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Changes in reindeer sleep regulation across the year: a central role for rumination? In this episode, I am joined by Melanie Furrer, who recently presented her study on sleep in reindeer. Most non-hibernating animals maintain daily “circadian ”rhythms of sleep across the year, as well as “homeostatic” sleep-wake patterns in which increasing time awake is followed by increased sleep amount or intensity. Strikingly, ruminant reindeer in the Arctic show 24-h rhythmicity at the equinoxes but none at either solstice; summertime activity greatly exceeds wintertime activity. So far, nothing is known about their sleep or how it might be seasonally modulated. Methods: We simultaneously recorded non-invasive electroencephalography EEG in four adult female reindeer for four days at The Arctic University of Norway in Tromsø, Norway in July, September, and December. Rapid eye movement, REM sleep, non-REM NREM sleep, and rumination were visually identified from the EEG, and slow-wave activity SWA, EEG power 1–18 4.5 Hz during NREM sleep, the classic marker for homeostatic changes in sleep pressure, was calculated. Results: Although sleep in reindeer generally resembled that of other mammals, key novel adaptations were observed in July/September: n=4, December: n=3. Like most species, sleep-wake distribution paralleled daily activity during seasonally changing light-dark conditions and SWA during NREM sleep increased after prolonged wake periods. Surprisingly, total sleep duration was roughly equal across seasons, and prolonged waking produced a lower SWA response in summer than in winter. As reported for some domestic ruminants, EEG during rumination showed typical characteristics of NREM sleep. Furthermore, rumination appeared to substitute for sleep under all observed conditions. Accordingly, SWA decreased across rumination, and total rumination and NREM sleep durations were negatively correlated. Homeostatic modelling of SWA further suggested that rumination was equivalent to sleep. Conclusions: We suggest that less pronounced SWA increases across waking in summer might indicate higher baseline sleep pressure during this season, possibly resulting from increased activity, food intake and light exposure. Within this context, rumination might partially substitute conventional sleep, permitting near-constant feeding in the arctic summer while compensating for increased sleep pressure. Contact or follow Melanie https://www.kispi.uzh.ch/forschungszentrum/person/furrer-melanie. https://www.researchgate.net/profile/Melanie-Furrer-2 Contact me at iandunican@sleep4performance.com.au or www.sleep4performance.com.au and check out the YouTube channel. Check out our sponsor LMNT. Click on the link to order and get a free LMNT Sample Pack when you order through the custom link below. Key details: • The LMNT Sample Pack includes 1 packet of every flavour. This is the perfect offer for anyone interested in trying all of our flavours or who wants to introduce a friend to LMNT. • This offer is exclusively available through VIP LMNT Partners – you won't find this offer publicly available. • This offer is available for new and returning customers • They offer refunds on all orders with no questions – you don't even have to send it back! DrinkLMNT.com/sleep4performance
1. Clarity on the End Game. The Vision, Mission, and Values of the company are clear and enjoy universal commitment from the workforce. The real end game is what culture are you trying to create? 2. Line of Sight to Business Objectives. The yearly business Plan This is where your use of MBO is critical. Managing By Objectives requires everyone has a piece of the action, an expressed part of this periods business objectives. 3. Ongoing Feedback on Performance and Results Although on occasion this is feedback delivered by an immediate supervisor, to make this work feedback on their performance (progress and/or results) needs to be delivered by the system. Consider the 80/20 rule as a great place to start.
Objective:Primary gastrointestinal neuropathies are a heterogeneous group of enteric nervous system (ENS) disorders that continue to cause difficulties in diagnosis and histological interpretation. Recently, an international working group published guidelines for histological techniques and reporting, along with a classification of gastrointestinal neuromuscular pathology. The aim of this article was to review and summarize the key issues for pediatric gastroenterologists on the diagnostic workup of congenital ENS disorders. In addition, we provide further commentary on the continuing controversies in the field.Results:Although the diagnostic criteria for Hirschsprung disease are well established, those for other forms of dysganglionosis remain ill-defined. Appropriate tissue sampling, handling, and expert interpretation are crucial to maximize diagnostic accuracy and reduce interobserver variability. The absence of validated age-related normal values for neuronal density, along with the lack of correlation between clinical and histological findings, result in significant diagnostic uncertainties while diagnosing quantitative aberrations such as hypoganglionosis or ultrashort Hirschsprung disease. Intestinal neuronal dysplasia remains a histological description of unclear significance.Conclusions:The evaluation of cellular quantitative or qualitative abnormalities of the ENS for clinical diagnosis remains complex. Such analysis should be carried out in laboratories that have the necessary expertise and access to their own validated reference values.
Background: For the treatment of the severe infantile coxa vara it is mandatory for the orthopaedic surgeon to observe the mechanobiology of the growing hip before and after the surgical intervention. We hereby would like to present our experiences with the subtrochanteric end-to-side valgization osteotomy and to compare the procedure with the alternatively used Y-shaped osteotomy as described by Pauwels. Methods: Thirteen patients (20 hips) who had undergone subtrochanteric end-to-side valgization were followed for a mean 6.2 years (range, 0.8 to 12.8 y). At the time of surgery the mean age was 7.1 years (range, 2.0 to 13.3 y), last follow-up examination was performed at a mean of 13.4 years of age (range, 5.1 to 18.3 y). The deformities were etiologically based on 5 entities: congenital coxa vara (n = 1), osteochondrodysplasias (n = 12), postosteomyelitic coxa vara (n = 5), and avascular femoral head necrosis in the course of congenital dysplasia of the hip (n = 2). The follow-up rate was 100%. In addition, we analyzed a total of 93 pelvic radiographies with a total of 139 hip joints. Thirty angles and distances were assessed according to parameters described in the literature. Results: Although preoperatively 12 patients presented with a positive Trendelenburg's sign, it was only present postoperatively in 2 patients. Duchenne's limp reduced from 10 to 1. All of the 15 preoperatively apparent nonunions could be healed by means of surgery. Two hips redeveloped pathologically lowered collodiaphyseal angles postoperatively, one of which had to undergo revision surgery. Preoperatively 15 out of 20 patients (75%) showed nonunions all of which healed after surgery. No recurrence could be seen at the time of the last follow-up. The following angles were assessed on plain radiographies of the pelvis preoperatively and directly postoperatively as well as on the last follow-up at a mean of 85 months: CCD-angle 98 degrees/156 degrees/144 degrees, EY-angle 55 degrees/5 degrees/15.7 degrees, AY-angle 32 degrees/75 degrees/66 degrees, CE-angle 20 degrees/25 degrees/18 degrees, AC-angle 20 degrees/18 degrees/20 degrees. The articulotrochanteric distance was 5 mm/26 mm/14 mm. Conclusions: The subtrochanteric end-to-side valgization osteotomy showed to be highly effective in the management of the infantile coxa vara, improving the clinical impairment of the patients postoperatively. All of the preoperatively present nonunions showed osseous consolidation at follow-up examination. Only minor revarization tendencies could be found. The procedure is technically less demanding, safer and more efficient regarding the lengthening of the affected limb in comparison to the Y-shaped intertrochanteric osteotomy as described by Pauwels. Level of Evidence: Case-control study (EBM-level III).
Aims: To assess temporal trends in birth weight and pregnancy weight gain in Bavaria from 2000 to 2007. Methods: Data on 695,707 mother and infant pairs (singleton term births) were available from a compulsory reporting system for quality assurance, including information on birth weight, maternal weight at delivery and at booking, maternal smoking, age, and further anthropometric and lifestyle factors. Pregnancy weight gain was defined as: weight prior to delivery minus weight at first booking minus weight of the newborn. Results: Although mean weight gain during pregnancy increased considerably from 10.10 to 10.73 kg in seven years, the mean birth weight in mature singletons decreased slightly from 3433 to 3414 g. These trends could not be explained by concurrent changes in the rates of primiparity, smoking and gestational diabetes. Conclusions: These German data confirm an increased weight gain during pregnancy with adjustment for potential confounders.
Background: The aim was to examine the agreement and differences between ICD-10 and DSM-IV in the classification of functional psychoses. Sampling and Methods: In a sample of 218 first-hospitalised patients, ICD-10 diagnoses were compared with DSM-IV diagnoses. Functional psychoses of both diagnostic systems were classified into the four diagnostic groups schizophrenia, transient/episodic psychoses, delusional disorders and affective disorders. Based on information from a 15-year follow-up, it was examined which course is associated with each diagnostic group. Results: Although in ICD-10 there was a higher frequency of schizophrenia and a lower one of affective disorders, a high agreement between ICD-10 and DSM-IV (kappa value of 0.82) was found. In both diagnostic systems, transient/episodic psychoses and affective disorders were mainly associated with a non-chronic course and schizophrenia was mainly associated with a chronic one. Nevertheless, several patients with transient/episodic psychoses showed a chronic course (ICD-10: 10%, DSM-IV: 15%) and more than one third of patients with schizophrenia a non-chronic one (ICD-10: 40%, DSM-IV: 33%). Conclusions: In the cross-sectional assessment, there is a high diagnostic agreement between ICD-10 and DSM-IV. With respect to the long-term course, the delimitation of transient/episodic psychoses from schizophrenia was neither completely achieved by ICD-10 nor by DSM-IV. Copyright (C) 2004 S. Karger AG, Basel.