Out-of-body experiences in relation to lucid dreaming and sleep paralysis: A theoretical review and conceptual model.

Out-of-body experiences (OBEs) are characterized by the subjective experience of being located outside the physical body. Little is known about the neurophysiology of spontaneous OBEs, which are often reported by healthy individuals as occurring during states of reduced vigilance, particularly in proximity to or during sleep (sleep-related OBEs). In this paper, we review the current state of research on sleep-related OBEs and hypothesize that maintaining consciousness during transitions from wakefulness to REM sleep (sleep-onset REM periods) may facilitate sleep-related OBEs. Based on this hypothesis, we propose a new conceptual model that potentially describes the relationship between OBEs and sleep states. The model sheds light on the phenomenological differences between sleep-related OBEs and similar states of consciousness, such as lucid dreaming (the realization of being in a dream state) and sleep paralysis (feeling paralyzed while falling asleep or waking up), and explores the potential polysomnographic features underlying sleep-related OBEs. Additionally, we apply the predictive coding framework and suggest a connecting link between sleep-related OBEs and OBEs reported during wakefulness.

Spontaneously ruptured hepatocellular carcinoma on non-cirrhotic liver: A prospective case series.

BACKGROUND AND AIMS: Spontaneous ruptured hepatocellular carcinoma is an uncommon complication, and there are scarce data about non-cirrhotic patients. Tumor treatment is not standardized and the risk of peritoneal dissemination is unclear. AIM: we analyzed the treatment and survival in patients with rHCC on non-cirrhotic liver. METHODS: One hundred and forty-one non-cirrhotic patients with hepatocellular carcinoma diagnosed by histology were included in a multicenter prospective registry (2018-2022). Seven of them (5%) presented with hemoperitoneum due to spontaneous rupture. RESULTS: Liver disease was associated in three patients (42.9%). A single nodule was detected in three cases (42.9%). One patient had vascular invasion and none extrahepatic spread. Initial hemostatic therapy and sequential treatment was individualized. Patients with single nodule were treated: resection (one case) with recurrence at 4 months treated with TACE and sorafenib. TACE/TAE followed by surgery (two cases) one in remission 43 months later, the other had liver recurrence at 18 months and was transplanted. Patients with multiple lesions were treated: TAE/emergency surgery and subsequent systemic therapy (two cases), one received lenvatinib (1-year survival) and the other sorafenib (5-month survival). TAE and surgery with subsequent systemic therapy (one case). Initial hemostatic surgery, dying on admission (one case). No patient developed intraperitoneal metastasis. All patients with multiple lesions died by tumor. The 3-year survival rate was 42.9%. CONCLUSIONS: Initial hemostasis was achieved in all patients by TAE/TACE or surgery. Subsequent treatment was individualized, based on tumor characteristics, regardless of rupture. Long-time remission could be achieved in single nodule patients.

Nothingness Is All There Is: An Exploration of Objectless Awareness During Sleep.

Recent years have seen a heightened focus on the study of minimal forms of awareness during sleep to advance the study of consciousness and understand what makes a state conscious. This focus draws on an increased interest in anecdotical descriptions made by classic Indian philosophical traditions about unusual forms of awareness during sleep. For instance, in the so-called state of witnessing-sleep or luminosity sleep, one is said to reach a state that goes beyond ordinary dreaming and abide in a state of just awareness, a state in which one is not aware of anything else other than one's own awareness. Moreover, for these traditions, this state is taken to be the essence or background of consciousness. Reports on such a state opens the door to exciting new lines of research in the study of consciousness, such as inquiry into the so-called objectless awareness during sleep-states of awareness that lack an ordinary object of awareness. In this two-staged research project, we attempted to find the phenomenological blueprints of such forms of awareness during sleep in 18 participants by conducting phenomenological interviews, informed by a novel tool in qualitative research, the micro-phenomenological interview (MPI) method. Following a phenomenological analysis, we isolated a similar phase across 12 reported experiences labeled as "nothingness phase" since it described what participants took to be an experience of "nothingness." This common phase was characterized by minimal sense of self-a bodiless self, yet experienced as being "somewhere"-, the presence of non-modal sensations, relatively pleasant emotions, an absence of visual experience, wide and unfocused attention, and an awareness of the state as it unfolded.

Quo Vadis, Amadeo Hand Robot? A Randomized Study with a Hand Recovery Predictive Model in Subacute Stroke.

BACKGROUND: Early identification of hand-prognosis-factors at patient's admission could help to select optimal synergistic rehabilitation programs based on conventional (COHT) or robot-assisted (RAT) therapies. METHODS: In this bi-phase cross-over prospective study, 58 stroke patients were enrolled in two randomized groups. Both groups received same treatments A + B (A = 36 COHT sessions for 10 weeks; B = 36 RAT sessions for 10 weeks; 45 min/session; 3 to 5 times per week). Outcome repeated measures by blinded assessors included FMUL, BBT, NHPT, Amadeo Robot (AHR) and AMPS. Statistical comparisons by Pearson's rank correlations and one-way analyses of variance (ANOVA) with Bonferroni posthoc tests, with size effects and statistic power, were reported. Multiple backward linear regression models were used to predict the variability of sensorimotor and functional outcomes. RESULTS: Isolated COHT or RAT treatments improved hand function at 3 months. While "higher hand paresis at admission" affected to sensorimotor and functional outcomes, "laterality of injury" did not seem to affect the recovery of the hand. Kinetic-kinematic parameters of robot allowed creating a predictive model of hand recovery at 3 and 6 months from 1st session. CONCLUSIONS: Hand impairment is an important factor in define sensorimotor and functional outcomes, but not lesion laterality, to predict hand recovery.

Modulation of phenolic metabolism under stress conditions in a Lotus japonicus mutant lacking plastidic glutamine synthetase.

This paper was aimed to investigate the possible implications of the lack of plastidic glutamine synthetase (GS2) in phenolic metabolism during stress responses in the model legume Lotus japonicus. Important changes in the transcriptome were detected in a GS2 mutant called Ljgln2-2, compared to the wild type, in response to two separate stress conditions, such as drought or the result of the impairment of the photorespiratory cycle. Detailed transcriptomic analysis showed that the biosynthesis of phenolic compounds was affected in the mutant plants in these two different types of stress situations. For this reason, the genes and metabolites related to this metabolic route were further investigated using a combined approach of gene expression analysis and metabolite profiling. A high induction of the expression of several genes for the biosynthesis of different branches of the phenolic biosynthetic pathway was detected by qRT-PCR. The extent of induction was always higher in Ljgln2-2, probably reflecting the higher stress levels present in this genotype. This was paralleled by accumulation of several kaempferol and quercetine glycosides, some of them described for the first time in L. japonicus, and of high levels of the isoflavonoid vestitol. The results obtained indicate that the absence of GS2 affects different aspects of phenolic metabolism in L. japonicus plants in response to stress.

Caries prevalence in children from Valencia (Spain) using ICDAS II criteria, 2010

OBJECTIVES: To assess the oral health status of the child population and its evolution over the 2004-2010 period. Study DESIGN: A descriptive cross-sectional study of the entire schoolchild population of the Valencia region of Spain was conducted using cluster sampling. Seventy schools were selected. The sample size was 1373 pupils, aged 6, 12 and 15 years. The children were examined in November and December 2010, at their schools, by 6 examiners calibrated in the ICDAS II method. The descriptive statistics, comparison of means and comparison of proportions (p < 0.05) were recorded. RESULTS: The caries prevalence (ICDAS 4-6>0) was 30% in primary dentition at 6 years and 37.7% and 43.6% in permanent dentition at 12 and 15 years respectively. At 6, 12 and 15 years, the df.t/DMF. TICDASII 4-6 scores were 0.98, 0.83 and 1.08, the df.s/DMF.SICDASII 4-6 scores were 1.43, 1.27 and 1.64 and the care index results were 14.3%, 59% and 71.3% respectively. CONCLUSIONS: Both the caries indices (df.t at 6 years and DMF.T at 12 and 15) and caries prevalence have improved, as the values obtained were lower than in 2004. Using the comparison at 95% CI, between both years, the improvement was only noticeable in the 15 year-old group. The care index continued to be low at 6 years of age but higher values than in 2004 were found at 12 and 15 years. Social class continued to influence the child caries indicators

Caries prevalence in children from Valencia (Spain) using ICDAS II criteria, 2010.

OBJECTIVES: To assess the oral health status of the child population and its evolution over the 2004-2010 period. STUDY DESIGN: A descriptive cross-sectional study of the entire schoolchild population of the Valencia region of Spain was conducted using cluster sampling. Seventy schools were selected. The sample size was 1373 pupils, aged 6, 12 and 15 years. The children were examined in November and December 2010, at their schools, by 6 examiners calibrated in the ICDAS II method. The descriptive statistics, comparison of means and comparison of proportions (p<0.05) were recorded. RESULTS: The caries prevalence (ICDAS 4-6>0) was 30% in primary dentition at 6 years and 37.7% and 43.6% in permanent dentition at 12 and 15 years respectively. At 6, 12 and 15 years, the df.t/DMF. TICDASII 4-6 scores were 0.98, 0.83 and 1.08, the df.s/DMF.SICDASII 4-6 scores were 1.43, 1.27 and 1.64 and the care index results were 14.3%, 59% and 71.3% respectively. CONCLUSIONS: Both the caries indices (df.t at 6 years and DMF.T at 12 and 15) and caries prevalence have improved, as the values obtained were lower than in 2004. Using the comparison at 95% CI, between both years, the improvement was only noticeable in the 15 year-old group. The care index continued to be low at 6 years of age but higher values than in 2004 were found at 12 and 15 years. Social class continued to influence the child caries indicators.

Cosas del desierto

Seminario dirigido por J.-A. Miller. 1º Jornada de la EEP-ECFB "¿Qué puedo saber? ¿Qué debo saber? ¿Qué me está permitido esperar? Respuestas psicoanalíticas" Barcelona, 18 y 19 de septiembre de 1999