Neuroethical issues in cognitive enhancement: Modafinil as the example of a workplace drug?

The use of cognitive-enhancing drugs by healthy individuals has been a feature for much of recorded history. Cocaine and amphetamine are modern cases of drugs initially enthusiastically acclaimed for enhancing cognition and mood. Today, an increasing number of healthy people are reported to use cognitive-enhancing drugs, as well as other interventions, such as non-invasive brain stimulation, to maintain or improve work performance. Cognitive-enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects 'cold' cognition, but also improves 'hot' cognition, such as emotion recognition and task-related motivation. The lifestyle use of 'smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups under what conditions and by what methods we would wish to improve and flourish

Neuroethical issues in cognitive enhancement: Modafinil as the example of a workplace drug?

The use of cognitive-enhancing drugs by healthy individuals has been a feature for much of recorded history. Cocaine and amphetamine are modern cases of drugs initially enthusiastically acclaimed for enhancing cognition and mood. Today, an increasing number of healthy people are reported to use cognitive-enhancing drugs, as well as other interventions, such as non-invasive brain stimulation, to maintain or improve work performance. Cognitive-enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects 'cold' cognition, but also improves 'hot' cognition, such as emotion recognition and task-related motivation. The lifestyle use of 'smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups under what conditions and by what methods we would wish to improve and flourish

Isotope measurements of the Arctic water cycle and exchange processes between seawater, sea ice, and snow during MOSAiC

For the past two decades, the Arctic water cycle changed rapidly due to surface air temperatures (SATs) increasing at twice the global rate. Terrestrial ice (i.e. Greenland Ice Sheet) and marine sea-ice loss, alterations of ocean circulation patterns, and shifting atmospheric moisture sources and transport are some of the most pronounced changes caused by the Arctic amplification, fostering increased humidity levels. Stable water isotopes (δ18O, δ2H) and the secondary parameter d-excess are valuable tracers for hydrological changes, including how these shifts may affect the global climate system. However, it is only recently that we are using precipitation and water vapor networks to resolve water isotope patterns and processes in the Arctic. However, a fully coordinated study of the entire water cycle attributes year-long including sea ice, ocean water, vapor, and precipitation has until recently has been absent. The Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC) expedition provided a unique opportunity to collect, analyze, and synthesize discrete samples of the different hydrological compartments in the central Arctic, covering a complete one-year seasonal cycle using a combination of ship-based, the pan-Arctic Water Isotope Network (PAPIN). These observations can lead to new insights into coupled ocean-atmosphere climate processes operating in the Arctic, especially during extreme events, sea ice formation, sea ice retreat, and during a dichotomy of synoptic weather patterns over the MOSAiC-year. We present the isotopic traits of more than 2,200 discrete samples (i.e., seawater, sea ice, snow, brines, frost flowers, lead ice, ridge ice, and precipitation) collected during MOSAiC. Snow has the most depleted δ18O values (-16.3 ± 9.1‰; the number of samples N=306), whereas seawater is the most enriched δ18O compartment (-1.5 ± 0.9‰; N=302) of the Arctic water cycle. Precipitation throughout the Arctic Basin varied from -10‰ to -35‰. Snow profiles are gradually enriched in δ18O from top to bottom by ~20‰ partially due to sublimation of deposited snow, as well as snow metamorphism and its effects on the water isotopes. Second-year ice (SYI) is isotopically relatively depleted in δ18O (-4.2 ± 2.6‰; N=200) compared to first-year ice (FYI) (-0.7 ± 2.1‰; N=635) and insulated FYI (i.e. FYI grown at the bottom of SYI) (-1.7 ± 2.4‰; N=214). The latter is likely caused by post-depositional exchange processes with snow. Open water leads (-1.6 ± 2.4‰; N=137) and melt ponds (-2.1 ± 2.7‰; N=109) on the surface of sea ice contribute to the moistening of the atmosphere in the Arctic on a regional scale. Our dataset provides an unprecedented snapshot of the present-day isotopic composition of the Arctic water cycle during an entire year. The coupling of these discrete samples data with the continuous measurements of atmospheric water vapor may shed light on the relative contribution of snow, sea ice, seawater, open water leads, and melt ponds both spatially and temporally to regional and local moisture levels in the Arctic. Stable water isotopes will ultimately contribute to resolving the linkages between sea ice, ocean, and atmosphere during the critical transition from frozen ocean to open water conditions

Two novel PRNP truncating mutations broaden the spectrum of prion amyloidosis

Truncating mutations in PRNP have been associated with heterogeneous phenotypes ranging from chronic diarrhea and neuropathy to dementia, either rapidly or slowly progressive. We identified novel PRNP stop-codon mutations (p.Y163X, p.Y169X) in two Italian kindreds. Disease typically presented in the third or fourth decade with progressive autonomic failure and diarrhea. Moreover, one proband (p.Y163X) developed late cognitive decline, whereas some of his relatives presented with isolated cognitive and psychiatric symptoms. Our results strengthen the link between PRNP truncating mutations and systemic abnormal PrP deposition and support a wider application of PRNP screening to include unsolved cases of familial autonomic neuropathy

Isotopic traits of the Arctic water cycle

The Arctic hydrological cycle undergoes rapid and pronounced changes, including alterations in oceanic and atmospheric circulations, and precipitation patterns. Stable water isotopes (δ18O, δ2H, d-excess) can be used to trace these processes including their potential to feedback into the global climate system. The MOSAiC expedition provided a unique opportunity to collect, analyze, and synthesize discrete samples of the different hydrological compartments in the central Arctic, comprising sea ice, seawater, snow, and melt ponds. Here, we present spatio-temporal variations in the isotopic signatures of more than 1,000 water samples. We found that (i) average seawater δ18O of -1.7‰ conforms to observed and modelled isotopic traits of the Arctic Ocean; (ii) second year ice is relatively depleted compared to first year ice with average δ18O values of -3.1‰ and -0.7‰, respectively. This might be due to post-depositional exchange processes with snow, which has the most depleted isotopic signature among all compartments (mean δ18O=-15.1‰). Our dataset provides an unprecedented description of the present-day isotopic composition of the Arctic water covering a complete seasonal cycle. This will ultimately contribute to resolve the linkages between sea ice, ocean, and atmosphere during critical transitions from frozen ocean to open water conditions

First isolation of Salmonella enterica serovar Napoli from wild birds in Italy

AbstractSalmonella enterica serovar Napoli (S. Napoli) is an emerging serovar in Italy. It accounts for 2-4% of all serovars isolated from human infections. The zoonotic origin of this serovar is still unknown and this makes difficult to apply any control intervention. We report here the isolation of S. Napoli from a river nightingale (Cettia cetti, Temminck 1820) which represents the first description of this serovar from wild birds. This finding adds knowledge to the ecology of S. Napoli and addresses further studies aimed to assess the epidemiologic link between S. Napoli isolated from wild birds, food, environmental sources and human infections.

Future of Health: Findings from a survey of stakeholders on the future of health and healthcare in England

This article presents findings from a survey conducted by RAND Europe at the request of the National Institute for Health Research (NIHR) to gather and synthesise stakeholder views on the future of health and healthcare in England in 20 to 30 years' time. The aim of the research was to generate an evidenced-based picture of the future health and healthcare needs, and how it might differ from today, in order to inform strategic discussions about the future priorities of the NIHR and the health and social care research communities more broadly. The survey provided a rich and varied dataset based on responses from 300 stakeholders in total. A wide range of fields were represented, including public health, social care, primary care, cancer, genomics, mental health, geriatrics, child health, patient advocacy and health policy. The respondent group also included a number of professional and private stakeholder categories, such as clinicians, policy experts, academics and patient and public representatives. The study findings validate a number of prominent health research priorities currently visible in England, such as antimicrobial resistance, the burden of dementia and age-related multi-morbidity, digital health and genomics. Interest in these areas and other themes, such as mental health, health inequalities and transforming health service models, cut across multiple disciplinary boundaries. However, it is clear that there are a variety of views among stakeholders on the relative importance of these areas of focus, and the best approach to manage their emergence in the coming decades. The full dataset of survey responses, for which permission to share was given, is a useful resource for those seeking to engage with a particular issue in more depth. The dataset can be found on NIHR's website at: http://nihr.ac.uk/news-and-events/documents/quotes.xls

Lifestyle use of drugs by healthy people for enhancing cognition, creativity, motivation and pleasure.

Today, there is continued, and in some cases growing, availability of not only psychoactive substances, including treatments for mental health disorders such as cognitive enhancers, which can enhance or restore brain function, but also 'recreational' drugs such as novel psychoactive substances (NPS). The use of psychoactive drugs has both benefits and risks: whilst new drugs to treat cognitive symptoms in neuropsychiatric or neurodegenerative disorders could have great benefits for many patient groups, the increasing ease of accessibility to recreational NPS and the increasing lifestyle use of cognitive enhancers by healthy people means that the effective management of psychoactive substances will be an issue of increasing importance. Clearly, the potential benefits of cognitive enhancers are large and increasingly relevant, particularly as the population ages, and for this reason, we should continue to devote resources to the development of cognitive enhancers as treatments for neurodegenerative diseases and psychiatric disorders, including Alzheimer's disease, attention deficit hyperactivity disorder and schizophrenia. However, the increasing use of cognitive enhancers by healthy individuals raises safety, ethical and regulatory concerns, which should not be ignored. Similarly, understanding the short- and long-term consequences of the use of NPS, as well as better understanding the motivations and profiles of users could promote more effective prevention and harm reduction measures. Linked Articles This article is part of a themed section on Pharmacology of Cognition: a Panacea for Neuropsychiatric Disease? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.19/issuetoc