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Author (up) Albala, L.; Bober, T.; Hale, G.; Warfield, B.; Collins, M.L.; Merritt, Z.; Steimetz, E.; Nadler, S.; Lev, Y.; Hanifin, J.
Title Effect on nurse and patient experience: overnight use of blue-depleted illumination Type Journal Article
Year 2019 Publication BMJ Open Quality Abbreviated Journal BMJ Open Qual
Volume 8 Issue 3 Pages e000692
Keywords Human Health
Abstract Background Typical hospital lighting is rich in blue-wavelength emission, which can create unwanted circadian disruption in patients when exposed at night. Despite a growing body of evidence regarding the effects of poor sleep on health outcomes, physiologically neutral technologies have not been widely implemented in the US healthcare system.

Objective The authors sought to determine if rechargeable, proximity-sensing, blue-depleted lighting pods that provide wireless task lighting can make overnight hospital care more efficient for providers and less disruptive to patients.

Design Non-randomised, controlled interventional trial in an intermediate-acuity unit at a large urban medical centre.

Methods Night-time healthcare providers abstained from turning on overhead patient room lighting in favour of a physiologically neutral lighting device. 33 nurses caring for patients on that unit were surveyed after each shift. 21 patients were evaluated after two nights with standard-of-care light and after two nights with lighting intervention.

Results Providers reported a satisfaction score of 8 out of 10, with 82% responding that the lighting pods provided adequate lighting for overnight care tasks. Among patients, a median 2-point improvement on the Hospital Anxiety and Depression Scale was reported.

Conclusion and relevance The authors noted improved caregiver satisfaction and decreased patient anxiety by using a blue-depleted automated task-lighting alternative to overhead room lights. Larger studies are needed to determine the impact of these lighting devices on sleep measures and patient health outcomes like delirium. With the shift to patient-centred financial incentives and emphasis on patient experience, this study points to the feasibility of a physiologically targeted solution for overnight task lighting in healthcare environments.
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Corporate Author Thesis
Publisher Place of Publication Editor
Language Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 2399-6641 ISBN Medium
Area Expedition Conference
Notes Approved no
Call Number GFZ @ kyba @ Serial 2681
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Author (up) Blask, D.E.; Brainard, G.C.; Dauchy, R.T.; Hanifin, J.P.; Davidson, L.K.; Krause, J.A.; Sauer, L.A.; Rivera-Bermudez, M.A.; Dubocovich, M.L.; Jasser, S.A.; Lynch, D.T.; Rollag, M.D.; Zalatan, F.
Title Melatonin-depleted blood from premenopausal women exposed to light at night stimulates growth of human breast cancer xenografts in nude rats Type Journal Article
Year 2005 Publication Cancer Research Abbreviated Journal Cancer Res
Volume 65 Issue 23 Pages 11174-11184
Keywords Human Health; Animals; Breast Neoplasms/*blood/genetics/pathology; Cell Growth Processes/physiology; Circadian Rhythm/*physiology; Female; Humans; Light; Liver Neoplasms, Experimental/metabolism; Male; Melatonin/blood/*deficiency; Premenopause/blood; RNA, Messenger/biosynthesis/genetics; Rats; Rats, Nude; Receptors, Melatonin/biosynthesis/genetics; Transplantation, Heterologous
Abstract The increased breast cancer risk in female night shift workers has been postulated to result from the suppression of pineal melatonin production by exposure to light at night. Exposure of rats bearing rat hepatomas or human breast cancer xenografts to increasing intensities of white fluorescent light during each 12-hour dark phase (0-345 microW/cm2) resulted in a dose-dependent suppression of nocturnal melatonin blood levels and a stimulation of tumor growth and linoleic acid uptake/metabolism to the mitogenic molecule 13-hydroxyoctadecadienoic acid. Venous blood samples were collected from healthy, premenopausal female volunteers during either the daytime, nighttime, or nighttime following 90 minutes of ocular bright, white fluorescent light exposure at 580 microW/cm2 (i.e., 2,800 lx). Compared with tumors perfused with daytime-collected melatonin-deficient blood, human breast cancer xenografts and rat hepatomas perfused in situ, with nocturnal, physiologically melatonin-rich blood collected during the night, exhibited markedly suppressed proliferative activity and linoleic acid uptake/metabolism. Tumors perfused with melatonin-deficient blood collected following ocular exposure to light at night exhibited the daytime pattern of high tumor proliferative activity. These results are the first to show that the tumor growth response to exposure to light during darkness is intensity dependent and that the human nocturnal, circadian melatonin signal not only inhibits human breast cancer growth but that this effect is extinguished by short-term ocular exposure to bright, white light at night. These mechanistic studies are the first to provide a rational biological explanation for the increased breast cancer risk in female night shift workers.
Address Laboratory of Chrono-Neuroendocrine Oncology, Bassett Research Institute, The Mary Imogene Bassett Hospital, Cooperstown, New York 13326, USA. david.blask@bassett.org
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0008-5472 ISBN Medium
Area Expedition Conference
Notes PMID:16322268 Approved no
Call Number LoNNe @ kagoburian @ Serial 721
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Author (up) Brainard, G.C.; Coyle, W.; Ayers, M.; Kemp, J.; Warfield, B.; Maida, J.; Bowen, C.; Bernecker, C.; Lockley, S.W.; Hanifin, J.P.
Title Solid-state lighting for the International Space Station: Tests of visual performance and melatonin regulation Type Journal Article
Year 2013 Publication Acta Astronautica Abbreviated Journal Acta Astronautica
Volume 92 Issue 1 Pages 21-28
Keywords Human Health; Lighting
Abstract The International Space Station (ISS) uses General Luminaire Assemblies (GLAs) that house fluorescent lamps for illuminating the astronauts' working and living environments. Solid-state light emitting diodes (LEDs) are attractive candidates for replacing the GLAs on the ISS. The advantages of LEDs over conventional fluorescent light sources include lower up-mass, power consumption and heat generation, as well as fewer toxic materials, greater resistance to damage and long lamp life. A prototype Solid-State Lighting Assembly (SSLA) was developed and successfully installed on the ISS. The broad aim of the ongoing work is to test light emitted by prototype SSLAs for supporting astronaut vision and assessing neuroendocrine, circadian, neurobehavioral and sleep effects. Three completed ground-based studies are presented here including experiments on visual performance, color discrimination, and acute plasma melatonin suppression in cohorts of healthy, human subjects under different SSLA light exposure conditions within a high-fidelity replica of the ISS Crew Quarters (CQ). All visual tests were done under indirect daylight at 201 lx, fluorescent room light at 531 lx and 4870 K SSLA light in the CQ at 1266 lx. Visual performance was assessed with numerical verification tests (NVT). NVT data show that there are no significant differences in score (F=0.73, p=0.48) or time (F=0.14, p=0.87) for subjects performing five contrast tests (10%–100%). Color discrimination was assessed with Farnsworth-Munsell 100 Hue tests (FM-100). The FM-100 data showed no significant differences (F=0.01, p=0.99) in color discrimination for indirect daylight, fluorescent room light and 4870 K SSLA light in the CQ. Plasma melatonin suppression data show that there are significant differences (F=29.61, p<0.0001) across the percent change scores of plasma melatonin for five corneal irradiances, ranging from 0 to 405 &#956;W/cm2 of 4870 K SSLA light in the CQ (0–1270 lx). Risk factors for the health and safety of astronauts include disturbed circadian rhythms and altered sleep–wake patterns. These studies will help determine if SSLA lighting can be used both to support astronaut vision and serve as an in-flight countermeasure for circadian desynchrony, sleep disruption and cognitive performance deficits on the ISS.
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Corporate Author Thesis
Publisher Place of Publication Editor
Language Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0094-5765 ISBN Medium
Area Expedition Conference
Notes Approved no
Call Number LoNNe @ kyba @ Serial 1533
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Author (up) Brainard, G.C.; Hanifin, J.P.; Greeson, J.M.; Byrne, B.; Glickman, G.; Gerner, E.; Rollag, M.D.
Title Action spectrum for melatonin regulation in humans: evidence for a novel circadian photoreceptor. Type Journal Article
Year 2001 Publication Journal of Neuroscience Abbreviated Journal
Volume 21 Issue Pages 6405-6412
Keywords Human Health
Abstract The photopigment in the human eye that transduces light for circadian and neuroendocrine regulation, is unknown. The aim of this study was to establish an action spectrum for light-induced melatonin suppression that could help elucidate the ocular photoreceptor system for regulating the human pineal gland. Subjects (37 females, 35 males, mean age of 24.5 ± 0.3 years) were healthy and had normal color vision. Full-field, monochromatic light exposures took place between 2:00 and 3:30 A.M. while subjects' pupils were dilated. Blood samples collected before and after light exposures were quantified for melatonin. Each subject was tested with at least seven different irradiances of one wavelength with a minimum of 1 week between each nighttime exposure. Nighttime melatonin suppression tests (n = 627) were completed with wavelengths from 420 to 600 nm. The data were fit to eight univariant, sigmoidal fluence–response curves (R 2 = 0.81–0.95). The action spectrum constructed from these data fit an opsin template (R 2 = 0.91), which identifies 446–477 nm as the most potent wavelength region providing circadian input for regulating melatonin secretion. The results suggest that, in humans, a single photopigment may be primarily responsible for melatonin suppression, and its peak absorbance appears to be distinct from that of rod and cone cell photopigments for vision. The data also suggest that this new photopigment is retinaldehyde based. These findings suggest that there is a novel opsin photopigment in the human eye that mediates circadian photoreception.
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Language Summary Language Original Title
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Notes Approved no
Call Number LoNNe @ christopher.kyba @ Serial 529
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Author (up) Brainard, G.C.; Rollag, M.D.; Hanifin, J.P.
Title Photic Regulation of Melatonin in Humans: Ocular and Neural Signal Transduction Type Journal Article
Year 1997 Publication Journal of Biological Rhythms Abbreviated Journal Journal of Biological Rhythms
Volume 12 Issue 6 Pages 537-546
Keywords Human Health; eye; lens; light; melatonin suppression; photoreceptor; pineal gland; pupil
Abstract
Address
Corporate Author Thesis
Publisher Place of Publication Editor
Language Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0748-7304 ISBN Medium
Area Expedition Conference
Notes Approved no
Call Number LoNNe @ schroer @ Serial 583
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Author (up) Brainard, G.C.; Sliney, D.; Hanifin, J.P.; Glickman, G.; Byrne, B.; Greeson, J.M.; Jasser, S.; Gerner, E.; Rollag, M.D.
Title Sensitivity of the human circadian system to short-wavelength (420-nm) light Type Journal Article
Year 2008 Publication Journal of Biological Rhythms Abbreviated Journal J Biol Rhythms
Volume 23 Issue 5 Pages 379-386
Keywords Human Health; Adult; Circadian Rhythm/*radiation effects; Female; Humans; *Light; Male; Melatonin/metabolism; Models, Biological; Neurosecretory Systems; Photons; Pineal Gland/metabolism; Retinal Ganglion Cells/*metabolism; Vision, Ocular
Abstract The circadian and neurobehavioral effects of light are primarily mediated by a retinal ganglion cell photoreceptor in the mammalian eye containing the photopigment melanopsin. Nine action spectrum studies using rodents, monkeys, and humans for these responses indicate peak sensitivities in the blue region of the visible spectrum ranging from 459 to 484 nm, with some disagreement in short-wavelength sensitivity of the spectrum. The aim of this work was to quantify the sensitivity of human volunteers to monochromatic 420-nm light for plasma melatonin suppression. Adult female (n=14) and male (n=12) subjects participated in 2 studies, each employing a within-subjects design. In a fluence-response study, subjects (n=8) were tested with 8 light irradiances at 420 nm ranging over a 4-log unit photon density range of 10(10) to 10(14) photons/cm(2)/sec and 1 dark exposure control night. In the other study, subjects (n=18) completed an experiment comparing melatonin suppression with equal photon doses (1.21 x 10(13) photons/cm(2)/sec) of 420 nm and 460 nm monochromatic light and a dark exposure control night. The first study demonstrated a clear fluence-response relationship between 420-nm light and melatonin suppression (p<0.001) with a half-saturation constant of 2.74 x 10(11) photons/cm(2)/sec. The second study showed that 460-nm light is significantly stronger than 420-nm light for suppressing melatonin (p<0.04). Together, the results clarify the visible short-wavelength sensitivity of the human melatonin suppression action spectrum. This basic physiological finding may be useful for optimizing lighting for therapeutic and other applications.
Address Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, USA. george.brainard@jefferson.edu
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0748-7304 ISBN Medium
Area Expedition Conference
Notes PMID:18838601 Approved no
Call Number LoNNe @ kagoburian @ Serial 724
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Author (up) deHaro, D.; Kines, K.J.; Sokolowski, M.; Dauchy, R.T.; Streva, V.A.; Hill, S.M.; Hanifin, J.P.; Brainard, G.C.; Blask, D.E.; Belancio, V.P.
Title Regulation of L1 expression and retrotransposition by melatonin and its receptor: implications for cancer risk associated with light exposure at night Type Journal Article
Year 2014 Publication Nucleic Acids Research Abbreviated Journal Nucleic Acids Res
Volume 42 Issue 12 Pages 7694-7707
Keywords Human Health
Abstract Expression of long interspersed element-1 (L1) is upregulated in many human malignancies. L1 can introduce genomic instability via insertional mutagenesis and DNA double-strand breaks, both of which may promote cancer. Light exposure at night, a recently recognized carcinogen, is associated with an increased risk of cancer in shift workers. We report that melatonin receptor 1 inhibits mobilization of L1 in cultured cells through downregulation of L1 mRNA and ORF1 protein. The addition of melatonin receptor antagonists abolishes the MT1 effect on retrotransposition in a dose-dependent manner. Furthermore, melatonin-rich, but not melatonin-poor, human blood collected at different times during the circadian cycle suppresses endogenous L1 mRNA during in situ perfusion of tissue-isolated xenografts of human cancer. Supplementation of human blood with exogenous melatonin or melatonin receptor antagonist during the in situ perfusion establishes a receptor-mediated action of melatonin on L1 expression. Combined tissue culture and in vivo data support that environmental light exposure of the host regulates expression of L1 elements in tumors. Our data imply that light-induced suppression of melatonin production in shift workers may increase L1-induced genomic instability in their genomes and suggest a possible connection between L1 activity and increased incidence of cancer associated with circadian disruption.
Address Department of Structural and Cellular Biology, Tulane School of Medicine, Tulane Cancer Center, New Orleans, LA 70115, USA Tulane Center for Aging, New Orleans, LA 70112, USA vperepe@tulane.edu
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0305-1048 ISBN Medium
Area Expedition Conference
Notes PMID:24914052; PMCID:PMC4081101 Approved no
Call Number LoNNe @ kyba @ Serial 1414
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Author (up) Hanifin, J.P.; Dauchy, R.T.; Blask, D.E.; Hill, S.M.; Brainard, G.C.
Title Relevance of Electrical Light on Circadian, Neuroendocrine, and Neurobehavioral Regulation in Laboratory Animal Facilities Type Journal Article
Year 2020 Publication ILAR Journal Abbreviated Journal
Volume in press Issue Pages
Keywords Review; Animals
Abstract Light is a key extrinsic factor to be considered in operations and design of animal room facilities. Over the past four decades, many studies on typical laboratory animal populations have demonstrated impacts on neuroendocrine, neurobehavioral, and circadian physiology. These effects are regulated independently from the defined physiology for the visual system. The range of physiological responses that oscillate with the 24 hour rhythm of the day include sleep and wakefulness, body temperature, hormonal secretion, and a wide range of other physiological parameters. Melatonin has been the chief neuroendocrine hormone studied, but acute light-induced effects on corticosterone as well as other hormones have also been observed. Within the last two decades, a new photosensory system in the mammalian eye has been discovered. A small set of retinal ganglion cells, previously thought to function as a visual output neuron, have been shown to be directly photosensitive and act differently from the classic photoreceptors of the visual system. Understanding the effects of light on mammalian physiology and behavior must take into account how the classical visual photoreceptors and the newly discovered ipRGC photoreceptor systems interact. Scientists and facility managers need to appreciate lighting impacts on circadian, neuroendocrine, and neurobehavioral regulation in order to improve lighting of laboratory facilities to foster optimum health and well-being of animals.
Address
Corporate Author Thesis
Publisher Place of Publication Editor
Language Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1084-2020 ISBN Medium
Area Expedition Conference
Notes Approved no
Call Number GFZ @ kyba @ Serial 3024
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Author (up) Hanifin, J.P.; Lockley, S.W.; Cecil, K.; West, K.; Jablonski, M.; Warfield, B.; James, M.; Ayers, M.; Byrne, B.; Gerner, E.; Pineda, C.; Rollag, M.; Brainard, G.C.
Title Randomized trial of polychromatic blue-enriched light for circadian phase shifting, melatonin suppression, and alerting responses Type Journal Article
Year 2018 Publication Physiology & Behavior Abbreviated Journal Physiol Behav
Volume in press Issue Pages
Keywords Human Health
Abstract Wavelength comparisons have indicated that circadian phase-shifting and enhancement of subjective and EEG-correlates of alertness have a higher sensitivity to short wavelength visible light. The aim of the current study was to test whether polychromatic light enriched in the blue portion of the spectrum (17,000K) has increased efficacy for melatonin suppression, circadian phase-shifting, and alertness as compared to an equal photon density exposure to a standard white polychromatic light (4000K). Twenty healthy participants were studied in a time-free environment for 7days. The protocol included two baseline days followed by a 26-h constant routine (CR1) to assess initial circadian phase. Following CR1, participants were exposed to a full-field fluorescent light (1x10(14) photons/cm(2)/s, 4000K or 17,000K, n=10/condition) for 6.5h during the biological night. Following an 8h recovery sleep, a second 30-h CR was performed. Melatonin suppression was assessed from the difference during the light exposure and the corresponding clock time 24h earlier during CR1. Phase-shifts were calculated from the clock time difference in dim light melatonin onset time (DLMO) between CR1 and CR2. Blue-enriched light caused significantly greater suppression of melatonin than standard light ((mean+/-SD) 70.9+/-19.6% and 42.8+/-29.1%, respectively, p<0.05). There was no significant difference in the magnitude of phase delay shifts. Blue-enriched light significantly improved subjective alertness (p<0.05) but no differences were found for objective alertness. These data contribute to the optimization of the short wavelength-enriched spectra and intensities needed for circadian, neuroendocrine and neurobehavioral regulation.
Address Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, USA
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0031-9384 ISBN Medium
Area Expedition Conference
Notes PMID:30296404 Approved no
Call Number GFZ @ kyba @ Serial 2025
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Author (up) West, K.E.; Jablonski, M.R.; Warfield, B.; Cecil, K.S.; James, M.; Ayers, M.A.; Maida, J.; Bowen, C.; Sliney, D.H.; Rollag, M.D.; Hanifin, J.P.; Brainard, G.C.
Title Blue light from light-emitting diodes elicits a dose-dependent suppression of melatonin in humans Type Journal Article
Year 2011 Publication Journal of Applied Physiology (Bethesda, Md. : 1985) Abbreviated Journal J Appl Physiol (1985)
Volume 110 Issue 3 Pages 619-626
Keywords Circadian Rhythm/*physiology/*radiation effects; Color; Dose-Response Relationship, Radiation; Humans; Lighting/*methods; Melatonin/*blood; Metabolic Clearance Rate/radiation effects; Photic Stimulation/*methods; Radiation Dosage; Retina/*physiology/*radiation effects; Semiconductors; Young Adult; blue light
Abstract Light suppresses melatonin in humans, with the strongest response occurring in the short-wavelength portion of the spectrum between 446 and 477 nm that appears blue. Blue monochromatic light has also been shown to be more effective than longer-wavelength light for enhancing alertness. Disturbed circadian rhythms and sleep loss have been described as risk factors for astronauts and NASA ground control workers, as well as civilians. Such disturbances can result in impaired alertness and diminished performance. Prior to exposing subjects to short-wavelength light from light-emitting diodes (LEDs) (peak lambda = 469 nm; 1/2 peak bandwidth = 26 nm), the ocular safety exposure to the blue LED light was confirmed by an independent hazard analysis using the American Conference of Governmental Industrial Hygienists exposure limits. Subsequently, a fluence-response curve was developed for plasma melatonin suppression in healthy subjects (n = 8; mean age of 23.9 +/- 0.5 years) exposed to a range of irradiances of blue LED light. Subjects with freely reactive pupils were exposed to light between 2:00 and 3:30 AM. Blood samples were collected before and after light exposures and quantified for melatonin. The results demonstrate that increasing irradiances of narrowband blue-appearing light can elicit increasing plasma melatonin suppression in healthy subjects (P < 0.0001). The data were fit to a sigmoidal fluence-response curve (R(2) = 0.99; ED(50) = 14.19 muW/cm(2)). A comparison of mean melatonin suppression with 40 muW/cm(2) from 4,000 K broadband white fluorescent light, currently used in most general lighting fixtures, suggests that narrow bandwidth blue LED light may be stronger than 4,000 K white fluorescent light for suppressing melatonin.
Address Dept. of Neurology, Thomas Jefferson Univ., Philadelphia, Pennsylvania 19107, USA
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0161-7567 ISBN Medium
Area Expedition Conference
Notes PMID:21164152 Approved no
Call Number IDA @ john @ Serial 287
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