Red blood cell volume and the capacity for exercise at moderate to high altitude

Hypoxia-stimulated erythropoiesis, such as that observed when red blood cell volume (RCV) increases in response to high-altitude exposure, is well understood while the physiological importance is not. Maximal exercise tests are often performed in hypoxic conditions following some form of RCV manipulation in an attempt to elucidate oxygen transport limitations at moderate to high altitudes. Such attempts, however, have not made clear the extent to which RCV is of benefit to exercise at such elevations. Changes in RCV at sea level clearly have a direct influence on maximal exercise capacity. Nonetheless, at elevations above 3000 m, the evidence is not that clear. Certain studies demonstrate either a direct benefit or decrement to exercise capacity in response to an increase or decrease, respectively, in RCV whereas other studies report negligible effects of RCV manipulation on exercise capacity. Adding to the uncertainty regarding the importance of RCV at high altitude is the observation that Andean and Tibetan high-altitude natives exhibit similar exercise capacities at high altitude (3900 m) even though Andean natives often present with a higher percent haematocrit (Hct) when compared with both lowland natives and Tibetans. The current review summarizes past literature that has examined the effect of RCV changes on maximal exercise capacity at moderate to high altitudes, and discusses the explanation elucidating these seemingly paradoxical observations.

Twenty-eight days at 3454-m altitude diminishes respiratory capacity but enhances efficiency in human skeletal muscle mitochondria

Modifications of skeletal muscle mitochondria following exposure to high altitude (HA) are generally studied by morphological examinations and biochemical analysis of expression. The aim of this study was to examine tangible measures of mitochondrial function following a prolonged exposure to HA. For this purpose, skeletal muscle biopsies were obtained from 8 lowland natives at sea level (SL) prior to exposure and again after 28 d of exposure to HA at 3454 m. High-resolution respirometry was performed on the muscle samples comparing respiratory capacity and efficiency. Exercise capacity was assessed at SL and HA. Respirometric analysis revealed that mitochondrial respiratory capacity diminished in complex I- and complex II-specific respiration in addition to a loss of maximal state-3 oxidative phosphorylation capacity from SL to HA, all independent from alterations in mitochondrial content. Leak control coupling, respiratory control ratio, and oligomycin-induced leak respiration, all measures of mitochondrial efficiency, improved in response to HA exposure. SL respiratory capacities correlated with measures of exercise capacity near SL, whereas mitochondrial efficiency correlated best with exercise capacity following HA. This data demonstrate that 1 mo of exposure to HA reduces respiratory capacity in human skeletal muscle; however, the efficiency of electron transport improves.

An ideal observer analysis of visual working memory

Limits in visual working memory (VWM) strongly constrain human performance across many tasks. However, the nature of these limits is not well understood. In this article we develop an ideal observer analysis of human VWM by deriving the expected behavior of an optimally performing but limited-capacity memory system. This analysis is framed around rate-distortion theory, a branch of information theory that provides optimal bounds on the accuracy of information transmission subject to a fixed information capacity. The result of the ideal observer analysis is a theoretical framework that provides a task-independent and quantitative definition of visual memory capacity and yields novel predictions regarding human performance. These predictions are subsequently evaluated and confirmed in 2 empirical studies. Further, the framework is general enough to allow the specification and testing of alternative models of visual memory (e.g., how capacity is distributed across multiple items). We demonstrate that a simple model developed on the basis of the ideal observer analysis-one that allows variability in the number of stored memory representations but does not assume the presence of a fixed item limit-provides an excellent account of the empirical data and further offers a principled reinterpretation of existing models of VWM.

The role of haemoglobin mass on VO(2)max following normobaric 'live high-train low' in endurance-trained athletes

It remains unclear by which mechanism 'live high-train low' (LHTL) altitude training increases exercise performance. Haematological and skeletal muscle adaptations have both been proposed. To test the hypotheses that (i) LHTL improves maximal oxygen uptake (VO(2)max) and (ii) this improvement is related to hypoxia-induced increases in total haemoglobin mass (Hb(mass)) and not to improved maximal oxidative capacity of skeletal muscle, we determined VO(2)max before LHTL and after LHTL, before and after the altitude-induced increases in Hb(mass) (measured by carbon-monoxide rebreathing) had been abolished by isovolumic haemodilution. We obtained skeletal muscle biopsies to quantify mitochondrial oxidative capacity and efficiency. Sixteen endurance-trained athletes were assigned (double-blinded, placebo controlled) to ≥16 h/day over 4 weeks to normoxia (placebo, n=6) or normobaric hypoxia equivalent to 3000 m altitude (LHTL, n=10). Four-week LHTL did not increase VO(2)max, irrespective of treatment (LHTL: 1.5%; placebo: 2.0%). Hb(mass) was slightly increased (4.6%) in 5 (of 10) LHTL subjects but this was not accompanied by a concurrent increase in VO(2)max. In the subjects demonstrating an increase in Hb(mass), isovolumic haemodilution elicited a 5.8% decrease in VO(2)max. Cycling efficiency was altered neither with time nor by LHTL. Neither maximal capacity of oxidative phosphorylation nor mitochondrial efficiency was modified by time or LHTL. The present results suggest that LHTL has no positive effect on VO(2)max in endurance-trained athletes because (i) muscle maximal oxidative capacity is not improved following LHTL and (ii) erythrocyte volume expansion after LHTL, if any, is too small to alter O(2) transport.

Acute and chronic elevation of erythropoietin in the brain improves exercise performance in mice without inducing erythropoiesis

Application of recombinant human erythropoietin (rhEpo) improves exercise capacity by stimulating red blood cell production that, in turn, enhances oxygen delivery and utilization. Apart from this, when applied at high doses, rhEpo crosses the blood-brain barrier, triggering protective neuronal effects. Here we show a fundamental new role by which the presence of Epo in the brain augments exercise performance without altering red blood cell production. Two different animal models, the transgenic mouse line Tg21, which constitutively overexpresses human Epo exclusively in the brain without affecting erythropoiesis, and wild-type mice treated with a single high dose of rhEpo, demonstrate an unexpected improvement in maximal exercise performance independent of changes in total hemoglobin mass, as well as in whole blood volume and cardiovascular parameters. This novel finding builds a more complete understanding regarding the central effects of endogenously produced and exogenously applied Epo on exercise performance.

Mitochondrial function in human skeletal muscle following high-altitude exposure

Studies regarding mitochondrial modifications in human skeletal muscle following acclimatization to high altitude are conflicting, and these inconsistencies may be due to the prevalence of representing mitochondrial function through static and isolated measurements of specific mitochondrial characteristics. The aim of this study, therefore, was to investigate mitochondrial function in response to high-altitude acclimatization through measurements of respiratory control in the vastus lateralis muscle. Skeletal muscle biopsies were obtained from 10 lowland natives prior to and again after a total of 9-11 days of exposure to 4559 m. High-resolution respirometry was performed on the muscle samples to compare respiratory chain function and respiratory capacities. Respirometric analysis revealed that mitochondrial function was largely unaffected, because high-altitude exposure did not affect the capacity for fat oxidation or individualized respiration capacity through either complex I or complex II. Respiratory chain function remained unaltered, because neither coupling nor respiratory control changed in response to hypoxic exposure. High-altitude acclimatization did, however, show a tendency (P = 0.059) to limit mass-specific maximal oxidative phosphorylation capacity. These data suggest that 9-11 days of exposure to high altitude do not markedly modify integrated measures of mitochondrial functional capacity in skeletal muscle despite significant decrements in the concentrations of enzymes involved in the tricarboxylic acid cycle and oxidative phosphorylation.

Four weeks of normobaric "live high-train low" do not alter muscular or systemic capacity for maintaining pH and K⁺ homeostasis during intense exercise

It was investigated if athletes subjected to 4 wk of living in normobaric hypoxia (3,000 m; 16 h/day) while training at 800-1,300 m ["live high-train low" (LHTL)] increase muscular and systemic capacity for maintaining pH and K(+) homeostasis as well as intense exercise performance. The design was double-blind and placebo controlled. Mean power during 30-s all-out cycling was similar before and immediately after LHTL (650 ± 31 vs. 628 ± 32 W; n = 10) and placebo exposure (658 ± 22 vs. 660 ± 23 W; n = 6). Supporting the performance data, arterial plasma pH, lactate, and K(+) during submaximal and maximal exercise were also unaffected by the intervention in both groups. In addition, muscle buffer capacity (in mmol H(+)·kg dry wt(-1)·pH(-1)) was similar before and after in both the LHTL (140 ± 12 vs. 140 ± 16) and placebo group (145 ± 2 vs. 140 ± 3). The expression of sarcolemmal H(+) transporters (Na(+)/H(+) exchanger 1, monocarboxylate transporters 1 and 4), as well as expression of Na(+)-K(+) pump subunits-α(1), -α(2), and -β(1) was also similar before and after the intervention. In conclusion, muscular and systemic capacity for maintaining pH and K(+) balance during exercise is similar before and after 4 wk of placebo-controlled normobaric LHTL. In accordance, 30-s all-out sprint ability was similar before and after LHTL.

A rational analysis of the acquisition of multisensory representations

How do people learn multisensory, or amodal, representations, and what consequences do these representations have for perceptual performance? We address this question by performing a rational analysis of the problem of learning multisensory representations. This analysis makes use of a Bayesian nonparametric model that acquires latent multisensory features that optimally explain the unisensory features arising in individual sensory modalities. The model qualitatively accounts for several important aspects of multisensory perception: (a) it integrates information from multiple sensory sources in such a way that it leads to superior performances in, for example, categorization tasks; (b) its performances suggest that multisensory training leads to better learning than unisensory training, even when testing is conducted in unisensory conditions; (c) its multisensory representations are modality invariant; and (d) it predicts ''missing" sensory representations in modalities when the input to those modalities is absent. Our rational analysis indicates that all of these aspects emerge as part of the optimal solution to the problem of learning to represent complex multisensory environments.

"Live high-train low" using normobaric hypoxia: a double-blinded, placebo-controlled study

The combination of living at altitude and training near sea level [live high-train low (LHTL)] may improve performance of endurance athletes. However, to date, no study can rule out a potential placebo effect as at least part of the explanation, especially for performance measures. With the use of a placebo-controlled, double-blinded design, we tested the hypothesis that LHTL-related improvements in endurance performance are mediated through physiological mechanisms and not through a placebo effect. Sixteen endurance cyclists trained for 8 wk at low altitude (<1,200 m). After a 2-wk lead-in period, athletes spent 16 h/day for the following 4 wk in rooms flushed with either normal air (placebo group, n = 6) or normobaric hypoxia, corresponding to an altitude of 3,000 m (LHTL group, n = 10). Physiological investigations were performed twice during the lead-in period, after 3 and 4 wk during the LHTL intervention, and again, 1 and 2 wk after the LHTL intervention. Questionnaires revealed that subjects were unaware of group classification. Weekly training effort was similar between groups. Hb mass, maximal oxygen uptake (VO(2)) in normoxia, and at a simulated altitude of 2,500 m and mean power output in a simulated, 26.15-km time trial remained unchanged in both groups throughout the study. Exercise economy (i.e., VO(2) measured at 200 W) did not change during the LHTL intervention and was never significantly different between groups. In conclusion, 4 wk of LHTL, using 16 h/day of normobaric hypoxia, did not improve endurance performance or any of the measured, associated physiological variables.

Determinants of time trial performance and maximal incremental exercise in highly trained endurance athletes

Human endurance performance can be predicted from maximal oxygen consumption (Vo(2max)), lactate threshold, and exercise efficiency. These physiological parameters, however, are not wholly exclusive from one another, and their interplay is complex. Accordingly, we sought to identify more specific measurements explaining the range of performance among athletes. Out of 150 separate variables we identified 10 principal factors responsible for hematological, cardiovascular, respiratory, musculoskeletal, and neurological variation in 16 highly trained cyclists. These principal factors were then correlated with a 26-km time trial and test of maximal incremental power output. Average power output during the 26-km time trial was attributed to, in order of importance, oxidative phosphorylation capacity of the vastus lateralis muscle (P = 0.0005), steady-state submaximal blood lactate concentrations (P = 0.0017), and maximal leg oxygenation (sO(2LEG)) (P = 0.0295), accounting for 78% of the variation in time trial performance. Variability in maximal power output, on the other hand, was attributed to total body hemoglobin mass (Hb(mass); P = 0.0038), Vo(2max) (P = 0.0213), and sO(2LEG) (P = 0.0463). In conclusion, 1) skeletal muscle oxidative capacity is the primary predictor of time trial performance in highly trained cyclists; 2) the strongest predictor for maximal incremental power output is Hb(mass); and 3) overall exercise performance (time trial performance + maximal incremental power output) correlates most strongly to measures regarding the capability for oxygen transport, high Vo(2max) and Hb(mass), in addition to measures of oxygen utilization, maximal oxidative phosphorylation, and electron transport system capacities in the skeletal muscle.

17 e- rhenium dicarbonyl CO-releasing molecules on a cobalamin scaffold for biological application

Cyanocobalamin (B(12)) offers a biocompatible scaffold for CO-releasing 17-electron dicarbonyl complexes based on the cis-trans-[Re(II)(CO)(2)Br(2)](0) core. A Co-C≡N-Re conjugate is produced in a short time and high yield from the reaction of [Et(4)N](2)[Re(II)Br(4)(CO)(2)] (ReCORM-1) with B(12). The B(12)-Re(II)(CO)(2) derivatives show a number of features which make them pharmaceutically acceptable CO-releasing molecules (CORMs). These cobalamin conjugates are characterized by an improved stability in aqueous aerobic media over the metal complex alone, and afford effective therapeutic protection against ischemia-reperfusion injury in cultured cardiomyocytes. The non-toxicity (at μM concentrations) of the resulting metal fragment after CO release is attributed to the oxidation of the metal and formation in solution of the ReO(4)(-) anion, which is among the least toxic of all of the rare inorganic compounds. Theoretical and experimental studies aimed at elucidating the aqueous chemistry of ReCORM-1 are also described.

Are people successful at learning sequences of actions on a perceptual matching task?

We report the results of an experiment in which human subjects were trained to perform a perceptual matching task. Subjects were asked to manipulate comparison objects until they matched target objects using the fewest manipulations possible. An unusual feature of the experimental task is that efficient performance requires an understanding of the hidden or latent causal structure governing the relationships between actions and perceptual outcomes. We use two benchmarks to evaluate the quality of subjects' learning. One benchmark is based on optimal performance as calculated by a dynamic programming procedure. The other is based on an adaptive computational agent that uses a reinforcement-learning method known as Q-learning to learn to perform the task. Our analyses suggest that subjects were successful learners. In particular, they learned to perform the perceptual matching task in a near-optimal manner (i.e., using a small number of manipulations) at the end of training. Subjects were able to achieve near-optimal performance because they learned, at least partially, the causal structure underlying the task. In addition, subjects' performances were broadly consistent with those of model-based reinforcement-learning agents that built and used internal models of how their actions influenced the external environment. We hypothesize that people will achieve near-optimal performances on tasks requiring sequences of action-especially sensorimotor tasks with underlying latent causal structures-when they can detect the effects of their actions on the environment, and when they can represent and reason about these effects using an internal mental model.

Bayesian learning theory applied to human cognition

Probabilistic models based on Bayes' rule are an increasingly popular approach to understanding human cognition. Bayesian models allow immense representational latitude and complexity. Because they use normative Bayesian mathematics to process those representations, they define optimal performance on a given task. This article focuses on key mechanisms of Bayesian information processing, and provides numerous examples illustrating Bayesian approaches to the study of human cognition. We start by providing an overview of Bayesian modeling and Bayesian networks. We then describe three types of information processing operations-inference, parameter learning, and structure learning-in both Bayesian networks and human cognition. This is followed by a discussion of the important roles of prior knowledge and of active learning. We conclude by outlining some challenges for Bayesian models of human cognition that will need to be addressed by future research. WIREs Cogn Sci 2011 2 8-21 DOI: 10.1002/wcs.80 For further resources related to this article, please visit the WIREs website.

Visual learning with reliable and unreliable features

Existing studies of sensory integration demonstrate how the reliabilities of perceptual cues or features influence perceptual decisions. However, these studies tell us little about the influence of feature reliability on visual learning. In this article, we study the implications of feature reliability for perceptual learning in the context of binary classification tasks. We find that finite sets of training data (i.e., the stimuli and corresponding class labels used on training trials) contain different information about a learner's parameters associated with reliable versus unreliable features. In particular, the statistical information provided by a finite number of training trials strongly constrains the set of possible parameter values associated with unreliable features, but only weakly constrains the parameter values associated with reliable features. Analyses of human subjects' performances reveal that subjects were sensitive to this statistical information. Additional analyses examine why subjects were sub-optimal visual learners.

Adaptive precision pooling of model neuron activities predicts the efficiency of human visual learning

When performing a perceptual task, precision pooling occurs when an organism's decisions are based on the activities of a small set of highly informative neurons. The Adaptive Precision Pooling Hypothesis links perceptual learning and decision making by stating that improvements in performance occur when an organism starts to base its decisions on the responses of neurons that are more informative for a task than the responses that the organism had previously used. We trained human subjects on a visual slant discrimination task and found their performances to be suboptimal relative to an ideal probabilistic observer. Why were subjects suboptimal learners? Our computer simulation results suggest a possible explanation, namely that there are few neurons providing highly reliable information for the perceptual task, and that learning involves searching for these rare, informative neurons during the course of training. This explanation can account for several characteristics of human visual learning, including the fact that people often show large differences in their learning performances with some individuals showing no performance improvements, other individuals showing gradual improvements during the course of training, and still others showing abrupt improvements. The approach described here potentially provides a unifying framework for several theories of perceptual learning including theories stating that learning is due to adaptations of the weightings of read-out connections from early visual representations, external noise filtering or internal noise reduction, increases in the efficiency with which learners encode task-relevant information, and attentional selection of specific neural populations which should undergo adaptation.

Perception of speech reflects optimal use of probabilistic speech cues

Listeners are exquisitely sensitive to fine-grained acoustic detail within phonetic categories for sounds and words. Here we show that this sensitivity is optimal given the probabilistic nature of speech cues. We manipulated the probability distribution of one probabilistic cue, voice onset time (VOT), which differentiates word initial labial stops in English (e.g., "beach" and "peach"). Participants categorized words from distributions of VOT with wide or narrow variances. Uncertainty about word identity was measured by four-alternative forced-choice judgments and by the probability of looks to pictures. Both measures closely reflected the posterior probability of the word given the likelihood distributions of VOT, suggesting that listeners are sensitive to these distributions.

Learning optimal integration of arbitrary features in a perceptual discrimination task

A number of studies have demonstrated that people often integrate information from multiple perceptual cues in a statistically optimal manner when judging properties of surfaces in a scene. For example, subjects typically weight the information based on each cue to a degree that is inversely proportional to the variance of the distribution of a scene property given a cue's value. We wanted to determine whether subjects similarly use information about the reliabilities of arbitrary low-level visual features when making image-based discriminations, as in visual texture discrimination. To investigate this question, we developed a modification of the classification image technique and conducted two experiments that explored subjects' discrimination strategies using this improved technique. We created a basis set consisting of 20 low-level features and created stimuli by linearly combining the basis vectors. Subjects were trained to discriminate between two prototype signals corrupted with Gaussian feature noise. When we analyzed subjects' classification images over time, we found that they modified their decision strategies in a manner consistent with optimal feature integration, giving greater weight to reliable features and less weight to unreliable features. We conclude that optimal integration is not a characteristic specific to conventional visual cues or to judgments involving three-dimensional scene properties. Rather, just as researchers have previously demonstrated that people are sensitive to the reliabilities of conventionally defined cues when judging the depth or slant of a surface, we demonstrate that they are likewise sensitive to the reliabilities of arbitrary low-level features when making image-based discriminations.

Tuberculous meningoencephalitis in a pregnant woman presenting 7 years after removal of a cerebral granuloma

We describe the unusual case of a young woman with a history of seizures and a granulomatous, likely tuberculous brain lesion that was surgically removed. She had an uneventful recovery without any additional therapy other than anti-epileptics. Seven years later, she presented during pregnancy with culture-confirmed tuberculous meningoencephalitis. This case highlights the spectrum of tuberculous central nervous system disease and the challenges in diagnosis.