1st Night Research Articles

Performance of Rabi Blackgram (Vigna mungoL.,) under Different Sowing Windows

Field experiment was conducted at the College Farm, Agricultural College, Mahanandi of Acharya N.G. Ranga Agricultural University during the period from October, 2017 to January 2018 to evaluate the performance of rabiblackgram (Vigna mungo L.) under different sowing windows. The experimental site was sandy loam and it was neutral in reaction with a pH of 7.30, EC of 0.20 ds m-1. The experiment comprised four blackgram varieties viz., TBG-104, LBG-787, GBG-1 and PU-31 and four sowing dates viz., 1st fort night of October, 2nd fort night of October, 1st fort night November and 2nd fort night November.The experiment was laid out in randomized block design with factorial concept (FRBD) having sixteen treatments and three replications. Results showed that varieties and dates of sowings significantly influenced all the parameters in the growth attributing experimentation characters such as plant height, dry weight, leaf area index, and yield attributing characters like number of pods plant-1, number of seeds pod-1 and 1000 seed weight and seed yield (kg ha-1), haulm yield (kg ha-1) and harvest index (%) and were found highest in PU-31and lowest in LBG-787. With regard to sowing windows, the higher as well as lower values of these parameters were observed with sowing 1st fort night of October and 2nd fort night of November, respectively. Sowing PU-31 on 1st fort night of October and 2nd fort night of November gave the highest seed yield (856.42 kg ha-1) and haulm yield (2473.96 kg ha-1) respectively. Overall the results proved that 1st FN of October seems to be the appropriate sowing date for getting higher yield of black gram during rabi season. Among different varieties PU-31 came out with higher yield followed by GBG-1, TBG-104 and LBG-787.

Impact of the addition of dexmedetomidine to patient-controlled intravenous analgesia on postoperative pain-sleep interaction cycle and delirium: A systematic review and meta-analysis of randomized controlled trials

BackgroundThe reciprocal nexus between sleep and pain is well-documented, with the deleterious impact of operative trauma potentially playing a pivotal role in the dysregulation of this interplay, which could significantly contribute to the manifestation of postoperative delirium (POD). Studies have investigated the effect of adding dexmedetomidine (DEX) to patient-controlled intravenous analgesia (PCIA) pumps on postoperative pain-sleep interaction cycle and POD, but conclusions remained uncertain. The objective of this investigation is to perform a meta-analysis that thoroughly assesses the impact of integrating DEX into PCIA, focusing on analgesic effectiveness, sleep quality, and the incidence of delirium in postoperative patients. MethodsPubMed, Embase, Cochrane Library, SinoMed, and Wanfang Data Knowledge Service Platform were searched, for publications in any language, from database inception to September 2023. Our analysis encompassed randomized controlled trials (RCTs) that examine the therapeutic efficacy and risk profile of adding DEX to the PCIA on the postoperative pain-sleep interaction cycle, by focusing on changes in postoperative analgesia (Visual analog scale (VAS) score), sleep efficiency, sleep structure, subjective sleep score (Assen insomnia scale and numerical rating scale) and adverse event rate. Results34 RCTs (4324 patients) were analyzed. This study shows DEX improved analgesia and reduced VAS scores at 6, 12, and 24 h after surgery. Sleep efficiency was enhanced on the 1st and 2nd postoperative night. DEX improved sleep structure at the 1st postoperative night by reducing non-rapid eye movement stage 1 (N1) sleep and increasing non-rapid eye movement stage 2 (N2) and non-rapid eye movement stage 3 (N3) sleep. At the 2nd night, DEX reduced N1 sleep and increased N2 sleep, but not N3 sleep. Data from AIS and NRS showed improvement in subjective sleep scores on the 1st postoperative night and 2nd night. Additionally, DEX decreased the occurrence of POD on the 24 h and first-three days. ConclusionThis study shows that the typical DEX doses added to PCIA with sufentanil were 2–5 μg/kg or approximately 200–250 μg, and the addition of DEX to PCIA can improve pain-sleep interaction cycle from multiple perspectives, and further decrease the occurrence of POD.

Adherence to continuous positive airway pressure therapy in patients with spinal cord injury andobstructive sleep apnea: trajectories and predictors.

To identify specific determinants of non-adherence or cessation of continuous positive airway pressure (CPAP) therapy in a population of patients with spinal cord injuries (SCI). Retrospective analysis of data from patients with SCI who underwent a full night supervised polysomnography between 2015 and 2021 and presented with moderate to severe obstructive sleep apnea (OSA) and for whom CPAP was indicated. Adherence was studied at 1, 6, and 12 months. Univariate and multivariate analyses were performed to identify factors associated with non-adherence (< 4 h per night or CPAP cessation). Factors studied were demographic and disease-related data and both subjective and objective sleep parameters. A total of 60 patients were included (40% cervical SCI). In univariate analysis, the only predictive parameters of non-adherence observed at 1, 6, and 12 months were the average use of CPAP on the 1st night (p = 0.02) and over the 1st week (p ≤ 0.001). A complete lesion (AIS-A) was predictive of non-adherence at 1 and 6 months (p = 0.02 at 6 months), while mask leakage was associated with non-adherence at 12 months (p = 0.02). Upper limb autonomy and the presence of family caregivers did not appear to be protective. In multivariate analysis, only the average use in the first week remained predictive of adherence (> 4 h) in the short, medium and long term. In patients with SCI and OSA, the 1st week of CPAP treatment seems to be determinant of short-, medium-, and long-term CPAP adherence. Support for SCI patients from the start of treatment is essential and may help avoid treatment failures.

Pawai Malam Lebaran Menggunakan Musik DJ di Perbaungan Kabupaten Serdang: Perspektif Tokoh Muhammadiyah dan Al-Washliyah

Every 1st night of Shawwal (Eid al-fithr of Muslims) in Perbaungan District, Serdang Bedagai Regency, North Sumatra, there have been a takbir parade with decorative cars and DJ music. Therefore, the author is interested in examining this problem from the perspective of Muhammadiyah and Al-Washliyah figures in Perbaungan District. This article is field research methods by conducting interviews to some religious figures in Perbaungan district. This article found that the event organizers forbid the use of DJ music in the regulation. Apart from that, the opinion of the Perbaungan District Muhammadiyah figures tends to prohibit this act due to the mixing of takbir with DJ music. this is inversely proportional to the figure of Al-Washliyah Perbaungan who still has the opportunity to allow it because there is no firmly argument (qoth'i) which prohibits music and as long as it is not negligent the listener. This article finds that the opinion of Al-Washliyah figures is more relevant and easily accepted by the public. This is because the banning of a tradition requires a lot of time. In Islamic law, the principle of tadarruj is known, which means the prohibition or order of something must be done in stages.

MON-149 SEASONAL AND WEEKLY VARIABILITY OF BLOOD PRESSURE IN HEMODIALYSIS PATIENTS IN MULTICENTER OF VARIOUS DISTRICT IN JAPAN

In general population, there are weekly and seasonal variabilities of blood pressure (BP) which are supposed to be the risk of cardiovascular disease. Home BP is well correlated to the cardiovascular risk compared to office BP. The aims of this study are to determine whether home BP in large number of hemodialysis (HD) patients fluctuate seasonally and weekly and whether the seasonal BP variability correlate to the temperature. 169 dialysis patients (93 male, 76 female) in ten Saiseikai hospitals in various districts in Japan were recruited. All patients were asked to measure BP at least twice a day in a sitting position, once in the morning after urination before breakfast and medication and once in the evening just before going to bed. Data from Oct. 2015 to Oct. 2017 were analyzed. If the dialysis were performed 3 times a week (Mon, Wed, Fri), Monday was defined as 1st day. If the dialysis were performed on Tue. Thurs. and Sat., Tuesday was defined as 1st day. Seasonal variabilities in morning home BP of 1st day and night home BP of 5th day were evaluated. Seasonal changes in clinic BP just before and after HD were also evaluated in 61 patients. Weekly home BP variability in the morning, 1st day 153±16 / 78±13 mmHg, 2nd day 144±28 / 76±12, 3rd day 150±14 / 77±13, 4th day 142±26 / 75±13, 5th day 149±14 / 77±12, 6th day 144±24 / 76±13, 7th day 149±16 / 78±13. Systolic home BPs in 1st, 3rd and 5th days were significantly elevated compared with 2nd, 4th and 6th days. Morning home BP significantly elevated gradually from 6th, 7th and to 1st day. Lowest SBP in the morning was 4th day but not 6th day which was the same as the previous result (CJASN 3: 416-422, 2008). Seasonal variability of morning home BP in 1st day was evident with the rise in autumn and winter (spring 153±19 / 78±12, summer 146±17 / 77±12, autumn 158±16* / 80±12, winter 156±19* / 80±13, * p<0.05 vs summer) (figure). Seasonal changes of highest temperature were significant (spring 19.9±3.1*℃, summer 30.9±2.6, autumn 23.3±2.7*, winter 8.5±2.8*, *p<0.05 vs summer) (figure). Morning BP of 1st day in a randomly selected patient was correlated with highest temperature (r=-0.397、p<0.0001). Seasonal changes of night home BP in 5th day were not significant through four seasons. Seasonal changes in clinic BP just before and after HD, in 1st day before HD: spring 147±19 / 74±13 mmHg, summer 144±20 / 71±11, autumn 150±19 / 74±13, winter 147±21 / 74±12. Systolic BP in autumn was significantly elevated compared to summer. In the other clinic BPs before and after HD in 3rd and 5th days, there were no significant seasonal changes observed. Even in the large number of HD patients, there is weekly home BP variability probably due to volume status. Seasonal morning BP variability was evident in the 1st day of the HD week, but this seasonal home BP variability was disappeared measuring BP in the night without volume overload.

Dexmedetomidine in combination with morphine improves postoperative analgesia and sleep quality in elderly patients after open abdominal surgery: A pilot randomized control trial.

BackgroundDexmedetomidine in combination with opioids has been used for postoperative analgesia. The purpose of this study was to investigate the impacts of dexmedetomidine supplemented intravenous analgesia on morphine consumption and subjective sleep quality in elderly patients after open abdominal surgery.MethodsThis was a pilot randomized controlled trial. 58 elderly patients (age ≥ 60 years) who underwent open abdominal surgery were randomized to receive either dexmedetomidine supplemented morphine analgesia (0.5 mg/ml morphine plus 2 μg/ml dexmedetomidine in 100 ml normal saline, DEX group) or morphine analgesia (0.5 mg/ml morphine in 100 ml normal saline, CTRL group) for 72 hours after surgery. Patient-controlled analgesia pump was programmed to deliver a 2ml bolus with a lockout interval of 8 minutes and a background infusion at a rate of 1 ml/h. The primary endpoint was 72-hour morphine consumption. Secondary endpoints included pain intensity, subjective sleep quality, and 30-day complications and mortality after surgery.ResultsThe 72-hour morphine consumption was lower in the DEX group than in the CTRL group (median 39.0 mg [interquartile range 37.3, 41.0] in the DEX group vs. 49.0 mg [45.5, 50.0] in the CTRL group; median difference -9.0 mg [95% CI -10.0, -6.0], P < 0.001). The intensity of pain within 48 hours was lower (P<0.001 at 4, 12 and 48 hours, P = 0.007 at 24 hours) whereas the subjective quality of sleep was higher (P = 0.031 during the night of surgery and P<0.001 during the 1st night after surgery, respectively) in the DEX group than in the CTRL group. The incidence of 30-day complications did not differ significantly between groups, but it was slightly lower in the DEX group (P = 0.060). There were no significant differences between groups regarding 30-day mortality and the incidences of adverse events.ConclusionsFor elderly patients after open abdominal surgery, dexmedetomidine supplemented analgesia decreases morphine consumption, improves analgesic effects and subjective sleep quality without increasing adverse events.Trial registrationChinese Clinical Trial Registry ChiCTR-IPR-14005620.

Effect of Acute, Subacute, and Repeated Exposure to High Altitude (5050 m) on Psychomotor Vigilance.

Aim: High altitude (HA) hypoxia may affect cognitive performance and sleep quality. Further, vigilance is reduced following sleep deprivation. We investigated the effect on vigilance, actigraphic sleep indices, and their relationships with acute mountain sickness (AMS) during very HA exposure, acclimatization, and re-exposure.Methods: A total of 21 healthy altitude-naive individuals (25 ± 4 years; 13 females) completed 2 cycles of altitude exposure separated by 7 days at low altitude (LA, 520 m). Participants slept at 2900 m and spent the day at HA, (5050 m). We report acute altitude exposure on Day 1 (LA vs. HA1) and after 6 days of acclimatization (HA1 vs. HA6). Vigilance was quantified by reaction speed in the 10-min psychomotor vigilance test reaction speed (PVT-RS). AMS was evaluated using the Environmental Symptoms Questionnaire Cerebral Score (AMS-C score). Nocturnal rest/activity was recorded to estimate sleep duration using actigraphy.Results: In Cycle 1, PVT-RS was slower at HA1 compared to LA (4.1 ± 0.8 vs. 4.5 ± 0.6 s-1, respectively, p = 0.029), but not at HA6 (4.6 ± 0.7; p > 0.05). In Cycle 2, PVT-RS at HA1 (4.6 ± 0.7) and HA6 (4.8 ± 0.6) were not different from LA (4.8 ± 0.6, p > 0.05) and significantly greater than corresponding values in Cycle 1. In both cycles, AMS scores were higher at HA1 than at LA and HA6 (p < 0.05). Estimated sleep durations (TST) at LA, 1st and 5th nights were 431.3 ± 28.7, 418.1 ± 48.6, and 379.7 ± 51.4 min, respectively, in Cycle 1 and they were significantly reduced during acclimatization exposures (LA vs. 1st night, p > 0.05; LA vs. 5th night, p = 0.012; and 1st vs. 5th night, p = 0.054). LA, 1st and 5th nights TST in Cycle 2 were 477.5 ± 96.9, 430.9 ± 34, and 341.4 ± 32.2, respectively, and we observed similar deteriorations in TST as in Cycle 1 (LA vs. 1st night, p > 0.05; LA vs. 5th night, p = 0.001; and 1st vs. 5th night, p < 0.0001). At HA1, subjects who reported higher AMS-C scores exhibited slower PVT-RS (r = -0.56; p < 0.01). Subjects with higher AMS-C scores took longer time to react to the stimuli during acute exposure (r = 0.62, p < 0.01) during HA1 of Cycle 1.Conclusion: Acute exposure to HA reduces the PVT-RS. Altitude acclimatization over 6 days recovers the reaction speed and prevents impairments during subsequent altitude re-exposure after 1 week spent near sea level. However, acclimatization does not lead to improvement in total sleep time during acute and subacute exposures.

Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia.

Background: Obesity, abdominal surgery, and intrathecal opioids are all factors associated with a risk for respiratory compromise. The aim of this explorative trial was to study the apnoea/hypopnea index 1st postoperative night in obese mothers having had caesarean section (CS) in spinal anaesthesia with a combination of bupivacaine/morphine and fentanyl. Methods: Consecutive obese (BMI >30 kg/m 2) mothers, ≥18 years, scheduled for CS with bupivacaine/morphine/fentanyl spinal anaesthesia were monitored with a portable polygraphy device Embletta /NOX on 1 st postoperative night. The apnoea/hypopnea index (AHI) was identified by clinical algorithm and assessed in accordance to general guidelines; number of apnoea/hypopnea episodes per hour: <5 "normal", ≥5 and <15 mild sleep apnoea, ≥15 and <30 moderate sleep apnoea, ≥ 30 severe sleep apnoea. Oxygen desaturation events were in similar manner calculated per hour as oxygen desaturation index (ODI). Results: Forty mothers were invited to participate: 27 consented, 23 were included, but polysomnography registration failed in 3. Among the 20 mothers studied: 11 had an AHI <5 ( normal), 7 mothers had AHI ≥5 but <15 ( mild OSAS) and 2 mothers had AHI ≥15 ( moderate OSA), none had an AHI ≥ 30. The ODI was on average 4.4, and eight patients had an ODI >5. Mothers with a high AHI (15.3 and 18.2) did not show high ODI. Mean saturation was 94% (91-96%), and four mothers had mean SpO 2 90-94%, none had a mean SpO2<90%. Conclusion: Respiratory polygraphy 1 st night after caesarean section in spinal anaesthesia with morphine in moderately obese mothers showed AHIs that in sleep medicine terms are considered normal, mild and moderate. Obstructive events and episodes of desaturation were commonly not synchronised. Further studies looking at preoperative screening for sleep apnoea in obese mothers are warranted but early postop respiratory polygraphy recording is cumbersome and provided sparse important information.

Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia

Background: Obesity, abdominal surgery, and intrathecal opioids are all factors associated with a risk for respiratory compromise. The aim of this explorative trial was to study the apnoea/hypopnea index 1st postoperative night in obese mothers having had caesarean section (CS) in spinal anaesthesia with a combination of bupivacaine/morphine and fentanyl. Methods: Consecutive obese (BMI >30 kg/m 2) mothers, ≥18 years, scheduled for CS with bupivacaine/morphine/fentanyl spinal anaesthesia were monitored with a portable polygraphy device Embletta /NOX on 1 st postoperative night. The apnoea/hypopnea index (AHI) was identified by clinical algorithm and assessed in accordance to general guidelines; number of apnoea/hypopnea episodes per hour: <5 “normal”, ≥5 and <15 mild sleep apnoea, ≥15 and <30 moderate sleep apnoea, ≥ 30 severe sleep apnoea. Oxygen desaturation events were in similar manner calculated per hour as oxygen desaturation index (ODI). Results: Forty mothers were invited to participate: 27 consented, 23 were included, but polysomnography registration failed in 3. Among the 20 mothers studied: 11 had an AHI <5 ( normal), 7 mothers had AHI ≥5 but <15 ( mild OSAS) and 2 mothers had AHI ≥15 ( moderate OSA), none had an AHI ≥ 30. The ODI was on average 4.4, and eight patients had an ODI >5. Mothers with a high AHI (15.3 and 18.2) did not show high ODI. Mean saturation was 94% (91-96%), and four mothers had mean SpO 2 90-94%, none had a mean SpO2 <90%. Conclusion: Respiratory polygraphy 1 st night after caesarean section in spinal anaesthesia with morphine in moderately obese mothers showed AHIs that in sleep medicine terms are considered normal, mild and moderate. Obstructive events and episodes of desaturation were commonly not synchronised. Further studies looking at preoperative screening for sleep apnoea in obese mothers are warranted but early postop respiratory polygraphy recording is cumbersome and provided sparse important information.

TRADISI MASYARAKAT SELO DAN PARIWISATA DI TAMAN NASIONAL GUNUNG MERBABU, BOYOLALI JAWA TENGAH

Culture can form civilization or tradition in meeting the needs and well being of the people involved in the environment. One of form the human culture is a work of art. Artwork reveals the attitudes, processes, Symbolics meaning in the form of movement, carvings, paintings, material realized from social and cultural knowledge. Cultural attractions have a high appeal because it has a special value in the form of art performances, traditional ceremonies, the noble values that are contained in an object of man's work in the past. People have a variety of cultural art that consists of various traditions ceremonies, art performances, habits of indigenous people in life. It can be a potential cultural attraction for tourists who visit the National Park area of Mount Merbabu in District Selo, Boyolali regency. The purpose of this research is to know the traditions of performance, art, and culture the people of Selo, Merbabu Mountain National Park, Boyolali Central Java. Culture can shape civilization or tradition in the needs and welfare of life for the people involved in its environment. One form of human culture is the work of art, which reveals attitudes, processes, symbols of meaning in the form of movements, carvings, paintings, material embodied from social and cultural knowledge. Social and cultural knowledge embodies special things such as artistic attractions, traditional rituals passed down until to the present day. The meaning of this honor is an expression of gratitude to the spirit of the ancestors who have helped keep the balance of the region and the agriculture of the Selo community to be safe, safe and abundant. This research uses qualitative and quantitative analysis method by measuring distribution/frequency of performance and implementation of tradition/culture of Selo society. The Selo community has various artistic and traditional cultures, including art performances, ancestral honors (sadranan on the 1st night of Suro), clean villages, and thanksgiving for the harvest. The results of the study found that: 1) the tradition of traditional ceremonies in the form of homage to ancestral spirits (ancestors) of 7.1 percent, 2) performances sendratari of 54.52 percent, 3) the use of public buildings with local architecture of Java that serves as a gallery art as much as 59.03 percent, and 4) Community activities work together 75.48 percent. The data also indicates that the traditions and culture of the Selo community, not only as a potential support for tourism but become an integral part of the development of nature tourism in the area of Gunung Merbabu National Park Boyolali, Central Java.

Quality of sleep in patients undergoing cardiac surgery during the postoperative period in intensive care

ObjectivesTo describe the quality of sleep of patients undergoing cardiac surgery during the first two nights following surgery and identify some of the factors conditioning the nightly rest of these patients in the Intensive Care Unit. MethodObservational descriptive study based on applying the Richards–Campbell Sleep Questionnaire through a consecutive sample of patients undergoing cardiac surgery with Intensive Care Unit admission. Simultaneously, a questionnaire assessing different environmental factors existing in the unit as possible conditioning of the night's rest was applied. The association between consumption of opioid and sleep quality was studied. ResultsSample of 66 patients with a mean age of 65±11.57 years, of which 73% were men (N=48). The Richards–Campbell Sleep Questionnaire garnered average scores of 50.33mm (1st night) and 53.30mm (2nd night). The main sleep disturbing factors were discomfort with the different devices, 30.91mm and pain, 30.18mm. The problems caused by environmental noise, 27.5mm or through the voices of the professionals, 26.53mm were also elements of nocturnal discomfort. No statistical association was found between sleep and the distance of the patient with respect to the nursing control area or related to opioid analgesics. ConclusionsThe quality of sleep during the first two nights of Intensive Care Unit admission was “regular”. The environmental factors that conditioned the night-time rest of patients were discomfort, pain and ambient noise.

Response of guava (Psidium guajava L.) varieties to different time of softwood grafting

The present experiment was carried out during the year 2013–2014 at Department of Horticulture, Dr. Pan-jabrao Deshmukh Krishi Vidyapeeth, Akola (M.S.) India. The experiment was laid out in a Factorial Randomised Block Design, comprised of four different time of softwood grafting 1st forth night of January, 2nd forth night of January, 1st forth night of February, 2nd forth night of February and three guava varieties L-49, Lalit, Shweta with 12 treatment combinations replicated three times. The result indicated that amongst the four different time of grafting; 2nd forth night of February take minimum days for bud sprouting (14 days), also gave maximum percentage of graft take (98.33%), percentage of bud sprouting (98.33%) and final survival of graft (93.89%). Among the three different varieties taken as scion, the maximum percentage of bud sprouting (96.25%) and final survival of graft (93.34%) observed with the scion of cultivar Shweta.

Accelerated and synchronized oviposition induced by flight of young females may intensify larval outbreaks of the rice leaf roller.

Physiological management of migration-reproduction trade-offs in energy allocation often includes a package of adaptions referred to as the oogenesis-flight syndrome. In some species, this trade-off may be overestimated, because factors like flight behavior and environmental conditions may mitigate it. In this study, we examined the reproductive consequences induced by different flight scenarios in an economically-important Asian migrant insect, Cnaphalocrocis medinalis. We found that the influences of flight on reproduction are not absolutely positive or negative, but instead depend on the age at which the moth begins flight, flight duration, and how many consecutive nights they are flown. Adult flight on the 1st or 2nd night after emergence, flight for 6 h or 12 h nightly, and flight on the first two consecutive nights after emergence significantly accelerated onset of oviposition or enhanced synchrony of egg-laying. The latter can contribute to subsequent larval outbreaks. However, flight after the 3rd night, flight for 18 h at any age, or flight on more than 3 consecutive nights after adult emergence did not promote reproductive development, and in some scenarios even constrained adult reproduction. These results indicate that there is a migration/reproduction trade-off in C.medinalis, but that it is mitigated or eliminated by flight under appropriate conditions. The strategy of advanced and synchronized oviposition triggered by migratory flight of young females may be common in other migratory insect pests.

New Hypothesis and Theory about Functions of Sleep and Dreams

Aim: The aims of the study were: 1. revealing the new indicator(s) in internal organization of sleep in psychotic states; 2. constitution of new neurophysiologic and statistical models of sleep perturbation in psychotic states and/or altered states of consciousness based on experimental data. 3. Introduction of new sleep marker as biological marker for distinction of sleep organization by different psychotic states. 4. Established new hypothesis and theories in functions of sleep and dreams.Methods: The clinical neurophysiologic test (Polysomnography - PSG) were performed on 90 drug-free patients - 60 with depression (30 patients with reactive depression F32.0, F32.1, and 30 patients with depression with psychotic future F32.3); and 30 patients with Acute schizophrenia and schizophrenia-like states F23.1, F23.2 (all according to the DSM-IV criteria). Polysomnography was used for two nights, sleep staging (according to the criteria of Rechtschaffen & Kales, 1968) and statistical analysis of 130 sleep parameters with logistic regression (discriminative analysis “step by step”). All patients were drug-free in 3 days (1st adaptation night and 2 nights sleep investigation). The bigger part of investigation was performed in “Zentrum fuer Chronomedizin“in Wuerzburg (Germany) and one part at Psychiatric Clinic in Belgrade (Serbia).Results: 1. The results of our investigations demonstrate that the ratio between REM and NREM time in the first period of sleep (index of endogenous perturbation of sleep or IEP-P1=REM-1/NREM-1) is statistically the most significant chronobiological marker of internal sleep organization (through maturation and in different pathological states); 2. IEP-P1 is a highly reliable indicator of the development of endogenic perturbation of sleep in depression, mania, schizophrenic and other psychotic states, and in organic brain syndromes.Conclusion: IEP-P1 could be a new biological marker to distinction of sleep organization in different psychotic states and other states of altered consciousness. The developed statistical models could be the basis for new hypothesis and theories about functions of sleep and dreams.

New Hypothesis and Theory about Functions of Sleep and Dreams

Aim: The aims of the study were: 1. revealing the new indicator(s) in internal organization of sleep in psychotic states; 2. constitution of new neurophysiologic and statistical models of sleep perturbation in psychotic states and/or altered states of consciousness based on experimental data. 3. Introduction of new sleep marker as biological marker for distinction of sleep organization by different psychotic states. 4. Established new hypothesis and theories in functions of sleep and dreams.Methods: The clinical neurophysiologic test (Polysomnography - PSG) were performed on 90 drug-free patients - 60 with depression (30 patients with reactive depression F32.0, F32.1, and 30 patients with depression with psychotic future F32.3); and 30 patients with Acute schizophrenia and schizophrenia-like states F23.1, F23.2 (all according to the DSM-IV criteria). Polysomnography was used for two nights, sleep staging (according to the criteria of Rechtschaffen &amp; Kales, 1968) and statistical analysis of 130 sleep parameters with logistic regression (discriminative analysis “step by step”). All patients were drug-free in 3 days (1st adaptation night and 2 nights sleep investigation). The bigger part of investigation was performed in “Zentrum fuer Chronomedizin“in Wuerzburg (Germany) and one part at Psychiatric Clinic in Belgrade (Serbia).Results: 1. The results of our investigations demonstrate that the ratio between REM and NREM time in the first period of sleep (index of endogenous perturbation of sleep or IEP-P1=REM-1/NREM-1) is statistically the most significant chronobiological marker of internal sleep organization (through maturation and in different pathological states); 2. IEP-P1 is a highly reliable indicator of the development of endogenic perturbation of sleep in depression, mania, schizophrenic and other psychotic states, and in organic brain syndromes.Conclusion: IEP-P1 could be a new biological marker to distinction of sleep organization in different psychotic states and other states of altered consciousness. The developed statistical models could be the basis for new hypothesis and theories about functions of sleep and dreams.

Low-frequency rhythmic electrocutaneous hand stimulation during slow-wave night sleep: Physiological and therapeutic effects

Neocortical EEG slow wave activity (SWA) in the delta frequency band (0.5-4.0 Hz) is a hallmark of slow wave sleep (SWS) and its power is a function of prior wake duration and an indicator of a sleep need. SWS is considered the most important stage for realization of recovery functions of sleep. Possibility of impact on characteristics of a night sleep by rhythmic (0.8-1.2 Hz) subthreshold electrocutaneous stimulation of a hand during SWS is shown: 1st night--adaptation, 2nd night--control, 3d and 4th nights--with stimulation during SWA stages ofa SWS. Stimulation caused significant increase in average duration of SWS and EEG SWA power (in 11 of 16 subjects), and also well-being and mood improvement in subjects with lowered emotional tone. It is supposed that the received result is caused by functioning of a hypothetical mechanism directed on maintenance and deepening of SWS and counteracting activating, awakening influences of the afferent stimulation. The results can be of value both for understanding the physiological mechanisms of sleep homeostasis and for development of non-pharmacological therapy of sleep disorders.

Effect of short-term acclimatization to high altitude on sleep and nocturnal breathing.

Objective physiologic data on sleep and nocturnal breathing at initial exposure and during acclimatization to high altitude are scant. We tested the hypothesis that acute exposure to high altitude induces quantitative and qualitative changes in sleep and that these changes are partially reversed with acclimatization. Prospective observation. One night in a sleep laboratory at 490 meters, the first and the third night in a mountain hut at 4559 meters. Sixteen healthy mountaineers. Altitude exposure. Polysomnography, questionnaire evaluation of sleep and acute mountain sickness. Compared to 490 m, median nocturnal oxygen saturation decreased during the 1st night at 4559 m from 96% to 67%, minute ventilation increased from 4.4 to 6.3 L/min, and the apnea-hypopnea index increased from 0.1 to 60.9/h; correspondingly, sleep efficiency decreased from 93% to 69%, and slow wave sleep from 18% to 6% (P < 0.05, all instances). During the 3rd night at 4559 m, oxygen saturation was 71%, slow wave sleep 11% (P < 0.05 vs. 1st night, both instances) and the apnea/hypopnea index was 86.5/h (P = NS vs. 1st night). Symptoms of AMS and of disturbed sleep were significantly reduced in the morning after the 3rd vs. the 1st night at 4559 m. In healthy mountaineers ascending rapidly to high altitude, sleep quality is initially impaired but improves with acclimatization in association with improved oxygen saturation, while periodic breathing persists. Therefore, high altitude sleep disturbances seem to be related predominantly to hypoxemia rather than to periodic breathing.

Effectiveness of Multimodal Pain Control in Early Phase After Arthroscopic Rotator Cuff Repair

PURPOSE: The purpose of this study was to identify the effectiveness of multimodal pain control method in an early phase after arthroscopic rotator cuff repair, under interscalene brachial plexus block, this study was performed.MATERIALS AND METHODS: The study was progressed with the 80 cases of arthroscopic rotator cuff repair. Interscalene brachial plexus block was used to all of the 80 cases and patients were divided into 2 groups. Group A consisted of patients injected with bupivacaine, through subacromial space catheter after surgery, and group B consisted of patients with additional method of multimodal pain control using oral opioids, acetaminophen-tramadol complex and selective COX2 inhibitor. Subacromial cathter was removed after injection in both groups. The pain during the day time and night time was compared on the operation day, postoperative 1st, 2nd, 3rd day and 2nd weeks, and it was measured with VAS (visual analogue scale) score. Additionally, the number of ketolorac injection and side-effect related to analgesics was compared between the 2 groups.RESULTS: The mean VAS score of night time on the operation day and day/night time pain of the 1st, 2nd, 3rd day and 2nd weeks was 7.4, 7.0/6.8, 4.5/5.2, 4.8/5.0, 2.2/2.7 on group A and 6.5, 4.3/5.4, 3.2/4.3, 3.0/4.1, 2.4/2.5 on group B, respectively. Significant difference was observed in the night pain on the operation day, 1st, 2nd, 3rd day time and 1st night time pain (p&lt;.05). The average number of ketololac injection was 1.1 and 0.5 in each group, and there was no difference in the frequency of side effects.CONCLUSION: Multimodal pain control method, after arthroscopic rotator cuff repair, showed an effective early pain control and improved patients' satisfaction.

Sleeping In Normobaric Hypoxia (760 Torr; 14.4-16.2% O2) Did Not Cause Increased Restlessness Or AMS

Inducing altitude acclimatization during sleep using repeated exposures to normobaric hypoxia (NH; ∼760 Torr, <20.9% O2) has become a popular adjunct to exercise training. However, if NH conditions are too severe for unacclimatized individuals, restless sleep ("tossing and turning") and acute mountain sickness (AMS) symptoms can occur. PURPOSE: To determine if sleeping under progressively increasing NH conditions equivalent to 2200 to 3050 m causes increased restlessness or AMS. METHODS: 17 healthy, unacclimatized men and women slept for 7 consecutive nights in portable rooms (Colorado Altitude Training, Louisville, CO) under either NH (n=11, 25±6 yr, 77±16 kg; mean±SD) or "sham" (n=6, 25±5 yr, 73±19 kg) conditions. The ambient % O2 for the NH group was progressively reduced by ∼0.3% O2 (150 m equivalent) each night from ∼16.2% O2 (2200 m) on the 1st night to ∼14.4% O2 (3050 m) on the 7th night, while ambient O2 for the sham group remained at 20.9%. Both groups were blinded to the treatments. All wore a pulse oximeter (Nonin, Plymouth, MN) that recorded arterial oxygen saturation (SaO2) and heart rate (HR) using a finger sensor and a monitor on their wrist (Ambulatory Monitoring Inc, Ardeley, NY) to record motion. Recordings occurred for the entire recumbent duration. Sleep duration and number of hourly awakenings were determined by motion quantity. The Environmental Symptoms Questionnaire was administered each morning upon awakening and the cerebral factor score (AMS-C) was calculated. RESULTS: Each night, SaO2 was lower (P<0.001) in the NH group compared to the sham group. Over the 7 nights, SaO2 gradually decreased (P<0.05) from 92±2 to 88±3% for the NH group but remained at 96±1% for the sham group. HR did not differ between groups or within either group over time (∼64 b/min). Sleep duration (∼6.2 hrs) and the % time that each group slept while recumbent (∼93%), and rate of awakenings (1-2/hr) did not differ between groups for any night. Moreover, no one in either group developed AMS. CONCLUSION: Sleeping under progressive NH conditions equivalent to 2200-3050 m does not cause increased restlessness or AMS. Funding provided by US Army Medical Research Materiel Command ATO IV.MD.2006.01. Authors' views; not official U.S. Army or DoD policy.

Nocturnal Heart Rate Variability Following Supramaximal Intermittent Exercise

To assess the effect of supramaximal intermittent exercise on long-term cardiac autonomic activity, inferred from heart rate variability (HRV). Eleven healthy males performed a series of two consecutive intermittent 15-s runs at 95% VIFT (i.e., speed reached at the end of the 30-15 Intermittent Fitness Test) interspersed with 15 s of active recovery at 45% VIFT until exhaustion. Beat-to-beat intervals were recorded during two consecutive nights (habituation night and 1st night) before, 10 min before and immediately after exercise, as well as 12 h (2nd night) and 36 h (3rd night) after supramaximal intermittent exercise. The HRV indices were calculated from the last 5 min of resting and recovery periods, and the first 10 min of the first estimated slow wave sleep period. Immediate post-supramaximal exercise vagal-related HRV indices were significantly lower than immediate pre-supramaximal exercise values (P < .001). Most vagal-related indices were lower during the 2nd night compared with the 1st night (eg, mean RR intervals, P = .03). Compared with the 2nd night, vagal-related HRV indices were significantly higher during the 3rd night. Variables were not different between the 1st and 3rd nights; however, we noted a tendency (adjusted effect size, aES) for an increased normalized high-frequency component (P = .06 and aES = 0.70) and a tendency toward a decreased low-frequency component (P = .06 and aES = 0.74). Results confirm the strong influence of exercise intensity on short- and long-term postexercise heart rate variability recovery and might help explain the high efficiency of supramaximal training for enhancing indices of cardiorespiratory fitness.