Sleepiness, sleep, and use of sleepiness countermeasures in shift-working long-haul truck drivers.

Driver sleepiness is a prevalent phenomenon among professional drivers working unconventional and irregular hours. For compromising occupational and traffic safety, sleepiness has become one of the major conundrums of road transportation. To further elucidate the phenomenon, an on-road study canvassing the under-explored relationship between working hours and sleepiness, sleep, and use of sleepiness countermeasures during and outside statutory rest breaks was conducted. Testing the association between the outcomes and working hours, generalized estimating equations models were fitted on a data collected from 54 long-haul truck drivers (mean 38.1 ± 10.5 years, one female) volunteering in the 2-week study. Unobtrusive data-collection methods applied under naturalistic working and shift conditions included the Karolinska Sleepiness Scale (KSS) measuring sleepiness, a combination of actigraphy and sleep-log measuring sleep, and self-report questionnaire items incorporated into the sleep-log measuring the use of sleepiness countermeasures during and outside statutory rest breaks. Drivers' working hours were categorized into first and consecutive night, morning and day/evening shifts based on shift timing. The results reveal severe sleepiness (KSS≥7) was most prevalent on the first night (37.8%) and least on the morning (10.0%) shifts. Drivers slept reasonably well prior to duty hours, with main sleep being longest prior to the first night (total sleep time 7:21) and shortest prior to the morning (total sleep time 5:43) shifts. The proportion of shifts whereby drivers reported using at least one sleepiness countermeasure outside statutory rest breaks was approximately 22% units greater for the night than the non-night shifts. Compared to the day/evening shifts, the odds of severe sleepiness were greater only on the first night shifts (OR 6.4-9.1 with 95% confidence intervals, depending on the statistical model), the odds of insufficient daily sleep were higher especially prior to the consecutive night shifts (OR 3.5 with 95% confidence intervals), and the odds of using efficient sleepiness countermeasures outside statutory rest breaks were greater on the first as well as consecutive night shifts (OR 4.0-4.6 with 95% confidence intervals). No statistically significant association was found between shift type and use of efficient sleepiness countermeasures during statutory rest breaks. In all, the findings demonstrate marked differences in the occurrence of severe sleepiness at the wheel, sleep preceding duty hours, and the use of sleepiness countermeasures between different shift types. In addition, although drivers slept reasonably well in connection with different shift types, the findings imply there is still room for improvement in alertness management among this group of employees.

Aquatic environment and differentiation of vibrissae: comparison of sinus hair systems of ringed seal, otter and pole cat.

This study investigated the structure and innervation of the vibrissal systems of the pole cat (Mustela putorius), European otter (Lutra lutra) and ringed seal (Phoca hispida) in order to find adaptations to aquatic environment. The number of myelinated nerve fibers of deep vibrissal nerve (DVN) of the entire vibrissal system was considerably greater in the ringed seal (10x, aquatic mammal) and in the otter (4x, semi-aquatic mustelid) compared to the pole cat which is a terrestrial mustelid. Similarly, the number of neural end organs in the vibrissae of ringed seals was about ten times more numerous than in pole cats. The number of the vibrissae in the heads of otters was almost two times more than in pole cats, and all vibrissa groups had similar structures and innervation. The asymmetrically developed carpal vibrissae of otters were, however, more poorly innervated than the vibrissae of the head and had only smooth musculature. In the ringed seal the orientation of lanceolate end organs differed in different vibrissae, indicating the specialization of these vibrissae for different kinds of sensory functions. Ringed seal vibrissae contain structures which obviously are developed as adaptations to an aquatic environment. These include the modified mitochondria of Merkel cells, with Merkel cell-neurite complexes very often associated ciliated cells, liquid filled vesicles or intercellular spaces below the basal cell layer of the outer root sheath at the ring sinus level, a long upper cavernous sinus and a flattened beaded structure of the vibrissa hairs. As the vibrissae of aquatic mammals have analogous functions to the lateral line organ of fishes, we suggest using the term 'vibrissal sense' for the vibrissa system of aquatic mammals.

Quantitative EEG in occupational chronic solvent encephalopathy.

The aim of this study was to characterize the quantitative analyzed EEG (electroencephalogram) findings (qEEG) in chronic solvent encephalopathy (CSE) patients and study whether the qEEG findings associate with the duration and intensity of the solvent exposure. Also, the diagnostic value of qEEG in CSE is discussed. The EEG of 47 male CSE patients was analyzed. The laboratory's own reference EEG values of 24 healthy male subjects formed the laboratory control group. We also used an age-matched control group of 100 male blue-collar workers without occupational solvent exposure. The main finding of our study was that the power of the frontal theta band is increased in the CSE patient group compared with the laboratory control group. This suggests that the frontal cortex may be susceptible to the noxious effects of solvents. However, this difference was not seen in comparison with the matched control group, and thus, the connection with solvent effects remains uncertain. The variables indicating the level of solvent exposure did not associate with the power of the theta activity in the frontal area. Because of the small amount and unspecificity of the observed abnormalities, qEEG cannot be recommended to be used in the clinical diagnostics of solvent encephalopathy.

Physiological adaptations of the raccoon dog (Nyctereutes procyonoides) to seasonal fasting-fat and nitrogen metabolism and influence of continuous melatonin treatment.

The raccoon dog (Nyctereutes procyonoides) is a middle-sized canid with profound autumnal fattening followed by winter sleep. This study investigated the effects of prolonged fasting-induced winter sleep on the fat and nitrogen metabolism of the species. Half of the animals were treated with continuous-release melatonin implants to induce artificial short photoperiod. Autumnal accumulation of fat was characterized by low plasma free fatty acid (FFA), diacylglycerol (DG), and triacylglycerol (TG) levels. After transition to winter catabolism, the circulating lipid levels increased due to enhanced lipolysis. Two months of fasting resulted in a steady 3.1 kg weight loss (28% of body mass, 0.47% day(-1)). Storage fat was mobilized during the winter sleep reflected by the elevated FFA and DG concentrations. The lowered insulin levels could be a stimulator for TG hydrolysis. The plasma total amino acid concentrations, urea levels, and urea-creatinine ratios decreased due to fasting, whereas ammonia and total protein concentrations remained stable. The effects of melatonin on energy metabolism were modest. The results indicate that the raccoon dog is well adapted to long-term wintertime fasting utilizing fat as the principal metabolic fuel. The species can maintain its protein catabolism constant for at least 60 days. Decreased cortisol and thyroid hormone concentrations may contribute to protein sparing.

Effects of continuous light and melatonin treatment on energy metabolism of the rat.

Melatonin affects food intake, body mass and adiposity of several mammals, but the effects of melatonin on energy metabolism remain largely unknown. This study investigated subacute effects of persistent melatonin treatment and continuous light on carbohydrate and fat metabolism of rat liver and kidney. The male and female rats (no.=40) were maintained either in 12L:12D photoperiod or in constant light. Half the rats in both lighting conditions were treated with continuous-release melatonin implants. Liver lipid concentrations, liver and kidney glucose-6-phosphatase, glycogen phosphorylase and lipase esterase activities, glycogen contents as well as plasma T4, T3, insulin, glucose and melatonin concentrations were determined. There was clear sexual dimorphism in the responses to exogenous melatonin and constant light. Continuous light stimulated carbohydrate metabolism of rat liver. Exogenous melatonin enhanced utilization of liver carbohydrates but suppressed hepatic lipolysis. Changes in normal circulating melatonin concentrations led to enhanced utilization of kidney carbohydrates supporting a role for melatonin in renal function. Both exogenous melatonin and constant light seem to have a strong regulatory effect on rat energy metabolism.

Effects of low-dose leptin and gender on the physiology of the mouse (Mus musculus).

Exogenous leptin was given intraperitoneally to five male and five female mice at 0.2-0.3 mg/kg/day for 3 days. The plasma glucose and thyroxine concentrations as well as the hepatic and kidney enzyme activities were determined. The hepatic glycogen phosphorylase activity was suppressed by leptin treatment in the male mice. The other parameters were not significantly influenced by exogenous leptin, but there was a trend towards increased gluconeogenesis and glycogen storage due to leptin treatment. Enzyme activities of glucose and fat metabolism as well as the responses to leptin administration were sexually dimorphic. Discriminant analysis separated the control and the leptin-injected males and females to four distinct groups. Leptin seems to have minor but widespread effects on the energy metabolism of a nonmutant rodent. In nature, one function of leptin could be carbohydrate preservation.

Reproduction of the raccoon dog (Nyctereutes procyonoides) after feeding or food deprivation in winter.

The wild raccoon dog (Nyctereutes procyonoides, Canidae, Carnivora) goes through autumn fattening followed by winter sleep. Farmed raccoon dogs also exhibit autumn fattening but not winter sleep, as a result of daily feeding and lack of nests. We studied the effects of food deprivation and winter sleep or active winter feeding on the physiology and reproduction of farm-born raccoon dogs. Eighty-six animals were put on a 2-month fast in November-December. The fast caused no deleterious effects on the health of the raccoon dogs. In the spring the food-deprived animals had slightly more cubs per mated female than the fed animals. There was a significant negative correlation between the number of cubs obtained and the mean body mass of the females at the beginning of the mating season. The highest mean number of cubs was obtained by the females that weighed 5-7 kg. The results indicate that the raccoon dog is finely adapted to a long period of food deprivation in the winter. Furthermore, winter sleep and food deprivation could be introduced to farm conditions by providing the raccoon dogs with nestboxes and withholding food for a period of 6-8 weeks in mid-winter.

Fatty acids, lipids, and cytochrome p-450 monooxygenase in hepatic microsomes of minks fed fish-based diets and exposed to Aroclor 1242.

Minks were fed different fish-based diets and exposed to 1 mg/d of the commercial polychlorinated biphenyl (PCB) mixture Aroclor 1242 for 4 wk (November-December 1995) or 21 wk (July-December 1998). In all the dietary groups, the PCBs increased hepatic phospholipid (PL) content. No significant increase was detected in hepatic triacylglycerols (TGs). In the minks fed the different fish diets, the PCBs caused qualitatively and quantitatively different changes in the microsomal fatty acids. In the minks that were fed a diet rich in fat and low in polyunsaturated fatty acids (PUFAs), the PCBs increased the percentage of oleic acid (18:1n-9, characteristic of the storage TGs) at the expense of n-3 PUFAs. This seemed to be due to inclusions of TGs in the membrane fragments and partly due to incorporation of TG-derived fatty acids into the membrane PLs. In addition, significant decrease of PUFAs was detected also in the hepatic TGs. The concomitant decrease in the concentrations of hepatic vitamin E suggested that lipid oxidation may also contribute to the decrease of the PUFAs. In the liver of the minks fed a low-fat but PUFA- and vitamin E-rich diet, the fatty acid changes due to the PCBs (the 21-wk exposure) remained small but the cytochrome P-450 system was significantly activated. In the minks fed Baltic herring (rich in organochlorines via the foodweb), the cytosolic glutathione S-transferase (GST) activity, levels of microsomal thiobarbituric acid-reactive substances (TBARS), and hepatic PLs were significantly elevated. In conclusion, in the mink the microsomal fatty acid changes were not directly connected with the ethoxyresorufin O-deethylase (EROD) activity or P-450 expression. Apparently, the PCBs produced definite fatty acid changes only in certain lipid matrices of tissue. In addition, a rich dietary supply of PUFAs and vitamin E may prevent these changes, even in a long-term subchronic exposure.

Effects of seasonality and fasting on the body mass and plasma growth hormone concentrations of the raccoon dog (Nyctereutes procyonoides) and the blue fox (Alopex lagopus).

Growth hormone (GH) promotes growth and endochondral ossification, but it is also important in the response to fasting due to its effects of increasing gluconeogenesis and lipolysis. In this study eleven raccoon dogs and blue foxes were followed for six months and their body mass and GH levels were measured. In November half of the animals of both species were put to a three-week fast. There were no significant differences in the GH levels between the animals of different ages and the subadults and adults both had quite low GH levels in the summer. Fasting had no effect on the GH levels of the raccoon dogs, but the fasting blue foxes had lower GH concentrations than the controls in Nov 16th. The control blue foxes experienced a significant increase in the GH levels in early November and the fasting blue foxes in late November. The GH concentrations of all the raccoon dogs rose in early December. As fasting did not cause an elevation in the GH levels but the concentrations increased with decreasing temperature and shortening daylength, the autumnal GH secretion of these species could be regulated by endogenous seasonal rhythms entrained by exogenous Zeitgebers such as temperature or photoperiod. The autumnal increase of GH levels contributes to the response to fasting as an adaptation to survive the winter months with inadequate nutrition. The raccoon dog which spends the coldest part of the winter in winter sleep seems to be better adapted to a total fast than the actively wintering blue fox.

Brief intervention for male heavy drinkers in routine general practice: a three-year randomized controlled study.

The aim of this research was to evaluate the effectiveness of long-term brief intervention in routine general practice. In five primary care out-patient clinics in a Finnish town, 296 male early-phase heavy drinkers consulting a general practitioner (GP) for various reasons were identified. Control group C (n = 88) was informed of the risks of drinking after the screening and were advised at the subsequent feedback about 2 weeks later to reduce their drinking. Groups A (n = 109) and B (n = 99) were offered in addition seven and three brief intervention sessions, respectively. All GPs took part, whether or not they indicated a special interest. The main outcome measures were differences between beginning and end-point at 3 years in self-reported alcohol consumption, mean corpuscular volume (MCV), and serum carbohydrate-deficient transferrin, aspartate aminotransferase, alanine aminotransferase and gamma-glutamyltransferase. There were no statistically significant differences between study groups A, B and C in mean changes in outcome measures. Within all the groups, MCV decreased. Depending on the outcome measure used and the study group analysed, clinically significant reduction of drinking was found in 25-53% of the subjects. In routine general practice, giving additional sessions of brief intervention may not be as effective as in special research conditions. Factors reducing the effectiveness of brief intervention programmes should be investigated, so that primary health care staff can be better supported in their efforts.

Exogenous melatonin affects lipids and enzyme activities in mink (Mustela vison) liver.

Exogenous melatonin as subcutaneous 2.7-mg implants was given to eight female and male minks in late July with an equal number of animals in the control groups. The liver enzyme activities and major lipids of liver and plasma were measured in October-November. Melatonin had very pronounced effects on the lipid and carbohydrate metabolism of the minks and there was also a clear sexual dimorphism. In the males, melatonin decreased the lipase esterase activity of the liver. In the liver of the females, however, melatonin increased the glucose-6-phosphatase activity. Due to melatonin treatment the liver triacylglycerol contents diminished in both sexes. At the same time, in the females the liver cholesterol levels were decreased. In the plasma lipids, the only change was a fall in the polar lipids of the melatonin-treated females. Melatonin seems to be responsible for the metabolic changes associated with the onset of wintering, especially for the acceleration of the deposition of subcutaneous fat reserves. The smaller females experience the effects of exogenous melatonin more rapidly than the males. Perhaps the smaller body size requires an earlier onset of metabolic preparation for the winter.

Effects of seasonality and fasting on the plasma leptin and thyroxin levels of the raccoon dog (Nyctereutes procyonoides) and the blue fox (Alopex lagopus).

Plasma leptin and thyroxin concentrations of eleven raccoon dogs and eleven blue foxes were monitored for 6 months. Half of the animals were placed on a 3-week fast in November. Leptin levels were low in summer, but in October they rose significantly. In November, leptin concentrations decreased rapidly within a week although the body mass of the animals remained stable. There were no significant differences between experimental groups for raccoon dogs, but in blue foxes the fasting group had lower leptin levels than the control group. High thyroxin levels in summer decreased as autumn progressed, but thyroxin concentrations of the fasting groups increased at the end of the fast. Leptin levels of the raccoon dog and the blue fox are not determined only by the fat reserves of the animals, but they seem to reflect the autumnal deposition of fat at the onset of winter. Blue foxes have metabolic rates of active animals during the winter and higher leptin levels in December than raccoon dogs. The superficially hibernating raccoon dogs have low leptin levels after the onset of winter perhaps as an adaptation to fasting. J. Exp. Zool. 289:109-118, 2001.

Preliminary evidence that pharmacologic melatonin treatment decreases rat ghrelin levels.

Ghrelin is a signal peptide isolated from rat stomach antagonistic to actions of leptin. Ghrelin stimulates the secretion of growth hormone (GH) and increases food intake, body mass, and adiposity in rodents. Photoperiod and melatonin regulate leptin secretion of mammals. The aim of the study was to investigate possible melatonin-ghrelin interactions in weight regulation by studying the effects of continuous pharmacologic melatonin treatment and constant light on plasma ghrelin, leptin, and GH levels in rats. Plasma ghrelin concentrations were significantly reduced by exogenous melatonin. Ghrelin levels correlated negatively with plasma leptin levels in control rats kept in 12 h of light/12 h of dark but not in the melatonin-treated animals. The inverse ghrelin-leptin relationship was also disrupted by constant illumination. The circulating ghrelin and GH levels may not be interrelated in all metabolic situations. The results suggest new interplay between the pineal gland and energy metabolism as well as reenforce the hypothesis that ghrelin is antagonistic to leptin.

Exogenous melatonin elevates the plasma leptin and thyroxine concentrations of the mink (Mustela vison).

Eight male and eight female minks were given exogenous melatonin as subcutaneous implants. The plasma leptin and thyroxine concentrations were measured. The leptin concentrations showed clear seasonal variations and differences between the experimental groups. In September most of the control females had undetectable plasma leptin concentrations, but the melatonin-treated females had detectable concentrations significantly higher than the leptin levels of the controls. Most of the males had undetectable leptin concentrations, too. In October the plasma leptin levels had increased significantly in all the groups except the control males. The melatonin-treated minks had significantly higher leptin levels than the controls. There was a significant rise in the thyroxine levels from September to October and the melatonin-treated groups had significantly higher thyroxine levels than the controls. The effects of exogenous melatonin are very pronounced in the mink. Melatonin elevates the plasma leptin and thyroxine levels possibly by direct and indirect mechanisms.

Cure of Helicobacter pylori infection after failed primary treatment: one-center results from 120 patients.

BACKGROUND: Treatment with a proton pump inhibitor (PPI) and antimicrobials cures Helicobacter pylori infection in about 90% of patients. This is a retrospective overview of our studies aiming to cure the infection in all compliant patients with failed initial therapy. METHODS: We retreated 120 (19% of 644) H. pylori-infected patients whose initial therapy had failed. The retreatments included (i) triple therapy (TT): colloidal bismuth subcitrate, metronidazole, amoxicillin (or tetracycline); (ii) quadruple therapy (QT): TT and a PPI; or (iii) high doses of both a PPI and clarithromycin combined with a further 1-3 individually selected antimicrobials. The eradication results were determined after 6-12 months. RESULTS: The 1st retreatment was successful in 70 of 120 patients. The 2nd retreatment cured 25 of the remaining 42 patients, the 3rd 13 of 17, and the 4th the last 4 patients. The cumulative eradication rate (ITT) was 93% (95% CI: 88.9%-97.9%; 8 patients withdrew after a failed 1st retreatment) and the rate was 100% in the remaining 112 patients who accepted several retreatments. The 1st retreatment with TT cured 23% (95% CI: 12%-34%) of 57 patients and QT 85% (95% CI: 74%-96%) of 41 patients who had initially undergone a failed metronidazole-based treatment. All retreatments were well tolerated. CONCLUSIONS: In this study, high doses of a PPI and clarithromycin combined with 1-3 antimicrobials according to susceptibility data proved to be the best drug combination in the cure of H. pylori infection after failed primary treatment. Giving imidazole- and bismuth-based QT (without clarithromycin) as the first-line treatment of H. pylori infection ensures that the number of failures remains low.

Seasonality of leptin levels in the BAT of the common shrew (Sorex araneus).

Leptin concentrations in the interscapular brown adipose tissue (IBAT) of the common shrew (Sorex araneus) were measured in different seasons. The leptin concentrations in IBAT were much higher than in the liver, where leptin is supposed to be of blood origin. In the heart muscle no detectable amount of leptin was found. There were clear seasonal variations in the leptin concentrations in IBAT. Leptin levels in IBAT were the lowest in November at the beginning of the winter. The concentrations increased, however, strongly after the onset of the permanent snow cover, and the highest concentrations were measured in December-January, when the weight of the animals was very low. In April-May, at the time when shrews attain sexual maturity, leptin concentrations in IBAT were lower than in the mid-winter, but significantly higher than in November. In overwintered adults the leptin concentrations were at the same level as in nonwintered subadults. Leptin originating from BAT may inform the central nervous system about the amount of nonshivering thermogenesis as well as the amount of feeding necessary for survival in the winter months.

Plasma leptin and thyroxine of mink (Mustela vison) vary with gender, diet and subchronic exposure to PCBs.

Female minks (Mustela vison) fed diets based on freshwater, marine or mixed fish were exposed to 1 mg of polychlorinated biphenyls (PCBs) a day for 21 weeks. The plasma leptin and thyroxine concentrations and the glucose-6-phosphatase and glycogen phophorylase activities in the liver were measured at the end of the experiment. The plasma thyroxine concentrations were significantly higher in the group exposed to PCBs. The mean plasma leptin concentration and glucose-6-phosphatase activity was the highest in the group that had the lowest body-mass index (BMI). The glycogen phophorylase activity was the highest in the freshwater fish-control group. The results suggest that the amount of fat in the body of the female minks is not the only determinant of the plasma leptin levels, but the leptin levels seem to rise with a lowered BMI unlike in rodents or humans. The positive correlation between the leptin levels and the glucose-6-phosphatase activity suggests increased gluconeogenesis with high leptin levels. Subchronic exposure to PCBs seems to have no effect on the plasma leptin levels or the glucose-6-phophatase activities, but it elevates significantly the plasma thyroxine levels with a mechanism that remains unknown.

Structure and innervation of the vibrissal follicle-sinus complex in the Australian water rat, Hydromys chrysogaster.

Light and electron microscopic techniques were used to examine the structure and innervation of the mystacial vibrissal follicle-sinus complex (F-SC) in the Australian water rat. The F-SCs of this semiaquatic rodent show the same morphologic elements described in terrestrial rats but differ in size, structure, and innervation. Most striking is the size of the water rat's caudal F-SCs, measuring 6.3 mm in length and 2.4 mm in diameter. The sinus system is divisible into a ring sinus and a cavernous sinus and shows a distinct asymmetry. At the highest level of the cavernous sinus, the outer root sheath forms a ridge in the direction of the trabeculae, which bind the ridge to the capsule. A ringwulst is present only in small and medium-sized F-SCs. The mean number of myelinated axons counted in the deep vibrissal nerve (DVN) of most caudal F-SCs was 537, indicating an innervation density of the water rat's vibrissal system at least 2.5 times as high as that of terrestrial rats. The total number of nerve fibers of the small superficial nerves was less than 10% of that of the DVN. These fibers innervate almost exclusively the area of the inner conical body. Structural specializations of the water rat F-SC are discussed as an analogous development in mammals adapted to the aquatic environment, primarily in terms of thermoregulation, whereas its high degree of innervation is assessed to lend support to the hypothesis that the vibrissal system is of special significance in aquatic mammals.

Effects of nickel chloride on reproduction of the rat and possible antagonistic role of selenium.

Nickel (10-100 ppm added as NiCl2) was studied to determine its effects on reproduction of Wistar rats. In nine experimental groups, females, males or both were exposed to nickel in drinking water. In one female group and one male group, the drinking water was also supplemented with 0.3 ppm selenium (added as Na2SeO3). Breeding success and the growth and viability of pups were recorded. Nickel, copper and zinc concentrations in kidneys, liver and skin (with fur) of the females, males and pups were determined with an atomic absorption spectrophotometer. In addition, histology of the male testes (from control and nickel-exposed groups) was studied. The female exposures started 14, 28 or 100 days before copulation and continued during pregnancy and lactation. When the males were exposed (for 28 or 42 days before copulation), NiCl2 reduced both the number of pregnancies and the number of pups born. In the testes, NiCl2 induced shrinkage of the seminiferous tubules, which seemed to close some of the tubules. In the tubules, NiCl2 decreased the number of basal spermatogonia. When the females or both parents were exposed to NiCl2, pup mortality during lactation was high. However, when the females were drinking NiCl2 supplemented with selenium, all the pups survived and development of the total mass of the litters was even better than in the control group. In the same way, in males, selenium supplementation of the drinking water protected those pups that were born; but fertility was lower than with the control treatment. In the tissues studied, nickel accumulated most in the kidneys and then in the liver and skin. In each type of organ, there was a clear dose response relationship. In the pups, in particular, selenium (given to the females) increased the amount of nickel in tissues compared with corresponding administration of nickel without selenium. In summary, selenium seemed to counteract the deleterious effects of NiCl2 on the reproduction of rats.