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The aim of this study was to examine neurophysiological and behavioral correlates of cognitive control elicited by a modified flanker task while exercising at low and moderate intensities. A secondary aim was to examine cognitive control processes at several time points during an acute bout of exercise to determine whether cognition is selectively influenced by the duration of exercise. Twenty-seven healthy participants completed a modified version of the Eriksen flanker task while exercising on a cycle ergometer at 40% and 60% VO2 peak and during a no-exercise seated control across three separate days. During task performance, continuous EEG was collected to assess neurocognitive function using the N2 and P3 event-related brain potentials (ERPs). Neurocognitive performance was assessed at 5, 15, and 25min time points during steady-state exercise. Regardless of intensity, behavioral findings revealed impaired accuracy during both exercise conditions for the flanker task trials that require greater cognitive control. However, faster reaction times were found during moderate-intensity exercise. Neuroelectric measures revealed increased N2 and P3 amplitudes during both exercise conditions relative to rest. Together, these findings suggest divergent effects of exercise on behavioral performance measures accompanied by an upregulation of cognitive control during aerobic exercise. These impairments are discussed in terms of dual-task paradigms and the transient hypofrontality theory. •We examined neurocognitive performance during steady-state exercise.•Our aim was to study dose–response and time course effects of acute exercise.•Impaired accuracy but faster reaction times occurred during exercise.•Increased N2 and P3 amplitudes were observed during exercise compared with rest.•Results indicate select impairments in cognitive function during acute exercise.

Acute aerobic exercise exerts a small beneficial effect on cognition. Previous research primarily examines cognitive changes following a bout of exercise, while little is currently known about changes in cognitive performance during exercise. The primary purpose of this study was to examine the effects of low-intensity cycling on cognitive function indexed by behavioral (response accuracy; reaction time) and neurocognitive (P3 mean amplitude; P3 centroid latency) responses. Twenty-seven (Mage = 22.9 ± 3.0 years old) individuals were counterbalanced into low-intensity exercise (EX) and seated control (SC) conditions spread across two testing sessions. During each condition, participants completed a 10 min resting baseline period, 20 min of either sustained cycling or seated rest, and a 20 min recovery period. Primary outcomes were assessed at 10 min intervals (five blocks total) throughout each condition via a modified visual oddball task while electroencephalography (EEG) responses were measured. Across time blocks, both conditions exhibited faster reaction times on frequent trials but reduced accuracy to rare trials, suggesting a speed–accuracy tradeoff. There were no differences between conditions in P3 centroid latency, whereas a significant reduction in P3 amplitude was observed during the 20 min exercise period compared to the control condition. Taken together, results suggest that exercise at lower doses may have minimal influence on behavioral outcomes of cognitive performance but may impact more basic measures of brain function. Information gathered from this study may aid in the development of appropriate exercise prescriptions for populations looking to specifically target cognitive function deficits.

The American Academy of Sleep Medicine Sleep and Transportation Safety Awareness Task Force responded to the Federal Motor Carrier Safety Administration and Federal Railroad Administration Advance Notice of Proposed Rulemaking and request for public comments regarding the evaluation of safety-sensitive personnel for moderate-to-severe obstructive sleep apnea (OSA). The following document represents this response. The most salient points provided in our comments are that (1) moderate-to-severe OSA is common among commercial motor vehicle operators (CMVOs) and contributes to an increased risk of crashes; (2) objective screening methods are available and preferred for identifying at-risk drivers, with the most commonly used indicator being body mass index; (3) treatment in the form of continuous positive airway pressure (CPAP) is effective and reduces crashes; (4) CPAP is economically viable; (5) guidelines are available to assist medical examiners in determining whether CMVOs with moderate-to-severe OSA should continue to work without restrictions, with conditional certification, or be disqualified from operating commercial motor vehicles. Citation: Gurubhagavatula I, Sullivan S, Meoli A, Patil S, Olson R, Berneking M, Watson NF. Management of obstructive sleep apnea in commercial motor vehicle operators: recommendations of the AASM Sleep and Transportation Safety Awareness Task Force. J Clin Sleep Med . 2017;13(5):745–758.

Individuals with major depressive disorder (MDD) often ruminate about past experiences, especially those with negative content. These repetitive thoughts may interfere with cognitive processes related to attention and conflict monitoring. However, the temporal nature of these processes as reflected in event-related potentials (ERPs) has not been well-described. We examined behavioral and ERP indices of conflict monitoring during a modified flanker task and the allocation of attention during an attentional blink (AB) task in 33 individuals with MDD and 36 healthy controls, and whether their behavioral performance and ERPs varied with level of rumination. N2 amplitude elicited by the flanker task was significantly reduced in participants with MDD compared to healthy controls. Level of self-reported rumination was also correlated with N2 amplitude. In contrast, P3 amplitude during the AB task was not significantly different between groups, nor was it correlated with rumination. No significant differences were found in behavioral task performance measures between groups or by rumination levels. These findings suggest that rumination in MDD is associated with select deficits in cognitive control, particularly related to conflict monitoring.

Objectives. To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design. Methods. The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months. Results. In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = −0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity. Conclusions. Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers.

BackgroundTherapeutic drug monitoring (TDM) is important in optimizing use of biologics in inflammatory bowel diseases (IBD). However, the role of proactive TDM during remission remains uncertain.MethodsThis retrospective study included patients receiving infliximab (IFX) therapy at Massachusetts General Hospital or Erasmus University Medical Center. All eligible patients had completed induction phase of IFX and were in clinical and endoscopic remission. Our primary outcome was clinical relapse within 2 years after baseline. Multivariable regression models examined the association between infliximab trough levels during remission and relapse, need for IBD-related surgery or hospitalization.ResultsOur study cohort included 110 patients with IBD (72 CD, 38 UC) on IFX maintenance therapy. In total, 12 patients (10.9%) experienced relapse of disease over 2 years. The mean IFX trough level at baseline was 8.0 µg/mL (± 8.6) and did not differ between the institutions. 49.1% of patients had levels < 5 µg/mL and 2.7% had antibodies to infliximab at baseline. There was no difference in the mean IFX trough levels between patients who relapsed (7.5 µg/mL ± 3.7 µg/mL) over 24 months compared to those who did not (8.1 µg/mL ± 7.9 µg/mL, p = 0.815). On multivariable logistic regression analysis, IFX trough levels at baseline were not associated with relapse of disease over 24 months (OR 1.01, 95% CI 0.93–1.09, p = 0.856).ConclusionThis retrospective multicenter study provides evidence that IFX trough levels during quiescent disease do not predict relapse over 2 years, suggestive that proactive TDM in this setting is not warranted.

Background Chronic pain is a prevalent and costly problem that often has occupational origins. Home care workers (HCWs) are at high risk for work-related injuries, pain, and disability. Current treatments for chronic pain emphasize medications, which are an inadequate stand-alone treatment and can produce significant adverse effects. Methods In this translational study, we will adapt an established work-based injury prevention and health promotion program (COMmunity of Practice And Safety Support: COMPASS) to address the needs of HCWs experiencing chronic pain. COMPASS employs peer-led, scripted group meetings that include educational content, activities, goal setting, and structured social support. The translated intervention, named COMPASS for Navigating Pain (COMPASS-NP), will be delivered in an online group format. Safety protections will be strengthened through an ergonomic self-assessment and vouchers for purchasing ergonomic tools. Educational content will integrate a self-management approach to chronic pain using proven cognitive-behavioral therapy (CBT) principles. We will use a mixed-methods hybrid type 2 evaluation approach to assess effectiveness and implementation. A cluster-randomized waitlist control design will involve 14 groups of 10 HCWs ( n  = 140) recruited from Washington, Oregon, and Idaho. Half of the groups will be randomly selected to complete the intervention during the first 10 weeks, while the waitlist groups serve as controls. During weeks 10–20, the waitlist groups will complete the intervention while the original intervention groups complete a follow-up period without further intervention. Our primary hypothesis is that COMPASS-NP will reduce pain interference with work and life. Secondary outcomes include injury and pain prevention behaviors, pain severity, changes in medication use, risk for opioid misuse, well-being, physical activity, and sleep. Qualitative data, including phone interviews with group facilitators and organizational partners, will evaluate the implementation and guide dissemination. Discussion The results will advance the use and knowledge of secondary prevention interventions such as ergonomic tools and cognitive behavior therapy, to reduce injury, pain, and disability and to encourage appropriate uses of analgesic medications among HCWs. Trial registration ClinicalTrials.gov NCT05492903. Registered on 08 August 2022

Science and environmental education may promote life-long engagement in science and environmental conservation. We used hierarchical multiple linear regression to investigate how childhood participation in science education, environmental education, and outdoor science education interact to encourage long-term participation in science and support for local environments. Our survey of 231 high school students in North Carolina suggests outdoor science education is positively associated with enjoying time outdoors (p = 0.065) and the perception of the value of local natural resources (p = 0.021) four to seven years later. We also found support for science confidence following a science education program (p = 0.004).