Selective REM sleep deprivation in narcolepsy

Narcolepsy is characterized by excessive daytime sleepiness and rapid eye movement (REM) sleep abnormalities, including cataplexy. The aim of this study was to assess REM sleep pressure and homeostasis in narcolepsy. Six patients with narcolepsy and six healthy controls underwent a REM sleep deprivation protocol, including one habituation, one baseline, two deprivation nights (D1, D2) and one recovery night. Multiple sleep latency tests (MSLTs) were performed during the day after baseline and after D2. During D1 and D2 REM sleep was prevented by awakening the subjects at the first polysomnographic signs of REM sleep for 2 min. Mean sleep latency and number of sleep-onset REM periods (SOREMs) were determined on all MSLT. More interventions were required to prevent REM sleep in narcoleptics compared with control subjects during D1 (57 ± 16 versus 24 ± 10) and D2 (87 ± 22 versus 35 ± 8, P = 0.004). Interventions increased from D1 to D2 by 46% in controls and by 53% in narcoleptics (P < 0.03). Selective REM sleep deprivation was successful in both controls (mean reduction of REM to 6% of baseline) and narcoleptics (11%). Both groups had a reduction of total sleep time during the deprivation nights (P = 0.03). Neither group had REM sleep rebound in the recovery night. Narcoleptics had, however, an increase in the number of SOREMs on MSLT (P = 0.005). There was no increase in the number of cataplexies after selective REM sleep deprivation. We conclude that: (i) REM sleep pressure is higher in narcoleptics; (ii) REM sleep homeostasis is similar in narcoleptics and controls; (iii) in narcoleptics selective REM sleep deprivation may have an effect on sleep propensity but not on cataplexy.

Safety of endovascular treatment beyond the 6-h time window in 205 patients

Background and purpose Intra-arterial treatment (IAT) is effective when performed within 6 h of symptom onset in selected stroke patients (‘T < 6H’). Its safety and efficacy is unclear when the patient has had symptoms for more than 6 h (‘T > 6H’) or for an unknown time (unclear-onset stroke, UOS), or woke up with a stroke (wake-up stroke, WUS). In this study we compared the safety of IAT in these four patient groups. Methods Eight-hundred and fifty-nine patients treated with IAT were enrolled. The main outcome parameters were clinical outcome [excellent: modified Rankin Scale (mRS) 0 or 1; or favorable: mRS 0–2] or mortality 3 months after treatment. Further outcome parameters were the rates of vessel recanalization, and cerebral and systemic hemorrhage. Results Six-hundred and fifty-four patients were treated before (T < 6H) and 205 after 6 h or an unknown time (128 T > 6H, 55 WUS and 22 UOS). NIHSS scores were higher in UOS patients than in T < 6H patients, vertebrobasilar occlusion was more common in T > 6H and UOS patients, and middle cerebral artery occlusions less common in T > 6H than in T < 6H patients. Other baseline characteristics were similar. There was no significant difference in clinical outcome and the rate of hemorrhage in multivariable regression analysis. Conclusions Clinical outcome of our four groups of patients was similar with no increase of hemorrhage rates in patients treated after awakening, after an unknown time or more than 6 h. Our preliminary data suggest that treatment of such patients may be performed safely. If confirmed in randomized trials, this would have major clinical implications.

Cortisol levels and history of depression in acute coronary syndrome patients

BACKGROUND: Depressed mood following an acute coronary syndrome (ACS) is a risk factor for future cardiac morbidity. Hypothalamic-pituitary-adrenal (HPA) axis dysregulation is associated with depression, and may be a process through which depressive symptoms influence later cardiac health. Additionally, a history of depression predicts depressive symptoms in the weeks following ACS. The purpose of this study was to determine whether a history of depression and/or current depression are associated with the HPA axis dysregulation following ACS. METHOD: A total of 152 cardiac patients completed a structured diagnostic interview, a standardized depression questionnaire and a cortisol profile over the day, 3 weeks after an ACS. Cortisol was analysed using: the cortisol awakening response (CAR), total cortisol output estimated using the area under the curve method, and the slope of cortisol decline over the day. RESULTS: Total cortisol output was positively associated with history of depression, after adjustment for age, gender, marital status, ethnicity, smoking status, body mass index (BMI), Global Registry of Acute Cardiac Events (GRACE) risk score, days in hospital, medication with statins and antiplatelet compounds, and current depression score. Men with clinically diagnosed depression after ACS showed a blunted CAR, but the CAR was not related to a history of depression. CONCLUSIONS: Patients with a history of depression showed increased total cortisol output, but this is unlikely to be responsible for associations between depression after ACS and later cardiac morbidity. However, the blunted CAR in patients with severe depression following ACS indicates that HPA dysregulation is present.

"Progressiver Islam" im ausgehenden Zarenreich: Das Plädoyer des St. Petersburger Imams und Regierungsbeamten Ataulla Bajazitov (1846-1911) für die Partizipation der Muslime an der modernen Zivilisation

Ataulla Bajazitov (1846-1911) fulfilled a social double role by serving his Tatar community in St. Petersburg as imam and the Russian state as military Muslim ‘cleric’, translator and teacher. By founding Russia’s first monolingual Tatar newspaper, initiating St. Petersburg’s first Friday mosque and presenting scriptural and rational arguments for the compatibility of Islam and the modern Civilization to a Russian-speaking public as early as 1883, he has been a pioneer among the Muslims in Russia in several respects. In contrast though to similar activities of his Russian contemporary, the Krim Tatar Ismail Gasprinskii (1851-1914), Bajazitov’s endeavours have remained almost unnoticed in Western scholarship. Also in Tatarstan, his books have been only recently reprinted. The present study analyzes Bajazitov’s three monographs written in Russian, namely A Response to Ernest Renan’s lecture “Islam and Science” (1883), The Relationship of Islam towards Science and People of Different Faith (1887) and Islam and Progress (1898). There, he exposes many positions that around that time started to become key arguments of Muslim reformers in the Near East for the progressivness of Islam. The study takes also into account reactions to Bajazitov’s monographs by Russian officers in Tashkent who tried to demonstrate the backwardness of Islam, especially Nikolai Petrovič Ostroumov’s (1846-1930) response in his book entitled Quran and Progress – On the intellectual awakening of today’s Russian Muslims (1901/1903).

Polonofilizm i polskość wśród czeskich emancypantek w drugiej połowie XIX wieku: przykład Karoliny Světlej

The awakening of national consciousness went hand in hand in Bohemia with an anxiety about national disappearance. In this context, the recourse to Pan-Slavism was for the Czechs a way to encourage themselves through the idea of belonging to a great Slavic world, while the Slavic Congress organized in Prague in 1848 was an attempt to realize this ideal. The Congress was a failure from the political point of view, but it did have some socio-cultural repercussions: notably, it served as a pretext for the advancement of women's issues in Bohemia. It is indeed in the wake of the Congress that Honorata z Wiśniowskich Zapová, a Polish women settled in Prague after her marriage to a Czech intellectual, founded, under the guise of collaboration between all Slavic women, the first women's association, as well as a (very short-lived) Czech-Polish institute, where Czech, as well as Polish girls, could get a quality education in their mother tongue. Honorata was undoubtedly the source of the polonophilia wind that seemed to blow over the Czech emancipation movement in the second half of the nineteenth century. In particular, Karolina Světlá showed in her Memoirs a great recognition for Honorata's efforts in matters of emancipation and education, and explicitly took up the challenge launched by the latter in founding another women's association and in inaugurating a school for underprivileged girls. But the tribute Světlá paid to Honorata is even more evident in her literary work, where Poland and the Polish woman (who often wears Honorata's features) play a significant role (see for example her short novel Sisters or her story A Few Days in the Life of a Prague Dandy). Světlá was probably the Czech feminist writer who, in her activities and in her work, relied most strongly on the Polish woman as a model for the Czech woman. However, she wasn't alone. In general, it was a characteristic of the Czech feminist movement of the second half of the nineteenth century to have recourse to the Polish woman and to Poland as a landmark for comparison and as a goal to be achieved.

Indigenous land reconfiguration and fragmented institutions: a historical political ecology of Tsimane’ lands (Bolivian Amazon)

Lands inhabited by indigenous peoples often have low population density but abundant natural resources. For those reasons, many actors have historically attempted to occupy those lands or use the resources in them. Increasing pressures over lands occupied by indigenous peoples have resulted in the awakening of indigenous peoples over their rights to land and resources generating many debates over indigenous peoples' rights to land and self-governance. In this article, we provide a historical and geographical overview of territorial and governance issues among the Tsimane', an indigenous group native to the Bolivian Amazon. We examine how the Bolivian state economic policies implemented during the 20th century affected the Tsimane' ancestral lands, and how – over the late-20th century – the Bolivian state accommodated Tsimane' claims to lands in between multiple interests. We show how national policies led to the reconfiguration of Tsimane' territoriality and to a fragmented institutional representation. Current indigenous territories and indigenous political representation are an expression of conflictive policies that have involved multiple actors and their specific interests on indigenous lands and its resources.

The phenomenology of lucid dreaming: An online survey.

In lucid dreams the dreamer is aware that he or she is dreaming. Although such dreams are not that uncommon, many aspects of lucid dream phenomenology are still unclear. An online survey was conducted to gather data about lucid dream origination, duration, active or passive participation in the dream, planned actions for lucid dreams, and other phenomenological aspects. Among the 684 respondents who filled out the questionnaire, there were 571 lucid dreamers (83.5%). According to their reports, lucid dreams most often originate spontaneously in adolescence. The average lucid dream duration is about 14 minutes. Lucid dreamers are likely to be active in their lucid dreams and plan to accomplish different actions (e.g., flying, talking with dream characters, or having sex), yet they are not always able to remember or successfully execute their intentions (most often because of awakening or hindrances in the dream environment). The frequency of lucid dream experience was the strongest predictor of lucid dream phenomenology, but some differences were also observed in relation to age, gender, or whether the person is a natural or self-trained lucid dreamer. The findings are discussed in light of lucid dream research, and suggestions for future studies are provided.