Sleep-wake disorders persist 18 months after traumatic brain injury but remain underrecognized

OBJECTIVE This study is a prospective, controlled clinical and electrophysiologic trial examining the chronic course of posttraumatic sleep-wake disturbances (SWD). METHODS We screened 140 patients with acute, first-ever traumatic brain injury of any severity and included 60 patients for prospective follow-up examinations. Patients with prior brain trauma, other neurologic or systemic disease, drug abuse, or psychiatric comorbidities were excluded. Eighteen months after trauma, we performed detailed sleep assessment in 31 participants. As a control group, we enrolled healthy individuals without prior brain trauma matched for age, sex, and sleep satiation. RESULTS In the chronic state after traumatic brain injury, sleep need per 24 hours was persistently increased in trauma patients (8.1 ± 0.5 hours) as compared to healthy controls (7.1 ± 0.7 hours). The prevalence of chronic objective excessive daytime sleepiness was 67% in patients with brain trauma compared to 19% in controls. Patients significantly underestimated excessive daytime sleepiness and sleep need, emphasizing the unreliability of self-assessments on SWD in trauma patients. CONCLUSIONS This study provides prospective, controlled, and objective evidence for chronic persistence of posttraumatic SWD, which remain underestimated by patients. These results have clinical and medicolegal implications given that SWD can exacerbate other outcomes of traumatic brain injury, impair quality of life, and are associated with public safety hazards.

Ner mitzvoh : ...beʾur le-divre ha-Rambam be-Sefer ha-mitsṿot uve-Mishneh Torah...

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Hinterlassene Werke des Generals Carl von Clausewitz über Krieg und Kriegführung.

Each vol. has also special t.p.

Unterhaltungen am hau slichen Herd.

Editor 1852- : Karl Gutzkow.

Napoleon : a history of the art of war, from the beginning of the peninsular war to the end of the Russian campaign, with a detailed account of the Napoleonic Wars /

Mode of access: Internet.

Alt-Spanien,

On cover: "Architektur und kunstgewerbe in Alt-Spanien."

Der Deutsche Krieg.

Editor: E. Jäckh.

Archiv für experimentelle Pathologie und Pharmakologie

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Th. G. v. Hippel's sämmtliche Werke.

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Licht und Lampe.

"Rundschau für die Beleuchtungsindustrie, -installation, Elektrogerät, Sanitäre und Kühlanlagen."

The relationship between educational placement, instructional practices, and achievement gains of Black students with specific learning disabilities in secondary urban school settings

Black students, in general, are underserved academically (Darling-Hammond, 2000; Townsend, 2002) and overrepresented in special education (Donovan & Cross, 2002). Black students with disabilities are further overrepresented in more restrictive educational environments (Skiba, Poloni-Staudinger, Gallini, Simmons & Feggins-Azziz, 2006). Although the National Longitudinal Transition Study 2 (NLTS2) revealed that the academic performance of students with learning disabilities is positively related to the percentage of courses taken in the general education setting (Newman, 2006), the research specifically on placement of Black students with disabilities, particularly at the secondary level, as it relates to academic achievement is lacking. While previous studies have sought to determine which placement is better for students with disabilities, no study was found that specifically examined the impact of placement specific to Black students with specific learning disabilities (SLD) in urban settings (Fore, III, Hagan-Burke, Burke, Boon & Smith, 2008; Rea, McLaughlin & Walther-Thomas, 2002). This study examined educational placement, instructional best practices, and achievement gains of Black students with SLD in urban secondary settings using an ex post facto research design. Achievement, placement, and demographic data were collected and analyzed on approximately 314 Black eighth grade students with SLD. The Teacher Instructional Practices Survey was developed and used to collect and analyze data from the teachers of 78 of these students as it relates to instructional best practices. Results indicate no significant difference in reading but a significant difference in math gains of students served in inclusive settings as compared to resource settings with a small effect size. Also, no significant relationship was found between achievement gains and the reported use of instructional best practices. However, there was a relationship between educational placement and the use of instructional best practices. The results implied that there is a need for training with both general and special education teachers on instructional best practices for SWD and that there should be certain IEP team considerations when making placement decisions for this population of students with disabilities. It is recommended that future research in this area include classroom observations and factors other than test scores to measure growth in achievement.

Radiation fluxes, soil heat flux, air temperature, soil temperature, soil moisture and vegetation at dwarf shrubs and wet sedges in Kytalyk, NE Siberia

Vegetation changes, such as shrub encroachment and wetland expansion, have been observed in many Arctic tundra regions. These changes feed back to permafrost and climate. Permafrost can be protected by soil shading through vegetation as it reduces the amount of solar energy available for thawing. Regional climate can be affected by a reduction in surface albedo as more energy is available for atmospheric and soil heating. Here, we compared the shortwave radiation budget of two common Arctic tundra vegetation types dominated by dwarf shrubs (Betula nana) and wet sedges (Eriophorum angustifolium) in North-East Siberia. We measured time series of the shortwave and longwave radiation budget above the canopy and transmitted radiation below the canopy. Additionally, we quantified soil temperature and heat flux as well as active layer thickness. The mean growing season albedo of dwarf shrubs was 0.15 ± 0.01, for sedges it was higher (0.17 ± 0.02). Dwarf shrub transmittance was 0.36 ± 0.07 on average, and sedge transmittance was 0.28 ± 0.08. The standing dead leaves contributed strongly to the soil shading of wet sedges. Despite a lower albedo and less soil shading, the soil below dwarf shrubs conducted less heat resulting in a 17 cm shallower active layer as compared to sedges. This result was supported by additional, spatially distributed measurements of both vegetation types. Clouds were a major influencing factor for albedo and transmittance, particularly in sedge vegetation. Cloud cover reduced the albedo by 0.01 in dwarf shrubs and by 0.03 in sedges, while transmittance was increased by 0.08 and 0.10 in dwarf shrubs and sedges, respectively. Our results suggest that the observed deeper active layer below wet sedges is not primarily a result of the summer canopy radiation budget. Soil properties, such as soil albedo, moisture, and thermal conductivity, may be more influential, at least in our comparison between dwarf shrub vegetation on relatively dry patches and sedge vegetation with higher soil moisture.

Multi-year weather data in the remote semi-arid to arid mountain region of the Saharan flank of the Atlas Mountains

In 2001, a weather and climate monitoring network was established along the temperature and aridity gradient between the sub-humid Moroccan High Atlas Mountains and the former end lake of the Middle Drâa in a pre-Saharan environment. The highest Automated Weather Stations (AWS) was installed just below the M'Goun summit at 3850 m, the lowest station Lac Iriki was at 450 m. This network of 13 AWS stations was funded and maintained by the German IMPETUS (BMBF Grant 01LW06001A, North Rhine-Westphalia Grant 313-21200200) project and since 2011 five stations were further maintained by the GERMAN DFG Fennec project (FI 786/3-1), this way some stations of the AWS network provided data for almost 12 years from 2001-2012. Standard meteorological variables such as temperature, humidity, and wind were measured at an altitude of 2 m above ground. Other meteorological variables comprise precipitation, station pressure, solar irradiance, soil temperature at different depths and for high mountain station snow water equivalent. The stations produced data summaries for 5-minute-precipitation-data, 10- or 15-minute-data and a daily summary of all other variables. This network is a unique resource of multi-year weather data in the remote semi-arid to arid mountain region of the Saharan flank of the Atlas Mountains. The network is described in Schulz et al. (2010) and its further continuation until 2012 is briefly discussed in Redl et al. (2015, doi:10.1175/MWR-D-15-0223.1) and Redl et al. (2016, doi:10.1002/2015JD024443).