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J Carrier

Publications and source records attributed to J Carrier.

At least 19 recordsLinked to original sources

Circadian and homeostatic sleep regulation in morningness-eveningness.

Morningness-eveningness has been associated with the entrained circadian phase. However, we recently identified morning and evening types having similar circadian phases. In this paper, we compared parameters of slow-wave activity (SWA) decay in non-rapid-eye-movement (NREM) sleep between these two subgroups to test the hypothesis that differences in the dynamics of nocturnal homeostatic sleep pressure could explain differences in sleep timing preference. Twelve morning-type subjects and 12 evening-type subjects with evening types (aged 19-34 years) selected using the Morningness-Eveningness Questionnaire were further classified according to the phase of their dim light melatonin onset (DLMO). The six morning types with the earliest DLMO were compared to the six evening types with the latest DLMO ('extreme' phases), and the six morning types with the latest DLMO were compared to the six evening types with the earliest DLMO ('intermediate' phases). Subjects slept according to their preferred sleep schedule. Spectral activity in four midline derivations (Fz, Cz, Pz, Oz) was calculated in NREM sleep and an exponential decay function was applied on SWA data averaged per sleep cycle. In the subjects with intermediate circadian phases, both initial level and decay rate of SWA in Fz were significantly higher in morning than in evening types. No difference appeared between chronotypes of extreme circadian phases. There was no correlation between individual estimates of SWA decay and DLMO. These results support the hypothesis that chronotype can originate from differences in the dissipation of sleep pressure and that homeostatic and circadian processes influence the sleep schedule preference independently.

Adult↗

Optimization of rib surgery parameters for the correction of scoliotic deformities using approximation models.

BACKGROUND: As opposed to thoracoplasty (a cosmetic surgical intervention used to reduce the rib hump associated with scoliosis), experimental scoliosis has been produced or reversed on animals by rib shortening or lengthening. In a prior work (J. Orthop. Res., 20, pp. 1121-1128), a finite element modeling (FEM) of rib surgeries was developed to study the biomechanics of their correction mechanisms. Our aims in the present study were to investigate the influence of the rib surgery parameters and to identify optimal configurations. Hence, a specific objective of this study was to develop a method to find surgical parameters maximizing the correction by addressing the issue of high computational cost associated with FEM. METHOD OF APPROACH: Different configurations of rib shortening or lengthening were simulated using a FEM of the complete torso adapted to the geometry of six patients. Each configuration was assessed using objective functions that represent different correction objectives. Their value was evaluated using the rib surgery simulation for sample locations in the design space specified by an experimental design. Dual kriging (interpolation technique) was used to fit the data from the computer experiment. The resulting approximation model was used to locate parameters minimizing the objective function. RESULTS: The overall coverage of the design space and the use of an approximation model ensured that the optimization algorithm had not found a local minimum but a global optimal correction. The interventions generally produced slight immediate modifications with final geometry presenting between 95-120% of the initial deformation in about 50% of the tested cases. But in optimal cases, important loads (500-2000 N mm) were generated on vertebral endplates in the apical region, which could potentially produce the long-term correction of vertebral wedging by modulating growth. Optimal parameters varied among patients and for different correction objectives. CONCLUSIONS: Approximation models make it possible to study and find optimal rib surgery parameters while reducing computational cost.

Adolescent↗

Association between waking EEG slowing and REM sleep behavior disorder in PD without dementia.

OBJECTIVE: To compare nondemented patients with Parkinson's disease (PD) with and without REM sleep behavior disorder (RBD) to healthy controls on quantitative EEG characteristics for both wakefulness and REM sleep. METHODS: Fifteen patients with PD (7 patients with polysomnographic-confirmed RBD [PD-RBD] and 8 patients without RBD [PD-NRBD]) and 15 healthy control subjects were studied. Each subject underwent a quantitative EEG analysis of both wakefulness and REM sleep. RESULTS: During wakefulness, patients with PD-RBD showed a higher theta power in frontal, parietal, temporal, and occipital regions in comparison to patients with PD-NRBD and control subjects. Moreover, a slowing of the dominant occipital frequency was observed only in patients with PD-RBD (p < 0.02). Patients with PD-NRBD did not present any slowing of the EEG. No between-group difference in quantitative REM sleep EEG was observed. CONCLUSIONS: This study demonstrates that the EEG slowing reported during wakefulness in nondemented patients with PD is strongly related to the presence of RBD.

Aged↗

Biomechanical modelling of growth modulation following rib shortening or lengthening in adolescent idiopathic scoliosis.

A biomechanical model was developed to evaluate the long-term correction resulting from rib shortening or lengthening in adolescent idiopathic scoliosis (AIS). A finite element model of the trunk, personalised to the geometry of a scoliotic patient, was used to simulate rib surgery. Stress relaxation of ligaments following surgery was integrated into the model, as well as longitudinal growth of vertebral bodies and ribs and its modulation due to mechanical stresses. Simulations were performed in an iterative fashion over 24 months. A concave side rib shortening, inducing load patterns on the vertebral end-plates that could act against the scoliosis progression, was tested. A fractional factorial experimental design of 16 runs documented the effects of six modelling parameters. Wedging of the apical vertebra in the frontal plane decreased from 5.2 degrees initially to a mean value of 3.8 degrees after 24 months. The wedging decrease in the thoracic apical region was reflected by changes in the spine curvature, with a Cobb angle decrease from 46 degrees to 44 degrees immediately after the surgery and to a mean of 41 degrees after 24 months. However, both rib hump and vertebral axial rotation increased, on average, by 4 degrees at the curve apex. The most significant parameters were the growth sensitivity to stress in ribs and vertebrae and the rate of stress relaxation of intercostal ligaments. The results confirmed the potential of long-term correction of spinal curvature resulting from the rib shortening on the concavity. This modelling approach could be used for further design of less invasive surgery, taking into account residual growth, for scoliosis correction.

Adolescent↗

Evaluation and use of three cowside tests for detection of subclinical ketosis in early postpartum cows.

The objective was to evaluate the performance of 3 cowside diagnostic tests for detection of subclinical ketosis, defined as a serum beta-hydroxybutyrate (BHBA) concentration >or=1400 micromol/L. On 16 d over a 5-mo period, samples of serum, milk, and urine were collected on a large dairy facility from cows of all parities between 2 and 15 DIM. The sample proportion of subclinical ketosis was 7.6% (n = 859 samples from 545 cows). The KetoCheck powder (Great States Animal Health, St. Joseph, MO) detecting acetoacetate in milk samples was very specific (99%) but poorly sensitive (41%). Respective sensitivities and specificities of the Ketostix strip detecting acetoacetate in urine samples (Bayer Corporation, Elkhart, IN) were 78 and 96% with a cut-off point of "small", or 49 and 99% with a cut-off of "moderate." The KetoTest strip (Sanwa Kagaku Kenkyusho Co. Ltd., Nagoya, Japan) using milk samples had a sensitivity and specificity of 73 and 96% with a cut-off of 100 micromol of BHBA/L or 27 and 99% with a cut-off of 200 micromol of BHBA/L. On average, use of the Ketostix at the "small" cut-off point or the KetoTest at 100 micromol/L would result in no more than 3 or 4 false positives per 100 cows screened, with prevalence levels ranging from 5 to 30%, whereas the number of false negatives would range from one false negative at 5% prevalence to 7 or 8 false negatives at 30% prevalence. Either the Ketostix or KetoTest strips would provide acceptable results for screening individual cows on commercial dairies to detect subclinical ketosis. Over this prevalence range, the KetoCheck powder test would have limited application as a screening test. Despite only one false positive per 100 animals screened, false negatives resulting from screening with the KetoCheck test would be too frequent, ranging from 3 false negatives at 5% prevalence to 18 at 30% prevalence in a population of 100 tested cows. Finally, given their relative imprecision, use of any of these individual cowside tests to estimate herd prevalence must be done cautiously, especially when only a small number of animals are sampled.

3-Hydroxybutyric Acid↗

Age and gender effects on heart rate activation associated with periodic leg movements in patients with restless legs syndrome.

OBJECTIVE: Periodic leg movements during sleep (PLMS) are often associated with electroencephalographic (EEG) changes, such as microarousals (MA), and with heart rate (HR) variations. The aim of the present study was to evaluate the effects of age and gender on HR changes associated with PLMS in restless legs syndrome (RLS) patients. METHODS: Forty-two RLS patients underwent one night of polysomnographic recordings. They were divided into 3 groups of 14 subjects (7 women and 7 men) according to age, i.e. young (25-40 years), middle-aged (41-55 years) and elderly (56-71 years) patients. The RR interval was calculated for 5 intervals before and 15 intervals after the onset of 50 PLMS in each patient. RESULTS: PLMS were associated with HR changes characterized by a tachycardia followed by a bradycardia. However, a reduction in the tachycardia and the bradycardia was observed with age. Moreover, women showed a higher amplitude in the bradycardia than men. No age or gender difference was found for MA index and duration. CONCLUSIONS: This study showed age and gender differences in the magnitude of the HR changes associated with PLMS. The knowledge of HR variations during sleep, including rapid HR changes associated with sleep events such as PLMS or MA, may be helpful in understanding the potential mechanisms involved in the increased cardiac risk observed in elderly.

Adult↗

REM sleep behavior disorder and REM sleep without atonia in Parkinson's disease.

OBJECTIVE: To determine the frequency of REM sleep behavior disorder (RBD) among patients with PD using both history and polysomnography (PSG) recordings and to further study REM sleep muscle atonia in PD. BACKGROUND: The reported occurrence of RBD in PD varies from 15 to 47%. However, no study has estimated the frequency of RBD using PSG recordings or analyzed in detail the characteristics of REM sleep muscle atonia in a large group of unselected patients with PD. METHODS: Consecutive patients with PD (n = 33) and healthy control subjects (n = 16) were studied. Each subject underwent a structured clinical interview and PSG recording. REM sleep was scored using a method that allows the scoring of REM sleep without atonia. RESULTS: One third of patients with PD met the diagnostic criteria of RBD based on PSG recordings. Only one half of these cases would have been detected by history. Nineteen (58%) of 33 patients with PD but only 1 of 16 control subjects had REM sleep without atonia. Of these 19 patients with PD, 8 (42%) did not present with behavioral manifestations of RBD, and their cases may represent preclinical forms of RBD associated with PD. Moreover, the percentage of time spent with muscle atonia during REM sleep was lower among patients with PD than among healthy control subjects (60.1% vs 93.2%; p = 0.003). CONCLUSIONS: RBD and REM sleep without atonia are frequent in PD as shown by PSG recordings.

Aged↗

Age difference in heart rate changes associated with micro-arousals in humans.

OBJECTIVES: Heart rate (HR) is known to change in association to micro-arousals (MA) during sleep. The aim of the present study was to evaluate the effect of age on HR variations associated with MA. METHODS: Thirty-two healthy subjects underwent one night of polysomnographic recording. They were divided into two groups of 16 subjects according to age i.e. young (20-35 years) and middle-aged (50-65 years). The R-R intervals were calculated for 11 heart beats (10 intervals) before and 15 heart beats after the onset of MA. RESULTS: HR changes associated with MA were characterized by a tachycardia followed by a bradycardia in both young- and middle-aged subjects. However, middle-aged subjects showed a significant reduction in the amplitude of both tachycardia and bradycardia as compared to young subjects. CONCLUSIONS: This study revealed an age-related reduction in the amplitude of the HR changes associated with MA. These results may reflect a decline in parasympathetic functions and a higher risk of cardiovascular diseases with advancing age.

Adult↗

Effects of afternoon "siesta" naps on sleep, alertness, performance, and circadian rhythms in the elderly.

STUDY OBJECTIVES: To determine the effects of a 90-minute afternoon nap regimen on nocturnal sleep, circadian rhythms, and evening alertness and performance levels in the healthy elderly. DESIGN AND SETTING: Nine healthy elderly subjects (4m, 5f, age range 74y-87y) each experienced both nap and no-nap conditions in two studies each lasting 17 days (14 at home, 3 in the laboratory). In the nap condition a 90-minute nap was enforced between 13:30 and 15:00 every day, in the no-nap condition daytime napping was prohibited, and activity encouraged in the 13:30-15:00 interval. The order of the two conditions was counterbalanced. PARTICIPANTS: N/A. INTERVENTIONS: N/A. MEASUREMENTS: Diary measures, pencil and paper alertness tests, and wrist actigraphy were used at home. In the 72 hour laboratory studies, these measures were augmented by polysomnographic sleep recording, continuous rectal temperature measurement, a daily evening single trial of a Multiple Sleep Latency Test (MSLT), and computerized tests of mood, activation and performance efficiency. RESULTS: By the second week in the "at home" study, an average of 58 minutes of sleep was reported per siesta nap; in the laboratory, polysomnography confirmed an average of 57 minutes of sleep per nap. When nap and no-nap conditions were compared, mixed effects on nocturnal sleep were observed. Diary measures indicated no significant difference in nocturnal sleep duration, but a significant increase (of 38 mins.) in 24-hour Total Sleep Time (TST) when nocturnal sleeps and naps were added together (p<0.025). The laboratory study revealed a decrease of 2.4% in nocturnal sleep efficiency in the nap condition (p<0.025), a reduction of nocturnal Total Sleep Time (TST) by 48 mins. in the nap condition (p<0.001) which resulted primarily from significantly earlier waketimes (p<0.005), but no reliable effects on Wake After Sleep Onset (WASO), delta sleep measures, or percent stages 1 & 2. Unlike the diary study, the laboratory study yielded no overall increase in 24-hour TST consequent upon the siesta nap regimen. The only measure of evening alertness or performance to show an improvement was sleep latency in a single-trial evening MSLT (nap: 15.6 mins., no nap: 11.5 mins., p<0.005). No significant change in circadian rhythm parameters was observed. CONCLUSIONS: Healthy seniors were able to adopt a napping regimen involving a 90-minute siesta nap each day between 13:30 and 15:00, achieving about one hour of actual sleep per nap. There were some negative consequences for nocturnal sleep in terms of reduced sleep efficiency and earlier waketimes, but also some positive consequences for objective evening performance and (in the diary study) 24-hour sleep totals. Subjective alertness measures and performance measures showed no reliable effects and circadian phase parameters appeared unchanged.

Aged↗

Molecular genetics of ulcerative colitis-associated colon cancer in the interleukin 2- and beta(2)-microglobulin-deficient mouse.

Mice deficient in beta(2)-microglobulin and interleukin 2 (beta(2)m(null) x IL-2(null)) spontaneously develop colon cancer in the setting of chronic ulcerative colitis (UC). We investigated mutations of the Apc and p53 genes and microsatellite instability in colonic adenocarcinomas arising in this model. Mutations of the Apc and p53 genes in the regions corresponding to mutation hot spots in human colorectal cancer were determined by sequencing in 11 colonic adenocarcinomas. Microsatellite instability was determined in matched normal and neoplastic DNA at five loci. All 11 adenocarcinomas harbored Apc mutations. Of these 11 tumors, 5 harbored truncating mutations. A total of 67 Apc mutations were found in these 11 tumors; 59 were missense mutations, whereas 8 were frameshift or nonsense mutations. Six of the 11 adenocarcinomas harbored p53 mutations. A total of seven p53 mutations were found in these 11 tumors; all mutations were transitions, 4 of which were C:G-->T:A transitions occurring in codon 229 at cytosine-guanine dinucleotides. Nine adenocarcinomas exhibited microsatellite instability in at least one of the five loci examined; 1 tumor had microsatellite instability in two loci. Molecular genetics, as well as clinical features, of colon cancer in the beta(2)m(null) x IL-2(null) mice are similar to those of human UC-associated colorectal cancer. As such, this model appears to be an excellent animal model to study UC-associated colorectal carcinogenesis.

Adenocarcinoma↗

Effect of iron supplementation on oxidative stress and intestinal inflammation in rats with acute colitis.

In this study, we investigated the effect of intraperitoneal iron dextran (100 mg/100 g body weight) on oxidative stress and intestinal inflammation in rats with acute colitis induced by 5% dextran sulfate sodium. In both colitis and healthy animals, disease activity index, crypt and inflammatory scores, colon length, plasma and colonic lipid peroxides, and plasma vitamins E, C, and retinol were assessed. The results showed that iron-supplemented groups had moderate iron deposition in the colonic submucosa and lamina propria. In the colitis group supplemented with iron, colon length was significantly shorter; disease activity index, crypt, and inflammatory scores and colonic lipid peroxides were significantly higher; and plasma alpha-tocopherol was significantly lower compared to the colitis group without iron supplementation. There was no intestinal inflammation and no significant increase in colonic lipid peroxides in healthy rats supplemented with iron. In conclusion, iron injection resulted in an increased oxidative stress and intestinal inflammation in rats with colitis but not in healthy rats.

Acute Disease↗

Effect of oral iron supplementation on oxidative stress and colonic inflammation in rats with induced colitis.

BACKGROUND: Iron supplementation may increase disease activity in ulcerative colitis, possibly through the production of reactive oxygen species from the Fenton reaction. AIM: To assess the effects of two doses of oral iron on intestinal inflammation and oxidative stress in experimental colitis. METHODS: Colitis was induced in rats by giving 5% dextran sulphate sodium in drinking water for 7 days. First, using a 2 x 2 factorial design, rats with or without dextran sulphate sodium received the regular diet or a diet containing iron 3%/kg diet. Second, rats with dextran sulphate sodium-induced colitis were supplemented with iron 0.3%/kg diet and compared with rats on dextran sulphate sodium and regular diet. The body weight change, histological scores, colon length, rectal bleeding, plasma and colonic lipid peroxides, colonic glutathione peroxidase and plasma vitamin E and C were measured. Faecal analysis for haem and total, free and ethylenediaminetetra-acetic acid-chelatable iron was also performed. RESULTS: Iron 3% and iron 0.3% increased the activity of dextran sulphate sodium-induced colitis, as demonstrated by higher histological scores, heavier rectal bleeding and further shortening of the colon. This was associated with increased lipid peroxidation and decreased antioxidant vitamins. Faecal iron available to the Fenton reaction was increased in a dose-dependent manner. CONCLUSIONS: Iron supplementation taken orally enhanced the activity of dextran sulphate sodium-induced colitis and is associated with an increase in oxidative stress.

Administration, Oral↗

Age-related modifications of NREM sleep EEG: from childhood to middle age.

This study investigated the modifications in non-rapid eye movement (NREM) sleep electroencephalogram (EEG) power in 54 subjects, from children to middle-aged adults. Spectral analyses were performed on 5 h of NREM sleep. A marked decrease of absolute slow-wave activity (SWA) was observed with increasing age; children had significantly more SWA than adolescents, young and middle-aged adults. The decline of SWA across the night seems to level off with increasing age, suggesting an age-related attenuation of homeostatic sleep pressure. Absolute theta power was higher for children compared with the other three groups, and adolescents had more theta power than young and middle-aged adults. In comparison to young and middle-aged adults, alpha power was higher for children and adolescents. Children and adolescents had more sigma power than middle-aged adults. Absolute beta power was higher for children than for the other age groups. Therefore, the major alterations of NREM sleep EEG occurring between childhood and middle age are not restricted to SWA, but encompassed the theta, alpha, sigma and beta frequency bands.

Adolescent↗

Mapping as a method for analysing policy response in the management of health services.

Health services are susceptible to changes in health need, resource allocation, public-health debates and health policies. Service mapping is considered a useful tool for analysing complex issues, monitoring changes over time and facilitating change. It also enables one to describe pathways of care and the relationships between services. This article centres on two projects--a London-wide project 'Service networks for HIV Care' and a local survey 'Mapping of HIV-related services for illicit drug users'--and demonstrates the usefulness of mapping for both studies. Mapping of service networks allowed exploration of a variety of connections between treatment centres, and led to recommendations for a model of HIV service networks across London. The mapping of HIV-related services for illicit drug users confirmed that the service provision was balanced in time, space and target groups, but also identified gaps showing that services were not very successful in attracting women and members of ethnic minority groups. It is clear from both studies that mapping provides an overview of existing services, describing details of services, their target groups or links. It can assist to monitor changes over time, to reconfigure services according to need, and to target resources where need becomes apparent. Mapping exercises also can be useful in identifying new areas for collaboration and interagency work.

Community Health Planning↗

The effects of age and gender on sleep EEG power spectral density in the middle years of life (ages 20-60 years old).

The effects of age and gender on sleep EEG power spectral density were assessed in a group of 100 subjects aged 20 to 60 years. We propose a new statistical strategy (mixed-model using fixed-knot regression splines) to analyze quantitative EEG measures. The effect of gender varied according to frequency, but no interactions emerged between age and gender, suggesting that the aging process does not differentially influence men and women. Women had higher power density than men in delta, theta, low alpha, and high spindle frequency range. The effect of age varied according to frequency and across the night. The decrease in power with age was not restricted to slow-wave activity, but also included theta and sigma activity. With increasing age, the attenuation over the night in power density between 1.25 and 8.00 Hz diminished, and the rise in power between 12.25 and 14.00 Hz across the night decreased. Increasing age was associated with higher power in the beta range. These results suggest that increasing age may be related to an attenuation of homeostatic sleep pressure and to an increase in cortical activation during sleep.

Adult↗

Inducing jet-lag in older people: directional asymmetry.

Twenty healthy elderly subjects (12 female, 8 male; mean age 81 years, range 67-87 years) each experienced a 15-day time isolation protocol in which they lived individually in a special laboratory apartment in which sleep and circadian rhythm measures could be taken. There were two experiments: one (6 females, 4 males) involved a 6-h phase advance of the sleep/wake cycle, and the other (6 females, 4 males) a 6-h phase delay. Each started with 5 baseline days, immediately followed by the phase shift. The subject was then held to the phase shifted routine for the remainder of the study. Rectal temperatures were recorded minute-by-minute throughout the entire experiment and each night of sleep was recorded using polysomnography. A directional asymmetry in phase-shift effects was apparent, with significantly more sleep disruption and circadian rhythm amplitude disruption after the phase advance than after the phase delay. Sleep disruption was reflected in reduced time spent asleep, and in changed REM latency, which increased in the phase advance direction but decreased in the phase delay direction. Although the phase advance led to a significant increase in wakefulness in the first half of the night, the phase delay did not lead to an equivalent increase in wakefulness during the second half of the night. Examination of both raw and 'demasked' circadian rectal temperature rhythms confirmed that phase adjustment was slow in both directions, but was less slow (and more monotonic) after the phase delay than after the phase advance. Subjective alertness suffered more disruption after the phase advance than after the phase delay.

Aged↗

Sleep and circadian phase characteristics of adolescent and young adult males in a naturalistic summertime condition.

Our aim was to compare the circadian phase characteristics of healthy adolescent and young adult males in a naturalistic summertime condition. A total of 19 adolescents (mean age 15.7 years) and 18 young adults (mean age 24.5 years) with no sleep problems took part in this study. Two-night polysomnographic (PSG) sleep recordings and 24h secretion patterns of urinary 6-sulfatoxymelatonin were monitored in all 37 subjects. Sleep-wake patterns were initially assessed at home using a standard sleep diary. Circadian assessment included the measure of dim light melatonin offset (DLMOff) and the morningness-eveningness (M/E) questionnaire. As expected, compared to young adults, adolescents habitually spent more nocturnal time in bed and spent more time (and percentage) in delta sleep. No difference was found between adolescents and young adults on multiple sleep latency test (MSLT) sleep onset latencies, M/E, melatonin secretion measures (24h total, nighttime, daytime, and night ratio), and DLMOff. For the subjects as a whole, correlational analyses revealed a significant association between the DLMOff and M/E and between both these phase markers and habitual bedtimes, habitual rising times, and melatonin secretion measures (daytime levels and the night ratio). No association was found between phase markers and daytime sleepiness or sleep consolidation parameters such as sleep efficiency or number of microarousals. These results together indicate that adolescents and young adults investigated during summertime showed similar circadian phase characteristics, and that, in these age groups, an evening phase preference is associated with a delayed melatonin secretion pattern and delayed habitual sleep patterns without a decrease in sleep consolidation or vigilance.

Adolescent↗