Decline of long-range temporal correlations in the human brain during sustained wakefulness

Sleep is crucial for daytime functioning, cognitive performance and general well-being. These aspects of daily life are known to be impaired after extended wake, yet, the underlying neuronal correlates have been difficult to identify. Accumulating evidence suggests that normal functioning of the brain is characterized by long-range temporal correlations (LRTCs) in cortex, which are supportive for decision-making and working memory tasks. Here we assess LRTCs in resting state human EEG data during a 40-hour sleep deprivation experiment by evaluating the decay in autocorrelation and the scaling exponent of the detrended fluctuation analysis from EEG amplitude fluctuations. We find with both measures that LRTCs decline as sleep deprivation progresses. This decline becomes evident when taking changes in signal power into appropriate consideration. Our results demonstrate the importance of sleep to maintain LRTCs in the human brain. In complex networks, LRTCs naturally emerge in the vicinity of a critical state. The observation of declining LRTCs during wake thus provides additional support for our hypothesis that sleep reorganizes cortical networks towards critical dynamics for optimal functioning

Highly Refractory Peridotites on Macquarie Island and the Case for Anciently Depleted Domains in the Earth's Mantle

Macquarie Island (Southern Ocean) is a fragment of Miocene ocean crust and upper mantle formed at a slow-spreading ridge system, uplifted and currently exposed above sea-level. The crustal rocks on the island have unusually enriched compositions and the strong signature of an enriched source requires low overall degrees of melt depletion in the underlying mantle. Peridotites on the island, however, are highly refractory harzburgites that can be modeled as residues of >20-25% of near-fractional melting from which all the free clinopyroxene was melted out. The peridotites have some of the highest spinel Cr-numbers (0·40-0·49) and lowest orthopyroxene-core Al2O3 concentrations (2·7-3·0 wt %) reported so far for oceanic peridotites. The peridotites were subsequently modified by melt-rock reactions underneath the Miocene ridge system. The refractory character of the peridotites is inconsistent with the slow-spreading ridge setting as well as with the enriched character of the overlying crust, and must indicate a previous depletion event; the peridotites are not the source residue of the overlying ocean crust on Macquarie Island. Osmium isotopic compositions of peridotite samples are very unradiogenic (187Os/188Os = 0·1194-0·1229) compared with normal abyssal peridotites and indicate a long-lived rhenium depletion. Proterozoic rhenium-depletion ages indicate that these rocks have preserved a memory of an old mantle melting event. We argue that the Macquarie Island harzburgites are samples from an anciently depleted refractory mantle reservoir that may be globally important, but that is generally overlooked because of its sterility; that is, its inability to produce basalts. This reservoir may preserve key information about the history of the Earth's mantle as a whol

Social work after stroke: identifying demand for support by recording stroke patients' and carers' needs in different phases after stroke.

BACKGROUND: Previous studies examining social work interventions in stroke often lack information on content, methods and timing over different phases of care including acute hospital, rehabilitation and out-patient care. This limits our ability to evaluate the impact of social work in multidisciplinary stroke care. We aimed to quantify social-work-related support in stroke patients and their carers in terms of timing and content, depending on the different phases of stroke care. METHODS: We prospectively collected and evaluated data derived from a specialized "Stroke-Service-Point" (SSP); a "drop in" center and non-medical stroke assistance service, staffed by social workers and available to all stroke patients, their carers and members of the public in the metropolitan region of Berlin, Germany. RESULTS: Enquiries from 257 consenting participants consulting the SSP between March 2010 and April 2012 related to out-patient and in-patient services, therapeutic services, medical questions, medical rehabilitation, self-help groups and questions around obtaining benefits. Frequency of enquiries for different topics depended on whether patients were located in an in-patient or out-patient setting. The majority of contacts involved information provision. While the proportion of male and female patients with stroke was similar, about two thirds of the carers contacting the SSP were female. CONCLUSION: The social-work-related services provided by a specialized center in a German metropolitan area were diverse in terms of topic and timing depending on the phase of stroke care. Targeting the timing of interventions might be important to increase the impact of social work on patient's outcome

identifying demand for support by recording stroke patients’ and carers’ needs in different phases after stroke

Background Previous studies examining social work interventions in stroke often lack information on content, methods and timing over different phases of care including acute hospital, rehabilitation and out-patient care. This limits our ability to evaluate the impact of social work in multidisciplinary stroke care. We aimed to quantify social-work-related support in stroke patients and their carers in terms of timing and content, depending on the different phases of stroke care. Methods We prospectively collected and evaluated data derived from a specialized “Stroke-Service-Point” (SSP); a “drop in” center and non-medical stroke assistance service, staffed by social workers and available to all stroke patients, their carers and members of the public in the metropolitan region of Berlin, Germany. Results Enquiries from 257 consenting participants consulting the SSP between March 2010 and April 2012 related to out-patient and in-patient services, therapeutic services, medical questions, medical rehabilitation, self-help groups and questions around obtaining benefits. Frequency of enquiries for different topics depended on whether patients were located in an in-patient or out-patient setting. The majority of contacts involved information provision. While the proportion of male and female patients with stroke was similar, about two thirds of the carers contacting the SSP were female. Conclusion The social- work-related services provided by a specialized center in a German metropolitan area were diverse in terms of topic and timing depending on the phase of stroke care. Targeting the timing of interventions might be important to increase the impact of social work on patient’s outcome

Directions of changes in the management of Polish NGOs in processes of governmentalisation and marketisation

The recent years brought worldwide development of managerial thinking and practices in the third sector, but these processes are barely identified within the Polish non-governmental sector. Polish organisations are considerably more influenced by the public sector, which often results in too close relationships, dependence from public financial resources, and advancing institutionalisation. Perhaps the state’s retreat from a broad partnership with NGOs, widely regarded as disadvantageous and dangerous to the Polish democracy, that could be observed for the past two years at the central level, will turn out to be the saving grace and will stop the processes of governmentalisation. In search of the sources of funding other than public, increasing the quality of services and learning new rules, relations and principles; perhaps we will witness the emergence of a new formula of the third sector in Poland. Keeping in mind, of course, the leading principle of heterogenicity and diversity of NGOs' objectives, stemming from unlimited human need

Diagnostic biomarkers for adult haemophagocytic lymphohistiocytosis in critically ill patients (HEMICU): a prospective observational study protocol

INTRODUCTION: Haemophagocytic lymphohistiocytosis (HLH) in adults is characterised by toxic immune activation and a sepsis-like syndrome, leading to high numbers of undiagnosed cases and mortality rates of up to 68%. Early diagnosis and specific immune suppressive treatment are mandatory to avoid fatal outcome, but the diagnostic criteria (HLH-2004) are adopted from paediatric HLH and have not been validated in adults. Experimental studies suggest biomarkers to sufficiently diagnose HLH. However, biomarkers for the diagnosis of adult HLH have not yet been investigated. METHODS AND ANALYSIS: The HEMICU (Diagnostic biomarkers for adult haemophagocytic lymphohistiocytosis in critically ill patients) study aims to estimate the incidence rate of adult HLH among suspected adult patients in intensive care units (ICUs). Screening for HLH will be performed in 16 ICUs of Charité - Universitätsmedizin Berlin. The inclusion criteria are bicytopaenia, hyperferritinaemia (≥500 µg/L), fever or when HLH is suspected by the clinician. Over a period of 2 years, we expect inclusion of about 100 patients with suspected HLH. HLH will be diagnosed if at least five of the HLH-2004 criteria are fulfilled, together with an expert review; all other included patients will serve as controls. Second, a panel of potential biomarker candidates will be explored. DNA, plasma and serum will be stored in a biobank. The primary endpoint of the study is the incidence rate of adult HLH among suspected adult patients during ICU stay. Out of a variety of measured biomarkers, this study furthermore aims to find highly potential biomarkers for the diagnosis of adult HLH in ICU. The results of this study will contribute to improved recognition and patient outcome of adult HLH in clinical routine