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Mental fatigue (MF) is a psychobiological state negatively impacting both cognitive and physical performance. Although recent research implies that some table tennis (TT) performance outcomes are impaired by MF, open skill sports such as TT require a more detailed overview of MF-related performance decrements. Moreover, research into MF and sport-specific psychomotor performance lacks the inclusion of brain-related measurements to identify MF mechanisms. Eleven experienced TT players participated in this randomized counterbalanced crossover trial. Participants were either required to perform an individualized Stroop task (MF condition) or watch a documentary (control condition). The primary outcomes were reaction time on a sport-specific visuomotor task and EEG activity throughout the trial. The subjective feeling of MF was significantly different between both conditions and confirmed that the MF condition induced the mentally fatigue state of participants (p < 0.001), though no behavioral indicators (i.e., decrease in performance on Stroop and flanker task) of MF. MF worsened reaction time on the visuomotor task, while other secondary measurements remained largely ambiguous. Spectral power (i.e., decreases in upper α band and θ band) was influenced by MF, while ERPs measured during the visuomotor task remained unaltered. The present study confirms that MF negatively impacts table tennis performance, specifically inhibitory stimuli during the visuomotor task. These findings also further augment our understanding of the effects of MF on human performance.

Introduction: A myriad of factors underlie pacing-/exhaustion-decisions that are made during whole-body endurance performance. The prefrontal cortex (PFC) is a brain region that is crucial for decision-making, planning, and attention. PFC oxygenation seems to be a mediating factor of performance decisions during endurance performance. Nowadays, there is no general overview summarizing the current knowledge on how PFC oxygenation evolves during whole-body endurance performance and whether this is a determining factor.Methods: Three electronic databases were searched for studies related to the assessment of PFC oxygenation, through near-IR spectroscopy (NIRS), during endurance exercise. To express PFC oxygenation, oxygenated (HbO2) and deoxygenated hemoglobin (HHb) concentrations were the primary outcome measures.Results: Twenty-eight articles were included. Ten articles focused on assessing prefrontal oxygenation through a maximal incremental test (MIT) and 18 focused on using endurance tasks at workloads ranging from low intensity to supramaximal intensity. In four MIT studies measuring HbO2, an increase of HbO2 was noticed at the respiratory compensation point (RCP), after which it decreased. HbO2 reached a steady state in the four studies and increased in one study until exhaustion. All studies found a decrease or steady state in HHb from the start until RCP and an increase to exhaustion. In regard to (non-incremental) endurance tasks, a general increase in PFC oxygenation was found while achieving a steady state at vigorous intensities. PCF deoxygenation was evident for near-to-maximal intensities at which an increase in oxygenation and the maintenance of a steady state could not be retained.Discussion/Conclusion: MIT studies show the presence of a cerebral oxygenation threshold (ThCox) at RCP. PFC oxygenation increases until the RCP threshold, thereafter, a steady state is reached and HbO2 declines. This study shows that the results obtained from MIT are transferable to non-incremental endurance exercise. HbO2 increases during low-intensity and moderate-intensity until vigorous-intensity exercise, and it reaches a steady state in vigorous-intensity exercise. Furthermore, ThCox can be found between vigorous and near-maximal intensities. During endurance exercise at near-maximal intensities, PFC oxygenation increases until the value exceeding this threshold, resulting in a decrease in PFC oxygenation. Future research should aim at maintaining and improving PFC oxygenation to help in improving endurance performance and to examine whether PFC oxygenation has a role in other performance-limiting factors.

Summary Background Cataract surgery is one of the most common operations in health care. Femtosecond laser-assisted cataract surgery (FLACS) enables more precise ocular incisions and lens fragmentation than does phacoemulsification cataract surgery (PCS). We hypothesised that FLACS might improve outcomes in cataract surgery compared with PCS despite having higher costs. Methods We did a participant-masked randomised superiority clinical trial comparing FLACS and PCS in two parallel groups (permuted block randomisation stratified on centres via a centralised web-based application, allocation ratio 1:1, block size of 2 or 4 for unilateral cases and 2 or 6 for bilateral cases). Five French University Hospitals enrolled consecutive patients aged 22 years or older who were eligible for unilateral or bilateral cataract surgery. Participants, outcome assessors, and technicians carrying out examinations were masked to the surgical treatment allocation until the last follow-up visit and a sham laser procedure was set up for participants randomly assigned to the PCS arm. The primary clinical endpoint was the success rate of surgery, defined as a composite of four outcomes at a 3-month postoperative visit: absence of severe perioperative complication, a best-corrected visual acuity (BCVA) of 0·0 LogMAR (logarithm of the minimum angle of resolution) or better, an absolute refractive error of 0·75 dioptres or less, and unchanged postoperative corneal astigmatism power (≤0·5 dioptres) and axis (≤20°). The primary economic endpoint was the incremental cost per additional patient who had treatment success at 3 months. Primary outcomes were assessed in all randomly assigned patients who met all eligibility criteria (missing data considered as failure). We used mixed logistic regression models or mixed linear regression models for statistical comparisons, adjusted on centres and whether cataract surgery was bilateral or unilateral. The study is registered with ClinicalTrials.gov , NCT01982006 . Findings Of the 907 patients (1476 eyes) randomly assigned between Oct 9, 2013, and Oct 30, 2015, 870 (704 eyes in FLACS group and 685 eyes in the PCS group) were analysed. We identified no significant difference in the success rate of surgery between the FLACS and PCS groups (FLACS: 41·1% [289 eyes]; PCS: 43·6% [299 eyes]); adjusted odds ratio 0·85, 95% CI 0·64–1·12, p=0·250). The incremental cost-effectiveness ratio was €10 703 saved per additional patient who had treatment success with PCS compared with FLACS. We observed no severe adverse events during the femtosecond laser procedure, and most of the complications in the FLACS group related to the primary outcome measures occurred during the phacoemulsification phase or postoperatively. Interpretation Despite its advanced technology, femtosecond laser was not superior to phacoemulsification in cataract surgery and, with higher costs, did not provide an additional benefit over phacoemulsification for patients or health-care systems. Funding French Ministry of Social Affairs and Health.

Neuropeptide S (NPS) has been shown to modulate arousal, sleep-wakefulness, anxiety-like behavior and feeding after central administration of the peptide agonist to mice or rats. We report here the chemical synthesis and pharmacological characterization of SHA 66 (3-Oxo-1,1-diphenyl-tetrahydro-oxazolo[3,4-a]pyrazine-7-carboxylic acid benzylamide) and SHA 68 (3-Oxo-1,1-diphenyl-tetrahydro-oxazolo[3,4-a]pyrazine-7-carboxylic acid 4-fluoro-benzylamide), two closely related bicyclic piperazines with antagonistic properties at the NPS receptor (NPSR). The compounds block NPS-induced Ca2+-mobilization and SHA 68 shows displaceable binding to NPSR in the nanomolar range. The antagonistic activity of SHA 68 appears to be specific as it does not affect signaling at fourteen unrelated G protein-coupled receptors. Analysis of pharmacokinetic parameters of SHA 68 demonstrates that the compound reaches pharmacologically relevant levels in plasma and brain following intraperitoneal (i.p.) administration. Furthermore, peripheral administration of SHA 68 in mice (50 mg/kg, i.p.) is able to antagonize NPS-induced horizontal and vertical activity as well as stereotypic behavior. Therefore, SHA 68 could be a useful tool to characterize physiological functions and pharmacological parameters of the NPS system in vitro and in vivo.

Purpose Many genes can be involved in congenital cataracts according to different inheritance pattern. NHS (Nance-Horan Syndrome) gene is involved in a rare X-linked syndromic cataract associating dental anomalies and facial dysmorphia. NHS gene mutations are essentially protein truncating mutations. Studies of gene localization show that non-syndromic form of congenital cataract have a gene located in the same region as the NHS gene. The purpose of this study was to determine if others mutations of the NHS gene might cause non syndromic cataracts and to analyse the expression of NHS in lenses. Methods Genomic DNA was isolated from white blood cells from 30 patients diagnosed with non syndromic congenital cataracts. When a surgery was performed, lenses were collected (n=10). The 11 exons of NHS gene were amplified from genomic DNA by PCR, and the amplicon were directly sequenced. NHS gene copy number anomalies were search by real time PCR. mRNA was extracted from the front capsule of lenses. After reverse transcription mRNA expression was analyzed by real time PCR. Results We identified 6 punctual mutations of NHS gene in different patients : 2 missenses mutations, 3 frameshift mutations and one intronic mutation. The analyze of NHS copy number revealed in one patient a duplication of exons 4 to 8. We manage to extract and amplified NHS mRNA in the front capsule. One patient with a missense mutation has a relative low expression. Conclusion We found 23% mutations of NHS gene in our cohort study. For some patients we can’t yet absolutely eliminate a Nance Horan Syndrom because of their young age. This high rate of mutations mean either the diagnostic of NHS is under evaluate or NHS gene is frequently involved in non syndromic cataracts.

SummaryEthyl ester of 4–4’ dioxycoumarinyl acetic acid has on dicoumarol several advantages. His effects are more rapid and constant although easily reversible.A survey of the methods used to follow the effects of the drug is done.

SummaryThe authors determine scrupulously a method of utilization of anticoagulants. They establish a series of strict rules thanks to which anticoagulant treatment is without danger and can be applied not only in clinics, but also at home, and even to out-door patients, when the acute period of the disease that requires this treatment is followed by a stage allowing a certain degree of mobilization.The authors emphasize that those indications should be followed, as they have been established on the basis of a four years experience with Pelantan and Tromexan.