms of blunted nocturnal decline in arterial blood pressure in NIDDM patients with diabetic nephropathy

DEFF Research Database (Denmark)

Nielsen, Flemming Steen; Rossing, P; Bang, L E

1995-01-01

Nondiabetic hypertensive patients lacking the normal nocturnal decline in arterial blood pressure have enhanced cardiovascular complications. Since cardiovascular morbidity and mortality are increased in non-insulin-dependent diabetes mellitus (NIDDM), we performed a prospective cross......-sectional case-controlled study comparing the diurnal variation in arterial blood pressure, prevalence of dippers, cardiac autonomic nervous function (beat-to-beat variation during deep breathing), and extracellular fluid volume (51Cr-labeled EDTA) in 55 NIDDM patients with diabetic nephropathy (group 1), 55...... NIDDM patients with normoalbuminuria (group 2), and 22 nondiabetic control subjects (group 3). All antihypertensive treatments were withdrawn at least 2 weeks before the study. The nocturnal blood pressure reduction (daytime-to-nighttime)/daytime (mean +/- SE) was impaired in group 1 (6.6 +/- 1...

Usefulness of indirect alcohol biomarkers for predicting recidivism of drunk-driving among previously convicted drunk-driving offenders: results from the recidivism of alcohol-impaired driving (ROAD) study.

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Maenhout, Thomas M; Poll, Anneleen; Vermassen, Tijl; De Buyzere, Marc L; Delanghe, Joris R

2014-01-01

In several European countries, drivers under the influence (DUI), suspected of chronic alcohol abuse are referred for medical and psychological examination. This study (the ROAD study, or Recidivism Of Alcohol-impaired Driving) investigated the usefulness of indirect alcohol biomarkers for predicting drunk-driving recidivism in previously convicted drunk-driving offenders. The ROAD study is a prospective study (2009-13) that was performed on 517 randomly selected drivers in Belgium. They were convicted for drunk-driving for which their licence was confiscated. The initial post-arrest blood samples were collected and analysed for percentage carbohydrate-deficient transferrin (%CDT), transaminsase activities [alanine amino transferase (ALT), aspartate amino transferase (AST)], gamma-glutamyltransferase (γGT) and red cell mean corpuscular volume (MCV). The observation time for each driver was 3 years and dynamic. A logistic regression analysis revealed that ln(%CDT) (P drunk-driving. The ROAD index (which includes ln(%CDT), ln(γGT), -ln(ALT) and the sex of the driver) was calculated and had a significantly higher area under the receiver operator characteristic curve (0.71) than the individual biomarkers for drunk-driving recidivism. Drivers with a high risk of recidivating (ROAD index ≥ 25%; third tertile) could be distinguished from drivers with an intermediate risk (16% ≤ ROAD index drunk-driving. The association with gamma-glutamyltransferase, alanine amino transferase and the sex of the driver could have additional value for identifying drunk-drivers at intermediate risk of recidivism. Non-specific indirect alcohol markers, such as alanine amino transferase, gamma-glutamyltransferase, aspartate amino transferase and red cell mean corpuscular volume have minimal added value to % carbohydrate-deficient transferrin for distinguishing drunk drivers with a low or high risk of recidivism. © 2013 Society for the Study of Addiction.

Prey interception drives web invasion and spider size determines successful web takeover in nocturnal orb-web spiders.

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Gan, Wenjin; Liu, Shengjie; Yang, Xiaodong; Li, Daiqin; Lei, Chaoliang

2015-09-24

A striking feature of web-building spiders is the use of silk to make webs, mainly for prey capture. However, building a web is energetically expensive and increases the risk of predation. To reduce such costs and still have access to abundant prey, some web-building spiders have evolved web invasion behaviour. In general, no consistent patterns of web invasion have emerged and the factors determining web invasion remain largely unexplored. Here we report web invasion among conspecifics in seven nocturnal species of orb-web spiders, and examined the factors determining the probability of webs that could be invaded and taken over by conspecifics. About 36% of webs were invaded by conspecifics, and 25% of invaded webs were taken over by the invaders. A web that was built higher and intercepted more prey was more likely to be invaded. Once a web was invaded, the smaller the size of the resident spider, the more likely its web would be taken over by the invader. This study suggests that web invasion, as a possible way of reducing costs, may be widespread in nocturnal orb-web spiders. © 2015. Published by The Company of Biologists Ltd.

Prey interception drives web invasion and spider size determines successful web takeover in nocturnal orb-web spiders

Directory of Open Access Journals (Sweden)

Wenjin Gan

2015-10-01

Full Text Available A striking feature of web-building spiders is the use of silk to make webs, mainly for prey capture. However, building a web is energetically expensive and increases the risk of predation. To reduce such costs and still have access to abundant prey, some web-building spiders have evolved web invasion behaviour. In general, no consistent patterns of web invasion have emerged and the factors determining web invasion remain largely unexplored. Here we report web invasion among conspecifics in seven nocturnal species of orb-web spiders, and examined the factors determining the probability of webs that could be invaded and taken over by conspecifics. About 36% of webs were invaded by conspecifics, and 25% of invaded webs were taken over by the invaders. A web that was built higher and intercepted more prey was more likely to be invaded. Once a web was invaded, the smaller the size of the resident spider, the more likely its web would be taken over by the invader. This study suggests that web invasion, as a possible way of reducing costs, may be widespread in nocturnal orb-web spiders.

Analysis of nocturia with 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration: concept for effective treatment modality.

Science.gov (United States)

Udo, Yukihiro; Nakao, Masahiro; Honjo, Hisashi; Ukimura, Osamu; Kawauchi, Akihiro; Kitakoji, Hiroshi; Miki, Tsuneharu

2011-03-01

• To determine the relationship between the number of nocturia and 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration as well as to assess the significance of these factors with respect to eliminating nocturnal voidings in individual patients with nocturia. • Among 532 participants who completed a 3-day bladder diary between April 2005 and December 2006, the diaries of 450 participants without 24-h polyuria were analyzed. • Clinical variables such as the number of daytime and night-time voids, 24-h urine volume, nocturnal polyuria index, daytime and night-time maximum voided volumes (MVV), night/day MVV ratio, sleep duration and proportion of night/day urine production rates were obtained from each diary. • Participants were classified into eight groups according to values of three factors: nocturnal MVV, proportion of night/day urine production rates and length of sleep duration. • Each group was divided into three subgroups: non-nocturics (number of nocturnal voidings is zero), mild nocturics (number of nocturnal voidings is one) and severe nocturics (number of nocturnal voidings is two or more). • The data from non-nocturics with three normal factors were regarded as the normal control and compared with the variables of the other subgroups using Dunnett's method. • Variables that form the basis of classifying participants into eight groups and corresponding to abnormal factors of each group were statistically significant in all the subgroups of each group. • Furthermore, a significantly increased 24-h urine volume was found in severe nocturics of the group with three normal factors. • A significantly decreased 24-h urine volume was found in non-nocturics of groups with nocturnal polyuria, decreased bladder capacity and both long sleep duration and nocturnal polyuria. • A significantly increased nocturnal MVV and night/day MVV ratio were shown in non-nocturics and mild nocturics of the groups

Nocturnal bees are attracted by widespread floral scents.

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Carvalho, Airton Torres; Maia, Artur Campos Dalia; Ojima, Poliana Yumi; dos Santos, Adauto A; Schlindwein, Clemens

2012-03-01

Flower localization in darkness is a challenging task for nocturnal pollinators. Floral scents often play a crucial role in guiding them towards their hosts. Using common volatile compounds of floral scents, we trapped female nocturnal Megalopta-bees (Halictidae), thus uncovering olfactory cues involved in their search for floral resources. Applying a new sampling method hereby described, we offer novel perspectives on the investigation of nocturnal bees.

Pathophysiology of nocturnal lower urinary tract symptoms in older patients with urinary incontinence.

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Denys, Marie-Astrid; Decalf, Veerle; Kumps, Candy; Petrovic, Mirko; Goessaert, An-Sofie; Everaert, Karel

2017-11-01

To explore the mismatch between functional bladder capacity and nocturnal urine production, and to study the pathophysiology of an increased nocturnal urine production in older patients with urinary incontinence. The present prospective observational study included adults aged ≥65 years with urinary incontinence. Participants completed questionnaires, frequency volume charts and renal function profiles. The nocturnal lower urinary tract symptom index was defined as nocturnal urine output/maximum voided volume; the nocturnal polyuria index as nocturnal/24 h urine output. The median age (n = 95) was 74 years (69-79), 87% were women and 73% had nocturnal lower urinary tract symptoms (nocturnal urinary incontinence or nocturia ≥2). Participants with nocturnal lower urinary tract symptoms had a significantly higher nocturnal urine output (809 mL vs 650 mL; P = 0.001) and no significant difference in maximum voided volume (350 mL vs 437 mL; P = 0.079) compared with participants without nocturnal lower urinary tract symptoms. Participants (nocturnal polyuria index >33% [n = 56], nocturnal polyuria index >40% [n = 42], nocturnal lower urinary tract symptom index >1.87 [n = 51]) showed higher night-time diuresis rates, free water and sodium clearance compared with during the daytime. Controls (nocturnal polyuria index ≤33% [n = 26], nocturnal polyuria index ≤40% [n = 40], nocturnal lower urinary tract symptom index ≤1.87 [n = 44]) had no circadian rhythm in their diuresis rate or sodium clearance, but more nocturnal free water clearance compared with during the daytime. The majority of older adults with urinary incontinence present nocturnal lower urinary tract symptoms. An increased nocturnal sodium diuresis seems to be the only mechanism differentiating patients with nocturnal lower urinary tract symptoms from controls. © 2017 The Japanese Urological Association.

The risk of hyponatremia with desmopressin use for nocturnal polyuria.

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Choi, Eun Young; Park, Joon-Sung; Kim, Yong Tae; Park, Sung Yul; Kim, Gheun-Ho

2015-01-01

Desmopressin is used for treating nocturnal polyuria, but hyponatremia is an associated concern in the elderly due to impaired urinary dilution. This study was undertaken to characterize hyponatremia occurring in adults using desmopressin for nocturnal polyuria. Data from 172 patients who were prescribed desmopressin for nocturnal polyuria at a urology clinic from September 2010 through February 2013 were retrospectively analyzed. Demographic and laboratory parameters were investigated to examine the risk factors for desmopressin-associated hyponatremia. The average follow-up serum sodium measured 21 ± 22 days after using desmopressin was 138 ± 5 mmol/l. Hyponatremia (<135 mmol/l) was found in 24 patients (14%), and it was severe in 7 (<126 mmol/l). In the hyponatremic patients, serum sodium decreased by 11 ± 6 mmol/l. Patients with hyponatremia were older than those with normonatremia (78 ± 7 vs. 68 ± 9 years, p < 0.0001). The presence of either hyponatremia-predisposing comorbidities or concurrent medications was associated with hyponatremia. Patients with hyponatremia had lower basal hemoglobin (11 ± 2 vs. 13 ± 2 g/dl, p < 0.001) and serum sodium (139 ± 2 vs. 140 ± 2 mmol/l, p < 0.05) than those with normonatremia. Multivariate logistic regression after adjustment for basal serum sodium showed that advanced age (OR 1.15; 95% CI 1.03-1.27) and lower hemoglobin level (OR 0.64; 95% CI 0.43-0.94) were independently associated with hyponatremia. Hyponatremia is not infrequently associated with desmopressin use. Those with advanced age (≥65 years) and lower hemoglobin are at risk of desmopressin-associated hyponatremia and need to be carefully monitored. © 2015 S. Karger AG, Basel.

Evaluation of responsible beverage service to reduce impaired driving by 21- to 34-year-old drivers : traffic tech.

Science.gov (United States)

2017-05-01

Young adult drivers 21 to 34 years old are a particularly highrisk : group for impaired-driving-related crashes. Numerous : studies have found that approximately half of intoxicated drivers : had their last drink at a licensed bar or restaurant, and ...

Medicinal Δ(9) -tetrahydrocannabinol (dronabinol) impairs on-the-road driving performance of occasional and heavy cannabis users but is not detected in Standard Field Sobriety Tests.

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Bosker, Wendy M; Kuypers, Kim P C; Theunissen, Eef L; Surinx, Anke; Blankespoor, Roos J; Skopp, Gisela; Jeffery, Wayne K; Walls, H Chip; van Leeuwen, Cees J; Ramaekers, Johannes G

2012-10-01

The acute and chronic effects of dronabinol [medicinal Δ(9) -tetrahydrocannabinol (THC)] on actual driving performance and the Standard Field Sobriety Test (SFST) were assessed. It was hypothesized that occasional users would be impaired on these tests and that heavy users would show less impairment due to tolerance. Double-blind, placebo-controlled, randomized, three-way cross-over study. Twelve occasional and 12 heavy cannabis users (14 males/10 females) received single doses of placebo, 10 and 20 mg dronabinol. Standard deviation of lateral position (SDLP; i.e. weaving) is the primary measure of road-tracking control. Time to speed adaptation (TSA) is the primary reaction-time measure in the car-following test. Percentage of impaired individuals on the SFST and subjective high on a visual analogue scale were secondary measures. Superiority tests showed that SDLP (P = 0.008) and TSA (P = 0.011) increased after dronabinol in occasional users. Equivalence tests demonstrated that dronabinol-induced increments in SDLP were bigger than impairment associated with BAC of 0.5 mg/ml in occasional and heavy users, although the magnitude of driving impairment was generally less in heavy users. The SFST did not discriminate between conditions. Levels of subjective high were comparable in occasional and heavy users. Dronabinol (medicinal tetrahydrocannabinol) impairs driving performance in occasional and heavy users in a dose-dependent way, but to a lesser degree in heavy users due possibly to tolerance. The Standard Field Sobriety Test is not sensitive to clinically relevant driving impairment caused by oral tetrahydrocannabinol. © 2012 The Authors. Addiction © 2012 Society for the Study of Addiction.

Driving While Impaired (DWI) Intervention Service Provider Orientations: The Scales of the DWI Therapeutic Educator Inventory (DTEI)

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DeMuro, Scott; Wanberg, Kenneth; Anderson, Rachel

2011-01-01

The therapeutic educator who provides services to driving while impaired (DWI) offenders is a unique professional hybrid, combining education and therapeutic service delivery. In an effort to understand and address this service provider, a 69-item DWI Therapeutic Educator Inventory (DTEI) was constructed. Using principal components and common…

Nocturnal Oviposition Behavior of Forensically Important Diptera in Central England.

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Barnes, Kate M; Grace, Karon A; Bulling, Mark T

2015-11-01

Timing of oviposition on a corpse is a key factor in entomologically based minimum postmortem interval (mPMI) calculations. However, there is considerable variation in nocturnal oviposition behavior of blow flies reported in the research literature. This study investigated nocturnal oviposition in central England for the first time, over 25 trials from 2011 to 2013. Liver-baited traps were placed in an urban location during control (diurnal), and nocturnal periods and environmental conditions were recorded during each 5-h trial. No nocturnal activity or oviposition was observed during the course of the study indicating that nocturnal oviposition is highly unlikely in central England. © 2015 American Academy of Forensic Sciences.

Sleep disturbances and nocturnal symptoms: relationships with quality of life in a population-based sample of women with interstitial cystitis/bladder pain syndrome.

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Troxel, Wendy M; Booth, Marika; Buysse, Daniel J; Elliott, Marc N; Suskind, Anne M; Clemens, J Quentin; Berry, Sandra H

2014-12-15

To characterize the nature and impact of sleep disturbances on quality of life (QOL) in women with interstitial cystitis/bladder pain syndrome (IC/BPS). Participants were 3,397 women from a telephone probability survey who met IC/BPS symptom criteria. Sleep quality, duration, and IC/BPS nocturnal symptoms (i.e., trouble sleeping due to bladder pain, urgency, or needing to use the bathroom), general QOL (mental and physical health and sexual functioning), and IC/BPS QOL impairment were assessed via self-report during telephone interview. Over half of the sample reported poor sleep quality, sleep duration ≤ 6 hours, or trouble sleeping due to IC/BPS symptoms. After covariate adjustment, short sleep duration was significantly associated with greater IC/BPS QOL impairment (β = -0.04; p < 0.001) and poorer self-reported physical health (β = 1.86; p < 0.001). Poor sleep quality was significantly associated with greater IC/BPS QOL impairment (β = 0.06; p < 0.001), poorer self-reported physical health (β = -2.86; p < 0.001), and greater sexual dysfunction (β = -0.04; p < 0.05). IC/BPS nocturnal symptoms were significantly associated with greater IC/BPS impairment (β = 0.14; p < 0.001), poorer physical health (β = -2.76; p < 0.001) and mental health (β = 0.52; p < 0.01), and greater sexual dysfunction (β = -0.10; p < 0.001), after covariate adjustment. After further adjustment for IC/BPS nocturnal symptoms, we found that poor sleep quality and short sleep duration were independent correlates of poor self-reported physical health. Poor sleep quality and short sleep duration, as well as disorder-specific sleep disturbances, are highly prevalent in women with IC/BPS and are associated with poorer disease-specific and general QOL. © 2014 American Academy of Sleep Medicine.

Sleep driving: sleepwalking variant or misuse of z-drugs?

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Pressman, Mark R

2011-10-01

Sleep driving is most often classified as a variant of sleepwalking, but should be distinguished from impaired driving due to misuse or abuse of sedative/hypnotic drugs. Z-drugs; zolpidem and zopiclone in particular, have been associated with the majority of reported cases of impaired driving. Numerous studies have found z-drugs in driving under influence (DUI) related police stops, arrests and accidents. Impaired drivers are reported to have 1) blood levels of z-drugs that exceed therapeutic ranges 2) failed to take the medication at the correct time or remain in bed for sufficient time and/or 3) combined z-drugs with other central nervous system (CNS) depressants and/or alcohol. Consistent with CNS depression, z-drug-impaired drivers may demonstrate cognitive function at low levels with drivers still able to understand and respond to questions while sleepwalkers are completely unable to understand or interact with police. Z-drug-impaired drivers are often severely physically impaired, unable to stand up or maintain balance while sleepwalkers are able to stand and walk unaided. Sleep driving and impaired driving due to z-drugs may overlap. Sleep driving and drug-impaired driving are statistically rare events, but due to the billions of doses prescribed each year may still result in numerous DUI related arrests and accidents. Copyright © 2010 Elsevier Ltd. All rights reserved.

Nocturnal Gastroesophageal Reflux Revisited by Impedance-pH Monitoring

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Blondeau, Kathleen; Mertens, Veerle; Tack, Jan; Sifrim, Daniel

2011-01-01

Background/Aims Impedance-pH monitoring allows detailed characterization of gastroesophageal reflux and esophageal activity associated with reflux. We assessed the characteristics of nocturnal reflux and esophageal activity preceding and following reflux. Methods Impedance-pH tracings from 11 healthy subjects and 76 patients with gastroesophageal reflux disease off acid-suppressive therapy were analyzed. Characteristics of nocturnal supine reflux, time distribution and esophageal activity seen on impedance at 2 minute intervals preceding and following reflux were described. Results Patients had more nocturnal reflux events than healthy subjects (8 [4-12] vs 2 [1-5], P = 0.002), with lower proportion of weakly acidic reflux (57% [35-78] vs 80% [60-100], P = 0.044). Nocturnal reflux was mainly liquid (80%) and reached the proximal esophagus more often in patients (6% vs 0%, P = 0.047). Acid reflux predominated in the first 2 hours (66%) and weakly acidic reflux in the last 3 hours (70%) of the night. Most nocturnal reflux was preceded by aboral flows and cleared by short lasting volume clearance. In patients, prolonged chemical clearance was associated with less esophageal activity. Conclusions Nocturnal weakly acidic reflux is as common as acid reflux in patients with gastroesophageal reflux disease, and predominates later in the night. Impedance-pH can predict prolonged chemical clearance after nocturnal acid reflux. PMID:21602991

Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's Disease).

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Meyer, Gesine; Hackemann, Annika; Reusch, Juergen; Badenhoop, Klaus

2012-05-01

Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days. In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.

Iatrogenic nocturnal eneuresis- an overlooked side effect of anti histamines?

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D Italiano

2015-01-01

Full Text Available Nocturnal enuresis is a common disorder in childhood, but its pathophysiological mechanisms have not been fully elucidated. Iatrogenic nocturnal enuresis has been described following treatment with several psychotropic medications. Herein, we describe a 6-year-old child who experienced nocturnal enuresis during treatment with the antihistamine cetirizine. Drug rechallenge was positive. Several neurotransmitters are implicated in the pathogenesis of nocturnal enuresis, including noradrenaline, serotonin and dopamine. Antihistamine treatment may provoke functional imbalance of these pathways resulting in incontinence.

A multimodal assessment of driving performance in HIV infection.

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Marcotte, T D; Wolfson, T; Rosenthal, T J; Heaton, R K; Gonzalez, R; Ellis, R J; Grant, I

2004-10-26

To examine if HIV-seropositive (HIV+) individuals are at risk for impaired driving. Sixty licensed drivers (40 HIV+, 20 HIV-) completed a neuropsychological (NP) test battery and driving assessments. Eleven HIV+ subjects were NP-impaired. Driving-related skills were assessed using 1) two driving simulations (examining accident avoidance and navigational abilities), 2) the Useful Field of View (UFOV) test, and 3) an on-road evaluation. HIV+ NP-impaired subjects had greater difficulty than cognitively intact subjects on all driving measures, whereas the HIV- and HIV+ NP-normal groups performed similarly. On the UFOV, the HIV+ NP-impaired group had worse performance on Visual Processing and Divided Attention tasks but not in overall risk classification. They also had a higher number of simulator accidents (1.3 vs 2.0; p = 0.03), were less efficient at completing the navigation task (3.2 vs 9.2 blocks; p = 0.001), and were more likely to fail the on-road evaluation (6 vs 36%; p = 0.02). Impairment in Executive Functioning was the strongest NP predictor of failing the on-road drive test. NP performance and both simulations independently contributed to a model predicting 48% of the variance in on-road performance. HIV+ NP-impaired individuals are at increased risk for on-road driving impairments, whereas HIV+ individuals with normal cognition are not at a significantly higher risk than HIV- subjects. Executive Functioning is most strongly associated with impaired on-road performance. Cognitive and simulator testing may each provide data in identifying driving-impaired individuals.

How much can you drink before driving? The influence of riding with impaired adults and peers on the driving behaviors of urban and rural youth.

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Leadbeater, Bonnie J; Foran, Kathleen; Grove-White, Aidan

2008-04-01

Following an ecological model to specify risks for impaired driving, we assessed the effects of youth attitudes about substance use and their experiences of riding in cars with adults and peers who drove after drinking alcohol or smoking cannabis on the youths' own driving after drinking or using cannabis. Participants were 2594 students in grades 10 and 12 (mean age = 16 years and 2 months; 50% girls) from public high schools in urban (994) and rural communities (1600) on Vancouver Island in British Columbia, Canada; 1192 of these were new drivers with restricted licenses. Self-report data were collected in anonymous questionnaires. Regression analyses were used to assess the independent and interacting effects of youth attitudes about substance use and their experiences of riding in cars with adults or peers who drove after drinking alcohol or smoking cannabis on youth driving. Youth driving risk behaviors were associated independently with their own high-risk attitudes and experiences riding with peers who drink alcohol or use cannabis and drive. However, risks were highest for the youth who also report more frequent experiences of riding with adults who drink alcohol or use cannabis and drive. Prevention efforts should be expanded to include the adults and peers who are role models for new drivers and to increase youths' awareness of their own responsibilities for their personal safety as passengers.

Cannabis effects on driving skills.

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Hartman, Rebecca L; Huestis, Marilyn A

2013-03-01

Cannabis is the most prevalent illicit drug identified in impaired drivers. The effects of cannabis on driving continue to be debated, making prosecution and legislation difficult. Historically, delays in sample collection, evaluating the inactive Δ(9)-tetrahydrocannabinol (THC) metabolite 11-nor-9-carboxy-THC, and polydrug use have complicated epidemiologic evaluations of driver impairment after cannabis use. We review and evaluate the current literature on cannabis' effects on driving, highlighting the epidemiologic and experimental data. Epidemiologic data show that the risk of involvement in a motor vehicle accident (MVA) increases approximately 2-fold after cannabis smoking. The adjusted risk of driver culpability also increases substantially, particularly with increased blood THC concentrations. Studies that have used urine as the biological matrix have not shown an association between cannabis and crash risk. Experimental data show that drivers attempt to compensate by driving more slowly after smoking cannabis, but control deteriorates with increasing task complexity. Cannabis smoking increases lane weaving and impaired cognitive function. Critical-tracking tests, reaction times, divided-attention tasks, and lane-position variability all show cannabis-induced impairment. Despite purported tolerance in frequent smokers, complex tasks still show impairment. Combining cannabis with alcohol enhances impairment, especially lane weaving. Differences in study designs frequently account for inconsistencies in results between studies. Participant-selection bias and confounding factors attenuate ostensible cannabis effects, but the association with MVA often retains significance. Evidence suggests recent smoking and/or blood THC concentrations 2-5 ng/mL are associated with substantial driving impairment, particularly in occasional smokers. Future cannabis-and-driving research should emphasize challenging tasks, such as divided attention, and include occasional and

Cannabis Effects on Driving Skills

Science.gov (United States)

Hartman, Rebecca L.; Huestis, Marilyn A.

2013-01-01

BACKGROUND Cannabis is the most prevalent illicit drug identified in impaired drivers. The effects of cannabis on driving continue to be debated, making prosecution and legislation difficult. Historically, delays in sample collection, evaluating the inactive Δ9-tetrahydrocannabinol (THC) metabolite 11-nor-9-carboxy-THC, and polydrug use have complicated epidemiologic evaluations of driver impairment after cannabis use. CONTENT We review and evaluate the current literature on cannabis’ effects on driving, highlighting the epidemiologic and experimental data. Epidemiologic data show that the risk of involvement in a motor vehicle accident (MVA) increases approximately 2-fold after cannabis smoking. The adjusted risk of driver culpability also increases substantially, particularly with increased blood THC concentrations. Studies that have used urine as the biological matrix have not shown an association between cannabis and crash risk. Experimental data show that drivers attempt to compensate by driving more slowly after smoking cannabis, but control deteriorates with increasing task complexity. Cannabis smoking increases lane weaving and impaired cognitive function. Critical-tracking tests, reaction times, divided-attention tasks, and lane-position variability all show cannabis-induced impairment. Despite purported tolerance in frequent smokers, complex tasks still show impairment. Combining cannabis with alcohol enhances impairment, especially lane weaving. SUMMARY Differences in study designs frequently account for inconsistencies in results between studies. Participant-selection bias and confounding factors attenuate ostensible cannabis effects, but the association with MVA often retains significance. Evidence suggests recent smoking and/or blood THC concentrations 2–5 ng/mL are associated with substantial driving impairment, particularly in occasional smokers. Future cannabis-and-driving research should emphasize challenging tasks, such as divided attention

Self-rated driving habits among older adults with clinically-defined mild cognitive impairment, clinically-defined dementia, and normal cognition.

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O'Connor, Melissa L; Edwards, Jerri D; Bannon, Yvonne

2013-12-01

Older adults with clinically-defined dementia may report reducing their driving more than cognitively normal controls. However, it is unclear how these groups compare to individuals with clinically-defined mild cognitive impairment (MCI) in terms of driving behaviors. The current study investigated self-reported driving habits among adults age 60 and older with clinical MCI (n=41), clinical mild dementia (n=40), and normal cognition (n=43). Participants reported their driving status, driving frequency (days per week), and how often they avoided accessing the community, making left turns, driving at night, driving in unfamiliar areas, driving on high-traffic roads, and driving in bad weather. After adjusting for education, a MANCOVA revealed that participants with MCI and dementia avoided unfamiliar areas and high-traffic roads significantly more than normal participants. Participants with dementia also avoided left turns and accessing the community more than those with normal cognition and MCI (pdriving variables did not significantly differ between groups. Thus, older adults with clinically-defined MCI, as well as those with dementia, avoided some complex driving situations more than cognitively intact adults. However, all diagnostic groups had similar rates of driving cessation and frequency. Future research should examine the safety implications of such findings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Desmopressin is an effective treatment for mixed nocturia with nocturnal polyuria and decreased nocturnal bladder capacity.

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Lee, Hye Won; Choo, Myung-Soo; Lee, Jeong Gu; Park, Choal Hee; Paick, Jae-Seung; Lee, Jeong Zoo; Han, Deok Hyun; Park, Won Hee; Lee, Kyu-Sung

2010-12-01

To investigate the efficacy and safety of desmopressin in patients with mixed nocturia, Patients aged ≥ 18 yr with mixed nocturia (≥ 2 voids/night and a nocturnal polyuria index [NPi] >33% and a nocturnal bladder capacity index [NBCi] >1) were recruited. The optimum dose of oral desmopressin was determined during a 3-week dose-titration period and the determined dose was maintained for 4 weeks. The efficacy was assessed by the frequency-volume charts and the sleep questionnaire. The primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids (NV) compared with baseline. Among 103 patients enrolled, 94 (79 men and 15 women) were included in the analysis. The proportion of patients with a 50% or greater reduction in NV was 68 (72%). The mean number of NV decreased significantly (3.20 to 1.34) and the mean nocturnal urine volume, nocturia index, NPi, and NBCi decreased significantly. The mean duration of sleep until the first NV was prolonged from 118.4 ± 44.1 to 220.3 ± 90.7 min (P<0.001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia.

Nocturnal enuresis in india: Are we diagnosing and managing correctly?

Directory of Open Access Journals (Sweden)

N M Reddy

2017-01-01

Full Text Available Nocturnal enuresis is a common problem affecting school-aged children worldwide. Although it has significant impact on child's psychology, it is always under-recognized in India and considered as a condition which will outgrow with advancing age. Nocturnal enuresis classified as primary or secondary and monosymptomatic or nonmonosymptomatic. Factors that cause enuresis include genetic factors, bladder dysfunction, psychological factors, and inappropriate antidiuretic hormone secretion, leading to nocturnal polyuria. Diagnosis consists of detailed medical history, clinical examination, frequency-volume charts, and appropriate investigations. The frequency-volume chart or voiding diary helps in establishing diagnosis and tailoring therapy. The first step in treating nocturnal enuresis is to counsel the parents and the affected child about the condition and reassure them that it can be cured. One of the effective strategies to manage enuresis is alarm therapy, but currently, it is not easily available in India. Desmopressin has been used in the treatment of nocturnal enuresis for close to 50 years. It provides an effective and safe option for the management of nocturnal enuresis. This review covers the diagnosis and management of nocturnal enuresis and introduces the concept of “bedwetting clinics” in India, which should help clinicians in the thorough investigation of bedwetting cases.

Circadian Rhythm of Glomerular Filtration and Solute Handling Related to Nocturnal Enuresis.

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Dossche, L; Raes, A; Hoebeke, P; De Bruyne, P; Vande Walle, J

2016-01-01

Although nocturnal polyuria in patients with monosymptomatic enuresis can largely be explained by the decreased nocturnal vasopressin secretion hypothesis, other circadian rhythms in the kidney also seem to have a role. We recently documented an absent day/night rhythm in a subgroup of desmopressin refractory cases. We explore the importance of abnormal circadian rhythm of glomerular filtration and tubular (sodium, potassium) parameters in patients with monosymptomatic enuresis. In this retrospective study of a tertiary enuresis population we collected data subsequent to a standardized screening (International Children's Continence Society questionnaire), 14-day diary for nocturnal enuresis and diuresis, and 24-hour concentration profile. The study population consisted of 139 children with nocturnal enuresis who were 5 years or older. Children with nonmonosymptomatic nocturnal enuresis were used as controls. There was a maintained circadian rhythm of glomerular filtration, sodium, osmotic excretion and diuresis rate in children with monosymptomatic and nonmonosymptomatic nocturnal enuresis, and there was no difference between the 2 groups. Secondary analysis revealed that in patients with nocturnal polyuria (with monosymptomatic or nonmonosymptomatic nocturnal enuresis) circadian rhythm of glomerular filtration, sodium and osmotic excretion, and diuresis rate was diminished in contrast to those without nocturnal polyuria (p Circadian rhythm of the kidney does not differ between patients with nonmonosymptomatic and monosymptomatic enuresis. However, the subgroup with enuresis and nocturnal polyuria has a diminished circadian rhythm of nocturnal diuresis, sodium excretion and glomerular filtration in contrast to children without nocturnal polyuria. This observation cannot be explained by the vasopressin theory alone. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate.

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De Guchtenaere, A; Vande Walle, C; Van Sintjan, P; Raes, A; Donckerwolcke, R; Van Laecke, E; Hoebeke, P; Vande Walle, J

2007-12-01

Monosymptomatic nocturnal enuresis is frequently associated with nocturnal polyuria and low urinary osmolality during the night. Initial studies found decreased vasopressin levels associated with low urinary osmolality overnight. Together with the documented desmopressin response, this was suggestive of a primary role for vasopressin in the pathogenesis of enuresis in the absence of bladder dysfunction. Recent studies no longer confirm this primary role of vasopressin. Other pathogenetic factors such as disordered renal sodium handling, hypercalciuria, increased prostaglandins and/or osmotic excretion might have a role. So far, little attention has been given to abnormalities in the circadian rhythm of glomerular filtration rate. We evaluated the circadian rhythm of glomerular filtration rate and diuresis in children with desmopressin resistant monosymptomatic nocturnal enuresis and nocturnal polyuria. We evaluated 15 children (9 boys) 9 to 14 years old with monosymptomatic nocturnal enuresis and nocturnal polyuria resistant to desmopressin treatment. The control group consisted of 25 children (12 boys) 9 to 16 years old with monosymptomatic nocturnal enuresis without nocturnal polyuria. Compared to the control population, children with nocturnal polyuria lost their circadian rhythm not only for diuresis and sodium excretion but also for glomerular filtration rate. Patients with monosymptomatic nocturnal enuresis and nocturnal polyuria lack a normal circadian rhythm for diuresis and sodium excretion, and the circadian rhythm of glomerular filtration rate is absent. This absence of circadian rhythm of glomerular filtration rate and/or sodium handling cannot be explained by a primary role of vasopressin, but rather by a disorder in circadian rhythm of renal glomerular and/or tubular functions.

Ethnic variation in the prevalence of visual impairment in people attending diabetic retinopathy screening in the United Kingdom (DRIVE UK.

Directory of Open Access Journals (Sweden)

Sobha Sivaprasad

Full Text Available To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom.The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London or August 2009 (West Yorkshire were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks ("Black/African/Caribbean/Black British" and South Asians ("Asians originating from the Indian subcontinent". We examined the prevalence of visual impairment in the better eye using three cut-off points (a loss of vision sufficient for driving (approximately <6/9 (b visual impairment (<6/12 and (c severe visual impairment (<6/60, standardising the prevalence of visual impairment in the minority ethnic groups to the age-structure of the white population.Data on visual acuity and were available on 50,331 individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI 3.2% to 3.5% and 0.39% severely visually impaired (0.33% to 0.44%. Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively compared to white people (3.3%, 95% CI 3.1% to 3.5%. Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire.Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK.

Eye shape and the nocturnal bottleneck of mammals.

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Hall, Margaret I; Kamilar, Jason M; Kirk, E Christopher

2012-12-22

Most vertebrate groups exhibit eye shapes that vary predictably with activity pattern. Nocturnal vertebrates typically have large corneas relative to eye size as an adaptation for increased visual sensitivity. Conversely, diurnal vertebrates generally demonstrate smaller corneas relative to eye size as an adaptation for increased visual acuity. By contrast, several studies have concluded that many mammals exhibit typical nocturnal eye shapes, regardless of activity pattern. However, a recent study has argued that new statistical methods allow eye shape to accurately predict activity patterns of mammals, including cathemeral species (animals that are equally likely to be awake and active at any time of day or night). Here, we conduct a detailed analysis of eye shape and activity pattern in mammals, using a broad comparative sample of 266 species. We find that the eye shapes of cathemeral mammals completely overlap with nocturnal and diurnal species. Additionally, most diurnal and cathemeral mammals have eye shapes that are most similar to those of nocturnal birds and lizards. The only mammalian clade that diverges from this pattern is anthropoids, which have convergently evolved eye shapes similar to those of diurnal birds and lizards. Our results provide additional evidence for a nocturnal 'bottleneck' in the early evolution of crown mammals.

Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women.

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Vaughan, Leslie; Hogan, Patricia E; Rapp, Stephen R; Dugan, Elizabeth; Marottoli, Richard A; Snively, Beverly M; Shumaker, Sally A; Sink, Kaycee M

2015-09-01

To investigate associations between proxy report of cognitive and functional limitations and cognitive performance and current or former driving status in older women with mild cognitive impairment (MCI) and all-cause dementia. Cross-sectional data analysis of retrospectively identified older women with adjudicated MCI and all-cause dementia in the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO). Academic medical center. Women (mean age ± standard deviation 83.7 ± 3.5) adjudicated with MCI or dementia during Year 1, 2, 3, or 4 of the WHIMS-ECHO follow-up period (N = 385). The telephone-administered cognitive battery included tests of attention, verbal learning and memory, verbal fluency, executive function, working memory, and global cognitive function plus self-report measures of depressive symptomatology. The Dementia Questionnaire (DQ) was administered to a knowledgeable proxy (family member, friend). Sixty percent of women with MCI and 40% of those with dementia are current drivers. Proxy reports of functional limitations in instrumental activities of daily living (IADLs) are associated with current driving status in women with MCI, whereas performance-based cognitive tests are not. In women with dementia, proxy reports of functional limitations in IADLs and performance-based cognitive tests are associated with current driving status, as expected. These findings have clinical implications for the importance of evaluating driving concurrently with other instrumental functional abilities in MCI and dementia. Additional work is needed to determine whether proxy report of cognitive and functional impairments should help guide referrals for driving assessment and rehabilitation or counseling for driving transition. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Effects of moderate and heavy endurance exercise on nocturnal HRV.

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Hynynen, E; Vesterinen, V; Rusko, H; Nummela, A

2010-06-01

This study examined the effects of endurance exercise on nocturnal autonomic modulation. Nocturnal R-R intervals were collected after a rest day, after a moderate endurance exercise and after a marathon run in ten healthy, physically active men. Heart rate variability (HRV) was analyzed as a continuous four-hour period starting 30 min after going to bed for sleep. In relation to average nocturnal heart rate after rest day, increases to 109+/-6% and 130+/-11% of baseline were found after moderate endurance exercise and marathon, respectively. Standard deviation of R-R intervals decreased to 90+/-9% and 64+/-10%, root-mean-square of differences between adjacent R-R intervals to 87+/-10% and 55+/-16%, and high frequency power to 77+/-19% and 34+/-19% of baseline after moderate endurance exercise and marathon, respectively. Also nocturnal low frequency power decreased to 56+/-26% of baseline after the marathon. Changes in nocturnal heart rate and HRV suggest prolonged dose-response effects on autonomic modulation after exercises, which may give useful information on the extent of exercise-induced nocturnal autonomic modulation and disturbance to the homeostasis.

Ethnic variation in the prevalence of visual impairment in people attending diabetic retinopathy screening in the United Kingdom (DRIVE UK).

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Sivaprasad, Sobha; Gupta, Bhaskar; Gulliford, Martin C; Dodhia, Hiten; Mann, Samantha; Nagi, Dinesh; Evans, Jennifer

2012-01-01

To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom). The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London) or August 2009 (West Yorkshire) were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks ("Black/African/Caribbean/Black British") and South Asians ("Asians originating from the Indian subcontinent"). We examined the prevalence of visual impairment in the better eye using three cut-off points (a) loss of vision sufficient for driving (approximately ethnic groups to the age-structure of the white population. Data on visual acuity and were available on 50,331 individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI) 3.2% to 3.5%) and 0.39% severely visually impaired (0.33% to 0.44%). Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively) compared to white people (3.3%, 95% CI 3.1% to 3.5%). Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire. Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK.

Cell-phone use diminishes self-awareness of impaired driving.

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Sanbonmatsu, David M; Strayer, David L; Biondi, Francesco; Behrends, Arwen A; Moore, Shannon M

2016-04-01

Multitasking diminishes the self-awareness of performance that is often essential for self-regulation and self-knowledge. Participants drove in a simulator while either talking or not talking on a hands-free cell phone. Following previous research, participants who talked on a cell phone made more serious driving errors than control participants who did not use a phone while driving. Control participants' assessments of the safeness of their driving and general ability to drive safely while distracted were negatively correlated with the actual number of errors made when they were driving. By contrast, cell-phone participants' assessments of the safeness of their driving and confidence in their driving abilities were uncorrelated with their actual errors. Thus, talking on a cell phone not only diminished the safeness of participants' driving, it diminished their awareness of the safeness of their driving.

The need for drugged driving per se laws: a commentary.

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DuPont, Robert L; Voas, Robert B; Walsh, J Michael; Shea, Corinne; Talpins, Stephen K; Neil, Mark M

2012-01-01

Triggered by the new federal commitment announced by the Office of National Drug Control Policy (ONCDP) to encourage states to enact drugged driving per se laws, this article reviews the reasons to establish such laws and the issues that may arise when trying to enforce them. A review of the state of drunk driving per se laws and their implications for drugged driving is presented, with a review of impaired driving enforcement procedures and drug testing technology. Currently, enforcement of drugged driving laws is an adjunct to the enforcement of laws regarding alcohol impairment. Drivers are apprehended when showing signs of alcohol intoxication and only in the relatively few cases where the blood alcohol concentration of the arrested driver does not account for the observed behavior is the possibility of drug impairment pursued. In most states, the term impaired driving covers both alcohol and drug impairment; thus, driver conviction records may not distinguish between the two different sources of impairment. As a result, enforcement statistics do not reflect the prevalence of drugged driving. Based on the analysis presented, this article recommends a number of steps that can be taken to evaluate current drugged driving enforcement procedures and to move toward the enactment of drug per se laws.

Identifying Method of Drunk Driving Based on Driving Behavior

Directory of Open Access Journals (Sweden)

Xiaohua Zhao

2011-05-01

Full Text Available Drunk driving is one of the leading causes contributing to traffic crashes. There are numerous issues that need to be resolved with the current method of identifying drunk driving. Driving behavior, with the characteristic of real-time, was extensively researched to identify impaired driving behaviors. In this paper, the drives with BACs above 0.05% were defined as drunk driving state. A detailed comparison was made between normal driving and drunk driving. The experiment in driving simulator was designed to collect the driving performance data of the groups. According to the characteristics analysis for the effect of alcohol on driving performance, seven significant indicators were extracted and the drunk driving was identified by the Fisher Discriminant Method. The discriminant function demonstrated a high accuracy of classification. The optimal critical score to differentiate normal from drinking state was found to be 0. The evaluation result verifies the accuracy of classification method.

Paroxysmal nocturnal hemoglobinuria (PNH)

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... help slow the breakdown of red blood cells. Blood transfusions may be needed. Supplemental iron and folic acid ... is no known way to prevent this disorder. Alternative Names PNH Images Blood cells References Brodsky RA. Proxymal nocturnal hemoglobinuria. In: ...

Nocturnal vision and landmark orientation in a tropical halictid bee.

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Warrant, Eric J; Kelber, Almut; Gislén, Anna; Greiner, Birgit; Ribi, Willi; Wcislo, William T

2004-08-10

Some bees and wasps have evolved nocturnal behavior, presumably to exploit night-flowering plants or avoid predators. Like their day-active relatives, they have apposition compound eyes, a design usually found in diurnal insects. The insensitive optics of apposition eyes are not well suited for nocturnal vision. How well then do nocturnal bees and wasps see? What optical and neural adaptations have they evolved for nocturnal vision? We studied female tropical nocturnal sweat bees (Megalopta genalis) and discovered that they are able to learn landmarks around their nest entrance prior to nocturnal foraging trips and to use them to locate the nest upon return. The morphology and optics of the eye, and the physiological properties of the photoreceptors, have evolved to give Megalopta's eyes almost 30 times greater sensitivity to light than the eyes of diurnal worker honeybees, but this alone does not explain their nocturnal visual behavior. This implies that sensitivity is improved by a strategy of photon summation in time and in space, the latter of which requires the presence of specialized cells that laterally connect ommatidia into groups. First-order interneurons, with significantly wider lateral branching than those found in diurnal bees, have been identified in the first optic ganglion (the lamina ganglionaris) of Megalopta's optic lobe. We believe that these cells have the potential to mediate spatial summation. Despite the scarcity of photons, Megalopta is able to visually orient to landmarks at night in a dark forest understory, an ability permitted by unusually sensitive apposition eyes and neural photon summation.

Preliminary report of the Hepatic Encephalopathy Assessment Driving Simulator (HEADS) score.

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Baskin-Bey, Edwina S; Stewart, Charmaine A; Mitchell, Mary M; Bida, John P; Rosenthal, Theodore J; Nyberg, Scott L

2008-01-01

Audiovisual simulations of real-life driving (ie, driving simulators) have been used to assess neurologic dysfunction in a variety of medical applications. However, the use of simulated driving to assess neurologic impairment in the setting of liver disease (ie, hepatic encephalopathy) is limited. The aim of this analysis was to develop a scoring system based on simulated driving performance to assess mild cognitive impairment in cirrhotic patients with hepatic encephalopathy. This preliminary analysis was conducted as part of the Hepatic Encephalopathy Assessment Driving Simulator (HEADS) pilot study. Cirrhotic volunteers initially underwent a battery of neuropsychological tests to identify those cirrhotic patients with mild cognitive impairment. Performance during an audiovisually simulated course of on-road driving was then compared between mildly impaired cirrhotic patients and healthy volunteers. A scoring system was developed to quantify the likelihood of cognitive impairment on the basis of data from the simulated on-road driving. Mildly impaired cirrhotic patients performed below the level of healthy volunteers on the driving simulator. Univariate logistic regression and correlation models indicated that several driving simulator variables were significant predictors of cognitive impairment. Five variables (run time, total map performance, number of collisions, visual divided attention response, and average lane position) were incorporated into a quantitative model, the HEADS scoring system. The HEADS score (0-9 points) showed a strong correlation with cognitive impairment as measured by area under the receiver-operator curve (.89). The HEADS system appears to be a promising new tool for the assessment of mild hepatic encephalopathy.

Glare disability and driving safety.

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Babizhayev, M A

2003-01-01

Increasing investigation of the visual elements of safe driving environments may be of great benefit to society. Visual disability appears to be only one of many visual factors related to traffic accidents. The purpose of this article was to examine the type of visual impairment mediated by the increased glare sensitivity in adult drivers using the original halometer glare test. In this article, the visual sensory, cognitive and motor functions relevant to driving, their measurement, the epidemiology and prevention of age-associated functional impairments and the relationship of functional impairments to both self-reported driving and the imposition of legal restrictions are reviewed. The problem of night and tunnel driving is the most urgent in relation to the effects of glare from vehicle headlights on motion perception of drivers. The reduced mesopic vision and increased sensitivity to glare are accompanied by an increased risk of nighttime accidents. Elderly drivers and patients with beginning cataract cannot sufficiently fulfill the criteria for night driving ability because of contrast and glare sensitivity. It is indispensable for the parameters mentioned to be carefully measured and for drivers to be informed that night driving ability may be impaired, even if visual acuity is sufficient. It would be advisable for traffic safety if simple tests for contrast and glare sensitivity were implemented for vehicles and/or were regularly added to the requirements for a driver's licence, at least for older drivers. The age, functional status and test result limits should be defined to avoid a risk factor in traffic. Copyright 2003 S. Karger AG, Basel

Temporal Relationships Between Napping and Nocturnal Sleep in Healthy Adolescents.

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Jakubowski, Karen P; Hall, Martica H; Lee, Laisze; Matthews, Karen A

2017-01-01

Many adolescents do not achieve the recommended 9 hr of sleep per night and report daytime napping, perhaps because it makes up for short nocturnal sleep. This article tests temporal relationships between daytime naps and nighttime sleep as measured by actigraphy and diary among 236 healthy high school students during one school week. Mixed model analyses adjusted for age, race, and gender demonstrated that shorter actigraphy-assessed nocturnal sleep duration predicted longer napping (measured by actigraphy and diary) the next day. Napping (by actigraphy and diary) predicted shorter nocturnal sleep duration and worse sleep efficiency that night measured by actigraphy. Diary-reported napping also predicted poorer self-reported sleep quality that night. Frequent napping may interfere with nocturnal sleep during adolescence.

Differences in ocular parameters between diurnal and nocturnal raptors.

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Beckwith-Cohen, Billie; Horowitz, Igal; Bdolah-Abram, Tali; Lublin, Avishai; Ofri, Ron

2015-01-01

To establish and compare normal ocular parameters between and within diurnal and nocturnal raptor groups. Eighty-eight ophthalmically normal raptors of six nocturnal and 11 diurnal species were studied. Tear production was measured using Schirmer tear test (STT) and phenol red thread test (PRTT), and applanation tonometry was conducted. Ultrasonographic measurements of axial length (AL), mediolateral axis (ML), vitreous body (VB), and pecten length (PL) were recorded, and conjunctival cultures were obtained. A weak correlation (R = 0.312, P = 0.006) was found between PRTT and STT. Tear production was significantly lower in nocturnal species (P raptors were positive for mycology or bacteriology, either on culture or PCR. The most common infectious agent isolated was Staphylococcus spp. Phenol red thread test and STT are both valid methods to measure tear production; however, a separate baseline must be determined for each species using these methods, as the results of one method cannot be extrapolated to the other. Due to significant differences observed within diurnal and nocturnal species, it appears that a more intricate division should be used when comparing these parameters for raptors, and the classification of diurnal or nocturnal holds little significance in the baseline of these data. © 2013 American College of Veterinary Ophthalmologists.

Nocturnal Hypertension: Neglected Issue in Comprehensive Hypertension Management

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Andi Kristanto

2016-09-01

Full Text Available The body circardian rhythm affects blood pressure variability at day and night, therefore blood pressure at day and night might be different. Nocturnal hypertension is defined as increase of blood pressure >120/70mmHg at night, which is caused by disturbed circadian rhythm, and associated with higher cardiovascular and cerebrovascular events also mortality in hypertensive patients. Nocturnal hypertension and declining blood pressure pattern, can only be detected by continuous examination for 24 hours, also known as ambulatory blood pressure measurement (ABPM. Chronotherapy, has become a strategy for managing the hypertensive nocturnal patients, by taking hypertensive medication at night to obtain normal blood pressure decrease in accordance with the normal circadian rhythm and, improving blood pressure control.

Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis

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Xu, Jianglin; Suri, Rita S.; Nesrallah, Gihad; Lindsay, Robert; Garg, Amit X.; Lester, Keith; Ofsthun, Norma; Lazarus, Michael; Hakim, Raymond M.

2012-01-01

Whether the duration of hemodialysis treatments improves outcomes remains controversial. Here, we evaluated survival and clinical changes associated with converting from conventional hemodialysis (mean=3.75 h/treatment) to in-center nocturnal hemodialysis (mean=7.85 h/treatment). All 959 consecutive patients who initiated nocturnal hemodialysis for the first time in 77 Fresenius Medical Care facilities during 2006 and 2007 were eligible. We used Cox models to compare risk for mortality during 2 years of follow-up in a 1:3 propensity score–matched cohort of 746 nocturnal and 2062 control patients on conventional hemodialysis. Two-year mortality was 19% among nocturnal hemodialysis patients compared with 27% among conventional patients. Nocturnal hemodialysis associated with a 25% reduction in the risk for death after adjustment for age, body mass index, and dialysis vintage (hazard ratio=0.75, 95% confidence interval=0.61–0.91, P=0.004). With respect to clinical features, interdialytic weight gain, albumin, hemoglobin, dialysis dose, and calcium increased on nocturnal therapy, whereas postdialysis weight, predialysis systolic blood pressure, ultrafiltration rate, phosphorus, and white blood cell count declined (all P<0.001). In summary, notwithstanding the possibility of residual selection bias, conversion to treatment with nocturnal hemodialysis associates with favorable clinical features, laboratory biomarkers, and improved survival compared with propensity score–matched controls. The potential impact of extended treatment time on clinical outcomes while maintaining a three times per week hemodialysis schedule requires evaluation in future clinical trials. PMID:22362905

Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep.

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Van Herzeele, Charlotte; Dhondt, Karlien; Roels, Sanne P; Raes, Ann; Hoebeke, Piet; Groen, Luitzen-Albert; Vande Walle, Johan

2016-09-01

There is a high comorbidity between nocturnal enuresis, sleep disorders and psychological problems. The aim of this study was to investigate whether a decrease in nocturnal diuresis volume not only improves enuresis but also ameliorates disrupted sleep and (neuro)psychological dysfunction, the major comorbidities of this disorder. In this open-label, prospective phase IV study, 30 children with monosymptomatic nocturnal enuresis (MNE) underwent standardized video-polysomnographic testing and multi-informant (neuro)psychological testing at baseline and 6 months after the start of desmopressin treatment in the University Hospital Ghent, Belgium. Primary endpoints were the effect on sleep and (neuro)psychological functioning. The secondary endpoint was the change in the first undisturbed sleep period or the time to the first void. Thirty children aged between 6 and 16 (mean 10.43, standard deviation 3.08) years completed the study. The results demonstrated a significant decrease in periodic limb movements during sleep (PLMS) and a prolonged first undisturbed sleep period. Additionally, (neuro)psychological functioning was improved on several domains. The study demonstrates that the degree of comorbidity symptoms is at least aggravated by enuresis (and/or high nocturnal diuresis rate) since sleep and (neuro)psychological functioning were significantly ameliorated by treatment of enuresis. These results indicate that enuresis is not such a benign condition as has previously been assumed.

Driver Drowsiness Warning System Using Visual Information for Both Diurnal and Nocturnal Illumination Conditions

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Flores MarcoJavier

2010-01-01

Full Text Available Every year, traffic accidents due to human errors cause increasing amounts of deaths and injuries globally. To help reduce the amount of fatalities, in the paper presented here, a new module for Advanced Driver Assistance System (ADAS which deals with automatic driver drowsiness detection based on visual information and Artificial Intelligence is presented. The aim of this system is to locate, track, and analyze both the drivers face and eyes to compute a drowsiness index, where this real-time system works under varying light conditions (diurnal and nocturnal driving. Examples of different images of drivers taken in a real vehicle are shown to validate the algorithms used.

Results from a national survey of Crown prosecutors and defense counsel on impaired driving in Canada: a "System Improvements" perspective.

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Robertson, Robyn; Vanlaar, Ward; Simpson, Herb; Boase, Paul

2009-01-01

This article summarizes the main findings from a study designed to examine the legal process in Canada as it applies to alcohol-impaired driving from the point of view of Crown prosecutors and defense counsel, and to identify evidentiary or procedural factors that may impact the legal process, the rights of the accused, and interactions of all parts in the legal process. The data in this study were collected by means of a survey that was mailed out to the population of Crown prosecutors and defense counsel in Canada. In total, 765 prosecutors and 270 defense lawyers or an estimated 33% of all Canadian prosecutors and 15% of defense lawyers completed and returned the questionnaire. The "systems improvement" paradigm was used to interpret the findings and draw conclusions. Such an approach acknowledges the importance of the context in which countermeasures are implemented and delivered and the structures or entities used to deliver countermeasures to a designated target group. Results on type of charges and breath alcohol concentration, caseload, case outcomes, case preparation time, conviction rate at trial and overall conviction rate, reasons for acquittals and time to resolve cases are described. The findings from this national survey suggest that there are important challenges within the criminal justice system that impede the effective and efficient processing of impaired driving cases. Some of these challenges occur as a function of practices and policies, while others occur as a function of legislation. This study illustrates that a "system improvements" approach that acknowledges the importance of all elements of the criminal justice system and the interaction between those elements, can be beneficial in overcoming the alcohol-impaired driving problem.

Global effects of moon phase on nocturnal acoustic scattering layers

KAUST Repository

Prihartato, Perdana; Irigoien, Xabier; Genton, Marc G.; Kaartvedt, Stein

2016-01-01

© Inter-Research 2016. The impact of moon phase on the global nocturnal vertical distribution of acoustic scattering layers (SLs) in the upper 200 m was studied during the Malaspina expedition that circumnavigated the world. We assessed the nocturnal weighted mean depths and the vertical extension of the SL (the range between the upper 25th percentile and lower 75th percentile of the backscatter) and used a generalized additive model to reveal the relationship between the nocturnal vertical distribution of the SL and moon phase, as well as other environmental factors. Moon phase significantly affected the SL distribution on a global scale, in contrast to other factors such as dissolved oxygen, temperature and fluorescence, which each correlated with nocturnal SL distribution during the large geographic coverage. Full moon caused a deepening effect on the nocturnal SL. Contrary to expectations, the shallowest distribution was not observed during the darkest nights (new moon) and there was no difference in vertical distribution between new moon and intermediate moon phases. We conclude that the trend of deepening SL during approximately full moon (bright nights) is a global phenomenon related to anti-predator behavior.

Global effects of moon phase on nocturnal acoustic scattering layers

KAUST Repository

Prihartato, PK

2016-01-18

© Inter-Research 2016. The impact of moon phase on the global nocturnal vertical distribution of acoustic scattering layers (SLs) in the upper 200 m was studied during the Malaspina expedition that circumnavigated the world. We assessed the nocturnal weighted mean depths and the vertical extension of the SL (the range between the upper 25th percentile and lower 75th percentile of the backscatter) and used a generalized additive model to reveal the relationship between the nocturnal vertical distribution of the SL and moon phase, as well as other environmental factors. Moon phase significantly affected the SL distribution on a global scale, in contrast to other factors such as dissolved oxygen, temperature and fluorescence, which each correlated with nocturnal SL distribution during the large geographic coverage. Full moon caused a deepening effect on the nocturnal SL. Contrary to expectations, the shallowest distribution was not observed during the darkest nights (new moon) and there was no difference in vertical distribution between new moon and intermediate moon phases. We conclude that the trend of deepening SL during approximately full moon (bright nights) is a global phenomenon related to anti-predator behavior.

[Nocturnal polyuria, treatment with desmopressin].

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Zachoval, R; Krhut, J; Šottner, O; Hanuš, T; Martan, A; Horčička, L; Feyereisl, J; Halaška, M; Švabík, K; Krofta, L

2013-08-01

Nonpharmacologic and especially pharmacologic treatment options are available for nocturnal polyuria. Desmopressin represents the basis of pharmacologic treatment. Desmopressin acetate is a synthetic analogue of arginine vasopressin with high affinity to V2 receptors with antidiuretic effect. It is the only medicament currently registered for antidiuretic treatment. Desmopressin has not any relevant affinity to V1 receptors, and therefore there is no hypertensive effect in contrary to natural vasopressin. Desmopressin use before a bedtime leads to reduced production of urine during a sleep, therefore time between desires to void is prolonged and number of nocturia is reduced. Clinical effect, in a meaning of reduced urine production and increased osmolality of urine, lasts approximately 8-12 hours. In the treatment of nocturnal polyuria desmopressin is used orally one hour before a bedtime. It is essential to titrate an ideal dose, the initial dose is 60 µg of MELT formula (fast melting oral formulation) and it can be increased according to the clinical effect up to the maximal recommended daily dose 240 µg. Patients treated with desmopressin should cut down a fluid intake 1 hour before and 8 hours after the use of desmopressin. Total number of adverse events connected withdesmopressin treatment in clinical studies was higher compared to placebo but the side effects were mostly mild. The most common adverse events were headaches, nausea, diarrhoea, abdominal pain, dry mouth and hyponatremia both in the short-term and long-term clinical trials. Hyponatremia was observed mainly in patients over 65 year of age. Therefore treatment with desmopressin should not be commended in patients over 65 year of age without close monitoring of the natrium level in serum and all patients should be informed about the first symptoms of hyponatremia - headache, nausea and insomnia. According to Evidence Based Medicine, the level of evidence for treatment of nocturnal polyuria with

Visual reliability and information rate in the retina of a nocturnal bee.

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Frederiksen, Rikard; Wcislo, William T; Warrant, Eric J

2008-03-11

Nocturnal animals relying on vision typically have eyes that are optically and morphologically adapted for both increased sensitivity and greater information capacity in dim light. Here, we investigate whether adaptations for increased sensitivity also are found in their photoreceptors by using closely related and fast-flying nocturnal and diurnal bees as model animals. The nocturnal bee Megalopta genalis is capable of foraging and homing by using visually discriminated landmarks at starlight intensities. Megalopta's near relative, Lasioglossum leucozonium, performs these tasks only in bright sunshine. By recording intracellular responses to Gaussian white-noise stimuli, we show that photoreceptors in Megalopta actually code less information at most light levels than those in Lasioglossum. However, as in several other nocturnal arthropods, Megalopta's photoreceptors possess a much greater gain of transduction, indicating that nocturnal photoreceptors trade information capacity for sensitivity. By sacrificing photoreceptor signal-to-noise ratio and information capacity in dim light for an increased gain and, thus, an increased sensitivity, this strategy can benefit nocturnal insects that use neural summation to improve visual reliability at night.

Driving with the wandering mind: the effect that mind-wandering has on driving performance.

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Yanko, Matthew R; Spalek, Thomas M

2014-03-01

The principal objective of the present work was to examine the effects of mind state (mind-wandering vs. on-task) on driving performance in a high-fidelity driving simulator. Mind-wandering is thought to interfere with goal-directed thought. It is likely, then, that when driving, mind-wandering might lead to impairments in critical aspects of driving performance. In two experiments, we assess the extent to which mind-wandering interferes with responsiveness to sudden events, mean velocity, and headway distance. Using a car-following procedure in a high-fidelity driving simulator, participants were probed at random times to indicate whether they were on-task at that moment or mind-wandering. The dependent measures were analyzed based on the participant's response to the probe. Compared to when on-task, when mind-wandering participants showed longer response times to sudden events, drove at a higher velocity, and maintained a shorter headway distance. Collectively, these findings indicate that mind-wandering affects a broad range of driving responses and may therefore lead to higher crash risk. The results suggest that situations that are likely associated with mind-wandering (e.g., route familiarity) can impair driving performance.

75 FR 75845 - National Impaired Driving Prevention Month, 2010

Science.gov (United States)

2010-12-07

... property in a moment. This reckless behavior not only includes drunk driving, but also the growing problem... dedicated to strengthening efforts against drunk, drugged, and distracted driving. To lead by example, we... Transportation's National Highway Traffic Safety Administration is also sponsoring the campaign, ``Drunk Driving...

Does petroleum development affect burrowing owl nocturnal space-use?

Energy Technology Data Exchange (ETDEWEB)

Scobie, Corey; Wellicome, Troy; Bayne, Erin [Department of Biological Sciences, University of Alberta (Canada)], email: cscobie@ualberta.ca, email: tiw@ualberta.ca, email: bayne@ualberta.ca

2011-07-01

Decline all over Canada in the population of burrowing owls, a federally listed endangered species, has raised concerns about the possible influence of petroleum infrastructure development on owl nocturnal space-use while foraging. Roads, wells, pipelines and sound-producing facilities related to petroleum development change the landscape and can influence the owls' mortality risk. For 3 years, 27 breeding adult male burrowing owls with nests close to different petroleum infrastructures were captured and fitted with a miniature GPS datalogger in order to track their nocturnal foraging. Data from these GPS devices were fed into a geographical information system and showed that pipelines and wells did not alter the foraging habits of the owls. Dirt and gravel roads, with little traffic, were preferentially selected by the owls, conceivably because of higher owl mortality risk along paved roads. Sound-producing facilities did not change owls' foraging behaviour, implying that sound may not affect their nocturnal space-use. Traffic data and sound power measurements will be used in further studies in an effort to better understand burrowing owls' nocturnal foraging habits.

Nocturnal asthma in school children of south punjab, pakistan

International Nuclear Information System (INIS)

Mustafa, G.; Khan, P.A.; Iqbal, I.

2008-01-01

At the present time, the epidemiology of the childhood asthma is of considerable interest. There is an understandable concern that changes in the geographical area, lifestyle, and environment. This study was conducted to find the prevalence of nocturnal asthma, in school children of south Punjab, Pakistan. It was a cross sectional, questionnaire based, descriptive survey of the children aged 3-18 years, in randomly selected primary and secondary schools, from October 2002 to March 2003. The data was analysed with Statistical Analysis System (SAS). Of 6120 questionnaire sent to the parents/guardians, we received 3180 back (52%). Of the 3180 respondents, 1767 (56%) were for boys and 1413 (44%) were for girls. The median age was 8.25 years. Around 71% of children were between 4 to 11 years of age. The parents reported nocturnal asthma in 177 (6%) of their children with an equal prevalence in boys and girls, i.e., (3% each, rounded off to nearest whole number). Of these 177 children with nocturnal asthma, 99 (56%) were boys and 78 (44%) were girls. Of the 1767 boys and 1413 girls, the nocturnal asthma reported by parents was 6% each (99 and 78 respectively). The nocturnal asthma was not reported in 14-18 years age group of females. The asthma is taken as a stigma in our society and as such is not reported or disclosed rather denied. An extensive educational media campaign is required for awareness of the masses. (author)

An assessment of driving fitness in patients with visual impairment to understand the elevated risk of motor vehicle accidents.

Science.gov (United States)

Kunimatsu-Sanuki, Shiho; Iwase, Aiko; Araie, Makoto; Aoki, Yuki; Hara, Takeshi; Nakazawa, Toru; Yamaguchi, Takuhiro; Ono, Hiroshi; Sanuki, Tomoyuki; Itoh, Makoto

2015-02-27

To assess the driving fitness of patients with glaucoma by identifying specific areas and degrees of visual field impairment that threaten safe driving. Case-control study. This prospective study included 36 patients with advanced glaucoma, defined as Humphrey field analyzer (HFA; 24-2 SITA standard program) measurements of mean deviation in both eyes of worse than -12 dB, and 36 age-matched and driving exposure time-matched normal subjects. All participants underwent testing in a novel driving simulator (DS) system. Participants were recruited between September 2010 and January 2012. The number of collisions with simulated hazards and braking response time in 14 DS scenarios was recorded. Monocular HFA 24-2 test results from both eyes were merged to calculate the binocular integrated visual field (IVF). The position of the IVF subfields in which the collision-involved patients had lower sensitivity than the collision-uninvolved patients was compared with the track of the hazard. The cut-off value to predict an elevated risk of collisions was determined, as were its sensitivity and specificity, with the area under the receiver operating characteristic (AUROC) curve. Patients with advanced glaucoma were involved in a significantly higher number of collisions in the DS than the age-matched and driving exposure time-matched normal subjects (119 vs 40, respectively, p<0.0001), especially in four specific DS scenarios. In these four scenarios, IVF sensitivity was significantly lower in the collision-involved patients than in the collision-uninvolved patients in subfields on or near the track of the simulated hazard (p<0.05). The subfields with the largest AUROC curve had values ranging from 0.72 to 0.91 and were located in the paracentral visual field just below the horizontal. Our novel DS system effectively assessed visual impairment, showing that simulators may have future potential in educating patients. Published by the BMJ Publishing Group Limited. For

A laboratory driving simulation for assessment of driving behavior in adults with ADHD: a controlled study

Directory of Open Access Journals (Sweden)

Aleardi Megan

2007-01-01

Full Text Available Abstract Background It is now estimated that attention deficit-hyperactivity disorder (ADHD afflicts at least 4% of adults in the United States and is associated with high levels of morbidity and functional impairment. One key area of dysfunction associated with ADHD is impaired motor vehicle operation. Our goal was to examine the association between ADHD and specific driving outcomes in a sample of adults using a driving simulator. Methods Subjects were 20 adults with full DSM-IV ADHD and 21 controls without ADHD of equal gender distribution. However, the mean age of subjects with ADHD was somewhat older. All analyses were adjusted for age and gender. All subjects participated in a driving simulation that lasted for one hour and consisted of a short training period, a high stimulus segment and a low stimulus segment with two distinct monotonous periods. Results In the second monotonous period within the low stimulus environment, ADHD subjects were significantly more likely than controls to collide with an obstacle suddenly appearing from the periphery, adjusting for age and gender. Conclusion Adults with ADHD were more likely than controls to collide with an obstacle during a driving simulation suggesting that deficits in directed attention may underlie driving impairments in this population.

Nocturnal motor activity in fibromyalgia patients with poor sleep quality.

Science.gov (United States)

Hyyppä, M T; Kronholm, E

1995-01-01

Nocturnal motor activity was examined in long-term rehabilitation patients complaining of poor sleep and having fibromyalgia syndrome (N = 24) or other musculoskeletal disorders (N = 60) and compared with that in 91 healthy controls drawn from a random community sample. Self-reports on sleep complaints and habits were collected. The frequency of nocturnal body movements, the "apnoea" index and ratio of "quiet sleep" to total time in bed were measured using the Static Charge Sensitive Bed (SCSB) (BioMatt). As a group, patients with fibromyalgia syndrome did not differ from patients with other musculoskeletal disorders or from healthy controls in their nocturnal motor activity. The "apnoea" index was a little higher in the fibromyalgia group than in the healthy control group but did not differ from that of the group of other musculoskeletal patients. Further multivariate analyses adjusted for age, BMI, medication and "apnoea" index did not support the assumption that an increased nocturnal motor activity characterizes patients with fibromyalgia syndrome.

Hearing is not necessarily believing in nocturnal anurans

OpenAIRE

Richardson, Christina; Gomez, Doris; Durieux, Romain; Théry, Marc; Joly, Pierre; Léna, Jean-Paul; Plénet, Sandrine; Lengagne, Thierry

2010-01-01

The recent discovery of the use of visual cues for mate choice by nocturnal acoustic species raises the important, and to date unaddressed, question of how these signals affect the outcome of mate choice predicted by female preference for male calls. In order to address this question, we presented female Hyla arborea tree frogs with a series of choices between combinations of acoustic and visual cues of varying quality in nocturnal conditions. While females exhibited the expected preference f...

Does the Age of Donor Kidneys Affect Nocturnal Polyuria in Patients With Successful Real Transplantation?

Science.gov (United States)

Mitsui, T; Morita, K; Iwami, D; Kitta, T; Kanno, Y; Moriya, K; Takeda, M; Shinohara, N

We investigated whether the age of donor kidneys influences the incidence of nocturnal polyuria in patients with successful renal transplantation (RTX). Eighty-five patients (45 men and 40 women) undergoing RTX (median age, 47 years) were included in this study. Twenty-four-hour bladder diaries were kept for 3 days, and nocturnal polyuria was defined as a nocturnal polyuria index (nocturnal urine volume/24-hour urine volume) of >0.33. Risk factors for nocturnal polyuria were analyzed in patients with RTX by means of the Mann-Whitney U test, χ 2 test, and a logistic regression analysis. End-stage renal disease (ESRD) developed from diabetes mellitus in 16 patients (19%). Sixty-five patients (76%) received pre-transplant dialysis, with a median duration of 5 years. The median serum creatinine level and body mass index at the most recent visit were 1.2 mg/dL and 21.2 kg/m 2 , respectively. On the basis of the 24-hour bladder diaries, nocturnal polyuria was identified in 48 patients (56%). A logistic regression analysis revealed that diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria (odds ratio, 8.95; 95% confidence interval, 2.01-65.3; P = .0028). The age of donor kidneys at examination did not affect the incidence of nocturnal polyuria (P = .9402). Nocturnal polyuria was not uncommon in patients with successful RTX. Diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria, whereas the age of donor kidneys at examination did not affect the incidence of nocturnal polyuria. Thus, nocturnal polyuria is caused by recipient factors but not donor factors. Copyright © 2016 Elsevier Inc. All rights reserved.

Drivers under the influence of drugs of abuse: quantification of cocaine and impaired driving.

Science.gov (United States)

Arroyo, Amparo; Sánchez, Marta; Barberia, Eneko; Barbal, Maria; Marrón, M Teresa; Mora, Agustí

2013-01-01

In recent years, the interest in oral fluid as a biological matrix has significantly increased, particularly for detecting driving under the influence of drugs. In this study, the concentration of cocaine and its relationship with clinical symptoms in drivers suspected of driving under the influence of drugs was evaluated. A total of 154 samples of oral fluid, which tested positive for cocaine in previous immunoassay screening, Cozart Drug Detector System, were confirmed using gas chromatography/mass spectrometry method. In Catalonia, during 2007-2010, there were 1791 samples positive for cocaine among a total of 3468 samples taken from drivers who tested positive for any drug of abuse. The evaluation of clinical symptoms was through a questionnaire that was filled in by the police officers who collected the samples. The mean concentration of cocaine was 4.11 mg/l and median concentration was 0.38 mg/l (range 0.01-345.64 mg/l). Clinical impairment symptoms such as motor coordination, walking, speech, mood and state of pupils were not significant. The testing of oral fluids presents fewer ethical problems than blood or urine.

Comparing the effects of nocturnal sleep and daytime napping on declarative memory consolidation.

Directory of Open Access Journals (Sweden)

June C Lo

Full Text Available Nocturnal sleep and daytime napping facilitate memory consolidation for semantically related and unrelated word pairs. We contrasted forgetting of both kinds of materials across a 12-hour interval involving either nocturnal sleep or daytime wakefulness (experiment 1 and a 2-hour interval involving either daytime napping or wakefulness (experiment 2. Beneficial effects of post-learning nocturnal sleep and daytime napping were greater for unrelated word pairs (Cohen's d=0.71 and 0.68 than for related ones (Cohen's d=0.58 and 0.15. While the size of nocturnal sleep and daytime napping effects was similar for unrelated word pairs, for related pairs, the effect of nocturnal sleep was more prominent. Together, these findings suggest that sleep preferentially facilitates offline memory processing of materials that are more susceptible to forgetting.

Comparing the effects of nocturnal sleep and daytime napping on declarative memory consolidation.

Science.gov (United States)

Lo, June C; Dijk, Derk-Jan; Groeger, John A

2014-01-01

Nocturnal sleep and daytime napping facilitate memory consolidation for semantically related and unrelated word pairs. We contrasted forgetting of both kinds of materials across a 12-hour interval involving either nocturnal sleep or daytime wakefulness (experiment 1) and a 2-hour interval involving either daytime napping or wakefulness (experiment 2). Beneficial effects of post-learning nocturnal sleep and daytime napping were greater for unrelated word pairs (Cohen's d=0.71 and 0.68) than for related ones (Cohen's d=0.58 and 0.15). While the size of nocturnal sleep and daytime napping effects was similar for unrelated word pairs, for related pairs, the effect of nocturnal sleep was more prominent. Together, these findings suggest that sleep preferentially facilitates offline memory processing of materials that are more susceptible to forgetting.

Ocellar optics in nocturnal and diurnal bees and wasps.

Science.gov (United States)

Warrant, Eric J; Kelber, Almut; Wallén, Rita; Wcislo, William T

2006-12-01

Nocturnal bees, wasps and ants have considerably larger ocelli than their diurnal relatives, suggesting an active role in vision at night. In a first step to understanding what this role might be, the morphology and physiological optics of ocelli were investigated in three tropical rainforest species - the nocturnal sweat bee Megalopta genalis, the nocturnal paper wasp Apoica pallens and the diurnal paper wasp Polistes occidentalis - using hanging-drop techniques and standard histological methods. Ocellar image quality, in addition to lens focal length and back focal distance, was determined in all three species. During flight, the ocellar receptive fields of both nocturnal species are centred very dorsally, possibly in order to maximise sensitivity to the narrow dorsal field of light that enters through gaps in the rainforest canopy. Since all ocelli investigated had a slightly oval shape, images were found to be astigmatic: images formed by the major axis of the ocellus were located further from the proximal surface of the lens than images formed by the minor axis. Despite being astigmatic, images formed at either focal plane were reasonably sharp in all ocelli investigated. When compared to the position of the retina below the lens, measurements of back focal distance reveal that the ocelli of Megalopta are highly underfocused and unable to resolve spatial detail. This together with their very large and tightly packed rhabdoms suggests a role in making sensitive measurements of ambient light intensity. In contrast, the ocelli of the two wasps form images near the proximal boundary of the retina, suggesting the potential for modest resolving power. In light of these results, possible roles for ocelli in nocturnal bees and wasps are discussed, including the hypothesis that they might be involved in nocturnal homing and navigation, using two main cues: the spatial pattern of bright patches of daylight visible through the rainforest canopy, and compass information

Nocturnal sleep pattern in native Brazilian Terena adults

Directory of Open Access Journals (Sweden)

REIMÃO RUBENS

2000-01-01

Full Text Available Social-economic factors influence sleep habits. This research analyzes characteristics of nocturnal sleep in Brazilian Native Terena adults. Sixty-four adults (31 M; 33 F from 18 to 75 years, with a mean age of 37.0, from the Indian Reservation village of Córrego do Meio, in the central region of Mato Grosso do Sul, an agriculturally oriented group were evaluated. Nocturnal sleep characteristics were evaluated by means of a standard questionnaire applied to each individual. It was observed that reported nocturnal sleep was longer, sleep onset was earlier and wake up time was also earlier than usually described in urban populations. The mean total time in bed was 8.5 h or more, in every age bracket. The seven-day prevalence rate of insomnia was 4.6%, while the seven-day prevalence rate of hypnotic use was 1.5%, both remarkably less than described in urban populations. These findings stress the need to consider ethnic influences on sleep patterns and disorders.

Technical advances in flow cytometry-based diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria

Science.gov (United States)

Correia, Rodolfo Patussi; Bento, Laiz Cameirão; Bortolucci, Ana Carolina Apelle; Alexandre, Anderson Marega; Vaz, Andressa da Costa; Schimidell, Daniela; Pedro, Eduardo de Carvalho; Perin, Fabricio Simões; Nozawa, Sonia Tsukasa; Mendes, Cláudio Ernesto Albers; Barroso, Rodrigo de Souza; Bacal, Nydia Strachman

2016-01-01

ABSTRACT Objective: To discuss the implementation of technical advances in laboratory diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria for validation of high-sensitivity flow cytometry protocols. Methods: A retrospective study based on analysis of laboratory data from 745 patient samples submitted to flow cytometry for diagnosis and/or monitoring of paroxysmal nocturnal hemoglobinuria. Results: Implementation of technical advances reduced test costs and improved flow cytometry resolution for paroxysmal nocturnal hemoglobinuria clone detection. Conclusion: High-sensitivity flow cytometry allowed more sensitive determination of paroxysmal nocturnal hemoglobinuria clone type and size, particularly in samples with small clones. PMID:27759825

The relationship between nocturnal polyuria and the distribution of body fluid: assessment by bioelectric impedance analysis.

Science.gov (United States)

Torimoto, Kazumasa; Hirayama, Akihide; Samma, Shoji; Yoshida, Katsunori; Fujimoto, Kiyohide; Hirao, Yoshihiko

2009-01-01

Increased nocturnal urinary volume is closely associated with nocturia. We investigated the relationship between nocturnal polyuria and the variation of body fluid distribution during the daytime using bioelectric impedance analysis. A total of 34 men older than 60 years were enrolled in this study. A frequency volume chart was recorded. Nocturnal polyuria was defined as a nocturnal urine volume per 24-hour production of greater than 0.35 (the nocturnal polyuria index). Bioelectric impedance analysis was performed 4 times daily at 8 and 11 a.m., and 5 and 9 p.m. using an InBody S20 body composition analyzer (BioSpace, Seoul, Korea). A significant difference was found in mean +/- SEM 24-hour urine production per fat-free mass between the groups with and without nocturnal polyuria (17.8 +/- 1.4 vs 7.7 +/- 0.9 ml/kg). The increase in fluid in the legs compared with the volume at 8 a.m. was significantly larger at 5 p.m., while there was no difference in the arms or trunk. Nocturnal urine volume significantly correlated with the difference in fluid volume in the legs (r = 0.527, p = 0.0019) and extracellular fluid volume (r = 0.3844, p = 0.0248) between the volumes at 8 a.m. and 9 p.m. Overproduction of urine per fat-free mass leads to nocturnal polyuria. Extracellular fluid accumulates as edema in the legs during the day in patients with nocturnal polyuria. The volume of accumulated extracellular fluid correlates with nocturnal urine volume. We suggest that leg edema is the source of nocturnal urine volume and decreasing edema may cure nocturnal polyuria.

Pregnancy and paroxysmal nocturnal hemoglobinuria

NARCIS (Netherlands)

Bais, J.; Pel, M.; von dem Borne, A.; van der Lelie, H.

1994-01-01

A patient is described who developed symptoms of paroxysmal nocturnal hemoglobinuria (PNH) in her first pregnancy. This was uneventful except for a spontaneous preterm delivery. The second pregnancy was complicated by severe anemia and a hemolytic crisis with Budd-Chiari syndrome at 31 weeks'

Driving under the influence of drugs -- evaluation of analytical data of drugs in oral fluid, serum and urine, and correlation with impairment symptoms.

Science.gov (United States)

Toennes, Stefan W; Kauert, Gerold F; Steinmeyer, Stefan; Moeller, Manfred R

2005-09-10

A study was performed to acquire urine, serum and oral fluid samples in cases of suspected driving under the influence of drugs of abuse. Oral fluid was collected using a novel sampling/testing device (Dräger DrugTest System). The aim of the study was to evaluate oral fluid and urine as a predictor of blood samples positive for drugs and impairment symptoms. Analysis for cannabinoids, amphetamine and its derivatives, opiates and cocaine was performed in urine using the Mahsan Kombi/DOA4-test, in serum using immunoassay and gas chromatography-mass spectrometry (GC-MS) confirmation and in oral fluid by GC-MS. Police and medical officer observations of impairment symptoms were rated and evaluated using a threshold value for the classification of driving inability. Accuracy in correlating drug detection in oral fluid and serum were >90% for all substances and also >90% in urine and serum except for THC (71.0%). Of the cases with oral fluid positive for any drug 97.1% of corresponding serum samples were also positive for at least one drug; of drug-positive urine samples this were only 82.4%. In 119 of 146 cases, impairment symptoms above threshold were observed (81.5%). Of the cases with drugs detected in serum, 19.1% appeared not impaired which were the same with drug-positive oral fluid while more persons with drug-positive urine samples appeared uninfluenced (32.7%). The data demonstrate that oral fluid is superior to urine in correlating with serum analytical data and impairment symptoms of drivers under the influence of drugs of abuse.

Sleep Apnea and Nocturnal Cardiac Arrhythmia: A Populational Study

Directory of Open Access Journals (Sweden)

Fatima Dumas Cintra

2014-11-01

Full Text Available Background: The mechanisms associated with the cardiovascular consequences of obstructive sleep apnea include abrupt changes in autonomic tone, which can trigger cardiac arrhythmias. The authors hypothesized that nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea. Objective: To analyze the relationship between obstructive sleep apnea and abnormal heart rhythm during sleep in a population sample. Methods: Cross-sectional study with 1,101 volunteers, who form a representative sample of the city of São Paulo. The overnight polysomnography was performed using an EMBLA® S7000 digital system during the regular sleep schedule of the individual. The electrocardiogram channel was extracted, duplicated, and then analyzed using a Holter (Cardio Smart® system. Results: A total of 767 participants (461 men with a mean age of 42.00 ± 0.53 years, were included in the analysis. At least one type of nocturnal cardiac rhythm disturbance (atrial/ventricular arrhythmia or beat was observed in 62.7% of the sample. The occurrence of nocturnal cardiac arrhythmias was more frequent with increased disease severity. Rhythm disturbance was observed in 53.3% of the sample without breathing sleep disorders, whereas 92.3% of patients with severe obstructive sleep apnea showed cardiac arrhythmia. Isolated atrial and ventricular ectopy was more frequent in patients with moderate/severe obstructive sleep apnea when compared to controls (p < 0.001. After controlling for potential confounding factors, age, sex and apnea-hypopnea index were associated with nocturnal cardiac arrhythmia. Conclusion: Nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea and the prevalence increases with disease severity. Age, sex, and the Apnea-hypopnea index were predictors of arrhythmia in this sample.

Glaucoma and Driving: On-Road Driving Characteristics

Science.gov (United States)

Wood, Joanne M.; Black, Alex A.; Mallon, Kerry; Thomas, Ravi; Owsley, Cynthia

2016-01-01

Purpose To comprehensively investigate the types of driving errors and locations that are most problematic for older drivers with glaucoma compared to those without glaucoma using a standardized on-road assessment. Methods Participants included 75 drivers with glaucoma (mean = 73.2±6.0 years) with mild to moderate field loss (better-eye MD = -1.21 dB; worse-eye MD = -7.75 dB) and 70 age-matched controls without glaucoma (mean = 72.6 ± 5.0 years). On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist using a standardized scoring system which assessed the types of driving errors and the locations where they were made and the number of critical errors that required an instructor intervention. Driving safety was rated on a 10-point scale. Self-reported driving ability and difficulties were recorded using the Driving Habits Questionnaire. Results Drivers with glaucoma were rated as significantly less safe, made more driving errors, and had almost double the rate of critical errors than those without glaucoma. Driving errors involved lane positioning and planning/approach, and were significantly more likely to occur at traffic lights and yield/give-way intersections. There were few between group differences in self-reported driving ability. Conclusions Older drivers with glaucoma with even mild to moderate field loss exhibit impairments in driving ability, particularly during complex driving situations that involve tactical problems with lane-position, planning ahead and observation. These results, together with the fact that these drivers self-report their driving to be relatively good, reinforce the need for evidence-based on-road assessments for evaluating driving fitness. PMID:27472221

Glaucoma and Driving: On-Road Driving Characteristics.

Directory of Open Access Journals (Sweden)

Joanne M Wood

Full Text Available To comprehensively investigate the types of driving errors and locations that are most problematic for older drivers with glaucoma compared to those without glaucoma using a standardized on-road assessment.Participants included 75 drivers with glaucoma (mean = 73.2±6.0 years with mild to moderate field loss (better-eye MD = -1.21 dB; worse-eye MD = -7.75 dB and 70 age-matched controls without glaucoma (mean = 72.6 ± 5.0 years. On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist using a standardized scoring system which assessed the types of driving errors and the locations where they were made and the number of critical errors that required an instructor intervention. Driving safety was rated on a 10-point scale. Self-reported driving ability and difficulties were recorded using the Driving Habits Questionnaire.Drivers with glaucoma were rated as significantly less safe, made more driving errors, and had almost double the rate of critical errors than those without glaucoma. Driving errors involved lane positioning and planning/approach, and were significantly more likely to occur at traffic lights and yield/give-way intersections. There were few between group differences in self-reported driving ability.Older drivers with glaucoma with even mild to moderate field loss exhibit impairments in driving ability, particularly during complex driving situations that involve tactical problems with lane-position, planning ahead and observation. These results, together with the fact that these drivers self-report their driving to be relatively good, reinforce the need for evidence-based on-road assessments for evaluating driving fitness.

Glaucoma and Driving: On-Road Driving Characteristics.

Science.gov (United States)

Wood, Joanne M; Black, Alex A; Mallon, Kerry; Thomas, Ravi; Owsley, Cynthia

2016-01-01

To comprehensively investigate the types of driving errors and locations that are most problematic for older drivers with glaucoma compared to those without glaucoma using a standardized on-road assessment. Participants included 75 drivers with glaucoma (mean = 73.2±6.0 years) with mild to moderate field loss (better-eye MD = -1.21 dB; worse-eye MD = -7.75 dB) and 70 age-matched controls without glaucoma (mean = 72.6 ± 5.0 years). On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist using a standardized scoring system which assessed the types of driving errors and the locations where they were made and the number of critical errors that required an instructor intervention. Driving safety was rated on a 10-point scale. Self-reported driving ability and difficulties were recorded using the Driving Habits Questionnaire. Drivers with glaucoma were rated as significantly less safe, made more driving errors, and had almost double the rate of critical errors than those without glaucoma. Driving errors involved lane positioning and planning/approach, and were significantly more likely to occur at traffic lights and yield/give-way intersections. There were few between group differences in self-reported driving ability. Older drivers with glaucoma with even mild to moderate field loss exhibit impairments in driving ability, particularly during complex driving situations that involve tactical problems with lane-position, planning ahead and observation. These results, together with the fact that these drivers self-report their driving to be relatively good, reinforce the need for evidence-based on-road assessments for evaluating driving fitness.

Running Club - Nocturne des Evaux

CERN Multimedia

Running club

2017-01-01

Les coureurs du CERN sont encore montés sur les plus hautes marches du podium lors de la course interentreprises. Cette course d’équipe qui se déroule de nuit et par équipe de 3 à 4 coureurs est unique dans la région de par son originalité : départ groupé toutes les 30 secondes, les 3 premiers coureurs doivent passer la ligne d’arrivée ensemble. Double victoire pour le running club a la nocturne !!!! 1ère place pour les filles et 22e au classement général; 1ère place pour l'équipe mixte et 4e au général, battant par la même occasion le record de l'épreuve en mixte d'environ 1 minute; 10e place pour l'équipe homme. Retrouvez tous les résultats sur http://www.chp-geneve.ch/web-cms/index.php/nocturne-des-evaux

Diurnal and Nocturnal Pollination of Marginatocereus marginatus (Pachycereeae: Cactaceae) in Central Mexico

Science.gov (United States)

DAR, SALEEM; ARIZMENDI, Ma. del CORO; VALIENTE-BANUET, ALFONSO

2006-01-01

• Background and Aims Chiropterophillous and ornithophillous characteristics can form part of a single reproductive strategy in plants that have flowers with diurnal and nocturnal anthesis. This broader pollination strategy can ensure seed set when pollinators are scarce or unpredictable. This appears to be true of hummingbirds, which presumably pollinate Marginatocereus marginatus, a columnar cactus with red nocturnal and diurnal flowers growing as part of dense bat-pollinated columnar cacti forests in arid regions of central Mexico. The aim of this study was to study the floral biology of M. marginatus, and evaluate the effectiveness of nocturnal vs. diurnal pollinators and the contribution of each pollinator group to overall plant fitness. • Methods Individual flower buds were marked and followed to evaluate flower phenology and anthesis time. Flowers and nectar production were measured. An exclusion experiment was conducted to measure the relative contribution of nocturnal and diurnal pollinators to seed set. • Key Results Marginatocereus marginatus has red hermaphroditic flowers with nocturnal and diurnal anthesis. The plant cannot produce seeds by selfing and was pollinated during the day by hummingbirds and during the night by bats, demonstrating that both pollinator groups were important for plant reproduction. Strong pollen limitation was found in the absence of one of the pollinator guilds. • Conclusions Marginatocereus marginatus has an open pollination system in which both diurnal and nocturnal pollinators are needed to set seeds. This represents a fail-safe pollination system that can ensure both pollination, in a situation of low abundance of one of the pollinator groups (hummingbirds), and high competition for nocturnal pollinators with other columnar cacti that bloom synchronously with M. marginatus in the Tehuacan Valley, Mexico. PMID:16394025

The impact of therapeutic opioid agonists on driving-related psychomotor skills assessed by a driving simulator or an on-road driving task: A systematic review.

Science.gov (United States)

Ferreira, Diana H; Boland, Jason W; Phillips, Jane L; Lam, Lawrence; Currow, David C

2018-04-01

Driving cessation is associated with poor health-related outcomes. People with chronic diseases are often prescribed long-term opioid agonists that have the potential to impair driving. Studies evaluating the impact of opioids on driving-related psychomotor skills report contradictory results likely due to heterogeneous designs, assessment tools and study populations. A better understanding of the effects of regular therapeutic opioid agonists on driving can help to inform the balance between individual's independence and community safety. To identify the literature assessing the impact of regular therapeutic opioid agonists on driving-related psychomotor skills for people with chronic pain or chronic breathlessness. Systematic review reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis statement; PROSPERO Registration CRD42017055909. Six electronic databases and grey literature were systematically searched up to January, 2017. Inclusion criteria were as follows: (1) empirical studies reporting data on driving simulation, on-the-road driving tasks or driving outcomes; (2) people with chronic pain or chronic breathlessness; and (3) taking regular therapeutic opioid agonists. Critical appraisal used the National Institutes of Health's quality assessment tools. From 3809 records screened, three studies matched the inclusion criteria. All reported data on people with chronic non-malignant pain. No significant impact of regular therapeutic opioid agonists on people's driving-related psychomotor skills was reported. One study reported more intense pain significantly worsened driving performance. This systematic review does not identify impaired simulated driving performance when people take regular therapeutic opioid agonists for symptom control, although more prospective studies are needed.

Assessment of driving-related performance in chronic whiplash using an advanced driving simulator.

Science.gov (United States)

Takasaki, Hiroshi; Treleaven, Julia; Johnston, Venerina; Rakotonirainy, Andry; Haines, Andrew; Jull, Gwendolen

2013-11-01

Driving is often nominated as problematic by individuals with chronic whiplash associated disorders (WAD), yet driving-related performance has not been evaluated objectively. The purpose of this study was to test driving-related performance in persons with chronic WAD against healthy controls of similar age, gender and driving experience to determine if driving-related performance in the WAD group was sufficiently impaired to recommend fitness to drive assessment. Driving-related performance was assessed using an advanced driving simulator during three driving scenarios; freeway, residential and a central business district (CBD). Total driving duration was approximately 15min. Five driving tasks which could cause a collision (critical events) were included in the scenarios. In addition, the effect of divided attention (identify red dots projected onto side or rear view mirrors) was assessed three times in each scenario. Driving performance was measured using the simulator performance index (SPI) which is calculated from 12 measures. z-Scores for all SPI measures were calculated for each WAD subject based on mean values of the control subjects. The z-scores were then averaged for the WAD group. A z-score of ≤-2 indicated a driving failing grade in the simulator. The number of collisions over the five critical events was compared between the WAD and control groups as was reaction time and missed response ratio in identifying the red dots. Seventeen WAD and 26 control subjects commenced the driving assessment. Demographic data were comparable between the groups. All subjects completed the freeway scenario but four withdrew during the residential and eight during the CBD scenario because of motion sickness. All scenarios were completed by 14 WAD and 17 control subjects. Mean z-scores for the SPI over the three scenarios was statistically lower in the WAD group (-0.3±0.3; Pdriving. There were no differences in the reaction time and missed response ratio in divided

A study on the effects of fatigue driving and drunk driving on drivers' physical characteristics.

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Zhang, Xingjian; Zhao, Xiaohua; Du, Hongji; Rong, Jian

2014-01-01

are found to impair drivers' physical characteristics. However, their impacts on the parameters SBP, HR, eyesight, and TDSA are different. A driver's physical characteristics will be impaired more seriously when he continues driving while drowsy, compared to driving under normal situation. These findings contribute to the current research on identifying drivers' driving state and quantifying the effects of fatigue driving and drunk driving on driving ability and driving behavior.

Targeting nocturnal hypertension in type 2 diabetes mellitus.

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Rossen, Niklas Blach; Knudsen, Søren Tang; Fleischer, Jesper; Hvas, Anne-Mette; Ebbehøj, Eva; Poulsen, Per Løgstrup; Hansen, Klavs Würgler

2014-11-01

Several studies in different populations have suggested that nighttime blood pressure (BP) is a stronger predictor of cardiovascular events than daytime BP. Consequently, treatment strategies to target nighttime BP have come into focus. The aim of the present study was to investigate the effect of change of administration time of antihypertensive drugs. We included 41 patients with type 2 diabetes mellitus and nocturnal hypertension (nighttime systolic BP >120 mm Hg) in an open-label, crossover study. Patients were randomized to 8 weeks of either morning or bedtime administration of all of the individual's once-daily antihypertensive drugs, followed by 8 weeks of switched dosing regimen. Bedtime administration of antihypertensive drugs resulted in a significant reduction in nighttime (7.5 mm Hg; Pdiabetes mellitus and nocturnal hypertension, administration of once-daily antihypertensive drugs at bedtime may be favorable. The increased nocturnal natriuresis may reflect increased effect of bedtime-administered thiazides and renin-angiotensin system inhibitors, suggesting a potential mechanism of the observed effects on BP with chronotherapeutic intervention. © 2014 American Heart Association, Inc.

Visual impairments and their influence on road safety.

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2015-01-01

Visual perception is an important source of information when driving a car. Visual impairments of drivers will therefore have an effect on performing the driving task. However, the effects on the crash rate are limited. The reason is, among other things, that people with visual impairments often

Sensor-based evaluation and treatment of nocturnal hypokinesia in Parkinson's disease: An evidence-based review.

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Bhidayasiri, Roongroj; Sringean, Jirada; Thanawattano, Chusak

2016-01-01

The manifestations of nocturnal movements in Parkinson's disease (PD) are protean, with major disabilities related to nocturnal hypokinesia. While it can be assessed by clinical interviews and screening instruments, these are often inaccurate and prone to recall bias. In light of advances in sensor technology, we explored the use of sensors in the study of nocturnal hypokinesia, by performing a systematic review of the professional literature on this topic. Evidence suggests that nocturnal hypokinesia exists even in patients in the early stages, and PD patients turned significantly less and with much slower speed and acceleration than controls, partly related to low nocturnal dopamine level. We conducted another systematic review to evaluate the evidence of the efficacy of dopaminergic agents in the treatment of nocturnal hypokinesia. Several lines of evidence support the use of long-acting drugs or by continuous administration of short-acting agents to control symptoms. Sensor parameters could be considered as one of the important objective outcomes in future clinical trials investigating potential drugs to treat nocturnal hypokinesia. Physicians should be aware of this technology as it can aid the clinical assessment of nocturnal hypokinesia and enhance the quality of patient care. In addition, the use of sensors currently is being considered for various aspects of research on early diagnosis, treatment, and rehabilitation of PD patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sleep Apnea and Circadian Extracellular Fluid Change as Independent Factors for Nocturnal Polyuria.

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Niimi, Aya; Suzuki, Motofumi; Yamaguchi, Yasuhiro; Ishii, Masaki; Fujimura, Tetsuya; Nakagawa, Tohru; Fukuhara, Hiroshi; Kume, Haruki; Igawa, Yasuhiko; Akishita, Masahiro; Homma, Yukio

2016-10-01

We investigated the relationships among nocturnal polyuria, sleep apnea and body fluid volume to elucidate the pathophysiology of nocturia in sleep apnea syndrome. We enrolled 104 consecutive patients who underwent polysomnography for suspected sleep apnea syndrome. Self-assessed symptom questionnaires were administered to evaluate sleep disorder and lower urinary tract symptoms, including nocturia. Voiding frequency and voided volume were recorded using a 24-hour frequency-volume chart. Body fluid composition was estimated in the morning and at night using bioelectric impedance analysis. Frequency-volume chart data were analyzed in 22 patients after continuous positive airway pressure therapy. Patients with nocturnal polyuria showed a higher apnea-hypopnea index (33.9 vs 24.2, p = 0.03) and a larger circadian change in extracellular fluid adjusted to lean body mass (0.22 vs -0.19, p = 0.019) than those without nocturnal polyuria. These relations were more evident in patients 65 years old or older than in those 64 years or younger. A multivariate linear regression model showed an independent relationship of nocturnal polyuria with the apnea-hypopnea index and the circadian change in extracellular fluid adjusted to lean body mass (p = 0.0012 and 0.022, respectively). Continuous positive airway pressure therapy significantly improved nocturnal polyuria and nocturia only in patients with nocturnal polyuria. This study identified sleep apnea and the circadian change in extracellular fluid as independent factors for nocturnal polyuria. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Nocturnal thoracoabdominal asynchrony in house dust mite-sensitive nonhuman primates

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XiaoJia Wang

2010-07-01

Full Text Available XiaoJia Wang, Shaun Reece, Stephen Olmstead, Robert L Wardle, Michael R Van ScottDepartment of Physiology, East Carolina University, Greenville, North Carolina, USAAbstract: Nocturnal bronchoconstriction is a common symptom of asthma in humans, but is poorly documented in animal models. Thoracoabdominal asynchrony (TAA is a noninvasive clinical indication of airway obstruction. In this study, respiratory inductive plethysmography (RIP was used to document nocturnal TAA in house dust mite (HDM-sensitive Cynomolgus macaques. Dynamic compliance (Cdyn and lung resistance (RL measured in anesthetized ­animals at rest and following exposure to HDM allergen, methacholine, and albuterol were highly ­correlated with three RIP parameters associated with TAA, ie, phase angle of the rib cage and abdomen waveforms (PhAng, baseline effort phase relation (eBPRL and effort phase relation (ePhRL. Twenty-one allergic subjects were challenged with HDM early in the morning, and eBPRL and ePhRL were monitored for 20 hours after provocation. Fifteen of the allergic subjects exhibited gradual increases in eBPRL and ePhRL between midnight and 6 am, with peak activity at 4 am. However, as in humans, this nocturnal response was highly variable both between subjects and within subjects over time. The results document that TAA in this nonhuman primate model of asthma is highly correlated with Cdyn and RL, and demonstrate that animals exhibiting acute responses to allergen exposure during the day also exhibit nocturnal TAA.Keywords: nocturnal asthma, late phase asthmatic response, respiratory inductive plethysmography

Nocturnal sleep problems among university students from 26 countries.

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Peltzer, Karl; Pengpid, Supa

2015-05-01

The aim of this study is to estimate the prevalence of nocturnal sleeping problems and its associated factors among university students in mainly low- and middle-income countries. A cross-sectional survey was conducted with 20,222 undergraduate university students (mean age, 20.8; SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Overall, 10.4% reported severe or extreme nocturnal sleeping problems (male, 10.2%; female, 10.5%) in the past month. Noctural sleeping problems differed by country, from 32.9% in Indonesia to 3.0 % in Thailand among Asian countries, from 13.7% in Mauritius to 7.5% in South Africa, and from 11.8% in Jamaica to 6.1% in Columbia in the Americas. In multivariate logistic regression analysis, coming from a poor family background, staying off campus (on their own or with parents or guardians), stress (history of child sexual abuse), poor mental health (depression and PTSD symptoms), health risk behaviour (tobacco use, heavy internet use, gambling, skipping breakfast and having sustained an injury), lack of social support and poor academic performance were associated with nocturnal sleeping problems. A significant prevalence of past-month nocturnal sleeping problems was found. Potential factors associated with the risk of reporting sleeping complaints were identified, which may assist in prevention strategies to promote a better quality of sleep.

Visually impaired drivers who use bioptic telescopes: self-assessed driving skills and agreement with on-road driving evaluation.

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Owsley, Cynthia; McGwin, Gerald; Elgin, Jennifer; Wood, Joanne M

2014-01-15

To compare self-assessed driving habits and skills of licensed drivers with central visual loss who use bioptic telescopes to those of age-matched normally sighted drivers, and to examine the association between bioptic drivers' impressions of the quality of their driving and ratings by a "backseat" evaluator. Participants were licensed bioptic drivers (n = 23) and age-matched normally sighted drivers (n = 23). A questionnaire was administered addressing driving difficulty, space, quality, exposure, and, for bioptic drivers, whether the telescope was helpful in on-road situations. Visual acuity and contrast sensitivity were assessed. Information on ocular diagnosis, telescope characteristics, and bioptic driving experience was collected from the medical record or in interview. On-road driving performance in regular traffic conditions was rated independently by two evaluators. Like normally sighted drivers, bioptic drivers reported no or little difficulty in many driving situations (e.g., left turns, rush hour), but reported more difficulty under poor visibility conditions and in unfamiliar areas (P Driving exposure was reduced in bioptic drivers (driving 250 miles per week on average vs. 410 miles per week for normally sighted drivers, P = 0.02), but driving space was similar to that of normally sighted drivers (P = 0.29). All but one bioptic driver used the telescope in at least one driving task, and 56% used the telescope in three or more tasks. Bioptic drivers' judgments about the quality of their driving were very similar to backseat evaluators' ratings. Bioptic drivers show insight into the overall quality of their driving and areas in which they experience driving difficulty. They report using the bioptic telescope while driving, contrary to previous claims that it is primarily used to pass the vision screening test at licensure.

The Relationship Between Child Anxiety Related Disorders and Primary Nocturnal Enuresis.

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Salehi, Bahman; Yousefichaijan, Parsa; Rafeei, Mohammad; Mostajeran, Mahssa

2016-06-01

Nocturnal enuresis, often called bedwetting or sleep wetting, is a common problem in children after the age of five and may lead to symptoms such as infection, incontinence and frequent urination. This problem refers to a state in which children after the age of five have no control of their urine for six continuous months and it cannot be attributed to any organic factors or drug use. In this study we aimed to study generalized anxiety disorder as one of the possible causes of primary nocturnal enuresis. In this case-control study 180 children with primary nocturnal enuresis and same number of healthy children with a mean age of 7 - 17 years old with the same demographic characteristics were selected. The study took place at Amir Kabir hospital of Arak, Iran during year 2014. After collecting the information, diagnosis was verified based on the diagnostic and statistical manual of mental disorders (DSM) IV-TR criteria. Results were analyzed using the SPSS software (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, version 20.0. Armonk, NY: IBM Corp.). Frequency of generalized anxiety disorder, panic disorder, school phobia, social anxiety, separation anxiety, history of anxiety in mother, history of primary nocturnal enuresis in parent's family and body mass index had a significant difference between the two groups (P = 0.005). With the results obtained from this study we could say that there was a clear significant difference between the two control and patient groups for all subgroups of anxiety disorders such as generalized anxiety disorder and their relationship with primary nocturnal enuresis. Given the higher prevalence of generalized anxiety disorder, panic disorder, school phobia, social anxiety, separation anxiety and comparison with healthy children, it is recommended for all children with primary nocturnal enuresis to be investigated and treated for generalized anxiety disorder.

The nocturnal bottleneck and the evolution of activity patterns in mammals

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Gerkema, Menno P.; Davies, Wayne I. L.; Foster, Russell G.; Menaker, Michael; Hut, Roelof A.

2013-01-01

In 1942, Walls described the concept of a ‘nocturnal bottleneck’ in placental mammals, where these species could survive only by avoiding daytime activity during times in which dinosaurs were the dominant taxon. Walls based this concept of a longer episode of nocturnality in early eutherian mammals by comparing the visual systems of reptiles, birds and all three extant taxa of the mammalian lineage, namely the monotremes, marsupials (now included in the metatherians) and placentals (included in the eutherians). This review describes the status of what has become known as the nocturnal bottleneck hypothesis, giving an overview of the chronobiological patterns of activity. We review the ecological plausibility that the activity patterns of (early) eutherian mammals were restricted to the night, based on arguments relating to endothermia, energy balance, foraging and predation, taking into account recent palaeontological information. We also assess genes, relating to light detection (visual and non-visual systems) and the photolyase DNA protection system that were lost in the eutherian mammalian lineage. Our conclusion presently is that arguments in favour of the nocturnal bottleneck hypothesis in eutherians prevail. PMID:23825205

Repeated-dose effects of mequitazine, cetirizine and dexchlorpheniramine on driving and psychomotor performance.

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Theunissen, Eef L; Vermeeren, Annemiek; Ramaekers, Johannes G

2006-01-01

Previous studies have demonstrated that the antihistamines mequitazine, cetirizine and dexchlorpheniramine produce mild sedation after single doses. It is unknown, however, whether acute sedation persists after repeated dosing. Therefore, this study assessed the effects of repeated dosing of these antihistamines on driving and psychomotor performance. Sixteen healthy volunteers were treated with mequitazine 10 mg q.a.m., cetirizine 10 mg q.a.m., dexchlorpheniramine Repetab 6 mg b.i.d. and placebo for four separate 8-day periods. Drug effects were assessed on days 1 and 8 using on-the-road driving tests (highway driving and car following), psychomotor tests (tracking and divided attention) and subjective questionnaires. Dexchlorpheniramine and mequitazine significantly impaired driving performance on the highway driving test on the first day; dexchlorpheniramine increased Standard Deviation of Lateral Position by 2 cm [95% confidence interval (CI) 0.5, 3.8] and mequitazine by 2.5 cm (CI 1.0, 4.3). These effects on driving performance disappeared after 8 days of treatment. No effect of treatment was found on car following, tracking and divided attention. Although subjective ratings confirmed that subjects knew their driving had been impaired in the mequitazine and dexchlorpheniramine condition after completion of the highway driving test on day 1, they did not expect their driving to be affected before the start of the test. Cetirizine did not impair performance on any of the tests. Single doses of mequitazine 10 mg and dexchlorpheniramine Repetab 6 mg cause mild driving impairment. However, when taken over several days, the impairing effect wears off, possibly as a result of tolerance.

Climatology of nocturnal low-level jets over North Africa and implications for modeling mineral dust emission.

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Fiedler, S; Schepanski, K; Heinold, B; Knippertz, P; Tegen, I

2013-06-27

[1] This study presents the first climatology for the dust emission amount associated with Nocturnal Low-Level Jets (NLLJs) in North Africa. These wind speed maxima near the top of the nocturnal boundary layer can generate near-surface peak winds due to shear-driven turbulence in the course of the night and the NLLJ breakdown during the following morning. The associated increase in the near-surface wind speed is a driver for mineral dust emission. A new detection algorithm for NLLJs is presented and used for a statistical assessment of NLLJs in 32 years of ERA-Interim reanalysis from the European Centre for Medium-Range Weather Forecasts. NLLJs occur in 29% of the nights in the annual and spatial mean. The NLLJ climatology shows a distinct annual cycle with marked regional differences. Maxima of up to 80% NLLJ frequency are found where low-level baroclinicity and orographic channels cause favorable conditions, e.g., over the Bodélé Depression, Chad, for November-February and along the West Saharan and Mauritanian coast for April-September. Downward mixing of NLLJ momentum to the surface causes 15% of mineral dust emission in the annual and spatial mean and can be associated with up to 60% of the total dust amount in specific areas, e.g., the Bodélé Depression and south of the Hoggar-Tibesti Channel. The sharp diurnal cycle underlines the importance of using wind speed information with high temporal resolution as driving fields for dust emission models. Citation: Fiedler, S., K. Schepanski, B. Heinold, P. Knippertz, and I. Tegen (2013), Climatology of nocturnal low-level jets over North Africa and implications for modeling mineral dust emission, J. Geophys. Res. Atmos., 118, 6100-6121, doi:10.1002/jgrd.50394.

Irregular bedtime and nocturnal cellular phone usage as risk factors for being involved in bullying: a cross-sectional survey of Japanese adolescents.

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Mamoru Tochigi

Full Text Available PURPOSE: A number of studies have tried to identify risk factors for being involved in bullying in order to help developing preventive measures; however, to our knowledge, no study has investigated the effect of nocturnal lifestyle behavior such as sleep pattern or cellular phone usage. In the present study, we aimed to investigate the relationship between school bullying and sleep pattern or nocturnal cellular phone usage in adolescents. The effect of school size on school bullying was also examined. METHODS: Data from the cross-sectional survey of psychopathologies conducted for 19,436 Japanese students from 45 public junior high schools (7(th-9(th grade and 28 senior high schools (10(th-12(th grade were analyzed. RESULTS: Bullying status was significantly associated with irregular bedtime (OR = 1.23 and 1.41 for pure bullies and bully-victims, respectively and e-mail exchange or calling after lights-out (OR = 1.53 and 1.31 for pure bullies and bully-victims, respectively after controlling domestic violence and substance usage. In addition, school size was significantly associated with the increased risk of bullying in junior high school students (OR = 1.13 for bully-victims. CONCLUSIONS: The present results suggested that sleep pattern and nocturnal cellular phone usage might be risk factors for being involved in school bullying in adolescents. Although further accumulation of data is needed, progressive trend towards nocturnal lifestyle and increasing usage of cellular phone might impair the well-being of adolescents. School-based interventions for lifestyle including sleep pattern and cellular phone usage may be encouraged to reduce school bullying.

Effect of melatonin on nocturnal blood pressure: meta-analysis of randomized controlled trials

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Laudon M

2011-09-01

Full Text Available Ehud Grossman1,4, Moshe Laudon2, Nava Zisapel2,31Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Israel; 2Neurim Pharmaceuticals Ltd, Tel Aviv, Israel and 3Department of Neurobiology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel; 4Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelBackground: Patients with nocturnal hypertension are at higher risk for cardiovascular complications such as myocardial infarction and cerebrovascular insult. Published studies inconsistently reported decreases in nocturnal blood pressure with melatonin.Methods: A meta-analysis of the efficacy and safety of exogenous melatonin in ameliorating nocturnal blood pressure was performed using a random effects model of all studies fitting the inclusion criteria, with subgroup analysis of fast-release versus controlled-release preparations.Results: Seven trials (three of controlled-release and four of fast-release melatonin with 221 participants were included. Meta-analysis of all seven studies did not reveal significant effects of melatonin versus placebo on nocturnal blood pressure. However, subgroup analysis revealed that controlled-release melatonin significantly reduced nocturnal blood pressure whereas fast-release melatonin had no effect. Systolic blood pressure decreased significantly with controlled-release melatonin (-6.1 mmHg; 95% confidence interval [CI] -10.7 to -1.5; P = 0.009 but not fast-release melatonin (-0.3 mmHg; 95% CI -5.9 to 5.30; P = 0.92. Diastolic blood pressure also decreased significantly with controlled-release melatonin (-3.5 mmHg; 95% CI -6.1 to -0.9; P = 0.009 but not fast-release melatonin (-0.2 mmHg; 95% CI -3.8 to 3.3; P = 0.89. No safety concerns were raised.Conclusion: Add-on controlled-release melatonin to antihypertensive therapy is effective and safe in ameliorating nocturnal hypertension, whereas fast-release melatonin is ineffective. It is necessary

Drinking and driving behavior at stop signs and red lights.

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Wan, Jingyan; Wu, Changxu; Zhang, Yiqi; Houston, Rebecca J; Chen, Chang Wen; Chanawangsa, Panya

2017-07-01

Alcohol is one of the principal risk factors for motor vehicle crashes. One factor that contributes to vehicle crashes is noncompliance with stop signs and red lights. The present experiment investigated the effects of alcohol and drinking patterns on driving behavior at stop signs and red lights. 28 participants participated in drinking and simulated driving sessions during which they received a moderate dose of alcohol (0.08% BAC) or a placebo. Simulated driving tasks measured participants' driving performance at stop signs and red lights in response to each dose. Results suggested that alcohol impaired the driver control of speed and direction and prolonged their simple and complex reaction time, which were exhibited by impaired speed and lateral control, longer reaction time when the lights turned yellow, and lower deceleration towards stop signs and red lights. Visual degradation may also occur under alcohol intake. It was also suggested that alcohol impaired non-binge drinkers more severely. To be specific, higher acceleration was observed in impaired non-binge drinkers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Phytotherapy for children's nocturnal enuresis | Ahmadipour ...

African Journals Online (AJOL)

Results have shown that Zingiber officinale, Valeriana officinalis, Alcea rosea, Elettaria cardamomum, Cinnamomum verum, Ribes uva-crispa, Cornus mas, Juglans regia, Vitis vinifera, Sinapis spp., Olea europaea, and Prunus cerasus are a number of important plants that are effective on nocturnal enuresis in traditional ...

Capnography for assessing nocturnal hypoventilation and predicting compliance with subsequent noninvasive ventilation in patients with ALS.

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Sung-Min Kim

Full Text Available BACKGROUND: Patients with amyotrophic lateral sclerosis (ALS suffer from hypoventilation, which can easily worsen during sleep. This study evaluated the efficacy of capnography monitoring in patients with ALS for assessing nocturnal hypoventilation and predicting good compliance with subsequent noninvasive ventilation (NIV treatment. METHODS: Nocturnal monitoring and brief wake screening by capnography/pulse oximetry, functional scores, and other respiratory signs were assessed in 26 patients with ALS. Twenty-one of these patients were treated with NIV and had their treatment compliance evaluated. RESULTS: Nocturnal capnography values were reliable and strongly correlated with the patients' respiratory symptoms (R(2 = 0.211-0.305, p = 0.004-0.021. The duration of nocturnal hypercapnea obtained by capnography exhibited a significant predictive power for good compliance with subsequent NIV treatment, with an area-under-the-curve value of 0.846 (p = 0.018. In contrast, no significant predictive values for nocturnal pulse oximetry or functional scores for nocturnal hypoventilation were found. Brief waking supine capnography was also useful as a screening tool before routine nocturnal capnography monitoring. CONCLUSION: Capnography is an efficient tool for assessing nocturnal hypoventilation and predicting good compliance with subsequent NIV treatment of ALS patients, and may prove useful as an adjunctive tool for assessing the need for NIV treatment in these patients.

Anatomical specializations for nocturnality in a critically endangered parrot, the Kakapo (Strigops habroptilus.

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Jeremy R Corfield

Full Text Available The shift from a diurnal to nocturnal lifestyle in vertebrates is generally associated with either enhanced visual sensitivity or a decreased reliance on vision. Within birds, most studies have focused on differences in the visual system across all birds with respect to nocturnality-diurnality. The critically endangered Kakapo (Strigops habroptilus, a parrot endemic to New Zealand, is an example of a species that has evolved a nocturnal lifestyle in an otherwise diurnal lineage, but nothing is known about its' visual system. Here, we provide a detailed morphological analysis of the orbits, brain, eye, and retina of the Kakapo and comparisons with other birds. Morphometric analyses revealed that the Kakapo's orbits are significantly more convergent than other parrots, suggesting an increased binocular overlap in the visual field. The Kakapo exhibits an eye shape that is consistent with other nocturnal birds, including owls and nightjars, but is also within the range of the diurnal parrots. With respect to the brain, the Kakapo has a significantly smaller optic nerve and tectofugal visual pathway. Specifically, the optic tectum, nucleus rotundus and entopallium were significantly reduced in relative size compared to other parrots. There was no apparent reduction to the thalamofugal visual pathway. Finally, the retinal morphology of the Kakapo is similar to that of both diurnal and nocturnal birds, suggesting a retina that is specialised for a crepuscular niche. Overall, this suggests that the Kakapo has enhanced light sensitivity, poor visual acuity and a larger binocular field than other parrots. We conclude that the Kakapo possesses a visual system unlike that of either strictly nocturnal or diurnal birds and therefore does not adhere to the traditional view of the evolution of nocturnality in birds.

A cutoff value based on analysis of a reference population decreases overestimation of the prevalence of nocturnal polyuria.

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van Haarst, Ernst P; Bosch, J L H Ruud

2012-09-01

We sought criteria for nocturnal polyuria in asymptomatic, nonurological adults of all ages by reporting reference values of the ratio of daytime and nighttime urine volumes, and finding nocturia predictors. Data from a database of frequency-volume charts from a reference population of 894 nonurological, asymptomatic volunteers of all age groups were analyzed. The nocturnal polyuria index and the nocturia index were calculated and factors influencing these values were determined by multivariate analysis. The nocturnal polyuria index had wide variation but a normal distribution with a mean ± SD of 30% ± 12%. The 95th percentile of the values was 53%. Above this cutoff a patient had nocturnal polyuria. This value contrasts with the International Continence Society definition of 33% but agrees with several other reports. On multivariate regression analysis with the nocturnal polyuria index as the dependent variable sleeping time, maximum voided volume and age were the covariates. However, the increase in the nocturnal polyuria index by age was small. Excluding polyuria and nocturia from analysis did not alter the results in a relevant way. The nocturnal voiding frequency depended on sleeping time and maximum voided volume but most of all on the nocturia index. The prevalence of nocturnal polyuria is overestimated. We suggest a new cutoff value for the nocturnal polyuria index, that is nocturnal polyuria exists when the nocturnal polyuria index exceeds 53%. The nocturia index is the best predictor of nocturia. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Adaptive genomic evolution of opsins reveals that early mammals flourished in nocturnal environments.

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Borges, Rui; Johnson, Warren E; O'Brien, Stephen J; Gomes, Cidália; Heesy, Christopher P; Antunes, Agostinho

2018-02-05

Based on evolutionary patterns of the vertebrate eye, Walls (1942) hypothesized that early placental mammals evolved primarily in nocturnal habitats. However, not only Eutheria, but all mammals show photic characteristics (i.e. dichromatic vision, rod-dominated retina) suggestive of a scotopic eye design. Here, we used integrative comparative genomic and phylogenetic methodologies employing the photoreceptive opsin gene family in 154 mammals to test the likelihood of a nocturnal period in the emergence of all mammals. We showed that mammals possess genomic patterns concordant with a nocturnal ancestry. The loss of the RH2, VA, PARA, PARIE and OPN4x opsins in all mammals led us to advance a probable and most-parsimonious hypothesis of a global nocturnal bottleneck that explains the loss of these genes in the emerging lineage (> > 215.5 million years ago). In addition, ancestral character reconstruction analyses provided strong evidence that ancestral mammals possessed a nocturnal lifestyle, ultra-violet-sensitive vision, low visual acuity and low orbit convergence (i.e. panoramic vision). Overall, this study provides insight into the evolutionary history of the mammalian eye while discussing important ecological aspects of the photic paleo-environments ancestral mammals have occupied.

Childhood nocturnal enuresis in the Netherlands

NARCIS (Netherlands)

Spee-van der Wekke, J.; Hirasing, R.A.; Meulmeester, J.F.; Radder, J.J.

1998-01-01

Objectives. To assess the prevalence of nocturnal enuresis in school children aged 5 to 15 years, and to investigate the association of bedwetting with ethnicity, the educational level of the parents, and the type of education (mainstream or special) received by the child. Methods. Data were

Prognostic value of nocturnal pulse oximetry in patients with heart failure.

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Rivera-López, Ricardo; Jordán-Martínez, Laura; López-Fernández, Silvia; Rivera-Fernandez, Ricardo; Tercedor, Luis; Sáez-Roca, Germán

2018-05-23

To analyze the prognostic value of nocturnal hypoxemia measured with portable nocturnal pulse-oximetry in patients hospitalized due to heart failure and its relation to mortality and hospital readmission. We included 38 patients who were admitted consecutively to our unit with the diagnosis of decompensated heart failure. Pulse-oximetry was considered positive for hypoxemia when more than 10 desaturations per hour were recorded during sleep. Follow-up was performed for 30.3 (standard deviation [SD] 14.2) months, the main objective being a combined endpoint of all-cause mortality and hospital readmission due to heart failure. The average age was 70.7 (SD 10.7) years, 63.3% were males. Pulse-oximetry was considered positive for hypoxemia in 27 (71%) patients. Patients with positive pulse-oximetry had the most frequent endpoint (9.1% [1] vs. 61.5% [16], P = 0.003). After multivariate analysis, continuous nocturnal hypoxemia was related to the combined endpoint (HR = 8.37, 1.19-68.4, P = 0.03). Patients hospitalized for heart failure and nocturnal hypoxemia measured with portable pulse-oximeter have an increased risk of hospital readmission and death. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Prevalence of Nocturnal Enuresis and Its Associated Factors in Primary School and Preschool Children of Khorramabad in 2013

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Katayoun Bakhtiar

2014-01-01

Full Text Available Background. Nocturnal enuresis refers to an inability to control urination during sleep. This study aimed to determine the prevalence of nocturnal enuresis and its associated factors in children in the city of Khorramabad. Materials and Methods. In this descriptive-analytic, cross-sectional study, 710 male and female children were divided into two groups with equal numbers. The samples were selected from the schools of Khorramabad using the multistage cluster and stratified random sampling methods based on the diagnostic criteria of DSM-IV. The data was analyzed using the logistic regression. Results. The results showed that 8% of the children had nocturnal enuresis, including 5.2% of primary nocturnal enuresis and 2.8% of secondary nocturnal enuresis. The prevalence of nocturnal enuresis in the boys (10.7% was higher compared with that in the girls (5.4% (P=0.009. There were statistically significant relationships between nocturnal enuresis and history of nocturnal enuresis in siblings (P=0.023, respiratory infections (P=0.036, deep sleep (P=0.007, corporal punishment at school (P=0.036, anal itching (P=0.043, and history of seizures (P=0.043. Conclusion. This study showed that the prevalence of nocturnal enuresis in the boys was higher compared with that in the girls.

Prevalence of nocturnal enuresis and its associated factors in primary school and preschool children of khorramabad in 2013.

Science.gov (United States)

Bakhtiar, Katayoun; Pournia, Yadollah; Ebrahimzadeh, Farzad; Farhadi, Ali; Shafizadeh, Fathollah; Hosseinabadi, Reza

2014-01-01

Background. Nocturnal enuresis refers to an inability to control urination during sleep. This study aimed to determine the prevalence of nocturnal enuresis and its associated factors in children in the city of Khorramabad. Materials and Methods. In this descriptive-analytic, cross-sectional study, 710 male and female children were divided into two groups with equal numbers. The samples were selected from the schools of Khorramabad using the multistage cluster and stratified random sampling methods based on the diagnostic criteria of DSM-IV. The data was analyzed using the logistic regression. Results. The results showed that 8% of the children had nocturnal enuresis, including 5.2% of primary nocturnal enuresis and 2.8% of secondary nocturnal enuresis. The prevalence of nocturnal enuresis in the boys (10.7%) was higher compared with that in the girls (5.4%) (P = 0.009). There were statistically significant relationships between nocturnal enuresis and history of nocturnal enuresis in siblings (P = 0.023), respiratory infections (P = 0.036), deep sleep (P = 0.007), corporal punishment at school (P = 0.036), anal itching (P = 0.043), and history of seizures (P = 0.043). Conclusion. This study showed that the prevalence of nocturnal enuresis in the boys was higher compared with that in the girls.

Innovative Visualizations Shed Light on Avian Nocturnal Migration.

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Judy Shamoun-Baranes

Full Text Available Globally, billions of flying animals undergo seasonal migrations, many of which occur at night. The temporal and spatial scales at which migrations occur and our inability to directly observe these nocturnal movements makes monitoring and characterizing this critical period in migratory animals' life cycles difficult. Remote sensing, therefore, has played an important role in our understanding of large-scale nocturnal bird migrations. Weather surveillance radar networks in Europe and North America have great potential for long-term low-cost monitoring of bird migration at scales that have previously been impossible to achieve. Such long-term monitoring, however, poses a number of challenges for the ornithological and ecological communities: how does one take advantage of this vast data resource, integrate information across multiple sensors and large spatial and temporal scales, and visually represent the data for interpretation and dissemination, considering the dynamic nature of migration? We assembled an interdisciplinary team of ecologists, meteorologists, computer scientists, and graphic designers to develop two different flow visualizations, which are interactive and open source, in order to create novel representations of broad-front nocturnal bird migration to address a primary impediment to long-term, large-scale nocturnal migration monitoring. We have applied these visualization techniques to mass bird migration events recorded by two different weather surveillance radar networks covering regions in Europe and North America. These applications show the flexibility and portability of such an approach. The visualizations provide an intuitive representation of the scale and dynamics of these complex systems, are easily accessible for a broad interest group, and are biologically insightful. Additionally, they facilitate fundamental ecological research, conservation, mitigation of human-wildlife conflicts, improvement of meteorological

The anti-bat strategy of ultrasound absorption: the wings of nocturnal moths (Bombycoidea: Saturniidae) absorb more ultrasound than the wings of diurnal moths (Chalcosiinae: Zygaenoidea: Zygaenidae).

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Ntelezos, Athanasios; Guarato, Francesco; Windmill, James F C

2017-01-15

The selection pressure from echolocating bats has driven the development of a diverse range of anti-bat strategies in insects. For instance, several studies have proposed that the wings of some moths absorb a large portion of the sound energy contained in a bat's ultrasonic cry; as a result, the bat receives a dampened echo, and the moth becomes invisible to the bat. To test the hypothesis that greater exposure to bat predation drives the development of higher ultrasound absorbance, we used a small reverberation chamber to measure the ultrasound absorbance of the wings of nocturnal (Bombycoidea: Saturniidae) and diurnal moths (Chalcosiinae: Zygaenoidea: Zygaenidae). The absorption factor of the nocturnal saturniids peaks significantly higher than the absorption factor of the diurnal chalcosiines. However, the wings of the chalcosiines absorb more ultrasound than the wings of some diurnal butterflies. Following a phylogenetic analysis on the character state of diurnality/ nocturnality in the Zygaenidae, we propose that diurnality in the Chalcosiinae is plesiomorphic (retained); hence, the absorbance of their wings is probably not a vestigial trait from an ancestral, nocturnal form but an adaptation to bat activity that overlaps their own. On a within-species level, females of the saturniids Argema mittrei and Samia cynthia ricini have significantly higher absorption factors than the males. In the female S. c. ricini, the higher absorption factor corresponds to a detection distance by bats that is at best 20-30% shorter than that of the male. © 2017. Published by The Company of Biologists Ltd.

Nocturnal hypoxia in ALS is related to cognitive dysfunction and can occur as clusters of desaturations.

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Su-Yeon Park

Full Text Available Amyotrophic lateral sclerosis (ALS is a neurodegenerative disease that leads to progressive weakness of the respiratory and limb muscles. Consequently, most patients with ALS exhibit progressive hypoventilation, which worsens during sleep. The aim of this study was to evaluate the relationship between nocturnal hypoxia and cognitive dysfunction and to assess the pattern of nocturnal hypoxia in patients with ALS.Twenty-five patients with definite or probable ALS underwent neuropsychologic testing, nocturnal pulse oximetry, and capnography. Patients were grouped according to the presence of nocturnal hypoxia (SpO2<95% for ≥10% of the night and their clinical characteristics and cognitive function were compared.Compared to patients without nocturnal hypoxia, those with nocturnal hypoxia (n = 10, 40% had poor memory retention (p = 0.039 and retrieval efficiency (p = 0.045. A cluster-of-desaturation pattern was identified in 7 patients (70% in the Hypoxia Group.These results suggest that nocturnal hypoxia can be related to cognitive dysfunction in ALS. In addition, a considerable number of patients with ALS may be exposed to repeated episodes of deoxygenation-reoxygenation (a cluster-of-desaturation pattern during sleep, which could be associated with the generation of reactive oxygen species. Further studies are required to define the exact causal relationships between these phenomena, the exact manifestations of nocturnal cluster-of-desaturation patterns, and the effect of clusters of desaturation on ALS progression.

Nocturnal Polyuria in Older Women with Urge Urinary Incontinence: Role of Sleep Quality, Time in Bed and Medications Used.

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Tyagi, Shachi; Perera, Subashan; Clarkson, Becky D; Tadic, Stasa D; Resnick, Neil M

2017-03-01

Nocturia is common and bothersome in older adults, especially those who are also incontinent. Since nocturnal polyuria is a major contributor, we examined factors associated with nocturnal polyuria in this population to identify those possibly amenable to intervention. We analyzed baseline data from 2 previously completed studies of urge urinary incontinence. The studies involved 284 women (mean age ± SD 72.9 ± 7.9 years) who also completed 3-day voiding diaries. Participants with a nocturnal polyuria index greater than 33% were categorized as having nocturnal polyuria (nocturnal polyuria index = nocturnal urinary volume per 24-hour urine volume). Associations between nocturnal polyuria and various demographic, clinical and sleep related parameters were determined. Overall 55% of the participants had nocturnal polyuria. Multivariable regression analysis revealed that age, body mass index, use of angiotensin converting enzyme inhibitor/angiotensin receptor blocker, time spent in bed and duration of first uninterrupted sleep were independent correlates of nocturnal polyuria. Participants with a larger nocturnal excretion reported a shorter duration of uninterrupted sleep before first awakening to void and worse sleep quality despite spending similar time in bed. Body mass index, use of angiotensin converting enzyme inhibitor/angiotensin receptor blockers, time in bed and duration of uninterrupted sleep before first awakening to void are independently associated with nocturnal polyuria in older women with urge urinary incontinence, and are potentially modifiable. These findings also confirm the association between sleep and nocturnal polyuria. Further studies should explore whether interventions to reduce nocturnal polyuria and/or increase the duration of uninterrupted sleep before first awakening to void would help to improve sleep quality in this population and thereby reduce or eliminate the need for sedative hypnotics. Copyright © 2017 American Urological

The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study

OpenAIRE

Kim, Young Won; Park, Jinsung; Chung, Hong; Kim, Hong-Wook; Kim, Hyung Joon; Jung, Jae Hung; Kim, Won Tae

2015-01-01

Purpose: To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. Methods: This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33), aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6%) completed the study according to...

The association between nocturia and nocturnal polyuria in clinical and epidemiological studies: a systematic review and meta-analyses.

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Hofmeester, Ilse; Kollen, Boudewijn J; Steffens, Martijn G; Bosch, J L H Ruud; Drake, Marcus J; Weiss, Jeffrey P; Blanker, Marco H

2014-04-01

We determined the relationship between nocturia and nocturnal polyuria. The PubMed® and Embase® databases were searched for studies written in English, German, French or Dutch with original data on adult participants in an investigation of the relationship between nocturia and nocturnal polyuria. A meta-analysis of the difference in mean nocturnal voiding frequencies between patients with and without nocturnal polyuria was conducted. Nocturnal polyuria risk was compared between participants with and without nocturia, and the resulting odds ratio was subsequently converted to relative risk with 95% CIs. From 511 references identified we selected 78 publications of 66 studies, 15 of which met the inclusion criteria for this study. Quality scores of studies were generally high for internal validity but low for external validity. In 7 studies (1,416 participants) we estimated a standardized mean difference of 0.59 (95% CI 0.29-0.89) for nocturnal voids between nocturnal polyuria and nonnocturnal polyuria cases. In 8 other studies (with 2,320 participants) we calculated a pooled OR of 4.99 (3.92-6.37) for nocturnal polyuria in individuals with nocturia. The corresponding RR, based on a nocturnal polyuria risk in the pooled population of 63.8%, was 1.41 (1.37-1.44). The association between nocturia and nocturnal polyuria is apparent and robust. However, the clinical importance of the association appears to be less obvious than previously suggested based on single studies. The observed high prevalence of nocturnal polyuria, as a result of the applied International Continence Society definition, may be responsible for this discrepancy. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Mental flexibility impairment in drivers with early Alzheimer's disease: A simulator-based study

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Virginie Etienne

2013-07-01

Full Text Available After memory impairment, one of the most common troubles of early Alzheimer's disease (AD is the impairment of executive functioning. However, it can have major consequences on daily life, notably on the driving activity. The present study focused on one important executive function involved in driving: mental flexibility; and considered how this impairment can affect driving. Ten patients with early AD were matched with 29 healthy older drivers. All participants were given an evaluation of mental flexibility through neuropsychological tests and an experimental test developed on a static driving simulator. The experiment was divided in two conditions; one without mental flexibility and another condition with a mental flexibility demand. AD patients showed impairments in the neuropsychological tests evaluating mental flexibility. These deficits are linked to the deficits they showed in the driving simulator flexibility tests. This study contributes to the understanding of mental flexibility mechanisms and on their role in driving activity. It also confirms that the driving simulator is a suitable tool to explore cognitive disorders and driving ability.

Fitness to drive after traumatic brain injury

NARCIS (Netherlands)

Brouwer, WH; Withaar, FK

This paper deals with the issue of fitness to drive in patients suffering from traumatic brain injury (TBI). Guidelines for assessment are proposed and three types of studies are reviewed: studies about impairments of attention and information processing, studies of driving competence, and driver

Local characteristics of the nocturnal boundary layer in response to external pressure forcing

NARCIS (Netherlands)

van der Linden, S.J.A.; Baas, P.; van Hooft, J.A.; van Hooijdonk, I.G.S.; Bosveld, F.C.; van de Wiel, B.J.H.

2017-01-01

Geostrophic wind speed data, derived from pressure observations, are used in combination with tower measurements to investigate the nocturnal stable boundary layer at Cabauw (The Netherlands). Since the geostrophic wind speed is not directly influenced by local nocturnal stability, it may be

Circadian rhythm of temperature selection in a nocturnal lizard.

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Refinetti, R; Susalka, S J

1997-08-01

We recorded body temperature and locomotor activity of Tokay geckos (Gekko gecko) with free access to a heat source under a 14:10 light-dark cycle and in constant darkness. Under the light-dark cycle, the lizards selected higher temperatures during the light phase, when locomotor activity was less intense. Rhythmicity in temperature selection was transiently disrupted but later resumed when the animals were placed in constant darkness. These results demonstrate the existence of a circadian rhythm of temperature selection in nocturnal ectotherms and extend previous findings of a temporal mismatch between the rhythms of locomotor activity and temperature selection in nocturnal rodents.

Light pollution modifies the expression of daily rhythms and behavior patterns in a nocturnal primate.

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Thomas Le Tallec

Full Text Available Among anthropogenic pressures, light pollution altering light/dark cycles and changing the nocturnal component of the environment constitutes a threat for biodiversity. Light pollution is widely spread across the world and continuously growing. However, despite the efforts realized to describe and understand the effects of artificial lighting on fauna, few studies have documented its consequences on biological rhythms, behavioral and physiological functions in nocturnal mammals. To determine the impacts of light pollution on nocturnal mammals an experimental study was conducted on a nocturnal primate, the grey mouse lemur Microcebus murinus. Male mouse lemurs (N = 8 were exposed 14 nights to moonlight treatment and then exposed 14 nights to light pollution treatment. For both treatments, chronobiological parameters related to locomotor activity and core temperature were recorded using telemetric transmitters. In addition, at the end of each treatment, the 14(th night, nocturnal and feeding behaviors were explored using an infrared camera. Finally, throughout the study, body mass and daily caloric food intake were recorded. For the first time in a nocturnal primate, light pollution was demonstrated to modify daily rhythms of locomotor activity and core temperature especially through phase delays and increases in core temperature. Moreover, nocturnal activity and feeding behaviors patterns were modified negatively. This study suggests that light pollution induces daily desynchronization of biological rhythms and could lead to seasonal desynchronization with potential deleterious consequences for animals in terms of adaptation and anticipation of environmental changes.

Light pollution modifies the expression of daily rhythms and behavior patterns in a nocturnal primate.

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Le Tallec, Thomas; Perret, Martine; Théry, Marc

2013-01-01

Among anthropogenic pressures, light pollution altering light/dark cycles and changing the nocturnal component of the environment constitutes a threat for biodiversity. Light pollution is widely spread across the world and continuously growing. However, despite the efforts realized to describe and understand the effects of artificial lighting on fauna, few studies have documented its consequences on biological rhythms, behavioral and physiological functions in nocturnal mammals. To determine the impacts of light pollution on nocturnal mammals an experimental study was conducted on a nocturnal primate, the grey mouse lemur Microcebus murinus. Male mouse lemurs (N = 8) were exposed 14 nights to moonlight treatment and then exposed 14 nights to light pollution treatment. For both treatments, chronobiological parameters related to locomotor activity and core temperature were recorded using telemetric transmitters. In addition, at the end of each treatment, the 14(th) night, nocturnal and feeding behaviors were explored using an infrared camera. Finally, throughout the study, body mass and daily caloric food intake were recorded. For the first time in a nocturnal primate, light pollution was demonstrated to modify daily rhythms of locomotor activity and core temperature especially through phase delays and increases in core temperature. Moreover, nocturnal activity and feeding behaviors patterns were modified negatively. This study suggests that light pollution induces daily desynchronization of biological rhythms and could lead to seasonal desynchronization with potential deleterious consequences for animals in terms of adaptation and anticipation of environmental changes.

Correlation of Sleep Disturbance and Cognitive Impairment in Patients with Parkinson’s Disease

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Eun Ja Kim

2014-04-01

Full Text Available Objective Cognitive impairment is a common nonmotor symptom of Parkinson’s disease (PD and is associated with high mortality, caregiver distress, and nursing home placement. The risk factors for cognitive decline in PD patients include advanced age, longer disease duration, rapid eye movement sleep behavior disorder, hallucinations, excessive daytime sleepiness, and nontremor symptoms including bradykinesia, rigidity, postural instability, and gait disturbance. We conducted a cross-sectional study to determine which types of sleep disturbances are related to cognitive function in PD patients. Methods A total of 71 PD patients (29 males, mean age 66.46 ± 8.87 years were recruited. All patients underwent the Mini- Mental State Examination (MMSE and the Korean Version of the Montreal Cognitive Assessments (MoCA-K to assess global cognitive function. Sleep disorders were evaluated with the Stanford Sleepiness Scale, Epworth Sleepiness Scale, Insomnia Severity Index (ISI, Pittsburg Sleep Quality Index, and Parkinson’s Disease Sleep Scale in Korea (PDSS. Results The ISI was correlated with the MMSE, and total PDSS scores were correlated with the MMSE and the MoCA-K. In each item of the PDSS, nocturnal restlessness, vivid dreams, hallucinations, and nocturnal motor symptoms were positively correlated with the MMSE, and nocturnal restlessness and vivid dreams were significantly related to the MoCA-K. Vivid dreams and nocturnal restlessness are considered the most powerful correlation factors with global cognitive function, because they commonly had significant correlation to cognition assessed with both the MMSE and the MoCA-K. Conclusions We found a correlation between global cognitive function and sleep disturbances, including vivid dreams and nocturnal restlessness, in PD patients.

Older drivers with cognitive impairments : issues of detection and assessment

OpenAIRE

Lundberg, Catarina

2003-01-01

Older drivers are often presented as a traffic safety problem . Age-related medical conditions such as dementias and stroke impair cognitive functions that are crucial for safe driving Uncertainty remains regarding the most appropriate clinical methods to assess driving fitness in these patient groups. Furthermore, preclinical dementia and cognitive impairment may affect driving performance and lead to an increased crash risk. The first general aim of the thesis was to inve...

Acute disinhibiting effects of alcohol as a factor in risky driving behavior

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Fillmore, Mark T.; Blackburn, Jaime S.; Harrison, Emily L. R.

2008-01-01

Automobile crash reports show that up to 40% of fatal crashes in the United States involve alcohol and that younger drivers are over-represented. Alcohol use among young drivers is associated with impulsive and risky driving behaviors, such as speeding, which could contribute to their over-representation in alcohol-related crash statistics. Recent laboratory studies show that alcohol increases impulsive behaviors by impairing the drinker’s ability to inhibit inappropriate actions and that this effect can be exacerbated in conflict situations where the expression and inhibition of behavior are equally motivating. The present study tested the hypothesis that this response conflict might also intensify the disruptive effects of alcohol on driving performance. Fourteen subjects performed a simulated driving and a cued go/no-go task that measured their inhibitory control. Conflict was motivated in these tasks by providing equal monetary incentives for slow, careful behavior (e.g., slow driving, inhibiting impulses) and for quick, abrupt behavior (fast driving, disinhibition). Subjects were tested under two alcohol doses (0.65 g/kg and a placebo) that were administered twice: when conflict was present and when conflict was absent. Alcohol interacted with conflict to impair inhibitory control and to increase risky and impaired driving behavior on the drive task. Also, individuals whose inhibitory control was most impaired by alcohol displayed the poorest driving performance under the drug. The study demonstrates potentially serious disruptions to driving performance as a function of alcohol intoxication and response conflict, and points to inhibitory control as an important underlying mechanism. PMID:18325693

Children with monosymptomatic primary nocturnal enuresis – the clinical profile of patients during the first nephrological consultation

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Anna Krakowska

2017-12-01

Full Text Available Introduction: Nocturnal enuresis can be diagnosed in a child older than 5 years of age who involuntarily discharges urine in the wrong time, i.e. at night, and in the wrong place, i.e. in bed. Aim: The aim of the study was to analyse the profile of patients who consult the specialist physician with monosymptomatic primary nocturnal enuresis. Material and methods: The data were collected from a questionnaire completed by guardians of children during the first nephrological consultation. The questions concerned the following: family history of nocturnal enuresis, bedwetting intensity, other urinary tract symptoms, a voiding chart and fluid intake record, number of nocturnal enuresis incidents in 14 days, episodes of nocturia, nocturnal diuresis volume, urinary urgency volume and constipation. Moreover, basic anthropometric measurements were taken. The data were analysed and the following values were calculated: average voided volumes, maximum voided volumes, voided volumes before 5 p.m. and 24-hour diuresis. An analogous analysis was conducted with respect to fluid intake. Results: Most patients were males. The family history of nocturnal enuresis was positive in ⅓ of patients. Approximately ⅓ of patients tended to drink fluids directly before bedtime. The number of patients with sporadic nocturnal enuresis (23–45% was comparable to the number of patients with frequent nocturnal enuresis (28–55%. Nocturnal diuresis suggested nocturnal polyuria in 11 patients (21.6%. Decreased functional bladder capacity was found in almost ¼ of patients (12–23.5%. Conclusions: Monosymptomatic nocturnal enuresis is more common in boys. The family history was positive in ⅓ of patients. Patients and their guardians are not aware of fluid intake restrictions at bedtime. The frequency of nocturnal polyuria and decreased functional bladder capacity is comparable in the investigated patients.

Older Adults with Mild Cognitive Impairments Show Less Driving Errors after a Multiple Sessions Simulator Training Program but Do Not Exhibit Long Term Retention.

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Teasdale, Normand; Simoneau, Martin; Hudon, Lisa; Germain Robitaille, Mathieu; Moszkowicz, Thierry; Laurendeau, Denis; Bherer, Louis; Duchesne, Simon; Hudon, Carol

2016-01-01

The driving performance of individuals with mild cognitive impairment (MCI) is suboptimal when compared to healthy older adults. It is expected that the driving will worsen with the progression of the cognitive decline and thus, whether or not these individuals should continue to drive is a matter of debate. The aim of the study was to provide support to the claim that individuals with MCI can benefit from a training program and improve their overall driving performance in a driving simulator. Fifteen older drivers with MCI participated in five training sessions in a simulator (over a 21-day period) and in a 6-month recall session. During training, they received automated auditory feedback on their performance when an error was noted about various maneuvers known to be suboptimal in MCI individuals (for instance, weaving, omitting to indicate a lane change, to verify a blind spot, or to engage in a visual search before crossing an intersection). The number of errors was compiled for eight different maneuvers for all sessions. For the initial five sessions, a gradual and significant decrease in the number of errors was observed, indicating learning and safer driving. The level of performance, however, was not maintained at the 6-month recall session. Nevertheless, the initial learning observed opens up possibilities to undertake more regular interventions to maintain driving skills and safe driving in MCI individuals.

Excursions out-of-lane versus standard deviation of lateral position as outcome measure of the on-the-road driving test.

Science.gov (United States)

Verster, Joris C; Roth, Thomas

2014-07-01

The traditional outcome measure of the Dutch on-the-road driving test is the standard deviation of lateral position (SDLP), the weaving of the car. This paper explores whether excursions out-of-lane are a suitable additional outcome measure to index driving impairment. A literature search was conducted to search for driving tests that used both SDLP and excursions out-of-lane as outcome measures. The analyses were limited to studies examining hypnotic drugs because several of these drugs have been shown to produce next-morning sedation. Standard deviation of lateral position was more sensitive in demonstrating driving impairment. In fact, solely relying on excursions out-of-lane as outcome measure incorrectly classifies approximately half of impaired drives as unimpaired. The frequency of excursions out-of-lane is determined by the mean lateral position within the right traffic lane. Defining driving impairment as having a ΔSDLP > 2.4 cm, half of the impaired driving tests (51.2%, 43/84) failed to produce excursions out-of-lane. Alternatively, 20.9% of driving tests with ΔSDLP < 2.4 cm (27/129) had at least one excursion out-of-lane. Excursions out-of-lane are neither a suitable measure to demonstrate driving impairment nor is this measure sufficiently sensitive to differentiate adequately between differences in magnitude of driving impairment. Copyright © 2014 John Wiley & Sons, Ltd.

The effect of cannabis compared with alcohol on driving.

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Sewell, R Andrew; Poling, James; Sofuoglu, Mehmet

2009-01-01

The prevalence of both alcohol and cannabis use and the high morbidity associated with motor vehicle crashes has lead to a plethora of research on the link between the two. Drunk drivers are involved in 25% of motor vehicle fatalities, and many accidents involve drivers who test positive for cannabis. Cannabis and alcohol acutely impair several driving-related skills in a dose-related fashion, but the effects of cannabis vary more between individuals than they do with alcohol because of tolerance, differences in smoking technique, and different absorptions of Delta(9)-tetrahydrocannabinol (THC), the active ingredient in marijuana. Detrimental effects of cannabis use vary in a dose-related fashion, and are more pronounced with highly automatic driving functions than with more complex tasks that require conscious control, whereas alcohol produces an opposite pattern of impairment. Because of both this and an increased awareness that they are impaired, marijuana smokers tend to compensate effectively while driving by utilizing a variety of behavioral strategies. Combining marijuana with alcohol eliminates the ability to use such strategies effectively, however, and results in impairment even at doses which would be insignificant were they of either drug alone. Epidemiological studies have been inconclusive regarding whether cannabis use causes an increased risk of accidents; in contrast, unanimity exists that alcohol use increases crash risk. Furthermore, the risk from driving under the influence of both alcohol and cannabis is greater than the risk of driving under the influence of either alone. Future research should focus on resolving contradictions posed by previous studies, and patients who smoke cannabis should be counseled to wait several hours before driving, and avoid combining the two drugs.

Effect of Nocturnal Haemodialysis on Body Composition

NARCIS (Netherlands)

Ipema, K.J.R.; Westerhuis, R.; van der Schans, C.P.; de Jong, P.E.; Gaillard, C.A. J. M.; Krijnen, W.P.; Slart, R.H.J.A.; Franssen, C.F.M.

2014-01-01

Background: Haemodialysis patients have a high risk of malnutrition which is associated with increased mortality. Nocturnal haemodialysis (NHD) is associated with a significant increase in protein intake compared with conventional haemodialysis (CHD). It is unclear whether this leads to improved

Environmental enrichment for a mixed-species nocturnal mammal exhibit.

Science.gov (United States)

Clark, Fay E; Melfi, Vicky A

2012-01-01

Environmental enrichment (EE) is an integral aspect of modern zoo animal management but, empirical evaluation of it is biased toward species housed in single-species groups. Nocturnal houses, where several nocturnal species are housed together, are particularly overlooked. This study investigated whether three species (nine-banded armadillos, Dasypus novemcinctus; Senegal bush babies, Galago senegalensis; two-toed sloths, Choloepus didactylus) in the nocturnal house at Paignton Zoo Environmental Park, UK could be enriched using food-based and sensory EE. Subjects were an adult male and female of each species. EE was deemed effective if it promoted target species-typical behaviors, behavioral diversity, and increased use of enriched exhibit zones. Results from generalized linear mixed models demonstrated that food-based EE elicited the most positive behavioral effects across species. One set of food-based EEs (Kong®, termite mound and hanging food) presented together was associated with a significant increase in species-typical behaviors, increased behavioral diversity, and increased use of enriched exhibit zones in armadillos and bush babies. Although one type of sensory EE (scented pine cones) increased overall exhibit use in all species, the other (rainforest sounds) was linked to a significant decrease in species-typical behavior in bush babies and sloths. There were no intra or interspecies conflicts over EE, and commensalism occurred between armadillos and bush babies. Our data demonstrate that simple food-based and sensory EE can promote positive behavioral changes in a mixed-species nocturnal mammal exhibit. We suggest that both food and sensory EE presented concurrently will maximize opportunities for naturalistic activity in all species. © 2011 Wiley Periodicals, Inc.

Adolescents with Low Vision: Perceptions of Driving and Nondriving

Science.gov (United States)

Sacks, Sharon Zell; Rosenblum, L. Penny

2006-01-01

Two studies examined how adolescents with low vision perceive their ability to drive. The results of both studies indicated similarities in the participants' responses with respect to knowledge of visual impairment, information about options for driving with low vision, frustrations and obstacles imposed by not being able to drive, and independent…

Lack of nocturnal blood pressure fall in elderly bedridden hypertensive patients with cerebrovascular disease.

Science.gov (United States)

Sasaki, Masato; Ando, Hitoshi; Fujimura, Akio

2012-02-01

To prevent recurrence of cerebrovascular disease (CVD), adequate control of blood pressure (BP) is extremely important for the treatment of hypertensive CVD patients. As absence of the nocturnal fall of BP by the expected 10-20% from daytime levels is reported to exaggerate target organ injury, 24-h ambulatory blood pressure monitoring (ABPM) was conducted, especially to obtain data during nighttime sleep. Forty-eight elderly bedridden chronic phase CVD hypertensive patients (assessed 1-3 mo after CVD accident) participated. As a group, nocturnal BP was higher than diurnal BP, whereas nocturnal pulse rate was lower than diurnal pulse rate. The nocturnal BP fall was blunted in most (∼90%) of the patients. These results suggest that to perform a rational drug treatment, it is essential to do 24-h ABPM before initiation of antihypertensive therapy in elderly bedridden hypertensive CVD patients.

Understanding nocturnal enuresis and its treatments.

Science.gov (United States)

Potter, D C; Wogoman, H A; Nietch, P

1999-09-01

Nocturnal enuresis is a condition that touches the lives of many children around the world. Affected children and their parents may experience feelings of guilt, frustration, and anxiety because of their lack of control over the situation. Nurses can play an important role in providing education to families in regards to the causes and treatment of enuresis. It is important for nurses to understand the problem of bedwetting thoroughly so they can assist the family in making an informed decision about the various options currently available. Nocturnal enuresis (bedwetting) is a common disorder that frequently results in frustration and stress on not only the children that experience it, but their parents as well. Scharf, Pravda, Jennings, Kauffman, and Ringel (1987) note that an estimated five to seven million children in America experience enuresis. Enuresis has family and psychosocial aspects, along with financial concerns. Therefore, it is important for nurses to be aware of the causes of enuresis, how it affects the family, and the current treatments that are available.

Nocturnal eating predicts tooth loss among adults: results from the Danish MONICA study

DEFF Research Database (Denmark)

Lundgren, Jennifer D; Williams, Karen B; Heitmann, Berit L

2010-01-01

The relationship between nocturnal eating, such as that associated with night eating syndrome (NES), and oral health is unknown. This study sought to determine if nocturnal eating is related to tooth loss in a large, epidemiologic sample. Danes (N=2217; age range 30-60 years, M BMI [kg/m(2...

Evaluation of the occurrence and diagnose definitions for Nocturnal Polyuria in Spinal Cord Injured patients during rehabilitation.

Science.gov (United States)

Viaene, Annick; Denys, Marie-Astrid; Goessaert, An-Sofie; Claeys, Jana; Raes, Ann; Roggeman, Saskia; Everaert, Karel

2017-11-03

Little is known about the occurrence of nocturnal polyuria in spinal cord injured (SCI) patients and the definitions which are preferable in this population. To determine the occurrence of nocturnal polyuria (NP) in spinal cord injured patients during in-patient rehabilitation in the Ghent University Hospital. To study the influence of different time periods (daytime, bed rest and sleep) on the accuracy of the existing diagnose definitions for NP specifically for this type of patients. Retrospective study using patient records. SCI patients during hospital based rehabilitation between 2011 and 2014. Seventy-four SCI patients were selected and their records of frequency-volume charts were examined, after exclusion of unreliable data, forty-seven patients were retained for the current study. Retrospective study using data from frequency-volume charts of either two or three days from patients with SCI. Nocturnal urine production (NUP) and nocturnal polyuria index (NPi) were calculated. There was a significant increase in diuresis, calculated as urine production, between day time and bed rest (p=0.008) and between day time and sleep (p=0.001). All patients showed nocturnal polyuria during a 12-hour night time period (including both bed rest and sleep) and 39 patients showed nocturnal polyuria during the 8 hour period of sleep. There was no significant difference in mean urine production between bed rest and sleep. Prevalence of NP did not significantly differ between the complete or incomplete SCI patients or between patients with higher and lower SCI levels. This study showed that the occurrence of nocturnal polyuria in patients with SCI is high and that it is important to consider which definitions of NP are used for diagnosis. Increase in diuresis is observed during bed rest and sleep and the diagnose is correctly estimated when nocturnal urine production definitions are used in both time periods. In accordance with what was expected, diagnose of NP was

Dementia and driving.

Science.gov (United States)

O'Neill, D; Neubauer, K; Boyle, M; Gerrard, J; Surmon, D; Wilcock, G K

1992-04-01

Many European countries test cars, but not their drivers, as they age. There is evidence to suggest that human factors are more important than vehicular factors as causes of motor crashes. The elderly also are involved in more accidents per distance travelled than middle-aged drivers. As the UK relies on self-certification of health by drivers over the age of 70 years, we examined the driving practices of patients with dementia attending a Memory Clinic. Nearly one-fifth of 329 patients with documented dementia continued to drive after the onset of dementia, and impaired driving ability was noted in two-thirds of these. Their families experienced great difficulty in persuading patients to stop driving, and had to invoke outside help in many cases. Neuropsychological tests did not help to identify those who drove badly while activity of daily living scores were related to driving ability. These findings suggest that many patients with dementia drive in an unsafe fashion after the onset of the illness. The present system of self-certification of health by the elderly for driver-licensing purposes needs to be reassessed.

Epilepsy and driving

Directory of Open Access Journals (Sweden)

Matej Mavrič

2015-05-01

Full Text Available Epilepsy poses a risk for all participants in road traffic; therefore people with epilepsy do not meet the criteria for an unlimited driving license. Their driving is affected not only by epileptic seizures causing impaired consciousness and involuntary movements, but also by antiepileptic drugs with their many unwanted affects. The experts have not yet agreed on whether people with epilepsy have an increased risk of experiencing a road traffic accident. However, recent data suggests that the overall risk is lower compared to other medical conditions. Scientific evidence forms the basis of legislation, which by limiting people with epilepsy, enables all participants in road traffic to drive in the safest possible environment. The legislation that governs epilepsy and driving in Slovenia has been recently thoroughly reformed and thus allows a less discriminatory management of people with epilepsy. Although people with epilepsy experience many issues in their daily life, including their personal relationships and employment, they often list the need for driving as a top concern in surveys. General physicians play an important role in managing the issues of people with epilepsy.

Nocturnal Polyuria and Hypertension in Patients with Lifestyle Related Diseases and Overactive Bladder.

Science.gov (United States)

Yokoyama, Osamu; Nishizawa, Osamu; Homma, Yukio; Takeda, Masayuki; Gotoh, Momokazu; Kakizaki, Hidehiro; Akino, Hironobu; Hayashi, Koichi; Yonemoto, Koji

2017-02-01

The objective of this multicenter cross-sectional study was to investigate the relationship of nocturnal polyuria in patients with common lifestyle related diseases and overactive bladder, with special attention to hypertension. After baseline assessment, patients recorded 24-hour urinary frequency/volume, blood pressure and heart rate for 3 days. They were stratified into 4 groups based on mean blood pressure, including no hypertension, and controllable, untreated and uncontrolled hypertension, respectively. The 2,353 eligible patients, who had urinary urgency once or more per week and 1 or more nocturnal toilet visits, were enrolled from 543 sites in Japan. Of these patients complete data, including the 24-hour frequency volume chart, were collected from 1,271. Multivariable analyses showed a statistically significant association of nocturnal polyuria with increasing age (OR 1.04, 95% CI 1.02-1.05, p polyuria in women alone (p = 0.01 and 0.03, respectively). Lower urinary tract symptoms suggestive of benign prostatic hyperplasia were significantly associated with nocturnal polyuria in men alone (p polyuria was significantly associated with age, male gender, and untreated hypertension in patients with lifestyle related diseases and overactive bladder. The association between hypertension and nocturnal polyuria was significant in women alone. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Effects of a Heat Wave on Nocturnal Stomatal Conductance in Eucalyptus camaldulensis

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Víctor Resco de Dios

2018-06-01

Full Text Available Nocturnal transpiration constitutes a significant yet poorly understood component of the global water cycle. Modeling nocturnal transpiration has been complicated by recent findings showing that stomata respond differently to environmental drivers over day- vs. night-time periods. Here, we propose that nocturnal stomatal conductance depends on antecedent daytime conditions. We tested this hypothesis across six genotypes of Eucalyptus camaldulensis Dehnh. growing under different CO2 concentrations (ambient vs. elevated and exposed to contrasting temperatures (ambient vs. heat wave for four days prior to the night of measurements, when all plants experienced ambient temperature conditions. We observed significant effects after the heat wave that led to 36% reductions in nocturnal stomatal conductance. The response was partly driven by changes in daytime stomatal behavior but additional factors may have come into play. We also observed significant differences in response to the heat wave across genotypes, likely driven by local adaptation to their climate of origin, but CO2 played no effect. Stomatal models may need to incorporate the role of antecedent effects to improve projections particularly after drastic changes in the environment such as heat waves.

‘Zero Tolerance’ Drug Driving Laws in Australia: A Gap Between Rationale and Form?

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Julia Ann Quilter

2017-08-01

Full Text Available Legislation in all Australian states and territories creates offences and provides for police roadside testing in relation to ‘drug driving’. Ostensibly motivated by the same road safety objectives and impairment paradigm as drink driving laws, drug driving laws adopt a significantly different approach. Whereas random breath testing tests for all forms of alcohol and is designed to determine whether there is a sufficient concentration of alcohol in the driver’s body that s/he should be deemed to be impaired, random drug testing typically tests for the presence of any quantity of only the three most widely used illicit drugs—cannabis, methamphetamine and ecstasy—in the driver’s oral fluids, without reference to what is known about the different pharmacokinetic and pharmacodynamic qualities of different drugs. This article examines this idiosyncratic approach to the criminalisation of drug driving, highlighting its weak correlation with the important road safety objective of deterring substance-impaired driving, and the risks of both over- and under-criminalisation that it creates. It argues that public policy on the prohibition of certain drugs and the criminalisation of their use should be disentangled from public policy on impaired driving. It recommends that drug driving laws in all Australian jurisdictions should be brought back into line with drink driving laws, via legislation and testing practices that turn on substance-specific prescribed concentrations for all drugs (illicit and licit that have the potential to impair drivers.

Don’t Drink and Drive (A Cup of Health with CDC)

Centers for Disease Control (CDC) Podcasts

2015-08-06

Nearly one-third of fatalities in car crashes are caused by alcohol-impaired driving. In this podcast, Amy Jewett discusses the dangers of alcohol-impaired driving.  Created: 8/6/2015 by MMWR.   Date Released: 8/6/2015.

Alcohol calibration of tests measuring skills related to car driving.

Science.gov (United States)

Jongen, Stefan; Vuurman, Eric; Ramaekers, Jan; Vermeeren, Annemiek

2014-06-01

Medication and illicit drugs can have detrimental side effects which impair driving performance. A drug's impairing potential should be determined by well-validated, reliable, and sensitive tests and ideally be calibrated by benchmark drugs and doses. To date, no consensus has been reached on the issue of which psychometric tests are best suited for initial screening of a drug's driving impairment potential. The aim of this alcohol calibration study is to determine which performance tests are useful to measure drug-induced impairment. The effects of alcohol are used to compare the psychometric quality between tests and as benchmark to quantify performance changes in each test associated with potentially impairing drug effects. Twenty-four healthy volunteers participated in a double-blind, four-way crossover study. Treatments were placebo and three different doses of alcohol leading to blood alcohol concentrations (BACs) of 0.2, 0.5, and 0.8 g/L. Main effects of alcohol were found in most tests. Compared with placebo, performance in the Divided Attention Test (DAT) was significantly impaired after all alcohol doses and performance in the Psychomotor Vigilance Test (PVT) and the Balance Test was impaired with a BAC of 0.5 and 0.8 g/L. The largest effect sizes were found on postural balance with eyes open and mean reaction time in the divided attention and the psychomotor vigilance test. The preferable tests for initial screening are the DAT and the PVT, as these tests were most sensitive to the impairing effects of alcohol and being considerably valid in assessing potential driving impairment.

Scale Modelling of Nocturnal Cooling in Urban Parks

Science.gov (United States)

Spronken-Smith, R. A.; Oke, T. R.

Scale modelling is used to determine the relative contribution of heat transfer processes to the nocturnal cooling of urban parks and the characteristic temporal and spatial variation of surface temperature. Validation is achieved using a hardware model-to-numerical model-to-field observation chain of comparisons. For the calm case, modelling shows that urban-park differences of sky view factor (s) and thermal admittance () are the relevant properties governing the park cool island (PCI) effect. Reduction in sky view factor by buildings and trees decreases the drain of longwave radiation from the surface to the sky. Thus park areas near the perimeter where there may be a line of buildings or trees, or even sites within a park containing tree clumps or individual trees, generally cool less than open areas. The edge effect applies within distances of about 2.2 to 3.5 times the height of the border obstruction, i.e., to have any part of the park cooling at the maximum rate a square park must be at least twice these dimensions in width. Although the central areas of parks larger than this will experience greater cooling they will accumulate a larger volume of cold air that may make it possible for them to initiate a thermal circulation and extend the influence of the park into the surrounding city. Given real world values of s and it seems likely that radiation and conduction play almost equal roles in nocturnal PCI development. Evaporation is not a significant cooling mechanism in the nocturnal calm case but by day it is probably critical in establishing a PCI by sunset. It is likely that conditions that favour PCI by day (tree shade, soil wetness) retard PCI growth at night. The present work, which only deals with PCI growth, cannot predict which type of park will be coolest at night. Complete specification of nocturnal PCI magnitude requires knowledge of the PCI at sunset, and this depends on daytime energetics.

Paroxysmal nocturnal hemoglobinuria and telomere length predicts response to immunosuppressive therapy in pediatric aplastic anemia.

Science.gov (United States)

Narita, Atsushi; Muramatsu, Hideki; Sekiya, Yuko; Okuno, Yusuke; Sakaguchi, Hirotoshi; Nishio, Nobuhiro; Yoshida, Nao; Wang, Xinan; Xu, Yinyan; Kawashima, Nozomu; Doisaki, Sayoko; Hama, Asahito; Takahashi, Yoshiyuki; Kudo, Kazuko; Moritake, Hiroshi; Kobayashi, Masao; Kobayashi, Ryoji; Ito, Etsuro; Yabe, Hiromasa; Ohga, Shouichi; Ohara, Akira; Kojima, Seiji

2015-12-01

Acquired aplastic anemia is an immune-mediated disease characterized by severe defects in stem cell number resulting in hypocellular marrow and peripheral blood cytopenias. Minor paroxysmal nocturnal hemoglobinuria populations and a short telomere length were identified as predictive biomarkers of immunosuppressive therapy responsiveness in aplastic anemia. We enrolled 113 aplastic anemia patients (63 boys and 50 girls) in this study to evaluate their response to immunosuppressive therapy. The paroxysmal nocturnal hemoglobinuria populations and telomere length were detected by flow cytometry. Forty-seven patients (42%) carried a minor paroxysmal nocturnal hemoglobinuria population. The median telomere length of aplastic anemia patients was -0.99 standard deviation (SD) (range -4.01-+3.01 SD). Overall, 60 patients (53%) responded to immunosuppressive therapy after six months. Multivariate logistic regression analysis identified the absence of a paroxysmal nocturnal hemoglobinuria population and a shorter telomere length as independent unfavorable predictors of immunosuppressive therapy response at six months. The cohort was stratified into a group of poor prognosis (paroxysmal nocturnal hemoglobinuria negative and shorter telomere length; 37 patients) and good prognosis (paroxysmal nocturnal hemoglobinuria positive and/or longer telomere length; 76 patients), respectively. The response rates of the poor prognosis and good prognosis groups at six months were 19% and 70%, respectively (P<0.001). The combined absence of a minor paroxysmal nocturnal hemoglobinuria population and a short telomere length is an efficient predictor of poor immunosuppressive therapy response, which should be considered while deciding treatment options: immunosuppressive therapy or first-line hematopoietic stem cell transplantation. The trial was registered in www.umin.ac.jp with number UMIN000017972. Copyright© Ferrata Storti Foundation.

Retinal and optical adaptations for nocturnal vision in the halictid bee Megalopta genalis.

Science.gov (United States)

Greiner, Birgit; Ribi, Willi A; Warrant, Eric J

2004-06-01

The apposition compound eye of a nocturnal bee, the halictid Megalopta genalis, is described for the first time. Compared to the compound eye of the worker honeybee Apis mellifera and the diurnal halictid bee Lasioglossum leucozonium, the eye of M. genalis shows specific retinal and optical adaptations for vision in dim light. The major anatomical adaptations within the eye of the nocturnal bee are (1) nearly twofold larger ommatidial facets and (2) a 4-5 times wider rhabdom diameter than found in the diurnal bees studied. Optically, the apposition eye of M. genalis is 27 times more sensitive to light than the eyes of the diurnal bees. This increased optical sensitivity represents a clear optical adaptation to low light intensities. Although this unique nocturnal apposition eye has a greatly improved ability to catch light, a 27-fold increase in sensitivity alone cannot account for nocturnal vision at light intensities that are 8 log units dimmer than during daytime. New evidence suggests that additional neuronal spatial summation within the first optic ganglion, the lamina, is involved.

On-the-road driving performance and driving-related skills in older untreated insomnia patients and chronic users of hypnotics.

Science.gov (United States)

Leufkens, T R M; Ramaekers, J G; de Weerd, A W; Riedel, W J; Vermeeren, A

2014-07-01

Many older adults report sleep problems and use of hypnotics. Several studies have shown that hypnotics can have acute adverse effects on driving the next morning. It is unclear however whether driving of chronic hypnotic users is impaired. Therapeutic effects on insomnia and development of tolerance may reduce the residual effects on driving. The present study aimed to compare actual driving performance and driving-related skills of chronic hypnotic users to good sleepers. To determine whether insomnia itself affects driving performance, driving and driving-related skills were compared between insomnia patients who do not or infrequently use hypnotics and good sleepers. Twenty-two frequent users of hypnotics (using hypnotics ≥ 4 nights per week for more than 3 months), 20 infrequent users (using hypnotics ≤ 3 nights per week), and 21 healthy, age-matched controls participated in this study. On the night before testing, all subjects were hospitalized for an 8-h sleep recorded by polysomnography. Frequent hypnotic users used their regular medication at bedtime (2330 hours), while infrequent users and controls received no medication. Cognitive performance (word learning, digit span, tracking, divided attention, vigilance, and inhibitory control) was assessed 8.5 h and driving performance between 10 and 11 h after bedtime and dosing. Polysomnographic recordings did not significantly differ between the groups, but the insomnia patients, treated or untreated, still reported subjective sleep complaints. Results show no differences in driving performance and driving-related skills between both groups of insomnia patients and controls. Driving performance in chronic users of hypnotics and untreated insomnia patients is not impaired. For chronic users, this may be due to prescription of relatively safe drugs and low doses. For untreated insomniacs, this corroborates previous findings showing an absence of neuropsychological deficits in this group of patients.

How can repeat drunk drivers be influenced to change? Analysis of the association between drunk driving and DUI recidivists' attitudes and beliefs.

Science.gov (United States)

Greenberg, Michael D; Morral, Andrew R; Jain, Arvind K

2004-07-01

Public policy interventions designed to deter or prevent drunk driving depend, in part, on modifying beliefs concerning the riskiness, social acceptability and immorality of driving under the influence of alcohol. The current study examines the association of these beliefs with the incidence of alcohol-impaired driving. Interviews were conducted with 273 people with multiple driving under the influence (DUI) offenses. Data included self-reported frequency of driving after drinking in the past year, as well as measures of moral and prescriptive beliefs concerning alcohol-impaired driving (internal behavioral controls), perceived risks of criminal punishment and accidents associated with alcohol-impaired driving (external behavioral controls) and perceived peer group attitudes toward alcohol-impaired driving (social controls). Logit regression modeling showed significant, unique protective associations with behavioral control items in each category. Behavioral controls may protect against alcohol-impaired driving behavior even in a high-risk sample of repeat DUI offenders. Policy interventions designed to curtail drunk driving might seek to enhance these sorts of behavioral controls among DUI offenders.

Nocturnal faecal soiling and anal masturbation.

Science.gov (United States)

Clark, A F; Tayler, P J; Bhate, S R

1990-01-01

Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised. PMID:2270946

Reproductive biology of Echinopsis terscheckii (Cactaceae): the role of nocturnal and diurnal pollinators.

Science.gov (United States)

Ortega-Baes, P; Saravia, M; Sühring, S; Godínez-Alvarez, H; Zamar, M

2011-01-01

The aim of this study was to analyse the reproductive biology of Echinopsis terscheckii, a species endemic to northwest Argentina that has nocturnal flowers. We expected that this species had a generalised pollination system, with moths and diurnal visitors as the primary pollinators. To test this, we studied the floral biology, breeding system and floral visitors of this species and the effectiveness of nocturnal and diurnal visitors. Floral biology was defined based on floral morphology, floral cycle and nectar production of the flowers. The breeding system and relative contributions of diurnal and nocturnal visitors to fruit and seed set were analysed through field experiments. E. terscheckii flowers opened at sunset and closed the following day. The peak of nectar production occurred at midnight. Flowers were determined to be self-incompatible. Moths, bees and birds were identified as floral visitors. Moths were the most frequent visitors at night, whereas bees were the most frequent visitors during the day. Fruit production by diurnal pollinators was less than that by nocturnal pollinators; among all floral visitors, moths were the most effective pollinators. We have demonstrated for the first time that moths are the primary pollinators of columnar cacti of the genus Echinopsis. Our results suggest that moths might be important pollinators of columnar cactus species with nocturnal flowers in the extra-tropical deserts of South America. © 2010 German Botanical Society and The Royal Botanical Society of the Netherlands.

Naturalistic validation of an on-road driving test of older drivers.

Science.gov (United States)

Ott, Brian R; Papandonatos, George D; Davis, Jennifer D; Barco, Peggy P

2012-08-01

The objective was to compare a standardized road test to naturalistic driving by older people who may have cognitive impairment to define improvements that could potentially enhance the validity of road testing in this population. Road testing has been widely adapted as a tool to assess driving competence of older people who may be at risk for unsafe driving because of dementia; however, the validity of this approach has not been rigorously evaluated. For 2 weeks, 80 older drivers (38 healthy elders and 42 with cognitive impairment) who passed a standardized road test were video recorded in their own vehicles. Using a standardized rating scale, 4 hr of video was rated by a driving instructor. The authors examine weighting of individual road test items to form global impressions and to compare road test and naturalistic driving using factor analyses of these two assessments. The road test score was unidimensional, reflecting a major factor related to awareness of signage and traffic behavior. Naturalistic driving reflected two factors related to lane keeping as well as traffic behavior. Maintenance of proper lane is an important dimension of driving safety that appears to be relatively underemphasized during the highly supervised procedures of the standardized road test. Road testing in this population could be improved by standardized designs that emphasize lane keeping and that include self-directed driving. Additional information should be sought from observers in the community as well as crash evidence when advising older drivers who may be cognitively impaired.

An investigation of the impact of nocturnal enuresis on children's self-concept.

Science.gov (United States)

Collier, J; Butler, R J; Redsell, S A; Evans, J H C

2002-01-01

This study sought to evaluate the relationship between the self-esteem and the self-image of children with nocturnal enuresis and to examine these in relation to various aspects of clinical and demographic variables. Previous studies investigating the self-esteem of bedwetting children have had mixed findings. Some studies report that children with nocturnal enuresis have a lower self-esteem than their non-bedwetting peers, but other studies report that children with nocturnal enuresis perceive themselves similarly to non-bedwetting children. However, what have not been studied to date are the self-perceptions of bedwetting children treated in community clinics. A total of 114 bedwetting children treated in community clinics provided the sample. School nurses conducted a routine first-visit assessment, collected baseline demographic and social information and invited children to complete the Butler Self-Image Profile and the Coopersmith Self-Esteem Inventory. Age and extent of wetting were not significantly related to self-concept measures. Girls had significantly (p = 0.008) higher scores on positive self-image compared with boys. Children with secondary enuresis also scored higher on positive self-image compared with those with primary nocturnal enuresis (p = 0.02). The Butler self-image scores indicated a number of significant links between positive self-image and enuresis variables, whereas the Coopersmith self-esteem scores generally failed to distinguish between the enuresis variables and closely reflected those of the negative self-image scores. These findings suggest that amongst children with nocturnal enuresis, the most vulnerable in terms of self-image are male, those with primary enuresis and those with a greater number of wet nights a week.

High-intensity endurance training increases nocturnal heart rate variability in sedentary participants

Directory of Open Access Journals (Sweden)

A Nummela

2016-01-01

Full Text Available The effects of endurance training on endurance performance characteristics and cardiac autonomic modulation during night sleep were investigated during two 4-week training periods. After the first 4-week training period (3 x 40 min per week, at 75% of HRR the subjects were divided into HIGH group (n = 7, who performed three high-intensity endurance training sessions per week; and CONTROL group (n = 8 who did not change their training. An incremental treadmill test was performed before and after the two 4-weektraining periods. Furthermore, nocturnal RR-intervals were recorded after each training day. In the second 4-weektraining period HIGH group increased their V0Zmax (P = 0.005 more than CONTROL group. At the same time, nocturnal HR decreased (P = 0.039 and high-frequency power (HFP increased (P = 0.003 in HIGH group while no changes were observed in CONTROL group. Furthermore, a correlation was observed between the changes in nocturnal HFP and changes in V0Zmax during the second 4-week training period (r = 0.90, P < 0.001. The present study showed that the increased HFP is related to improved VO2max in sedentary subjects suggesting that nocturnal HFP can provide a useful method in monitoring individual responses to endurance training.

A State-by-State Analysis of Laws Dealing With Driving Under the Influence of Drugs

Science.gov (United States)

2009-12-01

This study reviewed each State statute regarding drug-impaired driving as of December 2008. There : is a high degree of variability across the States in the ways they approach drug-impaired driving. : Current laws in many States contain provisions ma...

Establishing legal limits for driving under the influence of marijuana

OpenAIRE

Wong, Kristin; Brady, Joanne E; Li, Guohua

2014-01-01

Marijuana has become the most commonly detected non-alcohol substance among drivers in the United States and Europe. Use of marijuana has been shown to impair driving performance and increase crash risk. Due to the lack of standardization in assessing marijuana-induced impairment and limitations of zero tolerance legislation, more jurisdictions are adopting per se laws by specifying a legal limit of ?9-tetrahydrocannabinol (THC) at or above which drivers are prosecuted for driving under the i...

A roadmap for interpreting the literature on vision and driving.

Science.gov (United States)

Owsley, Cynthia; Wood, Joanne M; McGwin, Gerald

2015-01-01

Over the past several decades there has been a sharp increase in the number of studies focused on the relationship between vision and driving. The intensified attention to this topic has most likely been stimulated by the lack of an evidence basis for determining vision standards for driving licensure and a poor understanding about how vision impairment impacts driver safety and performance. Clinicians depend on the literature on vision and driving to advise visually impaired patients appropriately about driving fitness. Policy makers also depend on the scientific literature in order to develop guidelines that are evidence-based and are thus fair to persons who are visually impaired. Thus it is important for clinicians and policy makers alike to understand how various study designs and measurement methods should be interpreted so that the conclusions and recommendations they make are not overly broad, too narrowly constrained, or even misguided. We offer a methodological framework to guide interpretations of studies on vision and driving that can also serve as a heuristic for researchers in the area. Here, we discuss research designs and general measurement methods for the study of vision as they relate to driver safety, driver performance, and driver-centered (self-reported) outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

The complement inhibitor eculizumab in paroxysmal nocturnal hemoglobinuria.

NARCIS (Netherlands)

Hillmen, P.; Young, N.S.; Schubert, J.; Brodsky, R.A.; Socie, G.; Muus, P.; Roth, A.; Szer, J.; Elebute, M.O.; Nakamura, R.; Browne, P.; Risitano, A.M.; Hill, A.; Schrezenmeier, H.; Fu, C.L.; Maciejewski, J; Rollins, S.A.; Mojcik, C.F.; Rother, R.P.; Luzzatto, L.

2006-01-01

BACKGROUND: We tested the safety and efficacy of eculizumab, a humanized monoclonal antibody against terminal complement protein C5 that inhibits terminal complement activation, in patients with paroxysmal nocturnal hemoglobinuria (PNH). METHODS: We conducted a double-blind, randomized,

Association between nocturnal bruxism and gastroesophageal reflux.

Science.gov (United States)

Miyawaki, Shouichi; Tanimoto, Yuko; Araki, Yoshiko; Katayama, Akira; Fujii, Akihito; Takano-Yamamoto, Teruko

2003-11-01

To examine the relationship between nocturnal bruxism and gastroesophageal reflux. Controlled descriptive study and double-blind, placebo-controlled, clinical study. Portable pH monitoring, electromyography, and audio-video recordings were conducted during the night in the subjects' home. Ten patients with bruxism and 10 normal subjects were matched for height, weight, age, and sex. They did not have symptoms of gastroesophageal reflux disease. Medication with a proton pump inhibitor (ie, a gastric-acid-inhibiting drug). The bruxism group showed a significantly higher frequency of nocturnal rhythmic masticatory muscle activity (RMMA) episodes (mean +/- SD: 6.7 +/- 2.2 times per hour) and a higher frequency and percentage of time of gastroesophageal reflux episodes with a pH less than 4.0 and 5.0 (0.5 +/- 0.9 and 3.6 +/- 1.6 times per hour and 1.3% +/- 2.5% and 7.4% +/- 12.6%, respectively) than the control group (RMMA episodes: 2.4 +/- 0.9 times per hour; gastroesophageal reflux episodes: 0.0 +/- 0.0 and 0.1 +/- 0.3 times per hour and 0.0% +/- 0.0% and 0.0% +/- 0.0%, respectively). In the bruxism group, 100% of the gastroesophageal reflux episodes with a pH less than 3.0 and 4.0 included both an RMMA episode and an electromyographic burst, the duration of which was approximately 0.5 to 1.0 seconds, probably representing swallowing of saliva. The majority of gastroesophageal reflux episodes with a pH of 4.0 to 5.0 also included both an RMMA episode and an electromyographic burst in the control and bruxism groups (100% +/- 0.0% vs 70.7% +/- 16.5%), again probably due to swallowing of saliva. The remaining minority of gastroesophageal reflux episodes with a pH of 4.0 to 5.0 contained only an electromyographic burst (swallowing of saliva). The frequency of RMMA episodes after the release of the medication from the proton pump inhibitor, which increased the gastric and esophageal pH, was significantly lower than that after administration of the placebo in the control

Excessive daytime sleepiness, nocturnal sleep duration and ...

African Journals Online (AJOL)

Background and objectives. Short nocturnal sleep duration resulting in sleep debt may be a cause of excessive daytime sleepiness (EDS). Severity of depression (psychopathology) has been found to be directly related to EDS. There is an association between sleep duration and mental health, so there may therefore be an ...

Prevalence and risk factors of monosymptomatic nocturnal enuresis in Turkish children

Directory of Open Access Journals (Sweden)

Secil Ozkan

2010-01-01

Full Text Available Objectives : To determine the prevalence of primary monosymptomatic nocturnal enuresis (PMNE and assess risk factors that can cause this disease. Methods : After the determination of 15 primary schools in the provincial center of Ankara, questionnaires were given to 15,150 students to be answered by their parents. Detailed urologic history was obtained and physical examination applied to the students whose parents answered the questionnaire. After excluding children with polysymptomatic NE, 14060 questionnaires of MNE patients were evaluated. Demographic features with social and medical history of students and their parents, general approach of family to the children, school success of the students and general behavioral attitudes, method of toilet training and the presence of nocturnal enuresis were questioned. Results : MNE was determined in 9.0% (n: 1266 of the students and nocturnal enuresis frequency was higher in boys than girls (P< 0.05. Univariate analysis revealed gender, method of toilet training, sleep problems, school success, and general approach of the family to children and general behavioral attitudes of the children as significant factors. In logistic regression analysis; age, male gender, toilette training with threatening method, deep sleeper, sleep walking, being introverted and shy, significantly increases the risk of nocturnal enuresis. Conclusions : The current study suggests that the methods of toilet training are extremely important to prevent bedwetting and behavioral disorders due to enuresis. Parents should be well-informed about the appropriate toilet training method.

Mobile Disdrometer Observations of Nocturnal Mesoscale Convective Systems During PECAN

Science.gov (United States)

Bodine, D. J.; Rasmussen, K. L.

2015-12-01

Understanding microphysical processes in nocturnal mesoscale convective systems (MCSs) is an important objective of the Plains Elevated Convection At Night (PECAN) experiment, which occurred from 1 June - 15 July 2015 in the central Great Plains region of the United States. Observations of MCSs were collected using a large array of mobile and fixed instrumentation, including ground-based radars, soundings, PECAN Integrated Sounding Arrays (PISAs), and aircraft. In addition to these observations, three mobile Parsivel disdrometers were deployed to obtain drop-size distribution (DSD) measurements to further explore microphysical processes in convective and stratiform regions of nocturnal MCSs. Disdrometers were deployed within close range of a multiple frequency network of mobile and fixed dual-polarization radars (5 - 30 km range), and near mobile sounding units and PISAs. Using mobile disdrometer and multiple-wavelength, dual-polarization radar data, microphysical properties of convective and stratiform regions of MCSs are investigated. The analysis will also examine coordinated Range-Height Indicator (RHI) scans over the disdrometers to elucidate vertical DSD structure. Analysis of dense observations obtained during PECAN in combination with mobile disdrometer DSD measurements contributes to a greater understanding of the structural characteristics and evolution of nocturnal MCSs.

Factors associated with nocturnal hypoglycemia in at-risk adolescents and young adults with type 1 diabetes.

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Wilson, Darrell M; Calhoun, Peter M; Maahs, David M; Chase, H Peter; Messer, Laurel; Buckingham, Bruce A; Aye, Tandy; Clinton, Paula K; Hramiak, Irene; Kollman, Craig; Beck, Roy W

2015-06-01

Hypoglycemia remains an impediment to good glycemic control, with nocturnal hypoglycemia being particularly dangerous. Information on major contributors to nocturnal hypoglycemia remains critical for understanding and mitigating risk. Continuous glucose monitoring (CGM) data for 855 nights were studied, generated by 45 subjects 15-45 years of age with hemoglobin A1c (HbA1c) levels of ≤8.0% who participated in a larger randomized study. Factors assessed for potential association with nocturnal hypoglycemia (CGM measurement of <60 mg/dL for ≥30 min) included bedtime blood glucose (BG), exercise intensity, bedtime snack, insulin on board, day of the week, previous daytime hypoglycemia, age, gender, HbA1c level, diabetes duration, daily basal insulin, and daily insulin dose. Hypoglycemia occurred during 221 of 885 (25%) nights and was more frequent with younger age (P<0.001), lower HbA1c levels (P=0.006), medium/high-intensity exercise during the preceding day (P=0.003), and the occurrence of antecedent daytime hypoglycemia (P=0.001). There was a trend for lower bedtime BG levels to be associated with more frequent nocturnal hypoglycemia (P=0.10). Bedtime snack, before bedtime insulin bolus, weekend versus weekday, gender, and daily basal and bolus insulin were not associated with nocturnal hypoglycemia. Awareness that HbA1c level, exercise, bedtime BG level, and daytime hypoglycemia are all modifiable factors associated with nocturnal hypoglycemia may help patients and providers decrease the risk of hypoglycemia at night. Risk for nocturnal hypoglycemia increased in a linear fashion across the range of variables, with no clear-cut thresholds to guide clinicians or patients for any particular night.

Texting while driving using Google Glass™: Promising but not distraction-free.

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He, Jibo; Choi, William; McCarley, Jason S; Chaparro, Barbara S; Wang, Chun

2015-08-01

Texting while driving is risky but common. This study evaluated how texting using a Head-Mounted Display, Google Glass, impacts driving performance. Experienced drivers performed a classic car-following task while using three different interfaces to text: fully manual interaction with a head-down smartphone, vocal interaction with a smartphone, and vocal interaction with Google Glass. Fully manual interaction produced worse driving performance than either of the other interaction methods, leading to more lane excursions and variable vehicle control, and higher workload. Compared to texting vocally with a smartphone, texting using Google Glass produced fewer lane excursions, more braking responses, and lower workload. All forms of texting impaired driving performance compared to undistracted driving. These results imply that the use of Google Glass for texting impairs driving, but its Head-Mounted Display configuration and speech recognition technology may be safer than texting using a smartphone. Copyright © 2015 Elsevier Ltd. All rights reserved.

Youth Driving without Impairment. Report on the Youth Impaired Driving Public Hearings (Atlanta, Georgia; Boston, Massachusetts; Chicago, Illinois; Fort Worth, Texas; Seattle, Washington). A Community Challenge.

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National Commission against Drunk Driving, Washington, DC.

The testimony heard by the National Commission against Drunk Driving on how to prevent alcohol-related motor vehicle crashes, which constitute the leading cause of death for youth of driving age, resulted in some of the recommendations in this report. The document consists of an executive summary, a preface, an explanation of the Youth Impaired…

[Urodynamic changes in patients with obstructive sleep apnea-hypopnea syndrome and nocturnal polyuria].

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Hu, Ke; Tu, Zuo-sheng; Lü, Sheng-qi; Li, Qing-quan; Chen, Xue-qin

2011-03-01

To investigate the urodynamic changes in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and nocturnal polyuria. From Sept. 2002 to Jun. 2008, 23 patients with nocturnal polyuria were diagnosed as having OSAHS by polysomnography (PSG). The number and output of nocturia, the osmotic pressure and the excretion of Na(+) were recorded during both the PSG night and CPAP titrating night. Plasma levels of brain natriuretic peptide (BNP) and atrial natriuretic peptides (ANP) were also measured at 11PM in the 2 nights and 7AM in the next mornings. Urodynamic studies including urine flow, bladder pressure during filling, pressure-flow study during voiding and urethral pressure were carried out in these patients. Urodynamic studies were performed again after treatment with CPAP for 3 months. PSG showed that the patients with nocturnal polyuria had moderate to severe OSAHS, in which the apnea-hypopnea index (AHI) being 48 ± 15 events per hour. The number of nocturnal voiding during the PSG night was more than that during the CPAP titrating night. During the PSG night, the output of nocturia, the nocturia excretion of Na(+), ANP levels (at 7am in the next morning after PSG night) increased and the osmotic pressure of nocturia decreased. CPAP therapy could reverse these abnormalities. The main characteristics of urodynamics in these patients included weak detrusor contraction, hypoesthesia in filling cystometry, and decreased bladder compliance, and detrusor external sphincter dyssynergia. After 3 months of CPAP treatment, both the motility of the detrusor of bladder and the bladder compliance improved. CPAP therapy can effectively reverse the nocturnal polyuria in OSAHS patients. In OSAHS patients, the features of nocturia, including the changes of output, osmotic pressure and the excretion of Na(+), may be related to the secretion of high-level of ANP. During the course of chronic progressively OSAHS pathophysiology, detrusor function of bladder may be damaged

Self-construing in children with primary mono-symptomatic nocturnal enuresis--an investigation of three measures.

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Robinson, Joanne C; Butler, Richard J; Holland, Philip; Doherty-Williams, Dianne

2003-01-01

This study aims to measure different aspects of self-construing in children with primary mono-symptomatic nocturnal enuresis. 25 children aged 7-14 years, with nocturnal enuresis were recruited from a paediatric outpatient's unit specialising in enuresis [mean age 10.6 [males], 9.39 [females

Evaluation of a responsible beverage service and enforcement program: Effects on bar patron intoxication and potential impaired driving by young adults.

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Fell, James C; Fisher, Deborah A; Yao, Jie; McKnight, A Scott

2017-08-18

Studies of alcohol-related harm (violence, injury, illness) suggest that the most significant risk factors are the amount of alcohol consumed and whether obviously intoxicated patrons continue to be served. This study's objective was to investigate the effects of a responsible beverage service (RBS)/enhanced alcohol enforcement intervention on bars, bar patrons, and impaired driving. Two communities-Monroe County, New York, and Cleveland, Ohio-participated in a demonstration program and evaluation. The intervention applied RBS training, targeted enforcement, and corrective actions by law enforcement to a random sample of 10 identified problem bars in each community compared to 10 matched nonintervention problem bars. Data were collected over 3 waves on bar serving practices, bar patron intoxication, drinking and driving, and other alcohol-related harm from intervention and control bars and treatment and comparison communities. In Monroe County, New York, of the 14 outcome measures analyzed, 7 measures showed statistically significant differences from pre- to postintervention. Six of those measures indicated changes in the desired or positive direction and 2 measures were in the undesired or negative direction. Of note in the positive direction, the percentage of intervention bar patrons who were intoxicated decreased from 44 to 27% and the average blood alcohol concentration of patrons decreased from 0.097 to 0.059 g/dL pre- to postintervention. In Cleveland, Ohio, 6 of the 14 measures showed statistically significant changes pre- to postintervention with 6 in the positive direction and 4 in the negative direction. Of note, the percentage of pseudo-intoxicated patrons denied service in intervention bars increased from 6 to 29%. Of the 14 outcome measures that were analyzed in each community, most indicated positive changes associated with the intervention, but others showed negative associations. About half of the measures showed no significance, the sample sizes

Naturalistic Validation of an On-Road Driving Test of Older Drivers

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Ott, Brian R.; Papandonatos, George D.; Davis, Jennifer D.; Barco, Peggy P.

2013-01-01

Objective The objective was to compare a standardized road test to naturalistic driving by older people who may have cognitive impairment to define improvements that could potentially enhance the validity of road testing in this population. Background Road testing has been widely adapted as a tool to assess driving competence of older people who may be at risk for unsafe driving because of dementia; however, the validity of this approach has not been rigorously evaluated. Method For 2 weeks, 80 older drivers (38 healthy elders and 42 with cognitive impairment) who passed a standardized road test were video recorded in their own vehicles. Using a standardized rating scale, 4 hr of video was rated by a driving instructor. The authors examine weighting of individual road test items to form global impressions and to compare road test and naturalistic driving using factor analyses of these two assessments. Results The road test score was unidimensional, reflecting a major factor related to awareness of signage and traffic behavior. Naturalistic driving reflected two factors related to lane keeping as well as traffic behavior. Conclusion Maintenance of proper lane is an important dimension of driving safety that appears to be relatively underemphasized during the highly supervised procedures of the standardized road test. Application Road testing in this population could be improved by standardized designs that emphasize lane keeping and that include self-directed driving. Additional information should be sought from observers in the community as well as crash evidence when advising older drivers who may be cognitively impaired. PMID:22908688

Eculizumab in Pregnant Patients with Paroxysmal Nocturnal Hemoglobinuria

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Kelly, R.J.; Hochsmann, B.; Szer, J.; Kulasekararaj, A.; Guibert, S. de; Roth, A.; Weitz, I.C.; Armstrong, E.; Risitano, A.M.; Patriquin, C.J.; Terriou, L.; Muus, P.; Hill, A.; Turner, M.P.; Schrezenmeier, H.; Peffault de Latour, R.

2015-01-01

BACKGROUND: Eculizumab, a humanized monoclonal antibody against complement protein C5 that inhibits terminal complement activation, has been shown to prevent complications of paroxysmal nocturnal hemoglobinuria (PNH) and improve quality of life and overall survival, but data on the use of eculizumab

Innovative Visualizations Shed Light on Avian Nocturnal Migration

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Shamoun-Baranes, J.; Farnsworth, A.; Aelterman, B.; Alves, J.A.; Azijn, K.; Bernstein, G.; Branco, S.; Desmet, P.; Dokter, A.M.; Horton, K.; Kelling, S.; Kelly, J.F.; Leijnse, H.; Rong, J.; Sheldon, D.; Van den Broeck, W.; Van Den Meersche, J.K.; Van Doren, B.M.; van Gasteren, H.

2016-01-01

Globally, billions of flying animals undergo seasonal migrations, many of which occur at night. The temporal and spatial scales at which migrations occur and our inability to directly observe these nocturnal movements makes monitoring and characterizing this critical period in migratory animals’

Effects of central nervous system drugs on driving: speed variability versus standard deviation of lateral position as outcome measure of the on-the-road driving test.

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Verster, Joris C; Roth, Thomas

2014-01-01

The on-the-road driving test in normal traffic is used to examine the impact of drugs on driving performance. This paper compares the sensitivity of standard deviation of lateral position (SDLP) and SD speed in detecting driving impairment. A literature search was conducted to identify studies applying the on-the-road driving test, examining the effects of anxiolytics, antidepressants, antihistamines, and hypnotics. The proportion of comparisons (treatment versus placebo) where a significant impairment was detected with SDLP and SD speed was compared. About 40% of 53 relevant papers did not report data on SD speed and/or SDLP. After placebo administration, the correlation between SDLP and SD speed was significant but did not explain much variance (r = 0.253, p = 0.0001). A significant correlation was found between ΔSDLP and ΔSD speed (treatment-placebo), explaining 48% of variance. When using SDLP as outcome measure, 67 significant treatment-placebo comparisons were found. Only 17 (25.4%) were significant when SD speed was used as outcome measure. Alternatively, for five treatment-placebo comparisons, a significant difference was found for SD speed but not for SDLP. Standard deviation of lateral position is a more sensitive outcome measure to detect driving impairment than speed variability.

Association between morphometric variables and nocturnal desaturation in sickle-cell anemia.

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Salles, Cristina; Bispo, Marcelo; Trindade-Ramos, Regina Terse

2014-01-01

to evaluate associations between morphometric variables, cervical circumference (CC), and abdominal circumference (AC) with the presence of nocturnal desaturation in children and adolescents with sickle-cell anemia. all patients were submitted to baseline polysomnography, oral cavity measurements (maxillary intermolar distance, mandibular intermolar distance, and overjet), and CC and AC measurements. a total of 85 patients were evaluated. A positive correlation was observed between the height/age Z-score and CC measurement (r = 0.233, p = 0.031). The presence of nocturnal desaturation was associated with CC (59.2± 9.3 vs. 67.5 ± 10.7, p = 0.006) and AC measurements (27.0 ± 2.0 vs. 29.0± 2.1, p = 0.028). There was a negative correlation between desaturation and maxillary intermolar distance (r = -0.365, p = 0.001) and mandibular intermolar distance (r = -0.233, p = 0.037). the morphometric variables of CC and AC may contribute to raise suspicion of nocturnal desaturation in children and adolescents with sickle-cell anemia. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Association between morphometric variables and nocturnal desaturation in sickle-cell anemia

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Cristina Salles

2014-07-01

Full Text Available OBJECTIVE: to evaluate associations between morphometric variables, cervical circumference (CC, and abdominal circumference (AC with the presence of nocturnal desaturation in children and adolescents with sickle-cell anemia. METHODS: all patients were submitted to baseline polysomnography, oral cavity measurements (maxillary intermolar distance, mandibular intermolar distance, and overjet, and CC and AC measurements. RESULTS: a total of 85 patients were evaluated. A positive correlation was observed between the height/age Z-score and CC measurement (r = 0.233, p = 0.031. The presence of nocturnal desaturation was associated with CC (59.2± 9.3 vs. 67.5 ± 10.7, p = 0.006 and AC measurements (27.0 ± 2.0 vs. 29.0± 2.1, p = 0.028. There was a negative correlation between desaturation and maxillary intermolar distance (r = -0.365, p = 0.001 and mandibular intermolar distance (r = -0.233, p = 0.037. CONCLUSIONS: the morphometric variables of CC and AC may contribute to raise suspicion of nocturnal desaturation in children and adolescents with sickle-cell anemia.

Psychological Factors related with Driving under the Influence of Alcohol and Substance Use

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Ersin Budak

2015-09-01

Full Text Available Driving under the influence of alcohol and substance use is an important traffic problem that caused many people in the world to lose their lieves. Many features that are important in terms of driving adversely affected under the influence of alcohol and substance and therefore impaired driving behavior arises in drivers. The most effective way to fight for prevent this impaired driver behavier is the restrictions and regulations imposed on drivers in traffic related to alcohol and drug use. Nevertheless, in the literature, some drivers continue to impaired driving function with a risky traffic behavior, in which the driver personality (risk-taking, thrill-seeking, self-control, psychopathological (substance abuse, personality disorders, mood disorders, attention deficit hyperactivity disorder, post-traumatic stress disorder, anxiety, anger and aggression, and many other neuropsychological features are considered to have a relationship with this situation. In this article psychological, psychopathological and neuropsychological studies have examined regarding drive under the influence of alcohol and drug. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(3.000: 333-347

Nocturnal drainage wind characteristics in two converging air sheds

International Nuclear Information System (INIS)

Gedayloo, T.; Clements, W.E.; Barr, S.; Archuleta, J.A.

1980-01-01

During the short experimental period in the Grants Basin of Northeastern New Mexico a survey was conducted on the complex meteorology of this area. Emphasis was placed on the nocturnal drainage flow because of the potential hazards to the populated areas of Milan and Grants from the effluents of the uranium mining and milling operation in this area. This investigation has shown that the nocturnal drainage flow patterns agree with the winds predicted on the basis of the complex terrain of the area. Because of the surface cooling at night (over 25 0 C during summer and about 20 0 C during winter), air from elevated surrounding areas flows to the low lying regions consequently setting up a nocturnal drainage flow. This regime exists over 60% of the time during summer months and over 65% of the time during winter months with a depth generally less than 200 m. In the San Mateo air shed the drainage flow is east northeast, and in the Ambrosia Lake air shed it is from northwest. The confluence of these two air flows contributes mainly to the drainage flow through the channel formed by La Ja Mesa and Mesa Montanosa. The analysis of data collected by the recording Flats Station confirms the prediction that although the area south of the channel region broadens considerably causing a reduction in flow speed, contributions from the southside of La Jara Mesa and Mesa Montanosa partly compensate for this reduction. The position of this recording station is 15 to 20 km from the populated towns of Milan and Grants. A drainage flow speed of approximately 2.2 m s -1 and the duration of over 11 hours as recorded by this station indicates that air from the San Mateo and Ambrosia Lake regions may be transported southwards to these population centers during a nocturnal period. In order to test this prediction, a series of multi-atmospheric tracer experiments were conducted in the Grants Basin

Quantitative demonstration of the efficacy of night-time apomorphine infusion to treat nocturnal hypokinesia in Parkinson's disease using wearable sensors.

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Bhidayasiri, Roongroj; Sringean, Jirada; Anan, Chanawat; Boonpang, Kamolwan; Thanawattano, Chusak; Ray Chaudhuri, K

2016-12-01

Nocturnal hypokinesia/akinesia is one of the common night-time symptoms in patients with Parkinson's disease (PD), negatively affecting quality of life of patients and caregivers. The recognition of this problem and treatment options are limited in clinical practice. To evaluate the efficacy of nocturnal apomorphine infusion, using a wearable sensor, in patients who are already on daytime continuous subcutaneous apomorphine infusion and still suffer from nocturnal hypokinesia. Nocturnal parameters in 10 PD patients before and during nocturnal infusion were assessed over two nights at their homes, using a wearable sensor (trunk). Nocturnal parameters included number, velocity, acceleration, degree, and duration of rolling over, and number of times they got out of bed. Correlations with validated clinical rating scales were performed. Following nocturnal apomorphine infusion (34.8 ± 6.5 mg per night), there were significant improvements in the number of turns in bed (p = 0.027), turning velocity (p = 0.046), and the degree of turning (p = 0.028) in PD patients. Significant improvements of Modified Parkinson's Disease Sleep Scale (p = 0.005), the axial score of Unified Parkinson's Disease Rating Scale (p = 0.013), and Nocturnal Akinesia Dystonia and Cramp Scale (p = 0.014) were also observed. Our study was able to demonstrate quantitatively the efficacy of nocturnal apomorphine infusion in PD patients with nocturnal hypokinesia and demonstrated the feasibility of using wearable sensors to yield objective and quantifiable outcomes in a clinical trial setting. More studies are needed to determine the long-term efficacy of this treatment in a large prospective cohort of PD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Neuropsychological functioning related to specific characteristics of nocturnal enuresis.

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Van Herzeele, C; Dhondt, K; Roels, S P; Raes, A; Groen, L-A; Hoebeke, P; Walle, J Vande

2015-08-01

There is a high comorbidity demonstrated in the literature between nocturnal enuresis and several neuropsychological dysfunctions, with special emphasis on attention deficit hyperactivity disorder (ADHD). However, the majority of the psychological studies did not include full non-invasive screening and failed to differentiate between monosymptomatic nocturnal enuresis (MNE) and non-MNE patients. The present study primarily aimed to investigate the association between nocturnal enuresis and (neuro)psychological functioning in a selective homogeneous patient group, namely: children with MNE and associated nocturnal polyuria (NP). Secondly, the study investigated the association between specific characteristics of nocturnal enuresis (maximum voided volume, number of wet nights and number of nights with NP) and ADHD-inattentive symptoms, executive functioning and quality of life. The psychological measurements were multi-informant (parents, children and teachers) and multi-method (questionnaires, clinical interviews and neuropsychological testing). Thirty children aged 6-16 years (mean 10.43 years, SD 3.08) were included. Of them, 80% had at least one psychological, motor or neurological difficulty. The comorbid diagnosis of ADHD, especially the predominantly inattentive presentation, was most common. According to the teachers, a low maximum voided volume (corrected for age) was associated with more attention problems, and a high number of nights with NP was associated with more behaviour-regulation problems. No significant correlations were found between specific characteristics of enuresis and quality of life. Details are demonstrated in Table. The children were recruited from a tertiary referral centre, which resulted in selection bias. Moreover, NP was defined as a urine output exceeding 100% of the expected bladder capacity for age (EBC), and not according to the expert-opinion-based International Children's Continence Society norm of 130% of EBC. The definition

Texting while driving: is speech-based text entry less risky than handheld text entry?

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He, J; Chaparro, A; Nguyen, B; Burge, R J; Crandall, J; Chaparro, B; Ni, R; Cao, S

2014-11-01

Research indicates that using a cell phone to talk or text while maneuvering a vehicle impairs driving performance. However, few published studies directly compare the distracting effects of texting using a hands-free (i.e., speech-based interface) versus handheld cell phone, which is an important issue for legislation, automotive interface design and driving safety training. This study compared the effect of speech-based versus handheld text entries on simulated driving performance by asking participants to perform a car following task while controlling the duration of a secondary text-entry task. Results showed that both speech-based and handheld text entries impaired driving performance relative to the drive-only condition by causing more variation in speed and lane position. Handheld text entry also increased the brake response time and increased variation in headway distance. Text entry using a speech-based cell phone was less detrimental to driving performance than handheld text entry. Nevertheless, the speech-based text entry task still significantly impaired driving compared to the drive-only condition. These results suggest that speech-based text entry disrupts driving, but reduces the level of performance interference compared to text entry with a handheld device. In addition, the difference in the distraction effect caused by speech-based and handheld text entry is not simply due to the difference in task duration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Genetics Home Reference: autosomal dominant nocturnal frontal lobe epilepsy

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... with ADNFLE have experienced psychiatric disorders (such as schizophrenia), behavioral problems, or intellectual disability. It is unclear ... Epilepsy Society Citizens United for Research in Epilepsy (CURE) GeneReviews (1 link) Autosomal Dominant Nocturnal Frontal Lobe ...

A prospective study of loss of consciousness in epilepsy using virtual reality driving simulation and other video games.

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Yang, Li; Morland, Thomas B; Schmits, Kristen; Rawson, Elizabeth; Narasimhan, Poojitha; Motelow, Joshua E; Purcaro, Michael J; Peng, Kathy; Raouf, Saned; Desalvo, Matthew N; Oh, Taemin; Wilkerson, Jerome; Bod, Jessica; Srinivasan, Aditya; Kurashvili, Pimen; Anaya, Joseph; Manza, Peter; Danielson, Nathan; Ransom, Christopher B; Huh, Linda; Elrich, Susan; Padin-Rosado, Jose; Naidu, Yamini; Detyniecki, Kamil; Hamid, Hamada; Farooque, Pue; Astur, Robert; Xiao, Bo; Duckrow, Robert B; Blumenfeld, Hal

2010-07-01

Patients with epilepsy are at risk of traffic accidents when they have seizures while driving. However, driving is an essential part of normal daily life in many communities, and depriving patients of driving privileges can have profound consequences for their economic and social well-being. In the current study, we collected ictal performance data from a driving simulator and two other video games in patients undergoing continuous video/EEG monitoring. We captured 22 seizures in 13 patients and found that driving impairment during seizures differed in terms of both magnitude and character, depending on the seizure type. Our study documents the feasibility of a prospective study of driving and other behaviors during seizures through the use of computer-based tasks. This methodology may be applied to further describe differential driving impairment in specific types of seizures and to gain data on anatomical networks disrupted in seizures that impair consciousness and driving safety. Copyright 2010 Elsevier Inc. All rights reserved.

Effects of exercise timing on sleep architecture and nocturnal blood pressure in prehypertensives

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Fairbrother K

2014-12-01

Full Text Available Kimberly Fairbrother,1 Ben Cartner,1 Jessica R Alley,1 Chelsea D Curry,1, David L Dickinson,2 David M Morris,1 Scott R Collier1 1Vascular Biology and Autonomic Studies Laboratory, Department of Health and Exercise Science, 2Department of Economics, Appalachian State University, Boone, NC, USA Background: During nocturnal sleep, blood pressure (BP “dips” compared to diurnal BP, reducing stress on the cardiovascular system. Both the hypotensive response elicited by acute aerobic exercise and sleep quality can impact this dipping response. Purpose: The purpose of this study was to investigate the effects of aerobic exercise timing on circadian BP changes and sleep architecture. Materials and methods: Twenty prehypertensive subjects completed the study. During four test sessions, participants first completed a graded exercise test to exhaustion and then performed 30 minutes of treadmill exercise at 7 am (7A, 1 pm (1P, and 7 pm (7P in a random, counterbalanced order at 65% of the heart rate obtained at peak oxygen uptake. An ambulatory cuff was used to monitor BP responses during 24 hours following exercise, and an ambulatory sleep-monitoring headband was worn during sleep following each session. Results: Aerobic exercise at 7A invoked a greater dip in nocturnal systolic BP than exercise at 1P or 7P, although the greatest dip in nocturnal diastolic BP occurred following 7P. Compared to 1P, 7A also invoked greater time spent in deep sleep. Conclusion: These data indicate that early morning may be the most beneficial time to engage in aerobic exercise to enhance nocturnal BP changes and quality of sleep. Keywords: nocturnal dipping, prehypertension, aerobic exercise

Neural organisation in the first optic ganglion of the nocturnal bee Megalopta genalis.

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Greiner, Birgit; Ribi, Willi A; Wcislo, William T; Warrant, Eric J

2004-11-01

Each neural unit (cartridge) in the first optic ganglion (lamina) of the nocturnal bee Megalopta genalis contains nine receptor cell axons (6 short and 3 long visual fibres), and four different types of first-order interneurons, also known as L-fibres (L1 to L4) or lamina monopolar cells. The short visual fibres terminate within the lamina as three different types (svf 1, 2, 3). The three long visual fibres pass through the lamina without forming characteristic branching patterns and terminate in the second optic ganglion, the medulla. The lateral branching pattern of svf 2 into adjacent cartridges is unique for hymenopterans. In addition, all four types of L-fibres show dorso-ventrally arranged, wide, lateral branching in this nocturnal bee. This is in contrast to the diurnal bees Apis mellifera and Lasioglossum leucozonium, where only two out of four L-fibre types (L2 and L4) reach neighbouring cartridges. In M. genalis, L1 forms two sub-types, viz. L1-a and L1-b; L1-b in particular has the potential to contact several neighbouring cartridges. L2 and L4 in the nocturnal bee are similar to L2 and L4 in the diurnal bees but have dorso-ventral arborisations that are twice as wide. A new type of laterally spreading L3 has been discovered in the nocturnal bee. The extensive neural branching pattern of L-fibres in M. genalis indicates a potential role for these neurons in the spatial summation of photons from large groups of ommatidia. This specific adaptation in the nocturnal bee could significantly improve reliability of vision in dim light.

Nocturnal herbivore-induced plant volatiles attract the generalist predatory earwig Doru luteipes Scudder

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Naranjo-Guevara, Natalia; Peñaflor, Maria Fernanda G. V.; Cabezas-Guerrero, Milton F.; Bento, José Maurício S.

2017-10-01

Numerous studies have demonstrated that entomophagous arthropods use herbivore-induced plant volatile (HIPV) blends to search for their prey or host. However, no study has yet focused on the response of nocturnal predators to volatile blends emitted by prey damaged plants. We investigated the olfactory behavioral responses of the night-active generalist predatory earwig Doru luteipes Scudder (Dermaptera: Forficulidae) to diurnal and nocturnal volatile blends emitted by maize plants ( Zea mays) attacked by either a stem borer ( Diatraea saccharalis) or a leaf-chewing caterpillar ( Spodoptera frugiperda), both suitable lepidopteran prey. Additionally, we examined whether the earwig preferred odors emitted from short- or long-term damaged maize. We first determined the earwig diel foraging rhythm and confirmed that D. luteipes is a nocturnal predator. Olfactometer assays showed that during the day, although the earwigs were walking actively, they did not discriminate the volatiles of undamaged maize plants from those of herbivore damaged maize plants. In contrast, at night, earwigs preferred volatiles emitted by maize plants attacked by D. saccharalis or S. frugiperda over undamaged plants and short- over long-term damaged maize. Our GC-MS analysis revealed that short-term damaged nocturnal plant volatile blends were comprised mainly of fatty acid derivatives (i.e., green leaf volatiles), while the long-term damaged plant volatile blend contained mostly terpenoids. We also observed distinct volatile blend composition emitted by maize damaged by the different caterpillars. Our results showed that D. luteipes innately uses nocturnal herbivore-induced plant volatiles to search for prey. Moreover, the attraction of the earwig to short-term damaged plants is likely mediated by fatty acid derivatives.

Nocturnality in synapsids predates the origin of mammals by over 100 million years.

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Angielczyk, K D; Schmitz, L

2014-10-22

Nocturnality is widespread among extant mammals and often considered the ancestral behavioural pattern for all mammals. However, mammals are nested within a larger clade, Synapsida, and non-mammalian synapsids comprise a rich phylogenetic, morphological and ecological diversity. Even though non-mammalian synapsids potentially could elucidate the early evolution of diel activity patterns and enrich the understanding of synapsid palaeobiology, data on their diel activity are currently unavailable. Using scleral ring and orbit dimensions, we demonstrate that nocturnal activity was not an innovation unique to mammals but a character that appeared much earlier in synapsid history, possibly several times independently. The 24 Carboniferous to Jurassic non-mammalian synapsid species in our sample featured eye morphologies consistent with all major diel activity patterns, with examples of nocturnality as old as the Late Carboniferous (ca 300 Ma). Carnivores such as Sphenacodon ferox and Dimetrodon milleri, but also the herbivorous cynodont Tritylodon longaevus were likely nocturnal, whereas most of the anomodont herbivores are reconstructed as diurnal. Recognizing the complexity of diel activity patterns in non-mammalian synapsids is an important step towards a more nuanced picture of the evolutionary history of behaviour in the synapsid clade. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Endurance performance and nocturnal HRV indices.

Science.gov (United States)

Nummela, A; Hynynen, E; Kaikkonen, P; Rusko, H

2010-03-01

The effects of endurance training on endurance performance characteristics and cardiac autonomic modulation during night sleep were investigated. Twenty-four sedentary subjects trained over four weeks two hours per week at an average running intensity of 76+/-4% of their heart rate reserve. The R to R ECG-intervals were recorded and heart rate variability indices including high frequency power (HFP) were calculated for the nights following the training days every week. The subjects were divided into responders and non-responders according to the improvements in the maximal velocity of the incremental treadmill test (v(max)). The responders improved their v(max) by 10.9+/-46 % (p < 0.001) while no changes were observed in the non-responders (1.6+/-3.0%), although there were no differences in any training load variables between the groups. In the responders nocturnal HFP was significantly higher during the fourth training week compared to the first training week (p=0.036). Furthermore, a significant correlation was observed between the change in v(max) and the change in nocturnal HFP (r=0.482, p=0.042). It was concluded that after similar training, an increase in cardiac vagal modulation was related to improved v(max) in the sedentary subjects. Georg Thieme Verlag KG Stuttgart.New York.

Small Screen Use and Driving Safety.

Science.gov (United States)

Atchley, Paul; Strayer, David L

2017-11-01

The increased availability of "small screens," wireless devices with Internet-enabled connections, and their associated applications has almost overnight changed the way that we interact with our phones. The current work outlines some of the aspects of this problem as it relates to the influence of small screens on driving safety. Small screens are highly compelling to drivers, both for the information they convey and because the ability to ignore them while driving is impaired by cognitive resources used by the driving task itself. However, much is unknown about why people make choices to multitask while driving. Given the safety risks, it is recommended that parents, the public, and regulators take a stand against the use of Internet-enabled small screens unrelated to driving when the vehicle is in motion. Copyright © 2017 by the American Academy of Pediatrics.

Drunk driving warning system (DDWS). Volume 2, Field test evaluation

Science.gov (United States)

1983-12-01

The Drunk Driving Warning System (DDWS) is a vehicle-mounted device for testing driver impairment and activating alarms. The driver must pass a steering competency test (the Critical Tracking Task or CTT) in order to drive the car in a normal manner....

Pattern of Primary Nocturnal Enuresis in Primary School Children ...

African Journals Online (AJOL)

Pattern of Primary Nocturnal Enuresis in Primary School Children (First Grade) in ... The control group consisting of 100 age-matched non-enuretic children ... was insignificantly associated with a positive family history, family size or birth rank.

Artificial light pollution increases nocturnal vigilance in peahens.

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Yorzinski, Jessica L; Chisholm, Sarah; Byerley, Sydney D; Coy, Jeanee R; Aziz, Aisyah; Wolf, Jamie A; Gnerlich, Amanda C

2015-01-01

Artificial light pollution is drastically changing the sensory environments of animals. Even though many animals are now living in these changed environments, the effect light pollution has on animal behavior is poorly understood. We investigated the effect of light pollution on nocturnal vigilance in peahens (Pavo cristatus). Captive peahens were exposed to either artificial lighting or natural lighting at night. We employed a novel method to record their vigilance behavior by attaching accelerometers to their heads and continuously monitoring their large head movements. We found that light pollution significantly increases nocturnal vigilance in peahens. Furthermore, the birds faced a trade-off between vigilance and sleep at night: peahens that were more vigilant spent less time sleeping. Given the choice, peahens preferred to roost away from high levels of artificial lighting but showed no preference for roosting without artificial lighting or with low levels of artificial lighting. Our study demonstrates that light pollution can have a substantial impact on animal behavior that can potentially result in fitness consequences.

The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia among Taiwanese adolescents.

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Yen, Cheng-Fang; Ko, Chih-Hung; Yen, Ju-Yu; Cheng, Chung-Ping

2008-11-01

The aim of this study was to examine the correlates associated with short nocturnal sleep duration and subjective insomnia, including individual factors, family factors, peer factors, school factors, and the problematic use of high-tech devices among a large-scale representative population of Taiwanese adolescents. Cross-sectional study. A total of 23 junior high and 29 senior high/vocational schools were randomly selected across southern Taiwan. Eight thousand four adolescent students. N/A. The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia were examined using chi2 automatic interaction detection analysis and logistic regression analysis models. The results indicated that an older age, self-reported depression, being in the third year of school, drinking coffee at night, and problematic Internet use were significantly associated with short nocturnal sleep duration in adolescents. Furthermore, self-reported depression, low school affinity, high family conflict, low connectedness to their peer group, and problematic Internet use were associated with subjective insomnia in adolescents. The results of this study indicate that a variety of individual, family, peer, and school factors were associated with short nocturnal sleep duration and subjective insomnia in adolescents. Furthermore, the correlates of short sleep duration were not identical to those of subjective insomnia. Parents and health professionals should be wary of sleep patterns among adolescents who have the identified correlates of short nocturnal sleep duration and subjective insomnia.

Microalbuminuria in patients with non-insulin-dependent diabetes mellitus relates to nocturnal systolic blood pressure.

LENUS (Irish Health Repository)

Mitchell, T H

2012-02-03

PURPOSE: Microalbuminuria predicts early mortality in non-insulin-dependent-diabetes mellitus patients (NIDDM). Our objective in the present study was to compare and assess the relationship between 24-hour, day and nocturnal ambulatory blood pressure (BP) and urinary albumin excretion rate (UAE) in microalbuminuric and normoalbuminuric NIDDM and in normal control subjects. PATIENTS AND METHODS: In the present cross-sectional study, 24 hour ambulatory BP (daytime BP and nocturnal BP) and HbA1c were compared in microalbuminuric (n = 10) and nonmicroalbuminuric NIDDM patients (n = 10) and in nondiabetic controls (n = 9). None of the patients were taking antihypertensive agents. RESULTS: In the microlbuminuric group, whereas 24 hour and daytime systolic BP differed significantly from control values (P < 0.025 and P < 0.05 respectively), there was no difference between diabetic groups. However, nocturnal systolic BP in the microalbuminuric group was significantly higher than in the normoalbuminuric diabetic patients (139 vs. 125) (P < 0.05) and a significant difference was also found between the NIDDM patients and the control group (139, 125 vs. 114) (P < 0.025). In multiple regression analysis, only nocturnal systolic BP showed a significant relationship with UAE (P < 0.05). CONCLUSIONS: We suggest that the higher nocturnal systolic blood pressure seen in our microalbuminuric NIDDM patients may contribute to the increased morbidity in this group.

Hospital outpatients' responses to taking medications with driving warnings.

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Smyth, T; Sheehan, M; Siskind, V

2013-01-01

The study investigates the knowledge, intentions, and driving behavior of persons prescribed medications that display a warning about driving. It also examines their confidence that they can self-assess possible impairment, as is required by the Australian labeling system. We surveyed 358 outpatients in an Australian public hospital pharmacy, representing a well-advised group taking a range of medications including those displaying a warning label about driving. A brief telephone follow-up survey was conducted with a subgroup of the participants. The sample had a median age of 53.2 years and was 53 percent male. Nearly three quarters (73.2%) had taken a potentially impairing class of medication and more than half (56.1%) had taken more than one such medication in the past 12 months. Knowledge of the potentially impairing effects of medication was relatively high for most items; however, participants underestimated the possibility of increased impairment from exceeding the prescribed dose and at commencing treatment. Participants' responses to the safety implications of taking drugs with the highest level of warning varied. Around two thirds (62.8%) indicated that they would consult a health practitioner for advice and around half would modify their driving in some way. However, one fifth (20.9%) would drive when the traffic was thought to be less heavy and over a third (37.7%) would modify their medication regime so that they could drive. The findings from the follow-up survey of a subsample taking target drugs at the time of the first interview were also of concern. Only just over half (51%) recalled seeing the warning label on their medications and, of this group, three quarters (78%) reported following the warning label advice. These findings indicated that there remains a large proportion of people who either did not notice or did not consider the warning when deciding whether to drive. There was a very high level of confidence in this group that they could

Nocturnal and Circadian Rhythm of Blood Pressure Is Associated with Renal Structure Damage and Function in Patients with IgAN.

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Lin, Lirong; Zhang, Huhai; Yang, Jurong; Zhang, Jianguo; Li, Kailong; Huo, Bengang; Dai, Huanzi; Zhang, Weiwei; Yang, Jie; Tan, Wei; He, Yani

2016-01-01

Abnormal circadian rhythm of blood pressure (BP) is closely related to target organ damage in hypertension. However, the association between abnormal circadian rhythm of BP and renal injury is not clear. We investigated whether renal injury is associated with nocturnal BP and circadian rhythm of BP in Chinese IgAN patients. Clinic and 24 h ambulatory BP monitoring data were obtained from 330 Chinese IgAN patients with mean 24 h BP circadian BP, and 27% had nocturnal hypertension with a nondipping pattern. Compared with nocturnal normotensive patients, patients with nocturnal hypertension had significantly higher levels of blood cystatin C, blood uric acid, and lower estimated glomerular filtration rate (eGFR), and significantly a higher mean renal tissue injury score. The nondipping hypertensive group had significantly higher nocturnal diastolic and systolic BP, blood uric acid, and glomerulosclerosis rates, whereas eGFR was lower. In nondipping hypertensive patients, urinary sodium excretion and renal tissue injury scores were significantly higher than dipping patients. Nocturnal hypertension and abnormal circadian BP correlated with renal tissue injury, renal interstitial fibrosis, and aortic arch atherosclerosis. Abnormal circadian rhythm of BP and nocturnal hypertension are common clinical manifestations in Chinese IgAN patients with normal mean 24 h BP. Abnormal circadian BP and nocturnal hypertension may accelerate IgAN progression by inducing renal dysfunction and histopathological damage. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

Experimental temperature manipulations alter songbird autumnal nocturnal migratory restlessness

Directory of Open Access Journals (Sweden)

Berchtold Adrienne

2017-02-01

Full Text Available Migrating birds may respond to a variety of environmental cues in order to time migration. During the migration season nocturnally migrating songbirds may migrate or stop-over at their current location, and when migrating they may vary the rate or distance of migration on any given night. It has long been known that a variety of weather-related factors including wind speed and direction, and temperature, are correlated with migration in free-living birds, however these variables are often correlated with each other. In this study we experimentally manipulated temperature to determine if it would directly modulate nocturnal migratory restlessness in songbirds. We experimentally manipulated temperature between 4, 14, and 24°C and monitored nocturnal migratory restlessness during autumn in white-throated sparrows (Zonotrichia albicollis. White-throated sparrows are relatively shortdistance migrants with a prolonged autumnal migration, and we thus predicted they might be sensitive to weatherrelated cues when deciding whether to migrate or stopover. At warm temperatures (24°C none of the birds exhibited migratory restlessness. The probability of exhibiting migratory restlessness, and the intensity of this restlessness (number of infra-red beam breaks increased at cooler (14°C, 4°C temperatures. These data support the hypothesis that one of the many factors that birds use when making behavioural decisions during migration is temperature, and that birds can respond to temperature directly independently of other weather-related cues.

Effects of Cognitive Load on Driving Performance: The Cognitive Control Hypothesis.

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Engström, Johan; Markkula, Gustav; Victor, Trent; Merat, Natasha

2017-08-01

The objective of this paper was to outline an explanatory framework for understanding effects of cognitive load on driving performance and to review the existing experimental literature in the light of this framework. Although there is general consensus that taking the eyes off the forward roadway significantly impairs most aspects of driving, the effects of primarily cognitively loading tasks on driving performance are not well understood. Based on existing models of driver attention, an explanatory framework was outlined. This framework can be summarized in terms of the cognitive control hypothesis: Cognitive load selectively impairs driving subtasks that rely on cognitive control but leaves automatic performance unaffected. An extensive literature review was conducted wherein existing results were reinterpreted based on the proposed framework. It was demonstrated that the general pattern of experimental results reported in the literature aligns well with the cognitive control hypothesis and that several apparent discrepancies between studies can be reconciled based on the proposed framework. More specifically, performance on nonpracticed or inherently variable tasks, relying on cognitive control, is consistently impaired by cognitive load, whereas the performance on automatized (well-practiced and consistently mapped) tasks is unaffected and sometimes even improved. Effects of cognitive load on driving are strongly selective and task dependent. The present results have important implications for the generalization of results obtained from experimental studies to real-world driving. The proposed framework can also serve to guide future research on the potential causal role of cognitive load in real-world crashes.

From dusk till dawn: nocturnal and diurnal pollination in the epiphyte Tillandsia heterophylla (Bromeliaceae).

Science.gov (United States)

Aguilar-Rodríguez, P A; Krömer, T; García-Franco, J G; MacSwiney G, M C

2016-01-01

In order to compare the effectiveness of diurnal and nocturnal pollinators, we studied the reproductive biology and pollinators of Tillandsia heterophylla E. Morren, an epiphytic tank bromeliad endemic to southeastern Mexico. Since anthesis in T. heterophylla is predominantly nocturnal but lasts until the following day, we hypothesised that this bromeliad would receive visits from both diurnal and nocturnal visitors, but that nocturnal visitors would be the most effective pollinators, since they arrive first to the receptive flower, and that bats would be the most frequent nocturnal visitors, given the characteristics of the nectar. Flowering of T. heterophylla began in May and lasted until July. The species is fully self-compatible, with an anthesis that lasts for ca. 15-16 h. Mean volume of nectar produced per flower was 82.21 μl, with a mean sugar concentration of 6.33%. The highest volume and concentration of nectar were found at 20:00 h, with a subsequent decline in both to almost zero over the following 12-h period. T. heterophylla has a generalist pollination system, since at least four different morphospecies of visitors pollinate its flowers: bats, moths, hummingbirds and bees. Most of the pollinating visits corresponded to bats and took place in the early evening, when stigma receptivity had already begun; making bats the probable pollinator on most occasions. However, diurnal pollinators may be important as a 'fail-safe' system by which to guarantee the pollination of T. heterophylla. © 2015 German Botanical Society and The Royal Botanical Society of the Netherlands.

The vomeronasal complex of nocturnal strepsirhines and implications for the ancestral condition in primates.

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Garrett, Eva C; Dennis, John C; Bhatnagar, Kunwar P; Durham, Emily L; Burrows, Anne M; Bonar, Christopher J; Steckler, Natalie K; Morrison, Edward E; Smith, Timothy D

2013-12-01

This study investigates the vomeronasal organ in extant nocturnal strepsirhines as a model for ancestral primates. Cadaveric samples from 10 strepsirhine species, ranging from fetal to adult ages, were studied histologically. Dimensions of structures in the vomeronasal complex, such as the vomeronasal neuroepithelium (VNNE) and vomeronasal cartilage (VNC) were measured in serial sections and selected specimens were studied immunohistochemically to determine physiological aspects of the vomeronasal sensory neurons (VSNs). Osteological features corresponding to vomeronasal structures were studied histologically and related to 3-D CT reconstructions. The VNC consistently rests in a depression on the palatal portion of the maxilla, which we refer to as the vomeronasal groove (VNG). Most age comparisons indicate that in adults VNNE is about twice the length compared with perinatal animals. In VNNE volume, adults are 2- to 3-fold larger compared with perinatal specimens. Across ages, a strong linear relationship exists between VNNE dimensions and body length, mass, and midfacial length. Results indicate that the VNNE of nocturnal strepsirhines is neurogenic postnatally based on GAP43 expression. In addition, based on Olfactory Marker Protein expression, terminally differentiated VSNs are present in the VNNE. Therefore, nocturnal strepsirhines have basic similarities to rodents in growth and maturational characteristics of VSNs. These results indicate that a functional vomeronasal system is likely present in all nocturnal strepsirhines. Finally, given that osteological features such as the VNG are visible on midfacial bones, primate fossils can be assessed to determine whether primate ancestors possessed a vomeronasal complex morphologically similar to that of modern nocturnal strepsirhines. Copyright © 2013 Wiley Periodicals, Inc.

The Australian Bogong Moth Agrotis infusa: A Long-Distance Nocturnal Navigator

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Eric Warrant

2016-04-01

Full Text Available The nocturnal Bogong moth (Agrotis infusa is an iconic and well-known Australian insect that is also a remarkable nocturnal navigator. Like the Monarch butterflies of North America, Bogong moths make a yearly migration over enormous distances, from southern Queensland, western and northwestern New South Wales (NSW and western Victoria, to the alpine regions of NSW and Victoria. After emerging from their pupae in early spring, adult Bogong moths embark on a long nocturnal journey towards the Australian Alps, a journey that can take many days or even weeks and cover over 1000 km. Once in the Alps (from the end of September, Bogong moths seek out the shelter of selected and isolated high ridge-top caves and rock crevices (typically at elevations above 1800 m. In hundreds of thousands, moths line the interior walls of these cool alpine caves where they “hibernate” over the summer months (referred to as “estivation”. Towards the end of the summer (February and March, the same individuals that arrived months earlier leave the caves and begin their long return trip to their breeding grounds. Once there, moths mate, lay eggs and die. The moths that hatch in the following spring then repeat the migratory cycle afresh. Despite having had no previous experience of the migratory route, these moths find their way to the Alps and locate their estivation caves that are dotted along the high alpine ridges of southeastern Australia. How naïve moths manage this remarkable migratory feat still remains a mystery, although there are many potential sensory cues along the migratory route that moths might rely on during their journey, including visual, olfactory, mechanical and magnetic cues. Here we review our current knowledge of the Bogong moth, including its natural history, its ecology, its cultural importance to the Australian Aborigines and what we understand about the sensory basis of its long-distance nocturnal migration. From this analysis it becomes

Separating selection by diurnal and nocturnal pollinators on floral display and spur length in Gymnadenia conopsea.

Science.gov (United States)

Sletvold, Nina; Trunschke, Judith; Wimmergren, Carolina; Agren, Jon

2012-08-01

Most plants attract multiple flower visitors that may vary widely in their effectiveness as pollinators. Floral evolution is expected to reflect interactions with the most important pollinators, but few studies have quantified the contribution of different pollinators to current selection on floral traits. To compare selection mediated by diurnal and nocturnal pollinators on floral display and spur length in the rewarding orchid Gymnadenia conopsea, we manipulated the environment by conducting supplemental hand-pollinations and selective pollinator exclusions in two populations in central Norway. In both populations, the exclusion of diurnal pollinators significantly reduced seed production compared to open pollination, whereas the exclusion of nocturnal pollinators did not. There was significant selection on traits expected to influence pollinator attraction and pollination efficiency in both the diurnal and nocturnal pollination treatment. The relative strength of selection among plants exposed to diurnal and nocturnal visitors varied among traits and populations, but the direction of selection was consistent. The results suggest that diurnal pollinators are more important than nocturnal pollinators for seed production in the study populations, but that both categories contribute to selection on floral morphology. The study illustrates how experimental manipulations can link specific categories of pollinators to observed selection on floral traits, and thus improve our understanding of how species interactions shape patterns of selection.

Nocturia in men is a chaotic condition dominated by nocturnal polyuria.

Science.gov (United States)

Fujimura, Tetsuya; Yamada, Yuta; Sugihara, Toru; Azuma, Takeshi; Suzuki, Motofumi; Fukuhara, Hiroshi; Nakagawa, Tohru; Kume, Haruki; Igawa, Yasuhiko; Homma, Yukio

2015-05-01

To characterize nocturia in men based on frequency volume chart data and symptom profiles assessed using the Core Lower Urinary Tract Symptom Score and Athens Insomnia Scale questionnaires. The Core Lower Urinary Tract Symptom Score and Athens Insomnia Scale questionnaires were administered to 299 consecutive treatment naïve men with nocturia (≥one time per night). Frequency volume chart data were recorded for 2 days. Correlations between nocturia and clinical characteristics including symptom scores, clinical diagnosis, Charlson Comorbidity Index, estimated glomerular filtration rate, uroflowmetry and prostate volume were analyzed. Patients were divided into five groups: one time (n = 36), two times (n = 65), three times (n = 85), four times (n = 78) and five times (n = 34) of nocturia. Age, prevalence or severity of chronic kidney disease, hyperlipidemia, low bladder capacity, nocturnal polyuria, urgency, bladder pain and sleep disorders were significantly correlated with the severity of nocturia. The Spearman correlation analysis identified eight possible independent factors for nocturia: age, estimated glomerular filtration rate, urgency, bladder pain, sleep quality, sleepiness during the day, average voided volume and nocturnal volume divided by body weight. Logistic regression analysis showed that nocturnal volume divided by body weight was the strongest factor of nocturia, and ≥7, 9 and 9.7 mL/kg were practical cut-off values of three, four and five times per night of nocturia, respectively. Nocturia in men is a chaotic condition dominated by nocturnal polyuria, and related to multiple factors including age, renal function, urgency, bladder pain, insomnia and bladder volume. © 2015 The Japanese Urological Association.

Fear of darkness, the full moon and the nocturnal ecology of African lions.

Science.gov (United States)

Packer, Craig; Swanson, Alexandra; Ikanda, Dennis; Kushnir, Hadas

2011-01-01

Nocturnal carnivores are widely believed to have played an important role in human evolution, driving the need for night-time shelter, the control of fire and our innate fear of darkness. However, no empirical data are available on the effects of darkness on the risks of predation in humans. We performed an extensive analysis of predatory behavior across the lunar cycle on the largest dataset of lion attacks ever assembled and found that African lions are as sensitive to moonlight when hunting humans as when hunting herbivores and that lions are most dangerous to humans when the moon is faint or below the horizon. At night, people are most active between dusk and 10:00 pm, thus most lion attacks occur in the first weeks following the full moon (when the moon rises at least an hour after sunset). Consequently, the full moon is a reliable indicator of impending danger, perhaps helping to explain why the full moon has been the subject of so many myths and misconceptions.

Fear of darkness, the full moon and the nocturnal ecology of African lions.

Directory of Open Access Journals (Sweden)

Craig Packer

Full Text Available Nocturnal carnivores are widely believed to have played an important role in human evolution, driving the need for night-time shelter, the control of fire and our innate fear of darkness. However, no empirical data are available on the effects of darkness on the risks of predation in humans. We performed an extensive analysis of predatory behavior across the lunar cycle on the largest dataset of lion attacks ever assembled and found that African lions are as sensitive to moonlight when hunting humans as when hunting herbivores and that lions are most dangerous to humans when the moon is faint or below the horizon. At night, people are most active between dusk and 10:00 pm, thus most lion attacks occur in the first weeks following the full moon (when the moon rises at least an hour after sunset. Consequently, the full moon is a reliable indicator of impending danger, perhaps helping to explain why the full moon has been the subject of so many myths and misconceptions.

Moonstruck primates: owl monkeys (Aotus need moonlight for nocturnal activity in their natural environment.

Directory of Open Access Journals (Sweden)

Eduardo Fernández-Duque

2010-09-01

Full Text Available Primates show activity patterns ranging from nocturnality to diurnality, with a few species showing activity both during day and night. Among anthropoids (monkeys, apes and humans, nocturnality is only present in the Central and South American owl monkey genus Aotus. Unlike other tropical Aotus species, the Azara's owl monkeys (A. azarai of the subtropics have switched their activity pattern from strict nocturnality to one that also includes regular diurnal activity. Harsher climate, food availability, and the lack of predators or diurnal competitors, have all been proposed as factors favoring evolutionary switches in primate activity patterns. However, the observational nature of most field studies has limited an understanding of the mechanisms responsible for this switch in activity patterns. The goal of our study was to evaluate the hypothesis that masking, namely the stimulatory and/or inhibitory/disinhibitory effects of environmental factors on synchronized circadian locomotor activity, is a key determinant of the unusual activity pattern of Azara's owl monkeys. We use continuous long-term (6-18 months 5-min-binned activity records obtained with actimeter collars fitted to wild owl monkeys (n =  10 individuals to show that this different pattern results from strong masking of activity by the inhibiting and enhancing effects of ambient luminance and temperature. Conclusive evidence for the direct masking effect of light is provided by data showing that locomotor activity was almost completely inhibited when moonlight was shadowed during three lunar eclipses. Temperature also negatively masked locomotor activity, and this masking was manifested even under optimal light conditions. Our results highlight the importance of the masking of circadian rhythmicity as a determinant of nocturnality in wild owl monkeys and suggest that the stimulatory effects of dim light in nocturnal primates may have been selected as an adaptive response to

Characterizing on-road driving performance in individuals with traumatic brain injury who pass or fail an on-road driving assessment.

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Stolwyk, Renerus J; Charlton, Judith L; Ross, Pamela E; Bédard, Michel; Marshall, Shawn; Gagnon, Sylvain; Gooden, James R; Ponsford, Jennie L

2018-01-15

To characterise on-road driving performance in individuals with traumatic brain injury who fail on-road driving assessment, compared with both those who pass assessment and healthy controls, and the injury and cognitive factors associated with driving performance. Cross-sectional. Forty eight participants with traumatic brain injury (Age M = 40.50 SD = 14.62, 77% male, post-traumatic amnesia days M = 28.74 SD =27.68) and 48 healthy matched controls completed a standardised on-road driving assessment in addition to cognitive measures. Individuals with traumatic brain injury who passed on-road driving assessment performed no differently from controls while individuals with traumatic brain injury who failed the assessment demonstrated significantly worse driving performance relative to controls across a range of driving manoeuvres and error types including observation of on-road environment, speed control, gap selection, lane position, following distance and basic car control. Longer time post-injury and reduced visual perception were both significantly correlated with reduced driving skills. This exploratory study indicated that drivers with traumatic brain injury who failed on-road assessment demonstrated a heterogeneous pattern of impaired driving manoeuvres, characterised by skill deficits across both operational (e.g., basic car control and lane position) and tactical domains (e.g., following distance, gap selection, and observation) of driving. These preliminary findings can be used for implementation of future driving assessments and rehabilitation programs. Implications for rehabilitation Clinicians should be aware that the majority of individuals with traumatic brain injury were deemed fit to resume driving following formal on-road assessment, despite having moderate to very severe traumatic brain injuries. Drivers with traumatic brain injury who failed an on-road assessment demonstrated a heterogeneous pattern of impaired skills including errors

Compensatory viewing training improves practical fitness to drive of subjects with impaired vision

NARCIS (Netherlands)

Kooijman, Aart C.; Brouwer, Wiebo H.; Coeckelbergh, Tanja R.M.; Tant, Mark L.M.; Cornelissen, Frans W.; Bredewoud, Ruud A.; Melis-Dankers, Bart J.M.

2004-01-01

In many countries strict legal requirements for obtaining a driver’s license are in effect for visual acuity and visual field.We studied the relationship between these characteristics and driving safety and driving proficiency in an on-the-road test of practical fitness to drive in subjects with

Relationships between frequency of driving under the influence of cannabis, self-reported reckless driving and risk-taking behavior observed in a driving simulator.

Science.gov (United States)

Bergeron, Jacques; Paquette, Martin

2014-06-01

The role of cannabis consumption in traffic crashes is unclear and the causal link between cannabis and collisions is still to be demonstrated. While cannabis use is very likely to impair driving ability, there is as yet no overwhelming evidence that cannabis use in isolation contributes more to collisions than other characteristics inherent to cannabis users. As noted in a growing body of literature, individuals driving under the influence of cannabis (DUIC) seem to exhibit a general reckless driving style putting them at higher risk to be involved in traffic crashes. This study aims at investigating the relationship between self-reported DUIC and reckless driving by means of self-reported measures and direct observations made in a driving simulator. Participants (n=72) were required to be between 18 and 25 years of age, to hold a valid driver's license, and to drive at least twice a week. They completed standard driving simulation tasks recreating everyday on-road trivial conditions. Results show that people admitting that they commit more real-life dangerous driving behaviors reached higher maximum speed and demonstrated more reckless driving behaviors on the driving simulation tasks. Self-reported DUIC is associated with a risky driving style including a broad range of reckless on-road behaviors and support the problem driving behavior theory. Moreover, beyond confounding factors, both self-report DUIC and observed dangerous behaviors are associated with real-life traffic violations. Since DUIC appears to be related to an overall reckless style of driving, it is proposed that public safety policies should be more holistic, simultaneously targeting multiple on-road dangerous behaviors for intervention. Copyright © 2014 Elsevier B.V. All rights reserved.

Primary nocturnal enuresis is associated with lower intelligence quotient scores in boys from poorer socioeconomic status families.

Science.gov (United States)

Basiri, Abbas; Bahrainian, Seyed Abdolmajid; Khoshdel, Alireza; Jalaly, Niloofar; Golshan, Shabnam; Pakmanesh, Hamid

2017-03-01

To explore intelligence quotient in boys with primary nocturnal enuresis compared with normal boys considering their socioeconomic status. A total of 152 school-aged boys (including 55 boys with primary nocturnal enuresis and 97 matched normal controls) were assessed. Boys with a history of any neurological or urological disease were excluded. Two different districts of Tehran: Khani-Abad (a poor district) and Pirouzi (a middle class district) districts were enrolled according to socioeconomic status data reported by the World Health Organization. Intelligence tests were carried out using a validated Iranian translation of the Wechsler Intelligence Scale for Children Revised. Total, as well as performance intelligence quotient and verbal intelligence quotient scores and verbal-performance discrepancy (the difference between verbal and performance intelligence quotient scores for each individual) were compared using a t-test between boys with primary nocturnal enuresis in each district and their matched controls. Considering each district separately, the total intelligence quotient score was lower in primary nocturnal enuresis cases than controls only in the lower income district (90.7 ± 23.3 vs 104.8 ± 14.7, P = 0.002). Similarly, boys with primary nocturnal enuresis ranked lower in verbal intelligence quotient (P = 0.002) and performance intelligence quotient (P = 0.004) compared with their matched normal controls only in lower income district, whereas in the higher income district, boys with primary nocturnal enuresis ranked similar in total intelligence quotient to their matched controls. Boys with primary nocturnal enuresis had a lower intelligence quotient compared with the control participants only in low-income district. It seems important to adjust the results of the intelligence quotient assessment in these children according to their socioeconomic status. © 2017 The Japanese Urological Association.

Driving under the influence of khat--alkaloid concentrations and observations in forensic cases.

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Toennes, Stefan W; Kauert, Gerold F

2004-02-10

The use of the herbal stimulant khat (Catha edulis FORSK) is maintained by immigrants from countries where it is part of their cultural life (Arabian Peninsula and eastern Africa). In western countries the drug and its effects are largely unknown and no experience in evaluating impairment symptoms due to the khat-alkaloids, e.g. cathinone, cathine and norephedrine exists. Blood and urine samples from khat users involved in 19 cases of suspected driving under the influence of drugs were analysed and correlated with the results of medical examination and police officer reports. In 3 cases impaired driving and in 10 cases marked impairment of psychophysical functions was observed such as effects on the nervous system (slow pupil reaction to light, dry mouth, increased heart-rate), trembling, restlessness/nervousness, daze/apathy/dullness, impairment of attention, walking and standing on one leg. However, the alkaloid concentrations assayed in blood did not correlate with the impairment symptoms. Apart from an acute phase of indirect sympathomimetic action the development of habituation and withdrawal symptoms must also be considered in explaining the diversity of effects observed. From these results it can be concluded that chewing khat may severely impair driving ability, but may also be without noticeable effects.

Glaucomatous Optic Neuropathy Associated with Nocturnal Dip in Blood Pressure: Findings from the Maracaibo Aging Study.

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Melgarejo, Jesús D; Lee, Joseph H; Petitto, Michele; Yépez, Juan B; Murati, Felipe A; Jin, Zhezhen; Chávez, Carlos A; Pirela, Rosa V; Calmón, Gustavo E; Lee, Winston; Johnson, Matthew P; Mena, Luis J; Al-Aswad, Lama A; Terwilliger, Joseph D; Allikmets, Rando; Maestre, Gladys E; De Moraes, C Gustavo

2018-01-05

To determine which nocturnal blood pressure (BP) parameters (low levels or extreme dipper status) are associated with an increased risk of glaucomatous damage in Hispanics. Observational cross-sectional study. A subset (n = 93) of the participants from the Maracaibo Aging Study (MAS) who met the study eligibility criteria were included. These participants, who were at least 40 years of age, had measurements for optical tomography coherence, visual field (VF) tests, 24-hour BP, office BP, and intraocular pressure 20% compared with daytime BP) were significant risk factors for glaucomatous damage (odds ratio, 19.78 and 5.55, respectively). In this population, the link between nocturnal BP and GON is determined by extreme dipping effects rather than low nocturnal BP levels alone. Further studies considering extreme decreases in nocturnal BP in individuals at high risk of glaucoma are warranted. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Nocturnal polyuria and decreased serum testosterone: is there an association in men with lower urinary tract symptoms?

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Kim, Jin Wook; Oh, Mi Mi; Yoon, Cheol Yong; Bae, Jae Hyun; Kim, Je Jong; Moon, Du Geon

2014-05-01

To investigate the putative association between nocturia and decreased serum testosterone in men with lower urinary tract symptoms. Frequency volume charts and serum testosterone levels of patients visiting the outpatient clinic for lower urinary tract symptoms were collected and analyzed. Age, prostate volume, body mass index and the presence of comorbidities were accounted for. Frequency volume charts were analyzed for pathophysiological components of nocturnal polyuria, global polyuria, decreased nocturnal bladder capacity and increased frequency to identify associated risks. Frequency volume charts were also used to chart 8-h changes of volume, frequency and capacity to identify time diurnal interactions with risk factors based on serum testosterone levels. A total of 2180 patients were enrolled in the study. Multivariate analysis showed testosterone decreased 0.142 ng/mL for every increase in nocturia, independent of other factors. Logistic regression analysis showed a significant difference between pathophysiological components. Decreased testosterone was shown to carry a significant independent risk for overall nocturia (odds ratio 1.60, 95% confidence interval 1.013-2.527, P = 0.044), and particularly nocturnal polyuria (odds ratio 1.934, 95% confidence interval 1.001-3.737, P = 0.027). Repeated measurement models showed patients with serum testosterone below 2.50 ng/mL to have a paradoxical increase in nocturnal urine volume at night. Nocturia, especially nocturnal polyuria, is associated with decreased serum testosterone. Patients with low serum testosterone show increased nocturnal urine output. © 2013 The Japanese Urological Association.

Influence of Frequent Nocturnal Home Hemodialysis on Food Preference

NARCIS (Netherlands)

Ipema, Karin; Franssen, Casper; van der Schans, Cees; Smit, Lianne; Noordman, Sabine; Haisma, Hinke

Objective: Dialysis patients frequently report a change of taste that is reversible after renal transplantation, suggesting that uremic toxins may negatively influence taste. Currently, frequent nocturnal home hemodialysis (NHHD) is the most effective method of hemodialysis, and is associated with

Impact of distraction on the driving performance of adolescents with and without attention-deficit/hyperactivity disorder.

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Narad, Megan; Garner, Annie A; Brassell, Anne A; Saxby, Dyani; Antonini, Tanya N; O'Brien, Kathleen M; Tamm, Leanne; Matthews, Gerald; Epstein, Jeffery N

2013-10-01

This study extends the literature regarding attention-deficit/hyperactivity disorder (ADHD)-related driving impairments to a newly licensed, adolescent population. To investigate the combined risks of adolescence, ADHD, and distracted driving (cell phone conversation and text messaging) on driving performance. Adolescents aged 16 to 17 years with (n = 28) and without (n = 33) ADHD engaged in a simulated drive under 3 conditions (no distraction, cell phone conversation, and texting). During each condition, one unexpected event (eg, another car suddenly merging into driver's lane) was introduced. Cell phone conversation, texting, and no distraction while driving. Self-report of driving history, average speed, standard deviation of speed, standard deviation of lateral position, and braking reaction time during driving simulation. Adolescents with ADHD reported fewer months of driving experience and a higher proportion of driving violations than control subjects. After controlling for months of driving history, adolescents with ADHD demonstrated more variability in speed and lane position than control subjects. There were no group differences for braking reaction time. Furthermore, texting negatively impacted the driving performance of all participants as evidenced by increased variability in speed and lane position. To our knowledge, this study is one of the first to investigate distracted driving in adolescents with ADHD and adds to a growing body of literature documenting that individuals with ADHD are at increased risk for negative driving outcomes. Furthermore, texting significantly impairs the driving performance of all adolescents and increases existing driving-related impairment in adolescents with ADHD, highlighting the need for education and enforcement of regulations against texting for this age group.

Drunk driving warning system (DDWS). Volume 1, System concept and description

Science.gov (United States)

1983-11-01

The Drunk Driving Warning System (DDWS) is a vehicle-mounted device for testing driver impairment and activating alarms. The driver must pass a steering competency test in order to drive the car in a normal manner. The emergency flasher system operat...

A pilot study of the effects of atomoxetine on driving performance in adults with ADHD.

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Barkley, Russell A; Anderson, Deborah L; Kruesi, Markus

2007-02-01

There is a high risk of vehicular crashes, traffic citations, and poorer driving performance in adults with ADHD. This pilot study examines the value of a new nonstimulant (atomoxetine) for improving the driving performance of adults with ADHD. Atomoxetine (1.2 mg/kg daily for 3 weeks) and a placebo are studied on 18 adults with ADHD (M age = 37 years) using ratings of ADHD symptoms, impairment, and safe driving behavior; a virtual reality driving simulator; and ratings of simulator performance. Atomoxetine improves self-ratings of ADHD symptoms, impairments, safe driving behavior, and simulator driving performance. No effects of atomoxetine are evident on others' ratings of driving behavior or on the simulator. Practice effects on the simulator may have obscured those drug effects. The authors find a mixed pattern of results such that atomoxetine warrants further study for its effects on driving in this high-risk population.

Self-reported sleep bruxism and nocturnal gastroesophageal reflux disease in patients with obstructive sleep apnea: relationship to gender and ethnicity.

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Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

2014-01-01

Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups.

Dual-task effects of simulated lane navigation and story recall in older adults with and without memory impairment.

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Cook, Sarah E; Sisco, Shannon M; Marsiske, Michael

2013-01-01

While driving is a complex task, it becomes relatively automatic over time although unfamiliar situations require increased cognitive effort. Much research has examined driving risk in cognitively impaired elders and found little effect. This study assessed whether mildly memory impaired elders made disproportionate errors in driving or story recall, under simultaneous simulated driving and story recall. Forty-six healthy (61% women; mean age = 76.4) and 15 memory impaired (66% women, mean age = 79.4) elders participated. Cognitive status was determined by neuropsychological performance. Results showed that during dual-task conditions, participants stayed in lane more, and recalled stories more poorly, than when they did the tasks separately. Follow-up analysis revealed that verbatim recall, in particular, was reduced while driving for healthy participants. While memory impaired participants performed more poorly than healthy controls on both tasks, cognitive status was not associated with greater dual-task costs when driving and story recall were combined.

Exploring the Drinking/Driving Behaviors and Attitudes of College Students.

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Geller, E. Scott

While there is little research specifically dealing with college students and drunk driving, there is ample evidence of frequent, heavy drinking by students. A series of projects was undertaken to explore college students' drinking behavior and attitudes related to alcohol-impaired driving. These projects included: (1) analysis of behavioral…

Wrong-way driving crashes on French divided roads.

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Kemel, Emmanuel

2015-02-01

The objective of divided roads is to increase users' safety by posting unidirectional traffic flows. It happens however that drivers proceed in the wrong direction, endangering themselves as well as other users. The crashes caused by wrong-way drivers are generally spotlighted by the media and call for public intervention. This paper proposes a characterization of wrong-way driving crashes occurring on French divided road on the 2008-2012 period. The objective is to identify the factors that delineate between wrong-way driving crashes and other crashes. Building on the national injury road crash database, 266 crashes involving a wrong-way driver were identified. Their characteristics (related to timing, location, vehicle and driver) are compared to those of the 22,120 other crashes that occurred on the same roads over the same period. The comparison relies on descriptive statistics, completed by a logistic regression. Wrong-way driving crashes are rare but severe. They are more likely to occur during night hours and on non-freeway roads than other crashes. Wrong-way drivers are older, more likely to be intoxicated, to be locals, to drive older vehicles, mainly passenger cars without passengers, than other drivers. The differences observed across networks can help prioritizing public intervention. Most of the identified WW-driving factors deal with cognitive impairment. Therefore, the specific countermeasures such as alternative road signs should be designed for and tested on cognitively impaired drivers. Nevertheless, WW-driving factors are also risk factors for other types of crashes (e.g. elderly driving, drunk driving and age of the vehicle). This suggests that, instead of (or in addition to) developing WW-driving specific countermeasures, managing these risk factors would help reducing a larger number of crashes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quantifying the local influence at a tall tower site in nocturnal conditions

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Werth, David; Buckley, Robert; Zhang, Gengsheng; Kurzeja, Robert; Leclerc, Monique; Duarte, Henrique; Parker, Matthew; Watson, Thomas

2015-10-17

The influence of the local terrestrial environment on nocturnal atmospheric CO₂ measurements at a 329-m television transmitter tower (and a component of a CO₂ monitoring network) was estimated with a tracer release experiment and a subsequent simulation of the releases. This was done to characterize the vertical transport of emissions from the surface to the uppermost tower level and how it is affected by atmospheric stability. The tracer release experiment was conducted over two nights in May of 2009 near the Department of Energy’s Savannah River Site (SRS) in South Carolina. Tracer was released on two contrasting nights—slightly stable and moderately stable—from several upwind surface locations. Measurements at the 329-m level on both nights indicate that tracer was able to mix vertically within a relatively short (~24 km) distance, implying that nocturnal stable conditions do not necessarily prevent vertical dispersion in the boundary layer and that CO₂ measurements at the tower are at least partly influenced by nearby emissions. A simulation of the tracer release is used to calculate the tower footprint on the two nights to estimate the degree to which the local domain affects the tower readings. The effect of the nocturnal boundary layer on the area sampled by the tower can be seen clearly, as the footprints were affected by changes in stability. The contribution of local sources to the measurements at the tower was minimal, however, suggesting that nocturnal concentrations at upper levels are contributed mostly by regional sources.

[Is nocturnal polyuria more frequent among patients with Parkinson's disease?].

Science.gov (United States)

Romain, J; Torny, F; Dumas, J-P; Gamé, X; Descazeaud, A

2015-05-01

Nocturia is a frequent complaint in the population of idiopathic Parkinson's disease patients (IPD). The consequences of nocturia in the IPD population are at high importance as these patients have motor problems and therefore a risk of nocturnal fall. The aim of the study was to determine the mechanism of nocturia in patients with MPI, by determining the prevalence of nocturnal polyuria (NP) in this population. A prospective study by bladder diary was conducted on 70 consecutive IPD patients consulting for regular neurological follow-up at a non-severe stage. Nocturia was defined as 1 or more awakenings to urinate. Two definitions of NP were used: nocturnal diuresis 33% or higher of the total diuresis (NUV33), which is the ICS (International Continence Society) definition, and nocturnal diuresis 90 mL/h or higher (NUP90). The mean patient age was 71 years (45-86, sex ratio 33/30). On average, patients were diagnosed for IPD 6.76 years earlier. The prevalence of NP was 64.5% according to NUV33 definition, and 17.7% according to NUP90 definition. Among patients with nocturia, the prevalence of NP was 66% (NUV33) and 21.5% (NUP90). No association was observed between disease duration of the IPD and the prevalence of nocturia and NP. Patients 70 years and older were more likely to have NP as defined by NUV33 than those less than 70 years (72.7% versus 55.17%, P=0.015). Men had more frequently nocturia (33.3% versus 20.7%, P=0.027). The prevalence of NP and nocturia was analyzed in patients with IPD at a non-severe stage. This prevalence was not higher than in the general population of the same age. The mechanism of nocturia in patients with IPD is not unambiguous and therefore requires to be explored by a bladder diary. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

An Improved Iterative Fitting Method to Estimate Nocturnal Residual Layer Height

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Wei Wang

2016-08-01

Full Text Available The planetary boundary layer (PBL is an atmospheric region near the Earth’s surface. It is significant for weather forecasting and for the study of air quality and climate. In this study, the top of nocturnal residual layers—which are what remain of the daytime mixing layer—are estimated by an elastic backscatter Lidar in Wuhan (30.5°N, 114.4°E, a city in Central China. The ideal profile fitting method is widely applied to determine the nocturnal residual layer height (RLH from Lidar data. However, the method is seriously affected by an optical thick layer. Thus, we propose an improved iterative fitting method to eliminate the optical thick layer effect on RLH detection using Lidar. Two typical case studies observed by elastic Lidar are presented to demonstrate the theory and advantage of the proposed method. Results of case analysis indicate that the improved method is more practical and precise than profile-fitting, gradient, and wavelet covariance transform method in terms of nocturnal RLH evaluation under low cloud conditions. Long-term observations of RLH performed with ideal profile fitting and improved methods were carried out in Wuhan from 28 May 2011 to 17 June 2016. Comparisons of Lidar-derived RLHs with the two types of methods verify that the improved solution is practical. Statistical analysis of a six-year Lidar signal was conducted to reveal the monthly average values of nocturnal RLH in Wuhan. A clear RLH monthly cycle with a maximum mean height of about 1.8 km above ground level was observed in August, and a minimum height of about 0.7 km was observed in January. The variation in monthly mean RLH displays an obvious quarterly dependence, which coincides with the annual variation in local surface temperature.

As Blood Alcohol Content (BAC) Increases, So Does Impairment | NIH MedlinePlus the Magazine

Science.gov (United States)

... 30% Severe Impairment – 0.16 - 0.30% Speech, memory, coordination, attention, reaction time, balance significantly impaired All driving-related skills dangerously impaired Judgement and decision making dangerously impaired Blackouts (amnesia) Vomiting and other signs ...

The Association of Sensation Seeking and Impulsivity to Driving while under the Influence of Alcohol

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Curran, Matthew F.; Fuertes, Jairo N.; Alfonso, Vincent C.; Hennessy, James J.

2010-01-01

This study examined the association between sensation seeking, impulsivity, and drunk driving. Results showed significant differences in sensation seeking and impulsivity among 160 individuals convicted of impaired or intoxicated driving and individuals who had never been arrested for driving while under the influence/driving while intoxicated…

Sibelius: Luonnotar. Chevauchee nocturne et lever du soleil / Pierre Gervasoni

Index Scriptorium Estoniae

Gervasoni, Pierre

1996-01-01

Uuest heliplaadist "Sibelius: Luonnotar. Chevauchee nocturne et lever du soleil. 4 Legendes. Orchestre Philharmonique Royal de Stockholm, Paavo Järvi. Virgin Classics 545 213-2 (CD:167F). 1996. TT: 1h 13'22"

Effects of desmopressin for the treatment of nocturnal polyuria in elderly women: impact on related sleep quality

Science.gov (United States)

Mun, Jong-Hyeon; Kim, Sun-Ouck; Yu, Ho Song; Chung, Ho Suck; Kwon, Dongdeuk

2015-01-01

Introduction: We investigated the efficacy, safety, and impact of desmopressin on quality of sleep in treating nocturnal polyuria in elderly women. Methods: We recruited 60 women over 60 years old with lower urinary tract symptoms (LUTS), including nocturia, and with nocturnal polyuria. Nocturnal polyuria was defined as nighttime urine production exceeding 33% of the 24-hour total urine volume determined by a frequency volume (FV) chart. All patients failed to respond to treatment of their underlying disease and evening fluid restriction. Desmopressin 0.1 mg was administered orally at bedtime for 12 weeks. The participants completed a series of questionnaires on the Medical Outcomes Study (MOS) sleep scale and FV chart before and after treatment. Results: The patient population had a mean age of 69.2 ± 9.4 years (range: 61–81). The mean duration of symptoms was 61.2 ± 45.1 months. Significant decreases were evident after desmopressin treatment in the number of nocturia episodes (3.63 ± 1.61 to 2.00 ± 1.13, p = 0.01), nocturnal urine volume (p = 0.01), nocturnal polyuria index (NPI) (p = 0.01), and nocturia index (NI) p = 0.01). Among the categories of the MOS sleep scale, sleep index (p = 0.003), sleep disturbance (p = 0.001), snoring (p = 0.028), and shortness of breath (p = 0.036) significantly changed, with a decreased number of nocturia episodes. Adverse events were mild. Conclusions: Desmopressin is an effective treatment for nocturnal polyuria in elderly women, where conservative treatment has failed. Sleep quality is also improved. PMID:26600882

Artificial light pollution increases nocturnal vigilance in peahens

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Jessica L. Yorzinski

2015-08-01

Full Text Available Artificial light pollution is drastically changing the sensory environments of animals. Even though many animals are now living in these changed environments, the effect light pollution has on animal behavior is poorly understood. We investigated the effect of light pollution on nocturnal vigilance in peahens (Pavo cristatus. Captive peahens were exposed to either artificial lighting or natural lighting at night. We employed a novel method to record their vigilance behavior by attaching accelerometers to their heads and continuously monitoring their large head movements. We found that light pollution significantly increases nocturnal vigilance in peahens. Furthermore, the birds faced a trade-off between vigilance and sleep at night: peahens that were more vigilant spent less time sleeping. Given the choice, peahens preferred to roost away from high levels of artificial lighting but showed no preference for roosting without artificial lighting or with low levels of artificial lighting. Our study demonstrates that light pollution can have a substantial impact on animal behavior that can potentially result in fitness consequences.

Radiation forcing by the atmospheric aerosols in the nocturnal boundary layer

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Singh, D. K.; Ponnulakshami, V. K.; Mukund, V.; Subramanian, G.; Sreenivas, K. R.

2013-05-01

We have conducted experimental and theoretical studies on the radiation forcing due to suspended aerosols in the nocturnal boundary layer. We present radiative, conductive and convective equilibrium profile for different bottom boundaries where calculated Rayleigh number is higher than the critical Rayleigh number in laboratory conditions. The temperature profile can be fitted using an exponential distribution of aerosols concentration field. We also present the vertical temperature profiles in a nocturnal boundary in the presence of fog in the field. Our results show that during the presence of fog in the atmosphere, the ground temperature is greater than the dew-point temperature. The temperature profiles before and after the formation of fog are also observed to be different.

Drug driving in Europe : policy measures for national and EU action.

NARCIS (Netherlands)

Atchison, L.

2017-01-01

Driving under the influence of psychoactive drugs leads to deaths and serious injuries on Europe’s roads. Both illicit and licit drugs can disrupt the psychological state of the driver and impair their driving performance. Using multiple drugs simultaneously, or in conjunction with alcohol,

The influence of periodic increases of human activity on crepuscular and nocturnal mammals: Testing the weekend effect.

Science.gov (United States)

Nix, Joshua H; Howell, Ryan G; Hall, Lucas K; McMillan, Brock R

2018-01-01

Human recreation can negatively affect wildlife, particularly on weekends when human activity is highest (i.e., the weekend effect). Much of what we understand about the weekend effect is based on research conducted on diurnal species, which have greater temporal overlap with humans. Because nocturnal species generally avoid times when humans are active, they are likely less affected by anthropogenic activity on weekends. Our objective was to test the weekend effect in relation to the degree of nocturnality of mammals in a recreational area. We predicted that as nocturnality increased, the effect of human activity would decrease. To address our objective, we placed 50 remote cameras along the Diamond Fork River in Utah from January to June 2015. We found that three out of the four focal species supported our predictions. Mule deer (crepuscular) reduced activity throughout our entire study area during weekends and avoided campgrounds. Beavers and mountain lions (both nocturnal) did not negatively respond to increased human activity. Raccoons (nocturnal) reduced activity during weekends, but only within campground areas. Our findings indicate that as the temporal overlap increases between wildlife and humans, so does the influence that humans have on wildlife. Copyright © 2017 Elsevier B.V. All rights reserved.

Driving performance in persons with mild to moderate symptoms of multiple sclerosis.

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Devos, Hannes; Brijs, Tom; Alders, Geert; Wets, Geert; Feys, Peter

2013-08-01

To investigate whether driving performance is impaired in persons with mild to moderate multiple sclerosis (MS). This study included 15 persons with MS (pwMS) and 17 healthy controls. The MS group exhibited mild to moderate impairments on the Expanded Disability Status Scale (median, Q1-Q3; 3.5, 2.5-4). The driving simulation required participants to drive in daily traffic while attending to a divided attention (DA) task. Computerized measures on the driving task included number of accidents, tickets, speed maintenance, standard deviation of lateral position, and time to collision. Response times and accuracy on the DA task were also computer generated. Additionally, pwMS completed a clinical evaluation encompassing motor, functional, visual, psychosocial and cognitive tests. No differences between healthy controls and pwMS were observed on all measures of the primary driving task. PwMS performed worse than healthy controls on DA response time (3.10 s, 2.87-3.68 versus 2.15 s, 2.04-2.43; p = 0.001) and accuracy (15 correct answers, 11-18 versus 24 correct answers, 22-25; p driving task above the DA task. The relationship between depression and driving performance in MS merits further investigation.

Navigational efficiency of nocturnal Myrmecia ants suffers at low light levels.

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Ajay Narendra

Full Text Available Insects face the challenge of navigating to specific goals in both bright sun-lit and dim-lit environments. Both diurnal and nocturnal insects use quite similar navigation strategies. This is despite the signal-to-noise ratio of the navigational cues being poor at low light conditions. To better understand the evolution of nocturnal life, we investigated the navigational efficiency of a nocturnal ant, Myrmecia pyriformis, at different light levels. Workers of M. pyriformis leave the nest individually in a narrow light-window in the evening twilight to forage on nest-specific Eucalyptus trees. The majority of foragers return to the nest in the morning twilight, while few attempt to return to the nest throughout the night. We found that as light levels dropped, ants paused for longer, walked more slowly, the success in finding the nest reduced and their paths became less straight. We found that in both bright and dark conditions ants relied predominantly on visual landmark information for navigation and that landmark guidance became less reliable at low light conditions. It is perhaps due to the poor navigational efficiency at low light levels that the majority of foragers restrict navigational tasks to the twilight periods, where sufficient navigational information is still available.

USE OF THREE-COMPONENT LEVODOPA (LEVODOPA/CARBIDOPA/ENTACAPONE TO CORRECT NOCTURNAL SYMPTOMS OF PARKINSON,S DISEASE

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T. K. Kulua

2015-01-01

Full Text Available Objective: to describe a clinical case of late-stage Parkinson’s disease (PD with nocturnal symptoms and fluctuations and to present successful experience in using the three-component drug Stalevo (levodopa/carbidopa/entacapone as a single dose prior to sleep. Patient V. aged 72 years took medical advice at the Department of Neurology, Russian Medical Academy of Postgraduate Education, for complaints of constrained movements, inability to turn in bed independently, painful muscle cramps, light sleep with nocturnal awakenings, and frequent (5–6 times urinations at night. The first symptoms of the disease appeared 12 years ago when the patient began to notice sluggishness, altered handwriting, and clumsiness during small movements of the right hand. By taking into account symptoms (obvious nocturnal akinesia, overactive bladder, sleep disorders, and cramps and the results of his examination, the patient was diagnosed with the akinetic-rigid form of PD (4 Hoehn-Yarh scores. Therapy was corrected as follows: the dose of amantadine remained the same (300 mg; its last administration is recommended to be at 16:00; the daily dose of levodopa was 700 mg; that of levodopa/benserazide was 550 mg/day (1 tablet × 3/4 tablet × 1 tablet. The evening intake of levodopa was changed for that of the three-component drug Stalevo (levodopa 150 mg/ carbidopa 37.5 mg/entacapone 200 mg. Results. After 3 months, the patient was observed to have significant health improvement: reduced nocturnal and morning akinesia, better gait, a considerably smaller number of nocturnal urinations (less than once per night, regression of painful calf muscle cramps, and improved sleep. Conclusion. The three-component drug Stalevo (levodopa/carbidopa/entacapone is effective in treating late-stage PD. Its use as a single dose before going to bed has led to regressive nocturnal symptoms, better sleep, and lower motor fluctuations. 

Dark Matters: Challenges of Nocturnal Communication Between Plants and Animals in Delivery of Pollination Services.

Science.gov (United States)

Borges, Renee M

2018-03-01

The night is a special niche characterized by dim light, lower temperatures, and higher humidity compared to the day. Several animals have made the transition from the day into the night and have acquired unique adaptations to cope with the challenges of performing nocturnal activities. Several plant species have opted to bloom at night, possibly as a response to aridity to prevent excessive water loss through evapotranspiration since flowering is often a water-demanding process, or to protect pollen from heat stress. Nocturnal pollinators have visual adaptations to function under dim light conditions but may also trade off vision against olfaction when they are dependent on nectar-rewarding and scented flowers. Nocturnal pollinators may use CO 2 and humidity cues emanating from freshly-opened flowers as indicators of nectar-rich resources. Some endothermic nocturnal insect pollinators are attracted to thermogenic flowers within which they remain to obtain heat as a reward to increase their energy budget. This review focuses on mechanisms that pollinators use to find flowers at night, and the signals that nocturnally blooming flowers may employ to attract pollinators under dim light conditions. It also indicates gaps in our knowledge. While millions of years of evolutionary time have given pollinators and plants solutions to the delivery of pollination services and to the offering of appropriate rewards, this history of successful evolution is being threatened by artificial light at night. Excessive and inappropriate illumination associated with anthropogenic activities has resulted in significant light pollution which serves to undermine life processes governed by dim light.

Effects of dexamphetamine with and without alcohol on simulated driving.

Science.gov (United States)

Simons, Ries; Martens, Marieke; Ramaekers, Jan; Krul, Arno; Klöpping-Ketelaars, Ineke; Skopp, Gisela

2012-08-01

In party circuits dexamphetamine is frequently used in combination with alcohol. It is hypothesized that co-administration of dexamphetamine to alcohol might reduce the sedative effects of alcohol, but may potentiate risk-taking behaviour. The study was aimed at assessing the effects of alcohol, dexamphetamine and the combination of both on simulated driving and cognitive performance. Eighteen subjects participated in a randomized, crossover, placebo-controlled study employing four conditions: 10 mg dexamphetamine, 0.8 g/kg alcohol, 10 mg dexamphetamine + 0.8 g/kg alcohol, and placebo. Fundamental driving skills and risk-taking behaviour were assessed in a driving simulator. Subjects also completed vigilance and divided attention tasks, and subjective ratings. Mean BAC levels during simulated driving were between 0.91‰ and 0.64‰. Subjects using alcohol showed a significantly larger mean standard deviation of lateral position and shorter accepted gap time and distance. Use of alcohol or dexamphetamine + alcohol was associated with a higher frequency of red light running and collisions than the dexamphetamine or placebo conditions. Performance of vigilance and divided attention tasks was significantly impaired in the alcohol condition and, to a lesser degree, in the dexamphetamine + alcohol condition. Single doses of 0.8 g/kg alcohol increased risk-taking behaviours and impaired tracking, attention and reaction time during a 3-h period after drinking when BACs declined from 0.9 to 0.2 mg/ml. The stimulatory effects of co-administration of dexamphetamine 10 mg were not sufficient to overcome the impairing effects of alcohol on skills related to driving.

Nocturnal raptors (owls: contributions to study of its popularity

Directory of Open Access Journals (Sweden)

Maria Lindelia Rincón Hernández

2017-01-01

Full Text Available This research characterizes the nocturnal birds of prey on the campus of Universidad Pedagógica y Tecnológica de Colombia (UPTC; in English, Pedagogical and Technological University of Colombia, in addition to the contribution to the study of its popularity, with students in fifth grade from two educational institutions, one, of the urban context, and other, of the rural context. The study involved the implementation of the didactic component to promote recognition of their biological significance in elementary school students. Among the findings two species of nocturnal birds of prey were identified: common currucutú owl (Tropical Screech Owl, Megascops choliba and the barn owl (Tyto alba, with a relative abundance of 12 individuals and 10 individuals, respectively. It also includes changes in perception from students regarding beliefs and superstitions about such species, which favors the recognition of the biological role in the ecosystem and the need for its conservation.

We can predict when driving is no longer safe for people who have HD using standard neuropsychological measures.

Science.gov (United States)

Hennig, Bonnie L; Kaplan, Richard F; Nowicki, Ariel E; Barclay, Jessy E; Gertsberg, Anna G

2014-01-01

Early cognitive dysfunction in Huntington's Disease (HD) is typically of a subcortical frontal executive type, with bradyphrenia, poor spatial and working memory, poor planning and organization, a lack of judgment, and poor mental flexibility. Although there is literature suggesting a correlation between deficits in speed of processing, working memory and executive function on driving competency, there is little direct evidence comparing these declines on tests to actual driving skills. The current study examines the utility of specific neuropsychological measures in predicting actual driving competency in patients with HD. Fifty-two patients at the UConn Health HD Program underwent yearly neuropsychological evaluations and were included in this study. Four scales were chosen a priori to predict driving impairment because of their reported relationship to driving ability. Within each test category, subjects who scored below the threshold suggestive of neurological impairment were found to have results within the impaired range (1.5 standard deviations below corrective normative data). A referral to the Connecticut Department of Motor Vehicles (DMV) for a driving evaluation was subsequently made on patients who were found impaired on any two of these tests. The authors found a strong relationship between scores on a simple battery of four neuropsychological tests and driving competency. This short battery may prove of pragmatic value for clinicians working with people with HD and their families.

Artificial light and nocturnal activity in gammarids

Directory of Open Access Journals (Sweden)

Elizabeth K. Perkin

2014-03-01

Full Text Available Artificial light is gaining attention as a potential stressor to aquatic ecosystems. Artificial lights located near streams increase light levels experienced by stream invertebrates and we hypothesized light would depress night drift rates. We also hypothesized that the effect of light on drift rates would decrease over time as the invertebrates acclimated to the new light level over the course of one month’s exposure. These hypotheses were tested by placing Gammarus spp. in eight, 75 m × 1 m artificial flumes. One flume was exposed to strong (416 lx artificial light at night. This strong light created a gradient between 4.19 and 0.04 lx over the neighboring six artificial flumes, while a control flume was completely covered with black plastic at night. Night-time light measurements taken in the Berlin area confirm that half the flumes were at light levels experienced by urban aquatic invertebrates. Surprisingly, no light treatment affected gammarid drift rates. In contrast, physical activity measurements of in situ individually caged G. roeseli showed they increased short-term activity levels in nights of complete darkness and decreased activity levels in brightly lit flumes. Both nocturnal and diurnal drift increased, and day drift rates were unexpectadly higher than nocturnal drift.

Driving difficulties of brain-injured drivers in reaction to high-crash-risk simulated road events: a question of impaired divided attention?

Science.gov (United States)

Cyr, Andrée-Ann; Stinchcombe, Arne; Gagnon, Sylvain; Marshall, Shawn; Hing, Malcolm Man-Son; Finestone, Hillel

2009-05-01

This study examined the role of impaired divided attention and speed of processing in traumatic brain injury (TBI) drivers in high-crash-risk simulated road events. A total of 17 TBI drivers and 16 healthy participants were exposed to four challenging simulated roadway events to which behavioral reactions were recorded. Participants were also asked to perform a dual task during portions of the driving task, and TBI individuals were administered standard measures of divided attention and reaction time. Results indicated that the TBI group crashed significantly more than controls (p < .05) and that dual-task performance correlated significantly with crash rate (r = .58, p = .05).

[Motor vehicle driving and diabetes mellitus - medical aspects].

Science.gov (United States)

Brož, Jan; Kriváňová, Lenka Syčová; Fedáková, Zuzana; Petrosyan, Lilit; Kvapil, Milan; Polák, Jan

2016-03-01

Diabetes mellitus is a disease which may affect the eligibility to hold a driving license and increase the risk of a road accident. Hypoglycemia while driving is considered to be the most risky situation, with diabetes increasing the mentioned risk for instance due to impaired vision in the case of possible retinopathy. The group of drivers with diabetes being at the greatest risk as to accidents are those with a case history of severe hypoglycemia or hypoglycemia occurred while driving, or possibly of a road accident. Measuring glycaemia before driving and their knowledge how to prevent and treat hypoglycemia - those are the two crucial preventive elements indispensable for insulin treated diabetes patients in order to secure safe road traffic.

The effect of lateral decubitus position on nocturnal intraocular pressure over a habitual 24-hour period in healthy adults.

Science.gov (United States)

Hao, Jie; Zhen, Yi; Wang, Hao; Yang, Diya; Wang, Ningli

2014-01-01

To investigate the effect of lateral decubitus position (LDP) on nocturnal intraocular pressure (IOP) and the effect of LDP on 24-hour habitual IOP pattern in healthy subjects. Intraocular pressure was measured every 2-hours using an Accupen Applanation Tonometer (Accutome, USA). During the diurnal period (7:30 am, 9:30 am, 11:30 am, 1:30 pm, 3:30 pm, 5:30 pm, 7:30 pm, and 9:30 pm), IOP was measured in the sitting position under bright light (500-1000 lux) after the subjects had been seated for 5 min. The nocturnal IOP was measured in the supine position, right LDP, and left LDP, with randomized sequences, under dim light (hour habitual IOP patterns were obtained according to the nocturnal position (supine, right LDP and left LDP) for either eye. Phour period, the effect of LDP on habitual IOP pattern was not statistically significant, although the mean nocturnal IOP and the diurnal-nocturnal IOP change for the right and the left eye in the LDP pattern was slightly higher than that in the sitting-supine pattern. Significant nocturnal IOP differences existed between the dependent eye and the supine, but did not occur consistently for all time points. Over a 24-hour period, the effect of LDP on habitual IOP pattern was not statistically significant in healthy subjects.

Social support and nocturnal blood pressure dipping: a systematic review.

Science.gov (United States)

Fortmann, Addie L; Gallo, Linda C

2013-03-01

Attenuated nocturnal blood pressure (BP) dipping is a better predictor of cardiovascular disease (CVD) morbidity and mortality than resting BP measurements. Studies have reported associations between social support, variously defined, and BP dipping. A systematic review of the literature was conducted to investigate associations of functional and structural social support with nocturnal BP dipping assessed over a minimum of 24 hours. A total of 297 articles were identified. Of these, 11 met criteria for inclusion; all studies were cross-sectional in design and included adult participants only (mean age = 19 to 72 years). Evidence was most consistent for an association between functional support and BP dipping, such that 5 of 7 studies reported statistically (or marginally) significant positive associations with BP dipping. Statistically significant functional support-BP dipping associations were moderate (standardized effect size (d) = 0.41) to large (d = 2.01) in magnitude. Studies examining structural support were fewer and relatively less consistent; however, preliminary evidence was observed for associations of marital status and social contact frequency with BP dipping. Statistically significant structural support findings were medium (d = 0.53) to large (d = 1.13) in magnitude. Overall, findings suggest a link between higher levels of functional support and greater nocturnal BP dipping; preliminary evidence was also observed for the protective effects of marriage and social contact frequency. Nonetheless, the relatively small number of studies conducted to date and the heterogeneity of findings across meaningful subgroups suggest that additional research is needed to substantiate these conclusions.

Treatment Options for Primary Nocturnal Enuresis by Parents in a ...

African Journals Online (AJOL)

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common treatment option was waking up child at intervals during the night to void by 103 (45.2 ... patient/family education, simple behavioral ... nocturnal enuresis were employing in managing ..... Dental and Medical Sciences 2014;13:41 – 4.

A Climatology of Nocturnal Low-Level Jets at Cabauw

NARCIS (Netherlands)

Baas, P.; Bosveld, F.C.; Baltink, H.K.; Holtslag, A.A.M.

2009-01-01

A climatology of nocturnal low-level jets (LLJs) is presented for the topographically flat measurement site at Cabauw, the Netherlands. LLJ characteristics are derived from a 7-yr half-hourly database of wind speed profiles, obtained from the 200-m mast and a wind profiler. Many LLJs at Cabauw

The effect of lateral decubitus position on nocturnal intraocular pressure over a habitual 24-hour period in healthy adults.

Directory of Open Access Journals (Sweden)

Jie Hao

Full Text Available PURPOSE: To investigate the effect of lateral decubitus position (LDP on nocturnal intraocular pressure (IOP and the effect of LDP on 24-hour habitual IOP pattern in healthy subjects. METHODS: Intraocular pressure was measured every 2-hours using an Accupen Applanation Tonometer (Accutome, USA. During the diurnal period (7:30 am, 9:30 am, 11:30 am, 1:30 pm, 3:30 pm, 5:30 pm, 7:30 pm, and 9:30 pm, IOP was measured in the sitting position under bright light (500-1000 lux after the subjects had been seated for 5 min. The nocturnal IOP was measured in the supine position, right LDP, and left LDP, with randomized sequences, under dim light (<10 lux at 11:30 pm, 1:30 am, 3:30 am, and 5:30 am. The subjects were awakened and maintained each position for 5 min before the measurement. The 24-hour habitual IOP patterns were obtained according to the nocturnal position (supine, right LDP and left LDP for either eye. P<0.05 was considered to be significant. RESULTS: Nineteen healthy subjects were included with a mean age of 51.3±5.8 years. During the nocturnal period, a significant IOP difference was found between the dependent eye (the eye on the lower side of LDP and the supine position, but not for all the nocturnal time points. Over a 24-hour period, the effect of LDP on habitual IOP pattern was not statistically significant, although the mean nocturnal IOP and the diurnal-nocturnal IOP change for the right and the left eye in the LDP pattern was slightly higher than that in the sitting-supine pattern. CONCLUSION: Significant nocturnal IOP differences existed between the dependent eye and the supine, but did not occur consistently for all time points. Over a 24-hour period, the effect of LDP on habitual IOP pattern was not statistically significant in healthy subjects.

The 2006 National Labor Day impaired driving enforcement crackdown : Drunk driving. Over the limit. Under arrest.

Science.gov (United States)

2008-09-01

The National Highway Traffic Safety Administrations 2006 Drunk Driving. Over the Limit. Under Arrest. Labor Day holiday campaign had three main components: (1) DWI enforcement, (2) public awareness efforts, and (3) evaluation. The 2006 program use...

The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study.

Science.gov (United States)

Kim, Young Won; Park, Jinsung; Chung, Hong; Kim, Hong-Wook; Kim, Hyung Joon; Jung, Jae Hung; Kim, Won Tae

2015-09-01

To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33), aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6%) completed the study according to the study protocol (per-protocol group), and 24 dropped out (dropout group). Of the 24 patients in the dropout group, 5 withdrew consent due to side effects or lack of efficacy, 7 were lost to follow-up at 4 weeks, 8 were lost to follow-up at 12 weeks, and 4 dropped out due to failure to complete 3-day frequency volume charts at 12 weeks. In the per-protocol group, there was significant improvement in the International Prostate Symptom Score (IPSS), especially question numbers 1, 3, 4, 5, 6, 7, and the quality of life question (P=0.001, P=0.007, Psilodosin monotherapy exhibits good efficacy in improving nocturia and nocturnal polyuria; however, the mean NPi was still >0.33. Considering the high dropout rate of our study due to no implementation of 3-day frequency volume charts, prospective and large-scale studies are needed to confirm our results.

Early dinner reduces nocturnal gastric acidity.

OpenAIRE

Duroux, P; Bauerfeind, P; Emde, C; Koelz, H R; Blum, A L

1989-01-01

This study examines whether eating food at different times has differential effects on intragastric pH. Experiments were done in 23 healthy volunteers (12 men). Intragastric acidity was monitored by ambulatory 22 hour pH-metry. Composition of meals was standardised: breakfast and lunch at 7 am and 12 noon respectively, and dinner at 6 or 9 pm, in random order. The time of going to bed and getting up was also standardised. With early dinner nocturnal pH was higher, than with late dinner (pH me...

Self-Reported Sleep Bruxism and Nocturnal Gastroesophageal Reflux Disease in Patients with Obstructive Sleep Apnea: Relationship to Gender and Ethnicity§

Science.gov (United States)

Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

2014-01-01

Study Objectives : Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. Methods : A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. Results : In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Conclusion : Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups. PMID:25352924

Differential arousal regulation by prokineticin 2 signaling in the nocturnal mouse and the diurnal monkey.

Science.gov (United States)

Zhou, Qun-Yong; Burton, Katherine J; Neal, Matthew L; Qiao, Yu; Kanthasamy, Anumantha G; Sun, Yanjun; Xu, Xiangmin; Ma, Yuanye; Li, Xiaohan

2016-08-18

The temporal organization of activity/rest or sleep/wake rhythms for mammals is regulated by the interaction of light/dark cycle and circadian clocks. The neural and molecular mechanisms that confine the active phase to either day or night period for the diurnal and the nocturnal mammals are unclear. Here we report that prokineticin 2, previously shown as a circadian clock output molecule, is expressed in the intrinsically photosensitive retinal ganglion cells, and the expression of prokineticin 2 in the intrinsically photosensitive retinal ganglion cells is oscillatory in a clock-dependent manner. We further show that the prokineticin 2 signaling is required for the activity and arousal suppression by light in the mouse. Between the nocturnal mouse and the diurnal monkey, a signaling receptor for prokineticin 2 is differentially expressed in the retinorecipient suprachiasmatic nucleus and the superior colliculus, brain projection targets of the intrinsically photosensitive retinal ganglion cells. Blockade with a selective antagonist reveals the respectively inhibitory and stimulatory effect of prokineticin 2 signaling on the arousal levels for the nocturnal mouse and the diurnal monkey. Thus, the mammalian diurnality or nocturnality is likely determined by the differential signaling of prokineticin 2 from the intrinsically photosensitive retinal ganglion cells onto their retinorecipient brain targets.

Pathophysiology of nocturnal enuresis

DEFF Research Database (Denmark)

Rittig, Søren; Kamperis, Konstantinos

2015-01-01

The perception of the pathogenesis of enuresis has undergone marked changes over the past 30 years from a psychiatric/psychological background to a more somatic model where nighttime urine production and bladder capacity are main components together with an arousal dysfunction that prevents...... that dysfunction of the intrinsic circadian regulation located in the suprachiasmatic nucleus results in dysfunction of one or more of the brainstem centers involved in AVP secretion, arousal function, bladder control, and blood pressure regulation. Furthermore, nocturnal enuresis has a strong genetic influence...... that in some families present as autosomal dominant inheritance with high degree of penetrance. Linkage to several chromosomal areas have been confirmed in such families although a specific causative enuresis gene has not yet been identified. In conclusion, our understanding of enuresis pathophysiology has...

Seeing in the dark: vision and visual behaviour in nocturnal bees and wasps.

Science.gov (United States)

Warrant, Eric J

2008-06-01

In response to the pressures of predation, parasitism and competition for limited resources, several groups of (mainly) tropical bees and wasps have independently evolved a nocturnal lifestyle. Like their day-active (diurnal) relatives, these insects possess apposition compound eyes, a relatively light-insensitive eye design that is best suited to vision in bright light. Despite this, nocturnal bees and wasps are able to forage at night, with many species capable of flying through a dark and complex forest between the nest and a foraging site, a behaviour that relies heavily on vision and is limited by light intensity. In the two best-studied species - the Central American sweat bee Megalopta genalis (Halictidae) and the Indian carpenter bee Xylocopa tranquebarica (Apidae) - learned visual landmarks are used to guide foraging and homing. Their apposition eyes, however, have only around 30 times greater optical sensitivity than the eyes of their closest diurnal relatives, a fact that is apparently inconsistent with their remarkable nocturnal visual abilities. Moreover, signals generated in the photoreceptors, even though amplified by a high transduction gain, are too noisy and slow to transmit significant amounts of information in dim light. How have nocturnal bees and wasps resolved these paradoxes? Even though this question remains to be answered conclusively, a mounting body of theoretical and experimental evidence suggests that the slow and noisy visual signals generated by the photoreceptors are spatially summed by second-order monopolar cells in the lamina, a process that could dramatically improve visual reliability for the coarser and slower features of the visual world at night.

The cell phone : a dangerous driving distraction

Energy Technology Data Exchange (ETDEWEB)

Kutlay, J. [Alberta Motor Association, Calgary, AB (Canada); Ure, D. [Shell Canada Ltd., Calgary, AB (Canada)

2005-07-01

Shell Canada demands that workers do not operate telecommunication systems while operating a motor vehicle for company business, with the exception of short acknowledgment conversations. This power point presentation advised of the dangers of using cell phones while driving. Cell phone use while driving is considered to be mentally demanding as well as contributing to slower reaction times to hazards and reducing driving field of view. Research has indicated that drivers visualize an image of the person being spoken to, in addition to thinking about issues being discussed. Statistics from the United Kingdom reveal that drivers engaged in cell phone conversations are 4 times more likely to crash than other drivers, and take risks comparable to alcohol impaired driving, as well as showing significantly poorer driving performance. Various types of driver distractions were presented. A comparison between radio and cell phones was presented. It was suggested that drivers should not take a phone call while driving alone, and in an emergency, should pull off the road to receive or send phone calls. It was also suggested that callers should ask if a person is driving, and end a conversation if they suspect the person is driving. tabs, figs.

Acute effects of alcohol on inhibitory control and simulated driving in DUI offenders.

Science.gov (United States)

Van Dyke, Nicholas; Fillmore, Mark T

2014-06-01

The public health costs associated with alcohol-related traffic accidents have prompted considerable research aimed at identifying characteristics of individuals who drive under the influence (DUI) in order to improve treatment and prevention strategies. Survey studies consistently show that DUI offenders self-report higher levels of impulsivity compared to their nonoffending counterparts. However, little is known about how individuals with a DUI history respond under alcohol. Inhibitory control is a behavioral component of impulsivity thought to underlie risky drinking and driving behaviors. The present study examined the degree to which DUI drivers display deficits of inhibitory control in response to alcohol and the degree to which alcohol impaired their simulated driving performance. It was hypothesized that DUI offenders would display an increased sensitivity to the acute impairing effects of alcohol on simulated driving performance. Young adult drivers with a history of DUI and a demographically-comparable group of drivers with no history of DUI (controls) were tested following a 0.65 g/kg dose of alcohol and a placebo. Inhibitory control was measured by using a cued go/no-go task. Drivers then completed a driving simulation task that yielded multiple indicators of driving performance, such as within-lane deviation, steering rate, centerline crossings and road edge excursions, and drive speed. Results showed that although DUI offenders self-reported greater levels of impulsivity than did controls, no group differences were observed in the degree to which alcohol impaired inhibitory control and driving performance. The findings point to the need to identify other aspects of behavioral dysfunction underlying the self-reported impulsivity among DUI offenders, and to better understand the specific driving situations that might pose greater risk to DUI offenders. The systematic study of candidate cognitive deficits in DUI offenders will provide important

Salmeterol versus slow-release theophylline combined with ketotifen in nocturnal asthma: a multicentre trial. French Multicentre Study Group.

Science.gov (United States)

Muir, J F; Bertin, L; Georges, D

1992-11-01

We wished to assess the efficacy of inhaled salmeterol (SML; 50 micrograms b.i.d.) compared to a combination of slow-release theophylline and ketotifen p.o. (TK; T 300 mg+K 1 mg b.i.d.) for the treatment of nocturnal asthma. Ninety six patients with nocturnal asthma, (forced expiratory volume in one second (FEV1) 60-90% of predicted value, reversibility > or = 15%, at least two nocturnal awakenings per week) were eligible for a multicentre, double-blind, double-dummy cross-over study (14-day run-in, two successive 28-day treatment periods). Efficacy was assessed as success/failure, success being defined as the complete disappearance of nocturnal symptoms/awakening during the last week of each treatment period. There was a statistically significant difference between SML and TK for this criterion: 46% and 39% success with SML during periods I (first 28-day period) and II (following the cross-over), compared to only 15% and 26% with TK, respectively (p < 0.01). SML was also significantly better for the other criteria (lung function, rescue salbutamol intake during day and night). Side-effects were five times less frequent in SML-treated patients (p < 0.004). Efficacy and tolerance of SML were obviously far better than those of TK in patients with nocturnal asthma.

Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension.

Science.gov (United States)

Kario, Kazuomi; Tomitani, Naoko; Matsumoto, Yuri; Hamasaki, Haruna; Okawara, Yukie; Kondo, Maiko; Nozue, Ryoko; Yamagata, Hiromi; Okura, Ayako; Hoshide, Satoshi

2016-01-01

Asians have specific characteristics of hypertension (HTN) and its relationship with cardiovascular disease. The morning surge in blood pressure (BP) in Asians is more extended, and the association slope between higher BP and the risk for cardiovascular events is steeper in this population than in whites. Thus, 24-hour BP control including at night and in the morning is especially important for Asian patients with HTN. There are 3 components of "perfect 24-hour BP control": the 24-hour BP level, adequate dipping of nocturnal BP (dipper type), and adequate BP variability such as the morning BP surge. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-hour BP control. After controlling morning HTN, nocturnal HTN is the second target. We have been developing HBPM that can measure nocturnal BP. First, we developed a semiautomatic HBPM device with the function of automatic fixed-interval BP measurement during sleep. In the J-HOP (Japan Morning Surge Home Blood Pressure) study, the largest nationwide home BP cohort, we successfully measured nocturnal home BP using this device with data memory, 3 times during sleep (2, 3, and 4 am), and found that nocturnal home BP is significantly correlated with organ damage independently of office and morning BP values. The second advance was the development of trigger nocturnal BP (TNP) monitoring with an added trigger function that initiates BP measurements when oxygen desaturation falls below a variable threshold continuously monitored by pulse oximetry. TNP can detect the specific nocturnal BP surges triggered by hypoxic episodes in patients with sleep apnea syndrome. We also added the lowest heart rate-trigger function to TNP to detect the "basal nocturnal BP," which is determined by the circulating volume and structural cardiovascular system without any increase in sympathetic tonus. This double TNP is a novel concept for evaluating the pathogenic pressor mechanism of nocturnal BP

Nocturnal polyuria and saluresis in renal allograft recipients.

Science.gov (United States)

Chan, M K; Varghese, Z; Fernando, O N; Moorhead, J F

1980-01-01

The evolution of nocturnal polyuria and saluresis in renal allograft recipients was studied by comparing the day to night (D:N) ratios of urine volume and sodium excretion in 15 patients who had undergone transplantation less than one year previously (recent-transplant group) with those in 11 patients who had undergone transplantation at least one year previously. Eleven patients with chronic renal failure and 12 normal subjects served as controls. Patients in the recent-transplant group had significantly lower D:N ratios of urine volume and sodium excretion than the patients who had undergone transplantation at least a year before, while the ratios in this last group did not differ significantly from those in the normal subjects. Nocturnal polyuria and saluresis gradually subsided in five patients studied for three months. Chronic renal failure and uraemic autonomic neuropathy were unlikely causes of the nocturia. The patients in the recent-transplant group had significantly lower D:N ratios of urine volume than the controls with chronic renal failure, and the mean Valsalva ratio in eight of them was not significantly different from that in the normal subjects. An undue sensitivity of renal allografts to postural influences was proposed. PMID:6986946

Nocturnal, every-other-day, online haemodiafiltration: an effective therapeutic alternative.

Science.gov (United States)

Maduell, Francisco; Arias, Marta; Durán, Carlos E; Vera, Manel; Fontseré, Néstor; Azqueta, Manel; Rico, Nayra; Pérez, Nuria; Sentis, Alexis; Elena, Montserrat; Rodriguez, Néstor; Arcal, Carola; Bergadá, Eduardo; Cases, Aleix; Bedini, Jose Luis; Campistol, Josep M

2012-04-01

Longer and more frequent dialysis sessions have demonstrated excellent survival and clinical advantages, while online haemodiafiltration (OL-HDF) provides the most efficient form of dialysis treatment. The aim of this study was to evaluate the beneficial effects of a longer (nocturnal) and more frequent (every-other-day) dialysis schedule with OL-HDF at the same or the highest convective volume. This prospective, in-centre crossover study was carried out in 26 patients, 18 males and 8 females, 49.2±14 years old, on 4-5 h thrice-weekly post-dilution OL-HDF, switched to nocturnal every-other-day OL-HDF. Patient inclusion criteria consisted of stable patients with good vascular access and with good prospects for improved occupational, psychological and social rehabilitation. Patients were randomly assigned into two groups: Group A received the same convective volume as previously for 6 months followed by a higher convective volume for a further 6 months, while Group B received the same schedule in reverse order. Nocturnal every-other-day OL-HDF was well tolerated and 56% of patients who were working during the baseline period continued to work throughout the study with practically no absenteeism. The convective volume was 26.7±2 L at baseline, 27.5±2 with the unchanged volume and 42.9±4 L with the higher volume. eKt/V increased from 1.75±0.4 to 3.37±0.9. Bicarbonate, blood urea nitrogen (BUN) and creatinine values decreased, while phosphate levels fell markedly with a 90% reduction in phosphate binders. Blood pressure and left ventricular hypertrophy (LVH) improved and the use of anti-hypertensive drugs decreased. In both groups, BUN, creatinine and β2-microglobulin reduction ratios improved. Different removal patterns were observed for myoglobin, prolactin and α1-acid glycoprotein. Nocturnal every-other-day OL-HDF could be an excellent therapeutic alternative since good tolerance and occupational rehabilitation, marked improvement in dialysis dose

Signatures of functional constraint at aye-aye opsin genes: the potential of adaptive color vision in a nocturnal primate.

Science.gov (United States)

Perry, George H; Martin, Robert D; Verrelli, Brian C

2007-09-01

While color vision perception is thought to be adaptively correlated with foraging efficiency for diurnal mammals, those that forage exclusively at night may not need color vision nor have the capacity for it. Indeed, although the basic condition for mammals is dichromacy, diverse nocturnal mammals have only monochromatic vision, resulting from functional loss of the short-wavelength sensitive opsin gene. However, many nocturnal primates maintain intact two opsin genes and thus have dichromatic capacity. The evolutionary significance of this surprising observation has not yet been elucidated. We used a molecular population genetics approach to test evolutionary hypotheses for the two intact opsin genes of the fully nocturnal aye-aye (Daubentonia madagascariensis), a highly unusual and endangered Madagascar primate. No evidence of gene degradation in either opsin gene was observed for any of 8 aye-aye individuals examined. Furthermore, levels of nucleotide diversity for opsin gene functional sites were lower than those for 15 neutrally evolving intergenic regions (>25 kb in total), which is consistent with a history of purifying selection on aye-aye opsin genes. The most likely explanation for these findings is that dichromacy is advantageous for aye-ayes despite their nocturnal activity pattern. We speculate that dichromatic nocturnal primates may be able to perceive color while foraging under moonlight conditions, and suggest that behavioral and ecological comparisons among dichromatic and monochromatic nocturnal primates will help to elucidate the specific activities for which color vision perception is advantageous.

Body position and late postoperative nocturnal hypoxaemia

DEFF Research Database (Denmark)

Rosenberg-Adamsen, S; Stausholm, K; Edvardsen, L

1997-01-01

Thirteen patients were monitored for nocturnal body position (supine vs. side) and arterial oxygen saturation pre-operatively and on the second postoperative night after major abdominal surgery. The number of positional changes were significantly decreased after operation (p ... position than on the side (p movements....... towards more time spent in the supine position (p = 0.1). Individual mean arterial oxygen saturation decreased postoperatively (p positions (p = 0.9). Pre-operatively, episodic desaturations were significantly more frequent in the supine...

Methods for automated identification of informative behaviors in natural bioptic driving.

Science.gov (United States)

Luo, Gang; Peli, Eli

2012-06-01

Visually impaired people may legally drive if wearing bioptic telescopes in some developed countries. To address the controversial safety issue of the practice, we have developed a low-cost in-car recording system that can be installed in study participants' own vehicles to record their daily driving activities. We also developed a set of automated identification techniques of informative behaviors to facilitate efficient manual review of important segments submerged in the vast amount of uncontrolled data. Here, we present the methods and quantitative results of the detection performance for six types of driving maneuvers and behaviors that are important for bioptic driving: bioptic telescope use, turns, curves, intersections, weaving, and rapid stops. The testing data were collected from one normally sighted and two visually impaired subjects across multiple days. The detection rates ranged from 82% up to 100%, and the false discovery rates ranged from 0% to 13%. In addition, two human observers were able to interpret about 80% of targets viewed through the telescope. These results indicate that with appropriate data processing the low-cost system is able to provide reliable data for natural bioptic driving studies.

Driving, brain injury and assistive technology.

Science.gov (United States)

Lane, Amy K; Benoit, Dana

2011-01-01

Individuals with brain injury often present with cognitive, physical and emotional impairments which impact their ability to resume independence in activities of daily living. Of those activities, the resumption of driving privileges is cited as one of the greatest concerns by survivors of brain injury. The integration of driving fundamentals within the hierarchical model proposed by Keskinen represents the complexity of skills and behaviors necessary for driving. This paper provides a brief review of specific considerations concerning the driver with TBI and highlights current vehicle technology which has been developed by the automotive industry and by manufacturers of adaptive driving equipment that may facilitate the driving task. Adaptive equipment technology allows for compensation of a variety of operational deficits, whereas technological advances within the automotive industry provide drivers with improved safety and information systems. However, research has not yet supported the use of such intelligent transportation systems or advanced driving systems for drivers with brain injury. Although technologies are intended to improve the safety of drivers within the general population, the potential of negative consequences for drivers with brain injury must be considered. Ultimately, a comprehensive driving evaluation and training by a driving rehabilitation specialist is recommended for individuals with brain injury. An understanding of the potential impact of TBI on driving-related skills and knowledge of current adaptive equipment and technology is imperative to determine whether return-to-driving is a realistic and achievable goal for the individual with TBI.

Validity of the mini-mental state examination and the montreal cognitive assessment in the prediction of driving test outcome.

Science.gov (United States)

Hollis, Ann M; Duncanson, Haley; Kapust, Lissa R; Xi, Patricia M; O'Connor, Margaret G

2015-05-01

To evaluate the effectiveness of two cognitive screening measures, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), in predicting driving test outcome for individuals with and without cognitive impairment. Retrospective cohort study. A clinical driving evaluation program at a teaching hospital in the United States. Adult drivers who underwent assessment with the MMSE and MoCA as part of a comprehensive driving evaluation between 2010 and 2014 (N=92). MMSE and MoCA total scores were independent variables. The outcome measure was performance on a standardized road test. A preestablished diagnosis of cognitive impairment enhanced the validity of cognitive screening measures in the identification of at-risk drivers. In individuals with cognitive impairment there was a significant relationship between MoCA score and on-road outcome. Specifically, an individual was 1.36 times as likely to fail the road test with each 1-point decrease in MoCA score. No such relationship was detected in those without a diagnosis of cognitive impairment. For individuals who have not been diagnosed with cognitive impairment, neither the MMSE nor the MoCA can be reliably used as an indicator of driving risk, but for individuals with a preestablished diagnosis of cognitive impairment, the MoCA is a useful tool in this regard. A score on the MoCA of 18 or less should raise concerns about driving safety. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Toking and Driving: Characteristics of Canadian University Students Who Drive after Cannabis Use--An Exploratory Pilot Study

Science.gov (United States)

Fischer, Benedikt; Rodopoulos, Jenny; Rehm, Jurgen; Ivsins, Andrew

2006-01-01

Cannabis use is increasingly prevalent among young adults in Canada. Due to cannabis' impairment effects, driving under the influence of cannabis has recently developed into a traffic-safety concern, yet little is known about the specific circumstances and factors characterizing this behavior among young people. In this study, we interviewed a…

Depression of nocturnal pineal serotonin N-acetyltransferase activity in castrate male rats

International Nuclear Information System (INIS)

Rudeen, P.K.; Reiter, R.J.; Texas Univ., San Antonio

1980-01-01

Pineal serotonin N-acetyltransferase (NAT) activity was examined in intact rats, castrated rats, and in rats that had been castrated and had received testosterone proprionate. Castration resulted in significantly depressing nocturnal levels of pineal NAT (p<0.05) when compared to enzyme activity in intact rats. Testosterone proprionate administration restored plasma LH levels to normal values in castrate rats but did not induce nocturnal pineal enzyme activity to levels seen in the pineal glands of intact rats. The data substantiate the existence of a feedback control of pineal biosynthetic activity by the hypophyseal-gonadal system, but the identity of the hormone(s) responsible for regulation of pineal NAT activity is not known. (author)

Choking at Night: A Case of Opercular Nocturnal Frontal Lobe Epilepsy

Directory of Open Access Journals (Sweden)

Geetanjali Rathore

2013-01-01

Full Text Available Frontal lobe seizures have a tendency to occur in sleep and in most cases occur exclusively insleep; these individuals are said to have nocturnal frontal lobe (NFLE. NFLE can be difficult to distinguish clinically from various other sleep disorders, particularly parasomnias, which also present with paroxysmal motor activity in sleep. Interictal and ictal EEG findings are frequently unremarkable or nonspecific in both parasomnias and NFLE making the diagnosis even more difficult. Nocturnal epilepsy should be suspected in patients with paroxysmal events at night characterized by high frequency, repetition, extrapyramidal features, and marked stereotypy of attacks. Here we present a 13-year-old female who was extensively worked up for choking episodes at night. On repeat video EEG she was found to have frontal opercular seizures. Once on Carbamazepine, her seizures completely resolved.

Effects of fexofenadine and hydroxyzine on brake reaction time during car-driving with cellular phone use.

Science.gov (United States)

Tashiro, Manabu; Horikawa, Etsuo; Mochizuki, Hideki; Sakurada, Yumiko; Kato, Motohisa; Inokuchi, Takatoshi; Ridout, Fran; Hindmarch, Ian; Yanai, Kazuhiko

2005-10-01

Antihistamines are a mainstay treatment for allergic rhinitis; however, many older agents cause adverse events, including sedation and central nervous system (CNS) impairment. Research has shown sedating effects of antihistamines on driving; currently, no known study has examined whether cellular phone usage while driving further compounds impairment in individuals administered antihistamines. The aim of this study was to examine this endpoint. In a randomized, double-blind, placebo-controlled, three-way crossover study, healthy volunteers received fexofenadine HCl 120 mg, hydroxyzine HCl 30 mg and placebo. Brake reaction time (BRT) was used to examine driving performance across four conditions: driving only; driving while completing simple calculations; complex calculations; and conversing on a cellular phone. Subjective sedation assessments were also conducted. Brake reaction time with and without cellular phone usage in fexofenadine-treated subjects did not differ significantly from placebo in any condition. In contrast, hydroxyzine-treated subjects were significantly more sedated and had slower BRTs, suggesting slower hazard recognition and brake application, compared with the fexofenadine and placebo groups in all conditions. Importantly, cellular phone operation was an additive factor, increasing BRTs in hydroxyzine-treated volunteers. Fexofenadine did not impair CNS function in subjects involved in a divided attention task of driving and cellular phone operation. Copyright (c) 2005 John Wiley & Sons, Ltd.

7A.01: INCREASED RISK OF MORTALITY IN OBESE PATIENTS WITH HIGH NOCTURNAL BLOOD PRESSURE VARIABILITY. RESULTS FROM THE ABP-INTERNATIONAL STUDY.

Science.gov (United States)

Palatini, P; Reboldi, G P; Beilin, L; Casiglia, E; Eguchi, K; Imai, Y; Kario, K; Ohkubo, T; Pierdomenico, S D; Schwartz, J E; Wing, L; Verdecchia, P

2015-06-01

The association between obesity and all-cause mortality is controversial and may differ according to subjects' characteristics. Blood pressure variability (BPV) may be increased in obese individuals and thus impair prognosis. The purpose of this study was to evaluate whether the relationship between obesity and mortality is influenced by short-term ambulatory BPV. The analysis was performed in 8724 participants (54% men) aged 51 ± 15 years enrolled in 8 prospective studies in Australia, Italy, Japan, and U.S.A. The predictive power of obesity (BMI >=30 kg/m2) for mortality was evaluated from multivariable Cox models in the subjects stratified by high or low nocturnal BPV (above or below the median). Obese participants (N = 1286) had higher age-and-sex adjusted systolic and diastolic BPV than the non-obese participants (p = 0.002/<0.001). Obese subjects with high systolic or diastolic BPV had higher nocturnal heart rate (p = 0.01/<0.001) than obese subjects with low BPV and were more frequently diabetic (p<0.001) and heavy alcohol drinkers (p < 0.001). During a median follow-up of 6.4 years there were 361 deaths, 4.7% in the obese and 4.0% in the non-obese individuals (P = NS). However, the risk of mortality among the obese subjects greatly differed according to BPV level. In Cox models including age, sex, mean ambulatory BP, smoking, alcohol use, diabetes, cholesterol, creatinine, and nocturnal heart rate, the obese group with high systolic BPV had a doubled risk of mortality compared to the non-obese group (HR,2.0, 95%CI,1.4-2.9, p < 0.001), whereas the risk was not increased in the obese group with low BPV (P = 0.81). Similar results were found for diastolic BPV, with a HR of 1.7 (1.2-2.5, p = 0.002) in the high BPV group and no association at all with mortality (p = 0.87) in the low BPV group. Inclusion of night-time BP dipping in the regressions did not change the strength of the associations. These data show that high

Monosymptomatic nocturnal enuresis

Directory of Open Access Journals (Sweden)

Bertan Karaboğa

2012-03-01

Full Text Available Enuresis Nocturna is the most common urologic problemin childhood. There is not a consensus about terminology.Terminology identified by The International Children’sContinence Society (ICCS is recommended. Bed-wettingat night during sleep (incontinence in children above 5years of age who don’t have congenital or acquired centralnervous system defect is defined as enuresis nocturna.There are two groups monosymptomatic (simpleand non-monosymptomatic (complicated. Monosymptomaticenuresis nocturna (MNE has no symptoms otherthan bed-wetting at night during sleep. Various theoriesconcerning etiology of MNE has been suggested; one ormore of genetic, hormonal, bladder associated and sleepdisorders are stated to play a role. Self-improvement canbe achieved each year by 15% increasing maturity. Underpinning treatment and in addition to this unique treatmentmust be done by considering the factors in the pathophysiology.The success of the treatment and roadmapto be followed must be arrange with child and family. Thepurpose of this eclectic is; evaluation of correct diagnosis,differential diagnosis, patient follow-up and treatment optionsof the cases applicant with nocturnal enuresis basedon the current knowledge of ICCS and Turkey EnuresisTreatment Guide.

Lessons learned from evaluating Maryland's anti-drunk driving campaign: assessing the evidence for cognitive, behavioral, and public health impact.

Science.gov (United States)

Beck, Kenneth H

2009-07-01

The evidence concerning Maryland's anti-drunk driving program, Checkpoint Strikeforce, is reviewed. To date, there is no evidence to indicate that this campaign, which involves a number of sobriety checkpoints and media activities to promote these efforts, has had any impact on public perceptions, driver behaviors, or alcohol-related motor vehicle crashes and injuries. This conclusion is drawn after examining statistics for alcohol-related crashes, police citations for impaired driving, and public perceptions of alcohol-impaired driving risk. Comparisons are also made with other states in the mid-Atlantic region, where similar campaign activities have occurred. Reasons for this failure in Maryland include insufficient levels of enforcement (e.g., too few sobriety checkpoints and vehicle contacts occurred to raise public perceptions of risk pertaining to impaired driving) and inadequate publicity surrounding this campaign. Suggestions for overcoming these problems are offered.

Effects of acute alcohol consumption on measures of simulated driving: A systematic review and meta-analysis.

Science.gov (United States)

Irwin, Christopher; Iudakhina, Elizaveta; Desbrow, Ben; McCartney, Danielle

2017-05-01

Driving simulators are used in a wide range of research settings to help develop an understanding of driver behavior in complex environments. Acute alcohol impairment is an important research topic for traffic safety and a large number of studies have indicated levels of simulated driving impairment imposed by alcohol across a range of performance outcome variables. The aim of the present study was to examine the impact of acute alcohol consumption on simulated driving performance by conducting a systematic review and meta-analysis of the available evidence. The online databases PubMed (MEDLINE), Web of Science (via Thomas Reuters) and Scopus were searched to identify studies that measured simulated car driving performance under control ('no alcohol' or 'placebo alcohol' ingestion) and intervention (acute alcohol ingestion) conditions, using repeated-measures experimental designs. Primary research outcomes were standard deviation of lane position (SDLP) and standard deviation of speed (SDSP); (total number of lane crossings (LC) and average speed (Speed) were secondary research outcomes). Meta-analytic procedures were used to quantify the effect of acute alcohol consumption on vehicle control, and to determine the influence of methodological variables (i.e. the duration of the simulated driving task, the limb of the BAC curve (ascending vs. descending) and the type of driving simulator employed (i.e. car vs. PC-based)) on the magnitude of the performance change due to alcohol consumption. 423 records were screened, and 50 repeated-measures trials (n=962 participants, 62% male) derived from 17 original publications were reviewed. 37 trials (n=721 participants) used a 'placebo alcohol' comparator to determine the effect of alcohol consumption on SDLP (32/37) and SDSP (22/37). Alcohol consumption significantly increased SDLP by 4.0±0.5cm (95% CI: 3.0, 5.1) and SDSP by 0.38±0.10km⋅h -1 (95% CI: 0.19, 0.57). Regression analyses indicate BAC (p=0.004) and driving

Nocturnal enuresis in school‑aged children with sickle‑cell anemia ...

African Journals Online (AJOL)

2016-05-09

May 9, 2016 ... socioeconomic class, and sibling history of enuresis were not statistically ... and parental history of childhood enuresis are significant risk factors. .... adolescents with SCA may be at a higher risk of nocturnal ..... Thus, factors which contribute to ... in male children,[30] and more frequent developmental delays ...

Working for Food Shifts Nocturnal Mouse Activity into the Day

NARCIS (Netherlands)

Hut, Roelof A.; Pilorz, Violetta; Boerema, Ate S.; Strijkstra, Arjen M.; Daan, Serge; Yamazaki, Shin

2011-01-01

Nocturnal rodents show diurnal food anticipatory activity when food access is restricted to a few hours in daytime. Timed food access also results in reduced food intake, but the role of food intake in circadian organization per se has not been described. By simulating natural food shortage in mice

Comparing effects of insulin analogues and human insulin on nocturnal glycaemia in hypoglycaemia-prone people with Type 1 diabetes

DEFF Research Database (Denmark)

Kristensen, P. L.; Tarnow, L.; Bay, C.

2017-01-01

. Conclusions: Treatment with insulin analogue reduces the occurrence of nocturnal hypoglycaemia assessed by nocturnal glucose profiles in people with Type 1 diabetes prone to severe hypoglycaemia. Nocturnal glucose profiles provide a more comprehensive assessment of clinical benefit of insulin regimens......Aims: To assess the difference between analogue and human insulin with regard to nocturnal glucose profiles and risk of hypoglycaemia in people with recurrent severe hypoglycaemia. Methods: A total of 72 people [46 men, mean ± sd age 54 ± 12 years, mean ± sd HbA1c 65 ± 12 mmol/mol (8.1 ± 1.1......%), mean ± sd duration of diabetes 30 ± 14 years], who participated in a 2-year randomized, crossover trial of basal-bolus therapy with insulin detemir/insulin aspart or human NPH insulin/human regular insulin (the HypoAna trial) were studied for 2 nights during each treatment. Venous blood was drawn...

A Dynamic Control Strategy for Hybrid Electric Vehicles Based on Parameter Optimization for Multiple Driving Cycles and Driving Pattern Recognition

Directory of Open Access Journals (Sweden)

Zhenzhen Lei

2017-01-01

Full Text Available The driving pattern has an important influence on the parameter optimization of the energy management strategy (EMS for hybrid electric vehicles (HEVs. A new algorithm using simulated annealing particle swarm optimization (SA-PSO is proposed for parameter optimization of both the power system and control strategy of HEVs based on multiple driving cycles in order to realize the minimum fuel consumption without impairing the dynamic performance. Furthermore, taking the unknown of the actual driving cycle into consideration, an optimization method of the dynamic EMS based on driving pattern recognition is proposed in this paper. The simulation verifications for the optimized EMS based on multiple driving cycles and driving pattern recognition are carried out using Matlab/Simulink platform. The results show that compared with the original EMS, the former strategy reduces the fuel consumption by 4.36% and the latter one reduces the fuel consumption by 11.68%. A road test on the prototype vehicle is conducted and the effectiveness of the proposed EMS is validated by the test data.

Remotely-sensed, nocturnal, dew point correlates with malaria transmission in Southern Province, Zambia: a time-series study.

Science.gov (United States)

Nygren, David; Stoyanov, Cristina; Lewold, Clemens; Månsson, Fredrik; Miller, John; Kamanga, Aniset; Shiff, Clive J

2014-06-13

Plasmodium falciparum transmission has decreased significantly in Zambia in the last decade. The malaria transmission is influenced by environmental variables. Incorporation of environmental variables in models of malaria transmission likely improves model fit and predicts probable trends in malaria disease. This work is based on the hypothesis that remotely-sensed environmental factors, including nocturnal dew point, are associated with malaria transmission and sustain foci of transmission during the low transmission season in the Southern Province of Zambia. Thirty-eight rural health centres in Southern Province, Zambia were divided into three zones based on transmission patterns. Correlations between weekly malaria cases and remotely-sensed nocturnal dew point, nocturnal land surface temperature as well as vegetation indices and rainfall were evaluated in time-series analyses from 2012 week 19 to 2013 week 36. Zonal as well as clinic-based, multivariate, autoregressive, integrated, moving average (ARIMAX) models implementing environmental variables were developed to model transmission in 2011 week 19 to 2012 week 18 and forecast transmission in 2013 week 37 to week 41. During the dry, low transmission season significantly higher vegetation indices, nocturnal land surface temperature and nocturnal dew point were associated with the areas of higher transmission. Environmental variables improved ARIMAX models. Dew point and normalized differentiated vegetation index were significant predictors and improved all zonal transmission models. In the high-transmission zone, this was also seen for land surface temperature. Clinic models were improved by adding dew point and land surface temperature as well as normalized differentiated vegetation index. The mean average error of prediction for ARIMAX models ranged from 0.7 to 33.5%. Forecasts of malaria incidence were valid for three out of five rural health centres; however, with poor results at the zonal level. In this

Treatment of paroxysmal nocturnal hemoglobinuria

Directory of Open Access Journals (Sweden)

I. A. Lisukov

2014-07-01

Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, life‑threatening clonal hematological disorder caused by an acquired mutation in the phosphatidylinositol glucan (PIG-A gene. PNH is characterized by chronic intravascular hemolysis, marrow failure, thrombophilia and other severe clinical syndromes. Until recently, the treatment of PNH has been symptomatic with blood transfusions, anticoagulation and supplementation with folic acid or iron. The only potentially curative treatment is allogeneic stem cell transplantation, but this has severe complications with high mortality rates. A new targeted treatment strategy is the inhibition of the terminal complement cascade with anti‑C5 monoclonal antibody (eculizumab. Eculizumab has shown significant efficacy in controlling of intravascular hemolysis resulting in improving quality of life and survival.

Treatment of paroxysmal nocturnal hemoglobinuria

Directory of Open Access Journals (Sweden)

I. A. Lisukov

2012-01-01

Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, life‑threatening clonal hematological disorder caused by an acquired mutation in the phosphatidylinositol glucan (PIG-A gene. PNH is characterized by chronic intravascular hemolysis, marrow failure, thrombophilia and other severe clinical syndromes. Until recently, the treatment of PNH has been symptomatic with blood transfusions, anticoagulation and supplementation with folic acid or iron. The only potentially curative treatment is allogeneic stem cell transplantation, but this has severe complications with high mortality rates. A new targeted treatment strategy is the inhibition of the terminal complement cascade with anti‑C5 monoclonal antibody (eculizumab. Eculizumab has shown significant efficacy in controlling of intravascular hemolysis resulting in improving quality of life and survival.

Differential residual effects of zaleplon and zopiclone on actual driving: a comparison with a low dose of alcohol.

Science.gov (United States)

Vermeeren, Annemiek; Riedel, Wim J; van Boxtel, Martin P J; Darwish, Mona; Paty, Isabelle; Patat, Alain

2002-03-15

To compare residual effects of zaleplon 10 mg, zopiclone 7.5 mg, and placebo, and a social dose of alcohol on car driving, memory, and psychomotor performance. Two-part placebo controlled, crossover study. Part 1 was single blind, Part 2 double blind. University research institute. Thirty healthy volunteers (15 men and 15 women, mean age 32 +/- 7 years) In Part 1 alcohol and alcohol-placebo drinks were administered around noon. In Part 2 single oral doses of zaleplon 10 mg, zopiclone 7.5 mg and placebo were administered at bedtime. A highway driving test, laboratory tests of word learning, critical tracking and divided attention, and subjective assessments of sleep, mood, and effects of treatments on driving. Driving started 40 minutes after a second alcohol dose in Part 1, and 10 hours after drug intake in Part 2. The results demonstrated that alcohol, at average plasma concentrations of approximately 0.030 g/dl, significantly impaired performance in all tests. Zaleplon's residual effects did not differ significantly from those of placebo in any test. In contrast, zopiclone had significant residual effects on driving, divided attention, and memory. The magnitude of impairment in the driving test observed the morning after zopiclone 7.5 mg was twice that observed with alcohol. Zaleplon 10 mg has no residual effects on driving when taken at bedtime, 10 hours before driving. In contrast, zopiclone 7.5 mg can cause marked residual impairment. Patients should be advised to avoid driving the morning after zopiclone administration.

Psychometrics of the AAN Caregiver Driving Safety Questionnaire and contributors to caregiver concern about driving safety in older adults.

Science.gov (United States)

Carvalho, Janessa O; Springate, Beth; Bernier, Rachel A; Davis, Jennifer

2018-03-01

ABSTRACTBackground:The American Academy of Neurology (AAN) updated their practice parameters in the evaluation of driving risk in dementia and developed a Caregiver Driving Safety Questionnaire, detailed in their original manuscript (Iverson Gronseth, Reger, Classen, Dubinsky, & Rizzo, 2010). They described four factors associated with decreased driving ability in dementia patients: history of crashes or citations, informant-reported concerns, reduced mileage, and aggressive driving. An informant-reported AAN Caregiver Driving Safety Questionnaire was designed with these elements, and the current study was the first to explore the factor structure of this questionnaire. Additionally, we examined associations between these factors and cognitive and behavioral measures in patients with mild cognitive impairment or early Alzheimer's disease and their informants. Exploratory factor analysis revealed a four-component structure, consistent with the theory behind the AAN scale composition. These four factor scores also were significantly associated with performance on cognitive screening instruments and informant reported behavioral dysfunction. Regressions revealed that behavioral dysfunction predicted caregiver concerns about driving safety beyond objective patient cognitive dysfunction. In this first known quantitative exploration of the scale, our results support continued use of this scale in office driving safety assessments. Additionally, patient behavioral changes predicted caregiver concerns about driving safety over and above cognitive status, which suggests that caregivers may benefit from psychoeducation about cognitive factors that may negatively impact driving safety.

Neurocognitive Correlates in Driving Under the Influence of Cannabis.

Science.gov (United States)

Busardò, Francesco P; Pellegrini, Manuela; Klein, Julia; di Luca, Natale M

2017-01-01

Delta (9)-tetrahydrocannabinol (THC) is the main psychoactive compound in cannabis and is frequently identified in blood samples from apprehended drivers suspected for driving under the influence of drugs. Changing social norms towards cannabis and higher acceptability towards the drug emphasize the need for in-depth understanding of the acute neurocognitive and psychomotor effects caused by cannabis and how these effects are correlated to driving skills and performance. In this review, PubMed, Cochrane Central, Scopus, Web of Science, Science Direct, EMBASE and Google Scholar databases were used to identify and select publications up to January 2017 dealing with acute and chronic neurocognitive effects induced by cannabis and ability to drive. Thirty-six publications were selected for this review. The studies conducted were experimental, using simulators or on-road studies and brain imaging (structural and functional) to better understand the acute and chronic effects on cognitive functions comprised in the short and long-term fitness to drive after cannabis consumption. In a case-crossover self-report study a significant odds ratio increase was found for driving- related injury after combined exposure to cannabis and alcohol compared to cannabis alone (OR of 10.9 and 5.8 respectively). Both, experimental and epidemiological studies have revealed that THC affects negatively both, psychomotor skills and cognitive functions. Studies of the acute effects of cannabis on driving have shown that drivers under the influence of this substance are impaired. Indeed, driving under the influence of cannabis doubles or triples the risk of a crash. Specifically, cannabis use impairs critical-tracking tasks, increases lane weaving, decreases reaction time, and divided attention. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Improvement of resistant hypertension by nocturnal hemodialysis in a patient with end-stage kidney disease.

Science.gov (United States)

Tang, Xiaojing; Hu, Xiaohong; Mei, Changlin; Yu, Shengqiang

2015-01-01

Resistant hypertension is a common and refractory complication of hemodialysis (HD) patients and is associated with a higher risk of cardiovascular morbidity and mortality. Here we present a case of resistant hypertension treated successfully by nocturnal HD. A 63-year-old female with end-stage kidney disease was hospitalized for severe headache, objective vertigo and persistent vomiting for 1 month on February 6, 2012. She had been on intermittent HD for 3 months, and her blood pressure maintained 200-240/100-130 mm Hg even after using 7 kinds of antihypertensive drugs including olmesartan, benazepril, nitrendipine, arotinolol, terazosin, clonidine and torasemide. A CT of the abdomen revealed a mild hyperplasia of the left adrenal gland (fig. 1). However, plasma renin, angiotensin and aldosterone were all within the normal range. Nocturnal extended HD was initiated with a blood flow rate of 150 ml/min and a dialysis time of 7 h. After 3 months of nocturnal HD, all symptoms were relieved and her systolic blood pressure started to decrease by 10-20 mm Hg. Six months later, the predialysis blood pressure was decreased to 140-160/90-100 mm Hg and the antihypertensive drugs were reduced to 4 kinds. Meanwhile, the blood biochemical parameters including hemoglobin, serum calcium, phosphate and parathyroid hormone were all controlled well during 2 years of treatment. This case indicates that nocturnal extended HD is probably a promising and effective choice for resistant hypertension in HD patients.

Effects of work stress on work-related rumination, restful sleep, and nocturnal heart rate variability experienced on workdays and weekends.

Science.gov (United States)

Vahle-Hinz, Tim; Bamberg, Eva; Dettmers, Jan; Friedrich, Niklas; Keller, Monika

2014-04-01

The present study reports the lagged effects of work stress on work-related rumination, restful sleep, and nocturnal heart rate variability experienced during both workdays and weekends. Fifty employees participated in a diary study. Multilevel and regression analyses revealed a significant relationship between work stress measured at the end of a workday, work-related rumination measured during the evening, and restful sleep measured the following morning. Work stress, measured as the mean of 2 consecutive workdays, was substantially but not significantly related to restful sleep on weekends. Work stress was unrelated to nocturnal heart rate variability. Work-related rumination was related to restful sleep on weekends but not on workdays. Additionally, work-related rumination on weekends was positively related to nocturnal heart rate variability during the night between Saturday and Sunday. No mediation effects of work stress on restful sleep or nocturnal heart rate variability via work-related rumination were confirmed.

Individual Interventions To Prevent Drunk Driving: Types, Efficacy, and a Theorectical Persepctive.

Science.gov (United States)

Shore, Elsie R.; Compton, Kristi L.

2000-01-01

College students (N=100) who had tried to stop someone from driving while drunk, or who someone had tried to stop, provided information about their interactions. Results suggest that the manner in which people intervene can affect the likelihood that the impaired person will not drive. Threat of competence is discussed, as are implications for…

Views of US drivers about driving safety.

Science.gov (United States)

Williams, Allan F

2003-01-01

To assess how drivers view dangers on the highway, what motivates them to drive safely, how they say they reduce their crash and injury risk, and how they rate their own driving skills. Most drivers rated their skills as better than average. The biggest motivating factor for safe driving was concern for safety of others in their vehicle, followed by negative outcomes such as being in a crash, increased insurance costs, and fines. The greatest threats to their safety were thought to be other drivers' actions that increase crash risk such as alcohol impairment or running red lights. In terms of reducing crashes and injuries, drivers tended to focus on actions they could take such as driving defensively or using seat belts. There was less recognition of the role of vehicles and vehicle features in crash or injury prevention. Knowing how drivers view themselves and others, their concerns, and their motivations and techniques for staying out of trouble on the roads provides insight into the difficulty of changing driving practices.

A nocturnal decline of salivary pH associated with airway hyperresponsiveness in asthma.

Science.gov (United States)

Watanabe, Masanari; Sano, Hiroyuki; Tomita, Katsuyuki; Yamasaki, Akira; Kurai, Jun; Hasegawa, Yasuyuki; Igishi, Tadashi; Okazaki, Ryota; Tohda, Yuji; Burioka, Naoto; Shimizu, Eiji

2010-08-01

Salivary pH is associated with esophageal acid reflux and neutralization of esophageal acid. In this study, we assessed the association between nocturnal decline of salivary pH and airway hyperresponsiveness. Salivary pH was serially assessed in 9 patients with mild asthma (7 men and 2 women; mean age 33.3 years; mean %predicted FEV(1.0) 89.4%) and 10 healthy volunteers (6 men and 4 women; mean age 31.2 years) using a pH indicator tape. The buffering capacity of saliva was defined as the median effective dose (ED(50)) for acidification of saliva with 0.01 N HCl, and airway responsiveness was defined as the dose of methacholine producing a 35% fall in Grs (PD(35)-Grs). There was a significant correlation between the values obtained from the pH indicator tape and those obtained from the electrometric pH meter. Using the indicator tape for sequential monitoring, we observed a nocturnal fall (ΔpH) in salivary pH in all subjects. A significant correlation was found between airway hyperresponsiveness (PD(35)-Grs) and either ΔpH or ED(50) in mildly asthmatic patients. Vagal reflux dysfunction might contribute to nocturnal salivary pH as well as to airway hyperresponsiveness in mild asthmatics.

Intermittent nocturnal hypoxia and metabolic risk in obese adolescents with obstructive sleep apnea.

Science.gov (United States)

Narang, Indra; McCrindle, Brian W; Manlhiot, Cedric; Lu, Zihang; Al-Saleh, Suhail; Birken, Catherine S; Hamilton, Jill

2018-01-22

There is conflicting data regarding the independent associations of obstructive sleep apnea (OSA) with metabolic risk in obese youth. Previous studies have not consistently addressed central adiposity, specifically elevated waist to height ratio (WHtR), which is associated with metabolic risk independent of body mass index. The objective of this study was to determine the independent effects of the obstructive apnea-hypopnea index (OAHI) and associated indices of nocturnal hypoxia on metabolic function in obese youth after adjusting for WHtR. Subjects had standardized anthropometric measurements. Fasting blood included insulin, glucose, glycated hemoglobin, alanine transferase, and aspartate transaminase. Insulin resistance was quantified with the homeostatic model assessment. Overnight polysomnography determined the OAHI and nocturnal oxygenation indices. Of the 75 recruited subjects, 23% were diagnosed with OSA. Adjusting for age, gender, and WHtR in multivariable linear regression models, a higher oxygen desaturation index was associated with a higher fasting insulin (coefficient [standard error] = 48.076 [11.255], p Intermittent nocturnal hypoxia rather than the OAHI was associated with metabolic risk in obese youth after adjusting for WHtR. Measures of abdominal adiposity such as WHtR should be considered in future studies that evaluate the impact of OSA on metabolic health.

Nocturnal antihypertensive treatment in patients with type 1 diabetes with autonomic neuropathy and non-dipping of blood pressure during night time

DEFF Research Database (Denmark)

Hjortkær, Henrik; Jensen, Tonny; Kofoed, Klaus

2014-01-01

INTRODUCTION: Cardiac autonomic neuropathy (CAN) and elevated nocturnal blood pressure are independent risk factors for cardiovascular disease in patients with diabetes. Previously, associations between CAN, non-dipping of nocturnal blood pressure and coronary artery calcification have been...

The Association of Pediatric Obesity With Nocturnal Non-Dipping on 24-Hour Ambulatory Blood Pressure Monitoring.

Science.gov (United States)

Macumber, Ian R; Weiss, Noel S; Halbach, Susan M; Hanevold, Coral D; Flynn, Joseph T

2016-05-01

Obesity has been linked with abnormal nocturnal dipping of blood pressure (BP) in adults, which in turn is associated with poor cardiovascular outcomes. There are few data regarding abnormal dipping status in the obese pediatric population. The goal of this study was to further describe the relationship between obesity and non-dipping status on ambulatory blood pressure monitor (ABPM) in children. We conducted a cross-sectional study using a database of patients aged 5-21 years who had undergone 24-hour ABPM at Seattle Children's Hospital from January 2008 through May 2014. Subjects were grouped by body mass index (BMI) into lean (BMI 15th-85th percentile) and obese (BMI >95th percentile) groups. Compared to lean subjects (n = 161), obese subjects (n = 247) had a prevalence ratio (PR) for non-dipping of 2.15, adjusted for race (95% confidence interval (CI) = 1.25-3.42). Increasing severity of obesity was not further associated with nocturnal non-dipping. Nocturnal non-dipping was not associated with left ventricular hypertrophy (PR = 1.01, 95% CI = 0.71-1.44). These results suggest that in children, just as in adults, obesity is related to a relatively decreased dipping in nocturnal BP. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Male broiler performance and nocturnal feeding under constant 8-h ...

African Journals Online (AJOL)

... however, they still consumed more feed in the 8-h dark period than birds that had always been given 16 h illumination. Cobb and Ross genotypes responded similarly to all lighting treatments. Keywords: Photoperiod, broiler growth, nocturnal feeding. South African Journal of Animal Science Vol. 38 (3) 2008: pp. 159-165 ...

Carbon dioxide measurements in the nocturnal boundary layer over Amazonian forest

Directory of Open Access Journals (Sweden)

A. D. Culf

1999-01-01

Full Text Available Measurements of carbon dioxide concentration, temperature and windspeed were made in the nocturnal boundary layer over a tropical forest near Manaus, Brazil using a tethered balloon system. The measurements were made up to a maximum height of 300 m on ten consecutive nights in November 1995. Simultaneous surface flux and in-canopy concentration measurements were made at the surface close to the site. The observation period included several different types of conditions. Generally strong windshear and relatively weak temperature gradients prevented the formation of a strong capping inversion to the nocturnal boundary layer. On some nights, however, the inversion was sufficiently strong that the CO2 concentration at 100 m above the surface exceeded 400 ppm. The concentration within the canopy was largely controlled by the presence of an inversion very close to the canopy surface. The temperature and wind profiles are contrasted with conditions in Randônia, Brazil, where the windshear was found to be weaker and higher carbon dioxide concentrations were observed in the early morning. The difference in carbon dioxide concentrations in the nocturnal boundary layer between dusk and dawn is used to estimate the regional nighttime flux of carbon dioxide. The value obtained generally exceeds the measured surface flux and sometimes exceeds the sum of the surface flux and the in-canopy storage made at the tower site. The reasons for the discrepancy are not clear; either one of the methods is in error or the regional carbon dioxide budget differs significantly from the local budget measured at the tower site.

Screening and managing obstructive sleep apnoea in nocturnal heart block patients: an observational study.

Science.gov (United States)

Wu, Xu; Liu, Zilong; Chang, Su Chi; Fu, Cuiping; Li, Wenjing; Jiang, Hong; Jiang, Liyan; Li, Shanqun

2016-02-16

Nocturnal heart block often occurs in patients with obstructive sleep apnoea (OSA). It is more likely to be undiagnosed in heart block patients who are ignorant of the symptoms of sleep disorder. Berlin Questionnaire (BQ) is a highly reliable way to discover the risk factors of OSA, whereas the validity in sleep-related heart block patients is uncertain. We performed an observational study to address these issues and confirmed the potential protective effect of continuous positive airway pressure (CPAP). Patients who were previously diagnosed with nocturnal heart block with R-R pauses exceeding 2 seconds were retrospective screened from the ECG centre of Zhongshan hospital. These recruited participants completed Berlin Questionnaire and underwent polysomnography synchronously with 24-hour Holter monitoring. A cross-sectional analysis was performed to confirm the association between nocturnal arrhythmia and OSA, as well as to assess the diagnostic accuracy of the BQ. Subsequently, subjects diagnosed with OSA (apnoea-hypopnoea index > 5) underwent 3 consecutive days of CPAP therapy. On the third day, patients repeated 24-hour Holter monitoring within the institution of CPAP. The symptoms of disruptive snoring and hypersomnolence in 72 enrolled patients were more related to the occurrence of nocturnal heart block (r = 0.306, 0.226, respectively, p = 0.015, 0.019) than syncope (r = 0.134, p = 0.282) and palpitations (r = 0.106, p = 0.119), which were prominent trait of our study population. The sensitivity, specificity, positive and negative predictive value of the BQ at a cut-off point of 5 of AHI for detecting OSA in heart block patients was 81.0 %, 44.4 %, 91.07 % and 25 %. Nocturnal heart block does not appear to occur exclusively in severe sleep apnoea. The frequent occurrence of arrhythmias in prominent oxygen desaturation supports the correlation between them. CPAP therapy resulted in significant decrease in the average number of

Detection of paroxysmal nocturnal hemoglobinuria clones in patients with myelodysplastic syndromes and related bone marrow diseases, with emphasis on diagnostic pitfalls and caveats.

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Wang, Sa A; Pozdnyakova, Olga; Jorgensen, Jeffrey L; Medeiros, L Jeffrey; Stachurski, Dariusz; Anderson, Mary; Raza, Azra; Woda, Bruce A

2009-01-01

The presence of paroxysmal nocturnal hemoglobinuria clones in the setting of aplastic anemia or myelodysplastic syndrome has been shown to have prognostic and therapeutic implications. However, the status of paroxysmal nocturnal hemoglobinuria clones in various categories of myelodysplastic syndrome and in other bone marrow disorders is not well-studied. By using multiparameter flow cytometry immunophenotypic analysis with antibodies specific for four glycosylphosphatidylinositol-anchored proteins (CD55, CD59, CD16, CD66b) and performing an aerolysin lysis confirmatory test in representative cases, we assessed the paroxysmal nocturnal hemoglobinuria-phenotype granulocytes in 110 patients with myelodysplastic syndrome, 15 with myelodysplastic/myeloproliferative disease, 5 with idiopathic myelofibrosis and 6 with acute myeloid leukemia. Paroxysmal nocturnal hemoglobinuria-phenotype granulocytes were detected in nine patients with low grade myelodysplastic syndrome who showed clinicopathological features of bone marrow failure, similar to aplastic anemia. All paroxysmal nocturnal hemoglobinuria-positive cases demonstrated loss of the four glycosylphosphatidylinositol-anchored proteins, with CD16(-)CD66b(-) clones being larger than those of CD55(-)CD59(-) (p<0.05). Altered glycosylphosphatidylinositol-anchored protein expression secondary to granulocytic hypogranulation, immaturity, and/or immunophenotypic abnormalities was present in a substantial number of cases and diagnostically challenging. These results show that routine screening for paroxysmal nocturnal hemoglobinuria clones in patients with an intrinsic bone marrow disease who show no clinical evidence of hemolysis has an appreciable yield in patients with low grade myelodysplastic syndromes. The recognition of diagnostic caveats and pitfalls associated with the underlying intrinsic bone marrow disease is essential in interpreting paroxysmal nocturnal hemoglobinuria testing correctly. In our experience, the CD

α(1)-adrenoceptor blocker naftopidil improves sleep disturbance with reduction in nocturnal urine volume.

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Yokoyama, Osamu; Aoki, Yoshitaka; Tsujimura, Akira; Takao, Tetsuya; Namiki, Mikio; Okuyama, Akihiko

2011-04-01

To examine the mechanism underlying improvements in nocturia by α(1)-blockers, we investigated whether the α(1)-blocker naftopidil acts on nocturia with sleep disturbance using a frequency/volume chart (FVC). A total of 56 male patients with lower urinary tract symptoms were enrolled. The inclusion criteria were as follows: eight or more points on the I-PSS; three or more points on the I-PSS score for nocturia; and prostate volume larger than 20 ml. Patients received 50 mg of naftopidil once daily for 4 weeks, and non-responders received 75 mg for another 4 weeks. All patients were examined, and their data entered into FVC for 2 days before and after administration of naftopidil. Quality of sleep was also evaluated using modified Pittsburgh sleep quality index (PSQI). Patients with sleep quality scores of three or four were assigned to sleep disturbance group (n = 33), while those with scores of less than three were assigned to non-disturbance group (n = 23). After administration of naftopidil, total I-PSS decreased and nocturia score decreased from 3.5 to 2.6 (P < 0.01). Total mean score of modified PSQI in sleep disturbance group became significantly lower after administration of naftopidil (from 16.9 to 14.0; P < 0.01). Naftopidil significantly decreased nocturnal urine volume, resulting in a decrease in the nocturnal polyuria index in both sleep disturbance and non-disturbance groups. These results suggest that α(1)-blockers have the ability to normalize sleep disorders. Naftopidil improved nocturnal polyuria regardless of the presence of sleep disturbance, meaning that it might directly reduce nocturnal urine production.

The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study

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Young Won Kim

2015-09-01

Full Text Available Purpose: To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. Methods: This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33, aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6% completed the study according to the study protocol (per-protocol group, and 24 dropped out (dropout group. Results: Of the 24 patients in the dropout group, 5 withdrew consent due to side effects or lack of efficacy, 7 were lost to follow-up at 4 weeks, 8 were lost to follow-up at 12 weeks, and 4 dropped out due to failure to complete 3-day frequency volume charts at 12 weeks. In the per-protocol group, there was significant improvement in the International Prostate Symptom Score (IPSS, especially question numbers 1, 3, 4, 5, 6, 7, and the quality of life question (P=0.001, P=0.007, P0.33. Considering the high dropout rate of our study due to no implementation of 3-day frequency volume charts, prospective and large-scale studies are needed to confirm our results.

Effect of different alcohol levels on take-over performance in conditionally automated driving.

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Wiedemann, Katharina; Naujoks, Frederik; Wörle, Johanna; Kenntner-Mabiala, Ramona; Kaussner, Yvonne; Neukum, Alexandra

2018-06-01

Automated driving systems are getting pushed into the consumer market, with varying degrees of automation. Most often the driver's task will consist of being available as a fall-back level when the automation reaches its limits. These so-called take-over situations have attracted a great body of research, focusing on various human factors aspects (e.g., sleepiness) that could undermine the safety of control transitions between automated and manual driving. However, a major source of accidents in manual driving, alcohol consumption, has been a non-issue so far, although a false understanding of the driver's responsibility (i.e., being available as a fallback level) might promote driving under its influence. In this experiment, N = 36 drivers were exposed to different levels of blood alcohol concentrations (BACs: placebo vs. 0.05% vs. 0.08%) in a high fidelity driving simulator, and the effect on take-over time and quality was assessed. The results point out that a 0.08% BAC increases the time needed to re-engage in the driving task and impairs several aspects of longitudinal and lateral vehicle control, whereas 0.05% BAC did only go along with descriptive impairments in fewer parameters. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Nocturnal insects use optic flow for flight control

OpenAIRE

Baird, Emily; Kreiss, Eva; Wcislo, William; Warrant, Eric; Dacke, Marie

2011-01-01

To avoid collisions when navigating through cluttered environments, flying insects must control their flight so that their sensory systems have time to detect obstacles and avoid them. To do this, day-active insects rely primarily on the pattern of apparent motion generated on the retina during flight (optic flow). However, many flying insects are active at night, when obtaining reliable visual information for flight control presents much more of a challenge. To assess whether nocturnal flyin...

Canadian drivers' attitudes regarding preventative responses to driving while impaired by alcohol.

Science.gov (United States)

Vanlaar, Ward; Nadeau, Louise; McKiernan, Anna; Hing, Marisela M; Ouimet, Marie Claude; Brown, Thomas G

2017-09-01

In many jurisdictions, a risk assessment following a first driving while impaired (DWI) offence is used to guide administrative decision making regarding driver relicensing. Decision error in this process has important consequences for public security on one hand, and the social and economic well being of drivers on the other. Decision theory posits that consideration of the costs and benefits of decision error is needed, and in the public health context, this should include community attitudes. The objective of the present study was to clarify whether Canadians prefer decision error that: i) better protects the public (i.e., false positives); or ii) better protects the offender (i.e., false negatives). A random sample of male and female adult drivers (N=1213) from the five most populated regions of Canada was surveyed on drivers' preference for a protection of the public approach versus a protection of DWI drivers approach in resolving assessment decision error, and the relative value (i.e., value ratio) they imparted to both approaches. The role of region, sex and age on drivers' value ratio were also appraised. Seventy percent of Canadian drivers preferred a protection of the public from DWI approach, with the overall relative ratio given to this preference, compared to the alternative protection of the driver approach, being 3:1. Females expressed a significantly higher value ratio (M=3.4, SD=3.5) than males (M=3.0, SD=3.4), pvalue ratios, R 2 (adj.)=0.014, pAccounting for community attitudes concerning DWI prevention and the individual differences that influence them could contribute to more informed, coherent and effective regional policies and prevention program development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nocturnal to Diurnal Switches with Spontaneous Suppression of Wheel-Running Behavior in a Subterranean Rodent.

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Patricia Tachinardi

Full Text Available Several rodent species that are diurnal in the field become nocturnal in the lab. It has been suggested that the use of running-wheels in the lab might contribute to this timing switch. This proposition is based on studies that indicate feed-back of vigorous wheel-running on the period and phase of circadian clocks that time daily activity rhythms. Tuco-tucos (Ctenomys aff. knighti are subterranean rodents that are diurnal in the field but are robustly nocturnal in laboratory, with or without access to running wheels. We assessed their energy metabolism by continuously and simultaneously monitoring rates of oxygen consumption, body temperature, general motor and wheel running activity for several days in the presence and absence of wheels. Surprisingly, some individuals spontaneously suppressed running-wheel activity and switched to diurnality in the respirometry chamber, whereas the remaining animals continued to be nocturnal even after wheel removal. This is the first report of timing switches that occur with spontaneous wheel-running suppression and which are not replicated by removal of the wheel.

Nocturnal to Diurnal Switches with Spontaneous Suppression of Wheel-Running Behavior in a Subterranean Rodent

Science.gov (United States)

Tachinardi, Patricia; Tøien, Øivind; Valentinuzzi, Veronica S.; Buck, C. Loren; Oda, Gisele A.

2015-01-01

Several rodent species that are diurnal in the field become nocturnal in the lab. It has been suggested that the use of running-wheels in the lab might contribute to this timing switch. This proposition is based on studies that indicate feed-back of vigorous wheel-running on the period and phase of circadian clocks that time daily activity rhythms. Tuco-tucos (Ctenomys aff. knighti) are subterranean rodents that are diurnal in the field but are robustly nocturnal in laboratory, with or without access to running wheels. We assessed their energy metabolism by continuously and simultaneously monitoring rates of oxygen consumption, body temperature, general motor and wheel running activity for several days in the presence and absence of wheels. Surprisingly, some individuals spontaneously suppressed running-wheel activity and switched to diurnality in the respirometry chamber, whereas the remaining animals continued to be nocturnal even after wheel removal. This is the first report of timing switches that occur with spontaneous wheel-running suppression and which are not replicated by removal of the wheel. PMID:26460828

Periodic limb movements during sleep are associated with a lower quality of life in children with monosymptomatic nocturnal enuresis.

Science.gov (United States)

Van Herzeele, Charlotte; Dhondt, Karlien; Roels, Sanne Patrick; Raes, Ann; Groen, Luitzen-Albert; Hoebeke, Piet; Vande Walle, Johan

2015-07-01

The study investigates whether cortical arousals and periodic limb movements during sleep are related to daytime psychological functioning in children with monosymptomatic nocturnal enuresis with associated nocturnal polyuria. Psychological functioning is evaluated on five domains: attention deficit hyperactivity disorder-inattentive problems, quality of life, internalizing problems, externalizing problems, and executive functioning. This multi-informant (parents, teachers, and children) and multi-method study included overnight video-polysomnography, questionnaires, and neuropsychological testing. Thirty children (7 girls) 6 to 16 years (mean 10.43 years, SD 3.08) were selected in a tertiary enuresis center. A high index of periodic limb movements during sleep was associated with a lower quality of life, according to the child. No significant correlations were found with attention deficit hyperactivity disorder-inattentive problems, internalizing problems, externalizing problems, and executive functioning. This study clarifies the relationship between sleep parameters and psychological functioning of the children with monosymptomatic nocturnal enuresis and associated nocturnal polyuria according to the child, the parents, and the teachers. Periodic limb movements during sleep are associated with a lower quality of life of the child.

Influence of bicarbonate on ventilatory drive in healthy subjects

NARCIS (Netherlands)

Mos-Oppersma, Eline; Doorduin, Jonne; van der Hoeven, J.G.; Veltink, Peter; Heunks, Leo M.A.

2016-01-01

Background Acute hypoventilation results in CO2 retention and respiratory acidosis. Bicarbonate retention aims to restore pH level. However, after institution of mechanical ventilation metabolic alkalosis may develop, which could impair respiratory drive. Aim To investigate whether increased plasma

Low levels of nitryl chloride at ground level: nocturnal nitrogen oxides in the Lower Fraser Valley of British Columbia

Directory of Open Access Journals (Sweden)

H. D. Osthoff

2018-05-01

Full Text Available The nocturnal nitrogen oxides, which include the nitrate radical (NO3, dinitrogen pentoxide (N2O5, and its uptake product on chloride containing aerosol, nitryl chloride (ClNO2, can have profound impacts on the lifetime of NOx ( =  NO + NO2, radical budgets, and next-day photochemical ozone (O3 production, yet their abundances and chemistry are only sparsely constrained by ambient air measurements.Here, we present a measurement data set collected at a routine monitoring site near the Abbotsford International Airport (YXX located approximately 30 km from the Pacific Ocean in the Lower Fraser Valley (LFV on the west coast of British Columbia. Measurements were made from 20 July to 4 August 2012 and included mixing ratios of ClNO2, N2O5, NO, NO2, total odd nitrogen (NOy, O3, photolysis frequencies, and size distribution and composition of non-refractory submicron aerosol (PM1.At night, O3 was rapidly and often completely removed by dry deposition and by titration with NO of anthropogenic origin and unsaturated biogenic hydrocarbons in a shallow nocturnal inversion surface layer. The low nocturnal O3 mixing ratios and presence of strong chemical sinks for NO3 limited the extent of nocturnal nitrogen oxide chemistry at ground level. Consequently, mixing ratios of N2O5 and ClNO2 were low ( <  30 and  <  100 parts-per-trillion by volume (pptv and median nocturnal peak values of 7.8 and 7.9 pptv, respectively. Mixing ratios of ClNO2 frequently peaked 1–2 h after sunrise rationalized by more efficient formation of ClNO2 in the nocturnal residual layer aloft than at the surface and the breakup of the nocturnal boundary layer structure in the morning. When quantifiable, production of ClNO2 from N2O5 was efficient and likely occurred predominantly on unquantified supermicron-sized or refractory sea-salt-derived aerosol. After sunrise, production of Cl radicals from photolysis of ClNO2 was negligible compared to production of OH

Fifty years of driving safety research.

Science.gov (United States)

Lee, John D

2008-06-01

This brief review covers the 50 years of driving-related research published in Human Factors, its contribution to driving safety, and emerging challenges. Many factors affect driving safety, making it difficult to assess the impact of specific factors such as driver age, cell phone distractions, or collision warnings. The author considers the research themes associated with the approximately 270 articles on driving published in Human Factors in the past 50 years. To a large extent, current and past research has explored similar themes and concepts. Many articles published in the first 25 years focused on issues such as driver impairment, individual differences, and perceptual limits. Articles published in the past 25 years address similar issues but also point toward vehicle technology that can exacerbate or mitigate the negative effect of these issues. Conceptual and computational models have played an important role in this research. Improved crash-worthiness has contributed to substantial improvements in driving safety over the past 50 years, but future improvements will depend on enhancing driver performance and perhaps, more important, improving driver behavior. Developing models to guide this research will become more challenging as new technology enters the vehicle and shifts the focus from driver performance to driver behavior. Over the past 50 years, Human Factors has accumulated a large base of driving-related research that remains relevant for many of today's design and policy concerns.

Expression and Evolution of Short Wavelength Sensitive Opsins in Colugos: A Nocturnal Lineage That Informs Debate on Primate Origins.

Science.gov (United States)

Moritz, Gillian L; Lim, Norman T-L; Neitz, Maureen; Peichl, Leo; Dominy, Nathaniel J

2013-01-01

A nocturnal activity pattern is central to almost all hypotheses on the adaptive origins of primates. This enduring view has been challenged in recent years on the basis of variation in the opsin genes of nocturnal primates. A correspondence between the opsin genes and activity patterns of species in Euarchonta-the superordinal group that includes the orders Primates, Dermoptera (colugos), and Scandentia (treeshrews)-could prove instructive, yet the basic biology of the dermopteran visual system is practically unknown. Here we show that the eye of the Sunda colugo ( Galeopterus variegatus ) lacks a tapetum lucidum and has an avascular retina, and we report on the expression and spectral sensitivity of cone photopigments. We found that Sunda colugos have intact short wavelength sensitive (S-) and long wavelength sensitive (L-) opsin genes, and that both opsins are expressed in cone photoreceptors of the retina. The inferred peak spectral sensitivities are 451 and 562 nm, respectively. In line with adaptation to nocturnal vision, cone densities are low. Surprisingly, a majority of S-cones coexpress some L-opsin. We also show that the ratio of rates of nonsynonymous to synonymous substitutions of exon 1 of the S-opsin gene is indicative of purifying selection. Taken together, our results suggest that natural selection has favored a functional S-opsin in a nocturnal lineage for at least 45 million years. Accordingly, a nocturnal activity pattern remains the most likely ancestral character state of euprimates.

Unusual nocturnal feeding by Brown Rock-chat Cercomela fusca (Passeriformes: Muscicapidae in Bikaner, Rajasthan, India

Directory of Open Access Journals (Sweden)

P. Singh

2009-04-01

Full Text Available Brown Rock-chat is a diurnal insectivorous bird commonly associated with human habitations. I report here nocturnal foraging of the species in and around Bikaner in Rajasthan. The birds showed a marked bimodal activity during their nocturnal foraging which peaked in early morning and late evening hours. Bright sodium-vapour lights that attracted a horde of insects during monsoons offered ideal foraging opportunities for the birds. This behavior is explained here as an adaptation to maximize their food intake during the period when the birds breed and their nutritional requirements are naturally high.

Sleep disturbances in IDDM patients with nocturnal hypoglycemia

DEFF Research Database (Denmark)

Bendtson, I; Gade, J; Thomsen, C E

1992-01-01

Eight insulin-dependent diabetic patients were studied to evaluate sleep patterns during normoglycemia and spontaneous and insulin-induced hypoglycemia. Two channels of electroencephalogram (EEG), electromyogram and actooculogram were recorded. The signals were analyzed off-line, using...... a polygraphic sleep analysis system. The scoring was mainly based on the color density spectral array of the EEG. Blood glucose and growth hormone were measured serially. Asymptomatic, spontaneous nocturnal hypoglycemia occurred in 38% of the nights. Conventional sleep analysis showed a tendency toward...

Predicting perceived safety to drive the morning after drinking: The importance of hangover symptoms.

Science.gov (United States)

Cameron, Elaine; French, David P

2016-07-01

People driving the day after drinking are at risk of impaired performance and accidents due to continued intoxication or the effects of alcohol hangover. Drivers are poor at estimating their own blood alcohol concentration, and some drive despite believing they are over the legal limit. It is therefore important to identify other factors influencing perceived ability to drive 'the morning after'. This study tested how accurately participants estimated their legal driving status, and the contribution of beliefs and hangover symptoms to the prediction of perceived driving safety. This cross-sectional study involved 193 students completing a questionnaire and alcohol breath test the morning after heavy alcohol consumption. Indicators of subjective intoxication, severity of hangover symptoms, estimated legal status and perceived safety to drive were measured. A hierarchical linear regression analysis was conducted. No participants thought they were under the English legal limit when they were not, and 47% thought they were over the limit when they were in fact legally permissible to drive. However, 20% of those believing they were over the limit nevertheless rated themselves as safe to drive. Hangover symptoms added 17% variance to the prediction of perceived safety to drive, over and above objective and subjective measures of intoxication. Perceived severity of hangover symptoms influence beliefs about driving ability: When judging safety to drive, people experiencing less severe symptoms believe they are less impaired. If this finding is robust, health promotion campaigns should aim to correct this misapprehension. [Cameron E, French D. Predicting perceived safety to drive the morning after drinking: The importance of hangover symptoms. Drug Alcohol Rev 2016;35:442-446]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Nutritional Status in Nocturnal Hemodialysis Patients : A Systematic Review with Meta-Analysis

NARCIS (Netherlands)

Ipema, Karin J. R.; Struijk, Simone; van der Velden, Annet; Westerhuis, Ralf; van der Schans, Cees P.; Gaillard, Carlo A. J. M.; Krijnen, Wim P.; Franssen, Casper F. M.

2016-01-01

Background Hemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients.

Structural Characteristics of Nocturnal Mesoscale Convective Systems in the U.S. Great Plains as Observed During the PECAN Field Campaign

Science.gov (United States)

Bodine, D. J.; Dougherty, E.; Rasmussen, K. L.; Torres, A. D.

2015-12-01

During the summer in the U.S. Great Plains, some of the heaviest precipitation falls from large thunderstorm complexes known as Mesoscale Convective Systems (MCSs). These frequently occurring MCSs are often nocturnal in nature, so the dynamics associated with these systems are more elusive than those in the daytime. The Plains Elevated Convection at Night (PECAN) field campaign was launched over a 7-week period as an endeavor to better understand nocturnal MCSs occurring in the Great Plains. PECAN featured a dense array of ground-based and airborne instruments to observe nocturnal MCS, including dual-polarization radars at multiple frequencies, mobile mesonets, and sounding units. Our role in PECAN involved deploying Ott Parsivel disdrometers to gain information on drop size distributions (DSDs) and fall speeds. Analysis of disdrometer data in conjunction with radar data presented using Contour Frequency by Altitude Diagrams (CFADs) and high-resolution radiosonde data allows for a structural comparison of PECAN MCS cases to previously identified MCS archetypes. Novel insights into the structural evolution of nocturnal MCSs in relation to their synoptic, mesoscale, and thermodynamic environments are presented, using data collected from dense and numerous observation platforms. Understanding the environmental conditions that result in different nocturnal MCS configurations is useful for gaining insight into precipitation distributions and potential severe weather and flooding hazards in the Great Plains.

Simulated driving in obstructive sleep apnoea-hypopnoea : effects of oral appliances and continuous positive airway pressure

NARCIS (Netherlands)

Hoekema, Aarnoud; Stegenga, Boudewijn; Bakker, Marije; Brouwer, Wiebo H.; de Bont, Lambert G. M.; Wijkstra, Peter J.; van der Hoeven, Johannes H.

Impaired simulated driving performance has been demonstrated in obstructive sleep apnoea-hypopnoea syndrome (OSAHS) patients. Although continuous positive airway pressure (CPAP) generally improves simulated driving performance, the effects of oral-appliance (OA) therapy are unknown. The aims of this

Seasonal associations with urban light pollution for nocturnally migrating bird populations.

Science.gov (United States)

La Sorte, Frank A; Fink, Daniel; Buler, Jeffrey J; Farnsworth, Andrew; Cabrera-Cruz, Sergio A

2017-11-01

The spatial extent and intensity of artificial light at night (ALAN) has increased worldwide through the growth of urban environments. There is evidence that nocturnally migrating birds are attracted to ALAN, and there is evidence that nocturnally migrating bird populations are more likely to occur in urban areas during migration, especially in the autumn. Here, we test if urban sources of ALAN are responsible, at least in part, for these observed urban associations. We use weekly estimates of diurnal occurrence and relative abundance for 40 nocturnally migrating bird species that breed in forested environments in North America to assess how associations with distance to urban areas and ALAN are defined across the annual cycle. Migratory bird populations presented stronger than expected associations with shorter distances to urban areas during migration, and stronger than expected association with higher levels of ALAN outside and especially within urban areas during migration. These patterns were more pronounced during autumn migration, especially within urban areas. Outside of the two migration periods, migratory bird populations presented stronger than expected associations with longer distances to urban areas, especially during the nonbreeding season, and weaker than expected associations with the highest levels of ALAN outside and especially within urban areas. These findings suggest that ALAN is associated with higher levels of diurnal abundance along the boundaries and within the interior of urban areas during migration, especially in the autumn when juveniles are undertaking their first migration journey. These findings support the conclusion that urban sources of ALAN can broadly effect migratory behavior, emphasizing the need to better understand the implications of ALAN for migratory bird populations. © 2017 John Wiley & Sons Ltd.

Prevalence of nocturnal hypoglycemia in first trimester of pregnancy in patients with insulin treated diabetes mellitus

DEFF Research Database (Denmark)

Hellmuth, Ellinor Adelheid; Damm, P; Mølsted-Pedersen, L

2000-01-01

BACKGROUND: Excellent metabolic control before conception and during diabetic pregnancies is the aim in order to avoid malformations and perinatal morbidity. Since an inverse correlation between median blood glucose concentration (BG) and hypoglycemia as well as a high prevalence of nocturnal...... the night, caused by either discomfort or cannula problems. Of the remaining 43 patients, 16 (37%) had at least one blood glucose ... of pregnancy in insulin treated patients. Only one patient registered the hypoglycemia. Nocturnal hypoglycemia could be predicted in the majority of patients by measurements of BG before bedtime....

Driving behaviour in adults with attention deficit/hyperactivity disorder.

Science.gov (United States)

Groom, Madeleine J; van Loon, Editha; Daley, David; Chapman, Peter; Hollis, Chris

2015-07-28

Little is known about the impact of cognitive impairments on driving in adults with ADHD. The present study compared the performance of adults with and without ADHD in a driving simulator on two different routes: an urban route which we hypothesised would exacerbate weak impulse control in ADHD and a motorway route, to challenge deficits in sustained attention. Adults with (n = 22, 16 males) and without (n = 21, 18 males) ADHD completed a simulated driving session while eye movement data were recorded simultaneously. Participants also completed the Manchester Driving Behaviour Questionnaire (DBQ) and the Conners Adult ADHD Rating Scale (CAARS). Measures of driving performance included average speed, proportion distance travelled over speed limit (speeding) and lane deviation. These variables and the eye movement measures (spread of fixations, mean fixation duration) were compared between groups and routes. Also, driving behaviours, including responses to programmed events, were categorised and the frequencies within categories were compared between groups. Finally, speech analysis was performed to compare emotional verbal expressions during driving between groups. ADHD participants reported significantly more Violations and Lapses on the DBQ than control participants and significantly more accidents. Average speed and speeding were also higher but did not interact with route type. ADHD participants showed poorer vehicle control, greater levels of frustration with other road users (including greater frequencies of negative comments) and a trend for less safe driving when changing lanes/overtaking on the motorway. These effects were predicted by hyperactive/impulsive CAARS scores. They were also more likely to cause a crash/near miss when an event occurred on the urban route. The results suggest that difficulty regulating and controlling impulsive behavior, reflected in speeding, frustration with other road users, less safety when changing lanes on the

Comparison of Nocturia Response to Desmopressin Treatment between Patients with Normal and High Nocturnal Bladder Capacity Index

Directory of Open Access Journals (Sweden)

Tine Hajdinjak

2013-01-01

Full Text Available Objective. To compare efficacy of desmopressin for treatment of nocturia between patients with normal and high nocturnal bladder capacity index (NBCi. Methods. Retrospective analysis of adult patients treated with desmopressin for nocturia. Patients were analyzed according to high or normal NBCi value before treatment. Results. 55 patients were identified, aged 49–84, 47 males, 8 females, who started desmopressin 0.2 mg nocte between 2009 and 2011. Two groups (N: normal and H: high NBCi were similar regarding number, gender, age, 24 h urine volume, and nocturnal urine volume. On treatment, nocturnal volume decreased by mean of 364 mL. Number of nightly voids decreased in N group from 3.11 to 1.50, in H from 3.96 to 1.44. Nocturnal polyuria and nocturia indices also decreased significantly. NBCi remained the same in N group (0.56 on therapy and in H group decreased to mean 0.63. All on-treatment values were statistically similar in N and H groups. Pretreatment differences were abolished with treatment. NBCi was significantly correlated to nocturia reduction—larger reduction was observed in patients with higher NBCi. In 8/55 patients, hyponatremia was detected, but without clinical consequences. Conclusions. The results indicate that the effectiveness of desmopressin on nocturia is not dependent upon the patient's pretreatment NBCi.

Effect of chronic nonmalignant pain on highway driving performance.

Science.gov (United States)

Veldhuijzen, D S; van Wijck, A J M; Wille, F; Verster, J C; Kenemans, J L; Kalkman, C J; Olivier, B; Volkerts, E R

2006-05-01

Most pain patients are treated in an outpatient setting and are engaged in daily activities including driving. Since several studies showed that cognitive functioning may be impaired in chronic nonmalignant pain, the question arises whether or not chronic nonmalignant pain affects driving performance. Therefore, the objective of the present study was to determine the effects of chronic nonmalignant pain on actual highway driving performance during normal traffic. Fourteen patients with chronic nonmalignant pain and 14 healthy controls, matched on age, educational level, and driving experience, participated in the study. Participants performed a standardized on-the-road driving test during normal traffic, on a primary highway. The primary parameter of the driving test is the Standard Deviation of Lateral Position (SDLP). In addition, driving-related skills (tracking, divided attention, and memory) were examined in the laboratory. Subjective assessments, such as pain intensity, and subjective driving quality, were rated on visual analogue scales. The results demonstrated that a subset of chronic nonmalignant pain patients had SDLPs that were higher than the matched healthy controls, indicating worse highway driving performance. Overall, there was a statistically significant difference in highway driving performance between the groups. Further, chronic nonmalignant pain patients rated their subjective driving quality to be normal, although their ratings were significantly lower than those of the healthy controls. No significant effects were found on the laboratory tests.

Effects of alcohol (BAC 0.5‰) and ecstasy (MDMA 100 mg) on simulated driving performance and traffic safety.

Science.gov (United States)

Veldstra, Janet L; Brookhuis, Karel A; de Waard, Dick; Molmans, Barbara H W; Verstraete, Alain G; Skopp, Gisela; Jantos, Ricarda

2012-08-01

An increasing number of fatal road-accidents have been reported in which ecstasy was found in the blood of drivers. Although, ecstasy is frequently found to have been used in combination with alcohol, studies on the acute effects of ecstasy co-administered with alcohol on driving performance are relatively rare. The present study was designed to establish the extent of driver impairment as a consequence of ecstasy or combined ecstasy and alcohol use as compared to driving under the influence of 0.3‰, 0.5‰ and 0.8‰ alcohol. Furthermore, subjective performance was also assessed. Alcohol and ecstasy mainly influenced automated driving performance such as lateral and speed control. However, small to no effects of the substances were found on more complex driving behaviour. Overall, variance within the different driving measures was high especially when participants were treated with 3.4-methylenedioxy-methamphetamine (MDMA) and alcohol. Furthermore, equivalence testing showed that combined use may lead to impaired driving for some, but not all, drivers. Participants rated their own performance to be slightly worse than normal in both studies. Since driving was actually seriously deteriorated, this was a falsely positive assessment of their condition. The dissociation between subjective perceptions and objective performance decrements are important notions for traffic safety since this may affect a driver's judgement of whether or not it is safe to drive. For example, an intoxicated individual might decide to drive because the feelings of alertness caused by MDMA cloud the impairing effects of other drugs such as alcohol, thereby creating a potentially serious risk for traffic safety.

Relationship between sleep stages and nocturnal trapezius muscle activity.

Science.gov (United States)

Müller, Christian; Nicoletti, Corinne; Omlin, Sarah; Brink, Mark; Läubli, Thomas

2015-06-01

Former studies reported a relationship between increased nocturnal low level trapezius muscle activity and neck or shoulder pain but it has not been explored whether trapezius muscle relaxation is related to sleep stages. The goal of the present study was to investigate whether trapezius muscle activity is related to different sleep stages, as measured by polysomnography. Twenty one healthy subjects were measured on four consecutive nights in their homes, whereas the first night served as adaptation night. The measurements included full polysomnography (electroencephalography (EEG), electrooculography (EOG), electromyography (EMG) and electrocardiography (ECG)), as well as surface EMG of the m. trapezius descendens of the dominant arm. Periods with detectable EMG activity of the trapezius muscle lasted on average 1.5% of the length of the nights and only in four nights it lasted longer than 5% of sleeping time. Neither rest time nor the length of periods with higher activity levels of the trapezius muscle did significantly differ between sleep stages. We found no evidence that nocturnal trapezius muscle activity is markedly moderated by the different sleep stages. Thus the results support that EMG measurements of trapezius muscle activity in healthy subjects can be carried out without concurrent polysomnographic recordings. Copyright © 2015 Elsevier Ltd. All rights reserved.

B-type natriuretic peptide is a determinant of the nocturnal increase in blood pressure independently of arterial hypertrophy and hypoxia.

Science.gov (United States)

Tabara, Yasuharu; Igase, Michiya; Miki, Tetsuro; Ohyagi, Yasumasa; Matsuda, Fumihiko; Kohara, Katsuhiko

2016-12-01

Loss of the nocturnal blood pressure (BP) drop is a risk factor for cardiovascular outcomes. However, clinical parameters that predispose to changes in nocturnal BP are currently uncertain. Given the possible involvement of salt sensitivity in nocturnal BP levels, we investigated a hypothesized association between plasma B-type natriuretic peptide (BNP) levels - a marker of body fluid retention - and nocturnal BP in a general population. Study participants were 1020 general individuals. Participants were divided into four groups (riser, nondipper, dipper, and extreme dipper) by their percentage changes in nocturnal SBP measured using an ambulatory BP monitor. Plasma BNP levels were positively associated with circadian BP change (β = 0.162, P < 0.001) independently of carotid hypertrophy (β = 0.133, P < 0.001), and awake heart rate (β = -0.102, P = 0.001) and SBP (β = -0.246, P < 0.001). Risers showed 1.6 times higher BNP levels than dippers, whereas oxygen desaturation during sleep was frequently observed in nondippers. Results of multinomial logistic regression analysis indicated that BNP level was a significant determinant for the riser pattern [odds ratio (OR) 1.27 (BNP 10 pg/ml), P < 0.001], whereas oxygen desaturation was specifically associated with the nondipping pattern (OR 1.04, P = 0.001). When participants were subdivided by BNP level, risers were more frequent in the high BNP subgroup (19.5%) than in the low BNP subgroup (6.7%) (OR 3.39, P < 0.001). A slight increase in plasma BNP level was independently associated with rising nocturnal BP. Our results may help to understand the pathophysiology of circadian BP variation, and be a clue to identify individuals who require careful BP monitoring.

Impact of the International Continence Society (ICS) report on the standardisation of terminology in nocturia on the quality of reports on nocturia and nocturnal polyuria : a systematic review

NARCIS (Netherlands)

Hofmeester, Ilse; Kollen, Boudewijn J.; Steffens, Martijn G.; Bosch, J. L. H. Ruud; Drake, Marcus J.; Weiss, Jeffrey P.; Blanker, Marco H.

Objective To systematically review and evaluate the impact of the International Continence Society (ICS)-2002 report on standardisation of terminology in nocturia, on publications reporting on nocturia and nocturnal polyuria (NP). In 2002, the ICS defined NP as a Nocturnal Polyuria Index (nocturnal

EVOLUTION OF THE NOCTURNAL INVERSION LAYER AT AN URBAN AND NONURBAN LOCATION

Science.gov (United States)

The evolutionary cycle of the nocturnal radiation inversion layer from formation until dissipation under fair weather conditions was investigated by time-series analyses of observations of inversion base and top heights, and inversion strength at an urban and a nonurban site in S...

Intervening to decrease the probability of alcohol-impaired driving: Impact of novel field sobriety tests.

Science.gov (United States)

Smith, Ryan C; Robinson, Zechariah; Bazdar, Alexandra; Geller, E Scott

2016-01-01

The efficacy of novel field sobriety tests to predict breath alcohol content (BAC) and perceptions of driving risk was evaluated. Participants (N = 210) were passersby at two downtown locations near local bars and one on-campus location near a late-night dining facility between the hours of 10:00 p.m. and 2:00 a.m. Participants gave ratings of their perceived risk to drive at their current level of intoxication, then completed three sobriety tests (a hand-pat, tracing test, and Romberg test), and finally provided new ratings of their perceived risk to drive. After completing the final set of questions, participants were administered a Lifeloc FC20 breath alcohol test (±.005 g/dL). Each of the sobriety tests performed better than chance at predicting participant intoxication, but the performance feedback did not enhance awareness of one's risk to drive at a given BAC. Actually, after the sobriety tests, Greek-life females perceived themselves to be less at-risk to drive.

Vertical Distribution of Daily Migrating Mesopelagic Fish in Respect to Nocturnal Lights

KAUST Repository

Prihartato, Perdana

2014-12-01

The nighttime distribution of vertically migrating mesopelagic fish in relation to nocturnal light was studied during a circumglobal survey, in the Red Sea, and in a fjord at high latitude. The study was based on data derived from ship borne echo sounders (circumglobal and the Red Sea) as well as using upward looking echo sounders mounted on the bottom (Masfjorden, Norway). We also applied a numerical model for analyzing diel vertical migration patterns. The effect of the lunar cycle was the focus in studies at low latitudes, while seasonal changes in nocturnal light climate was in focus at high latitude. Lunar phase significantly affected the distribution of mesopelagic fish at the global scale and in the Red Sea. During nights near full moon, scattering layers of mesopelagic fish distributed deeper than during darker phases of the moon. At high latitude, mesopelagic fish switched its behavior along with seasonal changes in nocturnal lights. In autumn, the population of the studied fish (Maurolicus mueleri) formed separated layers. Juveniles performed normal diel vertical migration followed by midnight sinking, with midnight sinking mainly related to temperature minima and also for avoiding predators. Meanwhile the adults did not migrate vertically, reducing foraging but increasing the adult survival. From late winter to mid-Spring, interrupted ascents behavior was noted in the afternoon. Predator avoidance, satiation, and finding temperature optimum might be the reason behind interrupted ascents. At lighter nights in mid-summer, M. muelleri took on schooling behavior, likely as an anti-predator behavior permitting access to the upper waters in the absence of darkness.

Low levels of nitryl chloride at ground level: nocturnal nitrogen oxides in the Lower Fraser Valley of British Columbia

Science.gov (United States)

Osthoff, Hans D.; Odame-Ankrah, Charles A.; Taha, Youssef M.; Tokarek, Travis W.; Schiller, Corinne L.; Haga, Donna; Jones, Keith; Vingarzan, Roxanne

2018-05-01

The nocturnal nitrogen oxides, which include the nitrate radical (NO3), dinitrogen pentoxide (N2O5), and its uptake product on chloride containing aerosol, nitryl chloride (ClNO2), can have profound impacts on the lifetime of NOx ( = NO + NO2), radical budgets, and next-day photochemical ozone (O3) production, yet their abundances and chemistry are only sparsely constrained by ambient air measurements. Here, we present a measurement data set collected at a routine monitoring site near the Abbotsford International Airport (YXX) located approximately 30 km from the Pacific Ocean in the Lower Fraser Valley (LFV) on the west coast of British Columbia. Measurements were made from 20 July to 4 August 2012 and included mixing ratios of ClNO2, N2O5, NO, NO2, total odd nitrogen (NOy), O3, photolysis frequencies, and size distribution and composition of non-refractory submicron aerosol (PM1). At night, O3 was rapidly and often completely removed by dry deposition and by titration with NO of anthropogenic origin and unsaturated biogenic hydrocarbons in a shallow nocturnal inversion surface layer. The low nocturnal O3 mixing ratios and presence of strong chemical sinks for NO3 limited the extent of nocturnal nitrogen oxide chemistry at ground level. Consequently, mixing ratios of N2O5 and ClNO2 were low ( formation of ClNO2 in the nocturnal residual layer aloft than at the surface and the breakup of the nocturnal boundary layer structure in the morning. When quantifiable, production of ClNO2 from N2O5 was efficient and likely occurred predominantly on unquantified supermicron-sized or refractory sea-salt-derived aerosol. After sunrise, production of Cl radicals from photolysis of ClNO2 was negligible compared to production of OH from the reaction of O(1D) + H2O except for a short period after sunrise.

Posterior urethral valve in a six year old boy with nocturnal ...

African Journals Online (AJOL)

We report a case of posterior urethral valve (PUV) in a six year old boy with nocturnal eneuresis and failure to thrive as the only presenting symptoms. The clinically occult lesion was only unravelled when micturating cystourethrogram revealed a dilated posterior urethra with a distal narrow stream of opacified urine, bilateral ...

A randomized controlled trial of brief motivational interviewing in impaired driving recidivists: a 5-year follow-up of traffic offenses and crashes.

Science.gov (United States)

Ouimet, Marie Claude; Dongier, Maurice; Di Leo, Ivana; Legault, Lucie; Tremblay, Jacques; Chanut, Florence; Brown, Thomas G

2013-11-01

In a previously published randomized controlled trial (Brown et al. Alcohol Clin Exp Res 2010; 34, 292-301), our research team showed that a 30-minute brief motivational interviewing (BMI) session was more effective in reducing percentages of risky drinking days in drunk driving recidivists than a control information-advice intervention at 12-month follow-up. In this sequel to the initial study, 2 main hypotheses were tested: (i) exposure to BMI increases the time to further arrests and crashes compared with exposure to the control intervention (CTL) and (ii) characteristics, such as age, moderate the benefit of BMI. A sample of 180 community-recruited recidivists who had drinking problems participated in the study. Participants gave access to their provincial driving records at baseline and were followed up for a mean of 1,684.5 days (SD = 155.7) after randomization to a 30-minute BMI or CTL session. Measured outcomes were driving arrests followed by convictions including driving while impaired (DWI), speeding, or other moving violations as well as crashes. Age, readiness to change alcohol consumption, alcohol misuse severity, and number of previous DWI convictions were included as potential moderators of the effect of the interventions. For arrests, Cox proportional hazards modeling revealed no significant differences between the BMI and the CTL group. When analyses were adjusted to age tertile categories, a significant effect of BMI in the youngest age tertile (<43 years old) emerged. For crashes, no between-group differences were detected. BMI was better at delaying DWI and other dangerous traffic violations in at-risk younger drivers compared with a CTL similar to that provided in many remedial programs. BMI may be useful as an opportunistic intervention for DWI recidivism prevention in settings such as DWI courts. Treatment effectiveness studies are needed to ascertain how the present findings generalize to the real-world conditions of mandated

The Effects of Dextromethorphan on Driving Performance and the Standardized Field Sobriety Test.

Science.gov (United States)

Perry, Paul J; Fredriksen, Kristian; Chew, Stephanie; Ip, Eric J; Lopes, Ingrid; Doroudgar, Shadi; Thomas, Kelan

2015-09-01

Dextromethorphan (DXM) is abused most commonly among adolescents as a recreational drug to generate a dissociative experience. The objective of the study was to assess driving with and without DXM ingestion. The effects of one-time maximum daily doses of DXM 120 mg versus a guaifenesin 400 mg dose were compared among 40 healthy subjects using a crossover design. Subjects' ability to drive was assessed by their performance in a driving simulator (STISIM® Drive driving simulator software) and by conducting a standardized field sobriety test (SFST) administered 1-h postdrug administration. The one-time dose of DXM 120 mg did not demonstrate driving impairment on the STISIM® Drive driving simulator or increase SFST failures compared to guaifenesin 400 mg. Doses greater than the currently recommended maximum daily dose of 120 mg are necessary to perturb driving behavior. © 2015 American Academy of Forensic Sciences.

Eight-Year Experience with Nocturnal, Every-Other-Day, Online Haemodiafiltration.

Science.gov (United States)

Maduell, Francisco; Ojeda, Raquel; Arias-Guillen, Marta; Rossi, Florencia; Fontseré, Néstor; Vera, Manel; Rico, Nayra; Gonzalez, Leonardo Nicolás; Piñeiro, Gastón; Jiménez-Hernández, Mario; Rodas, Lida; Bedini, José Luis

2016-01-01

New haemodialysis therapeutic regimens are required to improve patient survival. Longer and more frequent dialysis sessions have produced excellent survival and clinical advantages, while online haemodiafiltration (OL-HDF) provides the most efficient form of dialysis treatment. In this single-centre observational study, 57 patients on 4-5-hour thrice-weekly OL-HDF were switched to nocturnal every-other-day OL-HDF. Inclusion criteria consisted of stable patients with good prospects for improved occupational, psychological and social rehabilitation. The aim of this study was to report our 8-year experience with this schedule and to evaluate analytical and clinical outcomes. Nocturnal, every-other-day OL-HDF was well tolerated and 56% of patients were working. The convective volume increased from 26.7 ± 2 litres at baseline to 46.6 ± 6.5 litres at 24 months (p every-other-day OL-HDF could be an excellent therapeutic alternative since it is well tolerated and leads to clinical and social-occupational rehabilitation with satisfactory morbidity and mortality. These encouraging results strengthen us to continue and invite other clinicians to join this initiative. © 2016 S. Karger AG, Basel.

Long-term treatment of nocturnal enuresis with desmopressin. A follow-up study

DEFF Research Database (Denmark)

Knudsen, U B; Rittig, Søren; Nørgaard, J P

1991-01-01

Eight patients with monosymptomatic nocturnal enuresis (age 11-24 years) were investigated prior to and after 24 weeks of desmopressin treatment in order to evaluate the impact on the endogenous vasopressin secretion and urinary output. No effect on plasma vasopressin, diurnal urinary volume, and...

Systematic review of proposed definitions of nocturnal polyuria and population-based evidence of their diagnostic accuracy.

Science.gov (United States)

Olesen, Tine Kold; Denys, Marie-Astrid; Vande Walle, Johan; Everaert, Karel

2018-02-06

Background Evidence of diagnostic accuracy for proposed definitions of nocturnal polyuria is currently unclear. Purpose Systematic review to determine population-based evidence of the diagnostic accuracy of proposed definitions of nocturnal polyuria based on data from frequency-volume charts. Methods Seventeen pre-specified search terms identified 351 unique investigations published from 1990 to 2016 in BIOSIS, Embase, Embase Alerts, International Pharmaceutical Abstract, Medline, and Cochrane. Thirteen original communications were included in this review based on pre-specified exclusion criteria. Data were extracted from each paper regarding subject age, sex, ethnicity, health status, sample size, data collection methods, and diagnostic discrimination of proposed definitions including sensitivity, specificity, positive and negative predictive value. Results The sample size of study cohorts, participant age, sex, ethnicity, and health status varied considerably in 13 studies reporting on the diagnostic performance of seven different definitions of nocturnal polyuria using frequency-volume chart data from 4968 participants. Most study cohorts were small, mono-ethnic, including only Caucasian males aged 50 or higher with primary or secondary polyuria that were compared to a control group of healthy men without nocturia in prospective or retrospective settings. Proposed definitions had poor discriminatory accuracy in evaluations based on data from subjects independent from the original study cohorts with findings being similar regarding the most widely evaluated definition endorsed by ICS. Conclusions Diagnostic performance characteristics for proposed definitions of nocturnal polyuria show poor to modest discrimination and are not based on sufficient level of evidence from representative, multi-ethnic population-based data from both females and males of all adult ages.

ASPIRE In-Home: rationale, design, and methods of a study to evaluate the safety and efficacy of automatic insulin suspension for nocturnal hypoglycemia.

Science.gov (United States)

Klonoff, David C; Bergenstal, Richard M; Garg, Satish K; Bode, Bruce W; Meredith, Melissa; Slover, Robert H; Ahmann, Andrew; Welsh, John B; Lee, Scott W

2013-07-01

Nocturnal hypoglycemia is a barrier to therapy intensification efforts in diabetes. The Paradigm® Veo™ system may mitigate nocturnal hypoglycemia by automatically suspending insulin when a prespecified sensor glucose threshold is reached. ASPIRE (Automation to Simulate Pancreatic Insulin REsponse) In-Home (NCT01497938) was a multicenter, randomized, parallel, adaptive study of subjects with type 1 diabetes. The control arm used sensor-augmented pump therapy. The treatment arm used sensor-augmented pump therapy with threshold suspend, which automatically suspends the insulin pump in response to a sensor glucose value at or below a prespecified threshold. To be randomized, subjects had to have demonstrated ≥2 episodes of nocturnal hypoglycemia, defined as >20 consecutive minutes of sensor glucose values ≤65 mg/dl starting between 10:00 PM and 8:00 AM in the 2-week run-in phase. The 3-month study phase evaluated safety by comparing changes in glycated hemoglobin (A1C) values and evaluated efficacy by comparing the mean area under the glucose concentration time curves for nocturnal hypoglycemia events in the two groups. Other outcomes included the rate of nocturnal hypoglycemia events and the distribution of sensor glucose values. Data from the ASPIRE In-Home study should provide evidence on the safety of the threshold suspend feature with respect to A1C and its efficacy with respect to severity and duration of nocturnal hypoglycemia when used at home over a 3-month period. © 2013 Diabetes Technology Society.

Neuroethology of ultrasonic hearing in nocturnal butterflies (Hedyloidea)

DEFF Research Database (Denmark)

Yack, Jayne E.; Kalko, Elisabeth K.V.; Surlykke, Annemarie

2007-01-01

Nocturnal Hedyloidea butterflies possess ultrasound-sensitive ears that mediate evasive flight maneuvers. Tympanal ear morphology, auditory physiology and behavioural responses to ultrasound are described for Macrosoma heliconiaria, and evidence for hearing is described for eight other hedylid...... species. The ear is formed by modifications of the cubital and subcostal veins at the forewing base, where the thin (1-3 m), ovoid (520 £ 220 )mpanal membrane occurs in a cavity. The ear is innervated by nerve IIN1c, with three chordotonal organs attaching to separate regions of the tympanal membrane...

The effect of sleep on nocturnal urine output

DEFF Research Database (Denmark)

Kamperis, Konstantinos; Hagstrøm, Søren; Rittig, Søren

2005-01-01

sleep and the sequence was randomized. During these nights with sleep deprivation, participants were in lying position in a dimly lit room and physical activities, food and fluid intake were not allowed. Smoking was not allowed throughout the entire experimental protocol. Determinations of electrolytes...... sleep related physiological mechanisms into consideration. In the present study we report that acute sleep deprivation has a dramatic effect on the volume of nocturnal urine production in both genders although the effect is more pronounced in males. Natriuresis and kaliuresis were observed on nights...

The Nocturnal Avian Migration Experiment Final Campaign Report

Energy Technology Data Exchange (ETDEWEB)

Stepanian, P. M. [Univ. of Oklahoma, Norman, OK (United States); Horton, K. G. [Univ. of Oklahoma, Norman, OK (United States)

2016-03-01

Remote sensing techniques are playing a greater role in ornithology, and radar has proven a valuable tool for high resolution, long-term observations of airborne animals. The major disadvantage in radar remote sensing is the current inability to gain taxonomic information from these measurements. One solution is the incorporation of collocated acoustic monitoring that can provide recordings of species-specific nocturnal flight calls of migrating birds in flight. In addition, by taking multichannel recordings of these calls, the position of the calling bird can be calculated and linked to collocated radar measurements.

Nocturnal uptake and assimilation of nitrogen dioxide by C3 and CAM plants.

Science.gov (United States)

Takahashi, Misa; Konaka, Daisuke; Sakamoto, Atsushi; Morikawa, Hiromichi

2005-01-01

In order to investigate nocturnal uptake and assimilation of NO2 by C3 and crassulacean acid metabolism (CAM) plants, they were fumigated with 4 microl l(-1) 15N-labeled nitrogen dioxide (NO2) for 8 h. The amount of NO2 and assimilation of NO2 by plants were determined by mass spectrometry and Kjeldahl-nitrogen based mass spectrometry, respectively. C3 plants such as kenaf (Hibiscus cannabinus), tobacco (Nicotiana tabacum) and ground cherry (Physalis alkekengi) showed a high uptake and assimilation during daytime as high as 1100 to 2700 ng N mg(-1) dry weight. While tobacco and ground cherry strongly reduced uptake and assimilation of NO2 during nighttime, kenaf kept high nocturnal uptake and assimilation of NO2 as high as about 1500 ng N mg(-1) dry weight. Stomatal conductance measurements indicated that there were no significant differences to account for the differences in the uptake of NO2 by tobacco and kenaf during nighttime. CAM plants such as Sedum sp., Kalanchoe blossfeldiana (kalanchoe) and Aloe arborescens exhibited nocturnal uptake and assimilation of NO2. However, the values of uptake and assimilation of NO2 both during daytime and nighttime was very low (at most about 500 ng N mg(-1) dry weight) as compared with those of above mentioned C3 plants. The present findings indicate that kenaf is an efficient phytoremediator of NO2 both during daytime and nighttime.

The impact of antipsychotics on psychomotor performance with regards to car driving skills.

Science.gov (United States)

Brunnauer, Alexander; Laux, Gerd; Geiger, Elisabeth; Möller, Hans-Jürgen

2004-04-01

Cognitive and psychomotor impairments are a core feature of most patients with schizophrenia and may have an important influence on driving ability. The present study investigated the effects of neuroleptic monotherapy on psychomotor functions related to car driving skills in schizophrenic patients. Consecutively admitted schizophrenic inpatients (n = 120) were tested under steady state plasma level conditions before discharge to outpatient treatment. Patients met the International Classification of Diseases, Tenth Revision criteria for schizophrenia. The study followed a naturalistic nonrandomized design. Data were collected with the computerized Act & React Testsystem and were analyzed according to medication, severity of illness, and age. Only 32.5% of the schizophrenic inpatients passed the tests without major impairments. Patients treated with atypical neuroleptics or clozapine showed a better test performance on skills related to driving ability when compared with patients on typical neuroleptics. Differences were most pronounced in measures of divided attention, stress tolerance, and attention. Data also suggest that treatment with clozapine had an overall positive impact on measures of reactivity and stress tolerance. These results show that even under steady state pharmacologic conditions psychomotor functions of most schizophrenic patients partly remitted must be considered as impaired. To evaluate these effects, a systematic neuropsychologic examination is recommended.

Blood alcohol analysis alone versus comprehensive toxicological analysis - Systematic investigation of missed co-ingested other drugs in suspected alcohol-impaired drivers.

Science.gov (United States)

Steuer, Andrea E; Eisenbeiss, Lisa; Kraemer, Thomas

2016-10-01

Driving under the influence of alcohol and/or drugs (DUID) is a safety issue of increasing public concern. When a police officer has reasonable grounds to classify a driver as impaired, he may arrange for a blood sample to be taken. In many countries, alcohol analysis only is ordered if impairment is suspected to be exclusively due to alcohol while comprehensive toxicological screening will be performed if additional suspicion for other illegal drugs of abuse (DoA) or medicinal drugs is on hand. The aim of the present study was firstly to evaluate whether signs of impairment can be differentiated to be caused by alcohol alone or a combination of alcohol and other driving-impairing drugs and secondly to which extent additional drugs are missed in suspected alcohol-impaired drivers. A total of 293 DUID cases (negative n=41; alcohol positive only, n=131; alcohol+active drug positive, n=121) analyzed in 2015 in the Canton of Zurich were evaluated for their documented impairment symptoms by translating these into a severity score and comparing them applying principle component analysis (PCA). Additional 500 cases suspected for alcohol-impaired driving only were reanalyzed using comprehensive LC-MS/MS screening methods covering about 1500 compounds. Drugs detected were classified for severity of driving impairment using the classification system established in the DRUID study of the European Commission. As partly expected from the pharmacological and toxicological point of view, PCA analysis revealed no differences between signs of impairment caused by alcohol alone and those caused by alcohol plus at least one active drug. Breaking it down to different blood alcohol concentration ranges, only between 0.3 and 0.5g/kg trends could be observed in terms of more severe impairment for combined alcohol and drug intake. In the 500 blood samples retrospectively analyzed in this study, a total of 330 additional drugs could be detected; in some cases up to 9 co-ingested ones. In

Nocturnal levels of chemerin and progranulin in adolescents: influence of sex, body mass index, glucose metabolism and sleep.

Science.gov (United States)

Daxer, Johann; Herttrich, Theresa; Zhao, Ying Y; Vogel, Mandy; Hiemisch, Andreas; Scheuermann, Kathrin; Körner, Antje; Kratzsch, Jürgen; Kiess, Wieland; Quante, Mirja

2017-01-01

Adipokines have been implicated in obesity, insulin resistance and sleep regulation. However, the role of chemerin and progranulin, two recently described adipokines, in the context of sleep remains unclear. The aim of this study was to compare nocturnal serum chemerin and progranulin levels between overweight/obese and normal-weight adolescents and to assess variations by sex, across different sleep stages and in relation to glucose metabolism. The study sample included 34 overweight/obese and 32 normal-weight adolescents from secondary schools and the Leipzig Research Center for Civilization Diseases (LIFE) Child study cohort. We obtained longitudinal serum adipokine levels during in-laboratory polysomnography followed by an oral glucose tolerance test. Overweight/obese adolescents had significantly higher mean nocturnal serum chemerin area under the curve (AUC) levels (348.2±133.3 vs. 241.7±67.7 vs. ng/mL×h, pprogranulin AUC was found between the groups. However, when assessing sex-specific levels, serum progranulin AUC levels were ~30% higher in overweight/obese males compared to overweight/obese females. Of note, nocturnal serum chemerin and progranulin AUC did not exhibit a correlation with markers of glucose metabolism or sleep stages. Collectively, we report a sexual dimorphism in nocturnal progranulin and chemerin levels, which may help explain underlying differences in energy balance and body composition between males and females in the context of obesity.

The influence of drinking, texting, and eating on simulated driving performance.

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Irwin, Christopher; Monement, Sophie; Desbrow, Ben

2015-01-01

Driving is a complex task and distractions such as using a mobile phone for the purpose of text messaging are known to have a significant impact on driving. Eating and drinking are common forms of distraction that have received less attention in relation to their impact on driving. The aim of this study was to further explore and compare the effects of a variety of distraction tasks (i.e., text messaging, eating, drinking) on simulated driving. Twenty-eight healthy individuals (13 female) participated in a crossover design study involving 3 experimental trials (separated by ≥24 h). In each trial, participants completed a baseline driving task (no distraction) before completing a second driving task involving one of 3 different distraction tasks (drinking 400 mL water, drinking 400 mL water and eating a 6-inch Subway sandwich, drinking 400 mL water and composing 3 text messages). Primary outcome measures of driving consisted of standard deviation of lateral position (SDLP) and reaction time to auditory and visual critical events. Subjective ratings of difficulty in performing the driving tasks were also collected at the end of the study to determine perceptions of distraction difficulty on driving. Driving tasks involving texting and eating were associated with significant impairment in driving performance measures for SDLP compared to baseline driving (46.0 ± 0.08 vs. 41.3 ± 0.06 cm and 44.8 ± 0.10 vs. 41.6 ± 0.07 cm, respectively), number of lane departures compared to baseline driving (10.9 ± 7.8 vs. 7.6 ± 7.1 and 9.4 ± 7.5 vs. 7.1 ± 7.0, respectively), and auditory reaction time compared to baseline driving (922 ± 95 vs. 889 ± 104 ms and 933 ± 101 vs. 901 ± 103 ms, respectively). No difference in SDLP (42.7 ± 0.08 vs. 42.5 ± 0.07 cm), number of lane departures (7.6 ± 7.7 vs. 7.0 ± 6.8), or auditory reaction time (891 ± 98 and 885 ± 89 ms) was observed in the drive involving the drink-only condition compared to the corresponding baseline drive

Motivational factors associated with drowsy driving behavior: a qualitative investigation of college students.

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Beck, Kenneth H; Lee, Clark J; Weiner, Talia

2018-02-01

This qualitative investigation sought to identify the motivational factors that contribute to drowsy driving in college students and to discover important messaging strategies that may help prevent or reduce this behavior in this population. Four focus groups of college students. A large university in the Washington, DC, metropolitan area during the Fall 2016 term. Twenty-six undergraduate students between the ages of 18 and 25 years. Notes and transcripts from the focus group sessions were analyzed to identify recurring themes regarding attitudes, motivations, experiences, influences, and potential preventive messaging strategies related to drowsy driving. Although most participants had heard of drowsy driving and were concerned about it, they did not associate it with legal risks and were more concerned about alcohol-impaired and distracted driving as crash risks. Participants viewed drowsy driving as a normal and unavoidable part of their lives over which they had little control. For potential anti-drowsy driving messaging strategies, participants preferred messages delivered via audiovisual or social media that featured graphic and emotional portrayals of crashes and their consequences. Participants also voiced strong support for preventive messaging strategies equating various degrees of sleep deprivation to known impairing levels of alcohol, as well as messages providing cues to action to actual drowsy drivers on roadways. Increased enforcement, education, and public messaging campaigns are needed to increase knowledge and influence attitudes and opinions among young drivers about the dangers and social unacceptability of drowsy driving. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Changes in driving behavior and cognitive performance with different breath alcohol concentration levels.

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Liu, Yung-Ching; Fu, Shing-Mei

2007-06-01

This study examines the changes in driving behavior and cognitive performance of drivers with different breath alcohol concentration (BrAC) levels. Eight licensed drivers, aged between 20 and 30 years, with BrAC levels of 0.00, 0.25, 0.4 and 0.5 mg/l performed simulated driving tests under high- and low-load conditions. Subjects were asked to assess their subjective psychological load at specified intervals and perform various tasks. The outcome was measured in terms of reaction times for task completion, accuracy rates, and driver's driving behavior. The effects of BrAC vary depending on the task. Performance of tasks involving attention shift, information processing, and short-term memory showed significant deterioration with increasing BrAC, while dangerous external vehicle driving behavior occurred only when the BrAC reached 0.4 mg/l and the deterioration was marked. We can conclude that the cognitive faculty is the first to be impaired by drinking resulting in deteriorated performance in tasks related to divided attention, short-term memory, logical reasoning, followed by visual perception. On the other hand, increasing alcohol dose may not pose an immediate impact on the external vehicle driving behavior but may negatively affect the driver's motor behavior even at low BrAC levels. Experience and will power could compensate for the negative influence of alcohol enabling the drivers to remain in full steering control. This lag between alcohol consumption and impaired driving performance may mislead the drivers in thinking that they are still capable of safe steering and cause them to ignore the potential dangers of drunk driving.

Visual and cognitive predictors of driving safety in Parkinson's disease patients.

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Amick, M M; Grace, J; Ott, B R

2007-11-01

This study assessed the clinical utility of contrast sensitivity (CS) relative to attention, executive function, and visuospatial abilities for predicting driving safety in participants with Parkinson's disease (PD). Twenty-five, non-demented PD patients completed measures of contrast sensitivity, visuospatial skills, executive functions, and attention. All PD participants also underwent a formal on-road driving evaluation. Of the 25 participants, 11 received a marginal or unsafe rating on the road test. Poorer driving performance was associated with worse performance on measures of CS, visuospatial constructions, set shifting, and attention. While impaired driving was associated with a range of cognitive and visual abilities, only a composite measure of executive functioning and visuospatial abilities, and not CS or attentional skills, predicted driving performance. These findings suggest that neuropsychological tests, which are multifactorial in nature and require visual perception and visual spatial judgments are the most useful screening measures for hazardous driving in PD patients.

Circadian phase and period responses to light stimuli in two nocturnal rodents

NARCIS (Netherlands)

Sharma, Vijay Kumar; Daan, Serge

2002-01-01

We report period response curves (tauRC) for two nocturnal Murid species from India, Mus booduga and Mus platythrix. We further discuss the method of phase shift estimation in the presence of tau-changes, because such changes pose a serious methodological problem in the estimation of phase shifts.

Allergy medication in Japanese volunteers: treatment effect of single doses on nocturnal sleep architecture and next day residual effects.

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Boyle, Julia; Eriksson, Malin; Stanley, Neil; Fujita, Tomoe; Kumagi, Yuji

2006-07-01

To evaluate the acute effects of two histamine H(1)-receptor antagonists on nocturnal sleep architecture and on next day cognitive function and psychomotor performance. This was a single-site, randomized, double-blind, 3-way crossover study, comparing the effects of a single dose of chlorpheniramine (6 mg), fexofenadine (120 mg) and placebo in 18 healthy (male and female) Japanese volunteers aged 20-55 years. Volunteers were resident for 3 days and each period was separated by a minimum 5-day washout period. The three treatments were administered at 23.00 h. Overnight sleep was measured from 23.00 h to 07.00 h using polysomnography. Residual effects were studied at 07.00 h and 9.00 h the next morning, with the latency to sleep (sleep latency test) measured at 09.30 h. Compared with placebo, chlorpheniramine increased the latencies to sleep onset and rapid eye movement (REM) sleep (p < or = 0.05 for both), and reduced the duration of REM sleep (p impaired divided attention (p < 0.001), vigilance (p < 0.05), working memory (p < 0.0001) and sensori-motor performance (p < 0.01), and the latency to daytime sleep was reduced (p < 0.0001). Six adverse events possibly related to study medication were reported during the study, three of which were related to placebo, two to fexofenadine and one to chlorpheniramine. These findings suggest that a single nocturnal dose of fexofenadine has advantages over the first-generation antihistamine chlorpheniramine, being free of disruption of night-time sleep and detrimental effects on cognitive performance the next day. It is likely that this advantage will remain with chronic ingestion, but this would need to be confirmed.

Intervention improves physician counseling on teen driving safety.

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Campbell, Brendan T; Borrup, Kevin; Saleheen, Hassan; Banco, Leonard; Lapidus, Garry

2009-07-01

As part of a statewide campaign, we surveyed physician attitudes and practice regarding teen driving safety before and after a brief intervention designed to facilitate in office counseling. A 31-item self-administered survey was mailed to Connecticut physicians, and this was followed by a mailing of teen driving safety materials to physician practices in the state. A postintervention survey was mailed 8 months after the presurvey. A total of 102 physicians completed both the pre and postsurveys. Thirty-nine percent (39%) reported having had a teen in their practice die in a motor vehicle crash in the presurvey, compared with 49% in the postsurvey. Physician counseling increased significantly for a number of issues: driving while impaired from 86% to 94%; restrictions on teen driving from 53% to 64%; teen driving laws from 53% to 63%; safe vehicle from 32% to 42%; parents model safe driving from 29% to 44%; and teen-parent written contract from 15% to 37%. At baseline, the majority of physicians who provide care to teenagers in Connecticut report discussing and counseling teens on first wave teen driver safety issues (seat belts, alcohol use), but most do not discuss graduate driver licensing laws or related issues. After a brief intervention, there was a significant increase in physician counseling of teens on teen driving laws and on the use of teen-parent contracts. Additional interventions targeting physician practices can improve physician counseling to teens and their parents on issues of teen driving safety.

Nocturnal Activity of a Captive Aye-aye (Daubentonia madagascariensis)

OpenAIRE

IWANO, Taizo

1991-01-01

This report aims to clarify the nocturnal activity of the aye-aye (Daubentonia madagascariensis) under captive conditions to compare it with that under natural conditions. The aye-aye was nocuturnal and showed activity at any time at night. However, from 02:00 hrs until just prior to dawn, it often rested. It frequently returned to the nest throughout this period to take long rests of more than half an hour. The aye-aye's activities were classified into four categories: feeding, moving, resti...

Treatment of chronic pain associated with nocturnal bruxism with botulinum toxin. A prospective and randomized clinical study

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Al-Wayli, Hessa

2017-01-01

Background To evaluate the role of botulinum toxin type A (BTX-A) in the treatment of pain associated with nocturnal bruxism. Material and Methods Fifty subjects reporting nocturnal bruxism were recruited for a randomized clinical trial. Twenty five bruxers were injected with botulinum toxin in both masseters, and twenty five were treated with traditional methods of treating bruxism. Patients were evaluated at 3rd week, 2nd and 6th month and one year after injection and then used to calculate bruxism events. Bruxism symptoms were investigated using questionnaires. Results Mean pain score due to Bruxism events in the masseter muscle decreased significantly in the botulinum toxin injection group A (P =0.000, highly significant). However, in the conventional treatment group, mean pain score does not show improvement with time (p>0.05). Conclusions Our results suggest that botulinum toxin injection reduced the mean pain score and number of bruxism events, most likely by decreasing the muscle activity of masseter rather than affecting the central nervous system. Key words:Temporomandibular pain, nocturnal bruxism, botulinum toxin. PMID:28149474

End-Tidal CO2 Tension Is Predictive of Effective Nocturnal Oxygen Therapy in Patients with Chronic Heart Failure and Central Sleep Apnea.

Science.gov (United States)

Sugimura, Koichiro; Shinozaki, Tsuyoshi; Fukui, Shigefumi; Ogawa, Hiromasa; Shimokawa, Hiroaki

2016-05-01

Central sleep apnea (CSA) is characterized by recurring cycles of crescendo-decrescendo ventilation during sleep, and enhances sympathetic nerve activity. Thus CSA has a prognostic impact in patients with chronic heart failure (CHF). Although nocturnal oxygen (O2) therapy decreases frequency of CSA and improves functional exercise capacity, it is also known that some non-responders to the therapy exist. We thus aimed to identify predictors of responders to nocturnal O2 therapy in CHF patients with CSA. In 12 CHF patients with CSA hospitalized at our department, sleep study was performed at 2 consecutive nights. Patients nasally inhaled O2 at either the first or second night in a randomized manner. To predict the percentage reduction in apnea-hypopnea index (%ΔAHI) in response to the nocturnal O2 therapy, we performed multiple regression analysis with a stepwise method with variables including age, brain-natriuretic peptide, circulation time, baseline AHI, hypercapnic ventilatory response and end-tidal carbon dioxide tension (PETCO2). Nocturnal O2 therapy significantly decreased AHI (from 32 ± 13 /h to 12 ± 10 /h, P 50% reduction of AHI), with 88.9% of sensitivity and 66.7% of specificity. In conclusion, PETCO2 is useful to predict the efficacy of O2 therapy in CHF patients with CSA, providing important information to the current nocturnal O2 therapy.