Disorders of Arousal in adults: new diagnostic tools for clinical practice

Abstract Disorders of Arousal (DOA) are mental and motor behaviors arising from NREM sleep. They comprise a spectrum of manifestations of increasing intensity from confusional arousals to sleep terrors to sleepwalking. Although DOA in childhood are usually harmless, in adulthood they are often associated with injurious or violent behaviors to the patient or others. Driving motor vehicles, suspected suicide, and even homicide or attempted homicide have been described during sleepwalking in adults. Furthermore, adult DOA need to be differentiated from other sleep disorders such as Sleep-related Hypermotor Epilepsy or REM Sleep Behavior Disorder. Although many aspects of DOA have been clarified in the last two decades there is still a lack of objective and quantitative diagnostic criteria for DOA. Recent advances in EEG analysis and in the semiological characterization of DOA motor patterns have provided a better definition of DOA diagnosis. Our article focuses on the DOA diagnostic process describing accurately the newest DOA clinical, EEG and video-polysomnographic tools in order to aid clinicians in DOA assessment

Exercise effects on muscle quality in older adults: A systematic review and meta-analysis

To systematically review and analyse the effects of exercise on morphological and neuromuscular muscle quality (MQ) outcomes in older adults and assess a range of possible moderators that may affect the impact of exercise on MQ outcomes. Using PRISMA guidelines, randomised controlled trials were searched in CINAHL, EMBASE, LILACS, PubMed, SciELO, Web of Science, MedNar, OpenGrey and OpenThesis databases. Eligible trials examined the effects of exercise interventions on morphological and neuromuscular MQ in older adults ( ≥ 60 years). Twenty-one trials (n = 973 participants) were included. Exercise significantly improved morphological MQ (effect size (ES) = 0.32, 95% CI 0.13–0.51, P \u3c 0.001) with significant results maintained for studies assessing muscle density and intermuscular adipose tissue (ES = 0.45–0.52, P \u3c 0.05). For neuromuscular MQ, exercise provided significant positive effects (ES = 0.49, 95% CI 0.29–0.69, P \u3c 0.001) but only maintained for physically healthy participants (ES = 0.43, P \u3c 0.001), resistance exercise interventions (ES = 0.64, P \u3c 0.001), or studies assessing 1-RM or knee extensor isokinetic muscle strength relative to leg lean mass (ES = 0.48–0.62, P = 0.001). Associations between exercise duration and changes in MQ measures were not observed (P \u3e 0.05). Supervised exercise interventions significantly improved different measures of MQ regardless of exercise duration, although these effects were small-to-moderate and not supported across all population-, exercise-, and methods-related features

Assessing the influence of around-source deep crustal heterogeneities on the seismic wave propagation by 3-D broad-band numerical modelling

Tectonic and seismic activities induce crustal rock fracturing in the immediate surroundings of buried fault discontinuities. The heterogeneous nature of this 3-D scatter distribution leaves a high-frequency footprint on the recorded wave-field at surface. This study represents an attempt to clarify the complex relationship between the propagated wave-field and the statistical properties of the regional medium. This objective is pursued by inspecting the broadband (0-25Hz) synthetic wave-forms obtained by sourceto-site 3-D numerical simulations in regional-size scenarios. The presented numerical study compares the major differences obtained when including heterogeneous properties in the model. Coda-waves are analysed and the high-frequency attenuation is assessed by computing the k coefficient for different source-station configurations.This work was performed using HPC resources from the Mésocentre computing center of CentraleSupélec and École Normale Supérieure Paris-Saclay (http://mesocentre.centralesupelec.fr/)

Does high-velocity resistance exercise elicit greater physical function benefits than traditional resistance exercise in older adults? A systematic review and network meta-analysis of 79 trials

Background A systematic review and network meta-analysis was undertaken to examine the effectiveness of different modes of resistance exercise velocity in fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests in older adults. Methods CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus, and Web of Science databases were searched up to February 2022. Eligible randomized trials examined the effects of supervised high-velocity or traditional resistance exercise in older adults (ie, ≥ 60 years). The primary outcome for this review was physical function measured by fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests, while maximal muscle power and muscle strength were secondary. A random-effects network meta-analysis was undertaken to examine the effects of different resistance exercise interventions. Results Eighty articles describing 79 trials (n = 3 575) were included. High-velocity resistance exercise was the most effective for improving fast walking speed (standardized mean difference [SMD] −0.44, 95% confidence interval [CI]: 0.00 to 0.87), timed-up and go (SMD −0.76, 95% CI: −1.05 to −0.47), and 5-times sit-to-stand (SMD −0.74, 95% CI: −1.20 to −0.27), while traditional resistance exercise was the most effective for 30-second sit-to-stand (SMD 1.01, 95% CI: 0.68 to 1.34) and 6-minute walking (SMD 0.68, 95% CI: 0.34 to 1.03). Conclusion Our study provides evidence that resistance exercise velocity effects are specific in older adults, as evidenced by physical function test dependence. We suggest that prescriptions based on the velocity of contraction should be individualized to address the specific functional needs of participants

J Clin Med

The Barcelona Sleepiness Index (BSI) is an ultra-short instrument with several advantages for assessing excessive daytime sleepiness (EDS). The present study was performed to analyze the validity of the French version of the BSI in screening for EDS. We conducted a cross-sectional study on a population of students using an online questionnaire. The French version of the BSI was developed by a rigorous forward-backward translation process. We computed the discrimination properties of the BSI to predict EDS assessed by the Epworth Sleepiness Scale (ESS), as well as correlations with other sleep measures. In total, 662 students were enrolled in the study (mean age: 20.9 years, 76.0% women). The BSI score (mean = 1.5 ± 1.0) showed a strong correlation with the ESS score (r = 0.47, p < 10−4) and acceptable discrimination of EDS assessed by ESS score ≥ 11 (AUC = 0.742) with an optimal cutoff point of 2, as in the original study. The BSI score was significantly associated with sleep deprivation and social jetlag. Therefore, the French version of the BSI is a valid ultra-short instrument for EDS screening in individuals. In addition, the BSI score may be associated with both homeostatic and circadian processes. Further studies are needed to confirm these findings in general populations and in patients with sleep disorders

CARACTERIZAÇÃO FÍSICA E QUÍMICA DO SOLO SOB DIFERENTES USOS EM BACIA HIDROGRÁFICA

The soil has become an essential resource for the survival of human beings, but with the increasing levels of contamination generated by human actions, this resource is getting all this pollution load resulting in changes in their properties. Based on that, this study aimed to characterize the physical and chemical properties of soil under different uses in the Watershed of the Vacacaí-Mirim river. The clay content ranged from 8 to 51% with a mean of 28,84 ± 12,18%, the concentration of potassium ranged from 0,8 to 208 mg kg-1, with a mean of 54,56 ± 47,16 mg kg-1. The values of organic matter ranged from 0,6 to 2,9%, with a mean of 1,50 ± 0,63%, the concentration of phosphorus ranged from 0,7 to 6 mg kg-1 with a mean of 2,36 ± 1,52 mg kg-1, the pH values ranged from 4,2 to 5,8 with a mean of 4,76 ± 0,39. Among the analyzed parameters, we highlight the high levels of clay and organic matter in soils that are where the use is native forest and native field, being possible to say that the preservation of the soil contributes to the maintenance of these parameters. Among the chemical attributes, the highest concentrations are related to soils that have undergone human action, such as the ones grown with rice and soybean and the places used as pasture.O solo se tornou um recurso essencial à sobrevivência do ser humano, porém com o aumento dos níveis de contaminação gerado pelas ações antrópicas, esse recurso está recebendo toda essa carga poluidora acarretando em mudanças em suas propriedades. Com base nisso, o presente trabalho teve por objetivo caracterizar os atributos físicos e químicos de solo sob diferentes usos em uma bacia hidrográfica. Os teores de argila variaram de 8 a 51%, com média de 28,84 ± 12,18%, a concentração de Potássio variou de 0,8 a 208 mg kg-1, com média de 54,56 ± 47,16 mg kg-1. Os valores de Matéria Orgânica variaram de 0,6 a 2,9%, com média de 1,50 ± 0,63%, a concentração de Fósforo variou de 0,7 a 6 mg kg-1 com média de 2,36 ± 1,52 mg kg-1, já os valores de pH variaram de 4,2 a 5,8com média de 4,76 ± 0,39. Dentre os parâmetros analisados, destaca-se em os valores elevados de argila e M.O. os solos que estão sob uso de mata nativa e campo nativo, sendo possível afirmar que a preservação do solo contribui para manutenção destes parâmetros. Dentre os atributos químicos, os maiores valores relacionam-se com solos sob que sofreram ação antrópica, como cultivados com arroz e soja ou sob uso de pastagem

International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders

Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders.Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method.Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders.Conclusion: The administration of prolonged release melatonin at 2–10 mg, 1–2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at &lt;1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders