Automatic quantification of REM sleep without atonia reliably identifies patients with REM sleep behavior disorder: a possible screening tool?

BACKGROUND: REM Sleep Behavior Disorder (RBD) is characterized by absence of physiological muscle atonia during REM sleep (REM sleep without atonia, RWA). Nigro-striatal dopaminergic impairment is a feature of Parkinson disease (PD) and can be identified in prodromal stages as well, such as idiopathic RBD (iRBD). Aims of this study are to explore the efficacy of an automatic RWA quantification in identifying RBD patients and the correlation between RWA and nigro-striatal dopaminergic function. METHODS: Forty-five iRBD, 46 PD with RBD, 24 PD without RBD patients and 11 healthy controls were enrolled in the Genoa Center (group A) and 25 patients with iRBD (group B) were enrolled in the Danish Center. Group A underwent brain [123I]FP-CIT-SPECT and group B underwent brain [18F]PE2I-PET as measures of nigro-striatal dopaminergic function. Chin muscle activity was recorded in all subjects and analyzed by applying a published automatic algorithm. Correlations between RWA and nigro-striatal dopaminergic function were explored. RESULTS: The automatic quantification of RWA significantly differentiated RBD from non-RBD subjects (AUC = 0.86), although with lower accuracy compared with conventional visual scoring (AUC = 0.99). No significant correlation was found between RWA and nigro-striatal dopaminergic function. CONCLUSION: The automatic quantification of RWA is a reliable tool to identify subjects with RBD and may be used as a first-line screening tool, but without correlations with nigro-striatal dopaminergic functioning.

Slow-wave sleep and REM sleep without atonia predict motor progression in Parkinson's disease.

BACKGROUND: Growing evidence supports the potential role of sleep in the motor progression of Parkinson's disease (PD). Slow-wave sleep (SWS) and rapid eye movement (REM) sleep without atonia (RWA) are important sleep parameters. The association between SWS and RWA with PD motor progression and their predictive value have not yet been elucidated. METHODS: We retro-prospectively analyzed clinical and polysomnographic data of 136 patients with PD. The motor symptoms were assessed using Unified Parkinson's Disease Rating Scale Part III (UPDRS III) at baseline and follow-up to determine its progression. Partial correlation analysis was used to explore the cross-sectional associations between slow-wave energy (SWE), RWA and clinical symptoms. Longitudinal analyses were performed using Cox regression and linear mixed-effects models. RESULTS: Among 136 PD participants, cross-sectional partial correlation analysis showed SWE decreased with the prolongation of the disease course (P = 0.046), RWA density was positively correlated with Hoehn & Yahr (H-Y) stage (tonic RWA, P < 0.001; phasic RWA, P = 0.002). Cox regression analysis confirmed that low SWE (HR = 1.739, 95% CI = 1.038-2.914; P = 0.036; FDR-P = 0.036) and high tonic RWA (HR = 0.575, 95% CI = 0.343-0.963; P = 0.032; FDR-P = 0.036) were predictors of motor symptom progression. Furthermore, we found that lower SWE predicted faster rate of axial motor progression (P < 0.001; FDR-P < 0.001) while higher tonic RWA density was associated with faster rate of rigidity progression (P = 0.006; FDR-P = 0.024) using linear mixed-effects models. CONCLUSIONS: These findings suggest that SWS and RWA might represent markers of different motor subtypes progression in PD.

Are equitable physical performance tests perceived to be fair? Understanding officer cadets' perceptions of fitness standards.

In the last few decades, the armed forces in Western countries such as Canada and the United States have accepted women into virtually all military occupations. Despite this, a growing body of research confirms that female service members face prejudiced treatment while conducting their work in these organizations that continue to be predominately masculine and male-dominated. In particular, women attending the Canadian Military Colleges (CMCs) experience gender-related conflicts arising from the dissimilar fitness test standards between male and female cadets. There have been, however, few studies that scrutinize the psychological mechanisms of these tensions. The aim of this study was to unpack the existing biased perceptions against women pertaining to physical fitness through ambivalent sexism, social dominance orientation, and right-wing authoritarianism. Officer and naval cadets (n = 167, 33.5% women) at the Royal Military College of Canada (RMC) completed survey measures. Indirect effect analyses showed that cadets who viewed the fitness standards to be unfair expressed more hostile rather than benevolent sexist outlooks against women, and these negative feelings were connected to greater levels of social dominance and right-wing authoritarianism. These results indicate that sexist beliefs, competitive worldviews, and authoritarianism are underlying attitudes that should be addressed by militaries striving to fully integrate women into their forces.

Ikelos-RWA. Validation of an Automatic Tool to Quantify REM Sleep Without Atonia.

Study Objectives. To present and evaluate an automatic scoring algorithm for quantification of REM-sleep without atonia (RWA) in patients with REM-sleep behaviour disorder (RBD) based on a generally accepted, well-validated visual scoring method, ("Montreal" phasic and tonic) and a recently developed, concise scoring method (Ikelos-RWA). Methods. Video-polysomnographies of 20 RBD patients (68.2 ± 7.2 years) and 20 control patients with periodic limb movement disorder (65.9 ± 6.7 years) were retrospectively analysed. RWA was estimated from chin electromyogram during REM-sleep. Visual and automated RWA scorings were correlated, and agreement (a) and Cohen's Kappa (k) calculated for 1735 minutes of REM-sleep of the RBD patients. Discrimination performance was evaluated with receiver operating characteristic (ROC) analysis. The algorithm was then applied on the polysomnographies of a cohort of 232 RBD patients (total analysed REM-sleep: 17,219 minutes) and evaluated, while correlating the different output parameters. Results. Visual and computer-derived RWA scorings correlated significantly (tonic Montreal: rTM = 0.77; phasic Montreal: rPM = 0.78; Ikelos-RWA: rI = 0.97; all p < 0.001) and showed good to excellent Kappa coefficients (kTM = 0.71; kPM = 0.79; kI = 0.77). The ROC analysis showed high sensitivities (95%-100%) and specificities (84%-95%) at the optimal operation points, with area under the curve (AUC) of 0.98, indicating high discriminating capacity. The automatic RWA scorings of 232 patients correlated significantly (rTM{I} = 0.95; rPM{I} = 0.91, p < 0.0001). Conclusions. The presented algorithm is an easy-to-use and valid tool for automatic RWA scoring in patients with RBD and may prove effective for general use being publicly available.

A prospective case-control study of excessive fragmentary myoclonus in the upper and lower extremities: Clinical characteristics and electrophysiological correlates.

BACKGROUND: Excessive fragmentary myoclonus (EFM) is an incidental finding in video-polysomnography (VPSG) and listed among "Sleep Related Movement Disorders - Isolated symptoms and normal variants" in the ICSD-3. We aimed to prospectively evaluate EFM in the upper and lower extremities in a large sleep laboratory cohort and to investigate clinical characteristics and peripheral nerve pathology in patients with and without EFM. METHODS: Two-hundred consecutive sleep laboratory patients with EFM according to ICSD-3 criteria were included and matched to 100 patients without EFM for age, sex and presence or absence of sleep-related breathing disorder. Patients additionally underwent peripheral neurophysiological work-up. RESULTS: In 31/200 (15.5%) patients EFM was present not only in the lower extremities, but also in the upper extremities. Patients with EFM had less REM sleep (%/SPT; median (IQR); 13.8 (9.1-18.2) vs. 17.1 (10.1-20.5); p = 0.008) and the PLMS-Index was higher in patients with EFM than in those without (16.2 vs. 8.8/h; p = 0.009). Polyneuropathy (PNP) and nerve root lesions L5 and S1 were more frequent in patients with than in those without EFM (31.5% vs. 21% and 5% vs. 0%; p = 0.003). CONCLUSIONS: In this large cohort we systematically investigated upper and lower extremities with surface electromyography during sleep and show that EFM is much more frequent in the lower extremities than in the upper extremities and corroborate the association of EFM with peripheral nerve pathology and PLMS.

Insights into pectin O-acetylation in the plant cell wall: structure, synthesis, and modification.

O-Acetyl esterification is an important structural and functional feature of pectins present in the cell walls of all land plants. The amount and positions of pectin acetyl substituents varies across plant tissues and stages of development. Plant growth and response to biotic and abiotic stress are known to be significantly influenced by pectin O-acetylation. Gel formation is a key characteristic of pectins, and many studies have shown that gel formation is dependent upon the degree of acetylation. Previous studies have indicated that members of the TRICHOME BIREFRINGENCE-LIKE (TBL) family may play a role in the O-acetylation of pectin, however, biochemical evidence for acceptor specific pectin acetyltransferase activity remains to be confirmed and the exact mechanism(s) for catalysis must be determined. Pectin acetylesterases (PAEs) affect pectin acetylation as they hydrolyze acetylester bonds and have a role in the amount and distribution of O-acetylation. Several mutant studies suggest the critical role of pectin O-acetylation; however, additional research is required to fully understand this. This review aims to discuss the importance, role, and putative mechanism of pectin O-acetylation.

Automatic analysis of muscular activity in the flexor digitorum superficialis muscles: a fast screening method for rapid eye movement sleep without atonia.

STUDY OBJECTIVES: To identify a fast and reliable method for rapid eye movement (REM) sleep without atonia (RWA) quantification. METHODS: We analyzed 36 video-polysomnographies (v-PSGs) of isolated REM sleep behavior disorder (iRBD) patients and 35 controls' v-PSGs. Patients diagnosed with RBD had: i) RWA, quantified with a reference method, i.e. automatic and artifact-corrected 3-s Sleep Innsbruck Barcelona (SINBAR) index in REM sleep periods (RSPs, i.e. manually selected portions of REM sleep); and ii) v-PSG-documented RBD behaviors. We quantified RWA with other (semi)-automated methods requiring less human intervention than the reference one: the indices proposed by the SINBAR group (the 3-s and 30-s phasic flexor digitorum superficialis (FDS), phasic/"any"/tonic mentalis), and the REM atonia, short and long muscle activity indices (in mentalis/submentalis/FDS muscles). They were calculated in whole REM sleep (i.e. REM sleep scored following international guidelines), in RSPs, with and without manual artifact correction. Area under curves (AUC) discriminating iRBD from controls were computed. Using published cut-offs, the indices' sensitivity and specificity for iRBD identification were calculated. Apnea-hypopnea index in REM sleep (AHIREM) was considered in the analyses. RESULTS: RWA indices from FDS muscles alone had the highest AUCs and all of them had 100% sensitivity. Without manual RSP selection and artifact correction, the "30-s phasic FDS" and the "FDS long muscle activity" had the highest specificity (85%) with AHIREM < 15/h. RWA indices were less reliable when AHIREM≥15/h. CONCLUSIONS: If AHIREM<15/h, FDS muscular activity in whole REM sleep and without artifact correction is fast and reliable to rule out RWA.

The traditional vegetarians - improving attitudes toward vegetarians through emphasizing similarities between vegetarianism and traditional fasting.

The modern choices of diet are often perceived at odds with the traditional worldviews. This study aimed to test the possibility of improving attitudes toward vegetarians by emphasizing the similarity between vegetarianism and religious fasting. We expected the effects of induction to be moderated by endorsement of right-wing authoritarianism and social dominance orientation (SDO-D and SDO-E). Participants (N = 246) were randomly divided into three groups that all read a text about a traditional birthday celebration. The control group read a text about the celebration with meat-based meals, one experimental group read about a celebration with meatless dishes. In the second experimental group it was emphasized that the host became a vegetarian after years of religious fasting. Both inductions improved attitudes toward vegetarians. Only SDO-D proved to be a significant moderator, with induction exhibiting a significant effect at higher levels of SDO-D. The findings inform public communications about reducing meat consumption.

A vicious circle? Longitudinal relationships between different modes of in-group identity and COVID-19 conspiracy thinking.

Since March 2020, when the World Health Organization declared the spread of COVID-19 a global pandemic, conspiracy theories have continued to rise. This research examines the role of different forms of in-group identity in predicting conspiracy thinking in the context of the coronavirus pandemic. We hypothesized that conspiracy thinking would be predicted positively by national narcissism (i.e., a belief in in-group's greatness which is contingent on its external validation and makes in-group members sensitive to psychological threats) but negatively by secure national identification (i.e., a confidently held ingroup evaluation, which serves as a buffer against psychological threats). In a three-wave longitudinal study conducted on a representative sample of adult Poles (N = 650), conspiracy thinking was positively predicted by national narcissism, but negatively by national identification. Further, we found evidence that conspiracy thinking strengthened national narcissism (but not national identification) over time. Implications for intra- and intergroup processes are discussed.

Rapid eye movement sleep behaviour disorder: Past, present, and future.

This manuscript presents an overview of REM sleep behaviour disorder (RBD) with a special focus on European contributions. After an introduction examining the history of the disorder, we address the pathophysiological and clinical aspects, as well as the diagnostic issues. Further, implications of RBD diagnosis and biomarkers are discussed. Contributions of European researchers to this field are highlighted.

Ideological Influences on Intergroup Attitudes in the Context of the Hague Court Boundary Dispute between Peru and Chile / Influencias ideológicas de las actitudes intergrupales en el contexto de la disputa fronteriza entre Perú y Chile ante la Corte de la Haya / Influências ideológicas das atitudes intergrupais no contexto da disputa fronteiriça entre Peru e Chile frente à Corte de Haia

Abstract In the context of the border dispute presented by Peru against Chile in the The Hague Court, this study analyzes the influences of two ideological motivational dimensions: Right-Wing Authoritarianism (RWA) and Social Dominance Orientation (SDO) on a set of intergroup attitudes that involve both nations. To this end, a survey study of 196 Chileans and 223 Peruvians participants was conducted. The instruments used to measure ideology and political attitudes are the following ones: RWA Scale; SDO Scale; Scale of Intergroup attitudes between Chile-Peru and specific questions on interest in the Hague litigation and willingness to fight for one's country. The results show that in the Peruvian case attitudes of belligerence and alert and a greater willingness to fight for the country are better explained by the RWA, while in the Chilean case these same attitudes are explained both by the RWA as well as the SDO. On the other hand, pacificist attitudes are explained inversely by SDO in both countries. These findings support the hypothesis that intergroup dynamics between both countries have been marked by expressed actions of a Chilean expansionism versus a Peruvian vengefulness and suggest that equalitarianism will promote attitudes toward respect and cooperation between both groups, changing the frames of expansionism and vengefulness for one of a culture of peace.

Resumo Este estudo analisa as influências de duas dimensões motivacionais ideológicas: o Autoritarismo de Direita (RWA) e a Orientação à Dominação Social (SDO) em um conjunto de atitudes intergrupais que envolvem Perú e Chile, no contexto da disputa fronteiriça apresentada pelo primeiro contra o segundo na Corte de Haia. Para isso, foi desenvolvido um estudo com 196 participantes do Chile e 223 do Peru. Os instrumentos utilizados para medir a ideologia e as atitudes políticas são os seguintes: Questionário de RWA; questionário de SDO; questionário de atitudes intergrupos entre Chile é Peru e itens de interesse na disputa ante A Haia e a vontade de lutar pelo próprio país. Os resultados mostram que, no caso peruano, as atitudes de beligerância e alerta, e uma maior disposição de lutar pelo país são explicadas pelo RWA, enquanto no caso chileno, essas mesmas atitudes são explicadas tanto pelo RWA quanto pela SDO. Por outro lado, as atitudes pacifistas são diminuidas pela SDO nos dois países. Estos resultados corroboram á hipótese da dinâmica intergrupal entre os dois países, marcada por ações explícitas do expansionismo chileno versus revanchismo peruano; os resultados também sugerem que as ideologias igualitarias poderão promover atitudes de respeito e cooperação entre os dois grupos, alterando os esquemas expansionista e revanchista para uma cultura de paz.

Resumen En el contexto de la disputa fronteriza presentada por Perú contra Chile ante la Corte de la Haya, este estudio analiza las influencias dos dimensiones motivacionales ideológicas: el Autoritarismo de Derecha (RWA) y la Orientación a la Dominancia Social (SDO) en un conjunto de actitudes intergrupales que involucran a ambas naciones. Con esta finalidad, fue desarrollado un estudio por encuestas con 196 participantes de Chile y 223 de Perú. Los instrumentos utilizados para medir la ideología y las actitudes políticas son los siguientes: Escala de RWA; Escala de SDO; Escala de actitudes intergrupales entre Chile-Perú y preguntas específicas sobre el interés en el litigio de La Haya y la disposición de luchar por el propio país. Los resultados muestran que en el caso peruano las actitudes de beligerancia y alerta, y una mayor disposición a luchar por el país son explicadas por el RWA, mientras en el caso chileno, estas mismas actitudes son explicadas tanto por el RWA como por la SDO. Por otra parte, las actitudes pacifistas son explicadas inversamente por la SDO en ambos países. Estos hallazgos corroboran la hipótesis sobre las dinámicas intergrupales entre ambos países, las cuales han estado marcadas por acciones explicitas de expansionismo chileno versus revanchismo peruano; asimismo, los resultados sugieren que el igualitarismo promovería actitudes hacia el respeto y cooperación entre ambos grupos, cambiando los esquemas expansionista y revanchista por uno de cultura de paz.

[Discrimination of Chin Electromyography in REM Sleep Behavior Disorder Using Deep Learning].

OBJECTIVE: The confirmation of abnormal behavior during video monitoring in polysomnography (PSG) and the frequency of rapid eye movement (REM) sleep without atonia (RWA) during REM sleep based on physiological indicators are essential diagnostic criteria for the diagnosis of REM sleep behavior disorder (RBD). However, no clear criteria have been established for the determination of the tonic and phasic activities of RWA. In this study, we investigated an RWA decision program that simulates visual inspection by clinical laboratory technicians. METHODS: We used the measurement data of 25 men and women (average age±standard deviation: 72.7±1.7 years) who visited the Sleep Treatment Center for PSG inspection due to suspected RBD. The chin electromyography (EMG) during REM sleep was divided into 30 s intervals, and RWA decisions were made on the basis of visual inspection by a clinical laboratory technician. We compared and investigated two machine-learning methods namely support vector machine (SVM) and convolutional neural network (CNN) for RWA decisions. RESULTS: When comparing SVM and CNN, the highest discrimination accuracy for RWA decisions was obtained when using the average rectified value (ARV) processed chin EMG images using CNN as a feature. We also estimated the prevalence of RBD on the basis of the Mahalanobis distance measure using the frequency of occurrence of both tonic and phasic activities calculated from a total of 25 subjects in the patient and healthy groups. Consequently, estimation of RBD prevalence using CNN resulted in misclassification of none of the subjects in the patient group and two subjects in the healthy group. CONCLUSIONS: In this study, we investigated the automatic analysis of PSG results focusing on RBD, which is a parasomnia. As a result, there were no misclassifications of patients in the 25 subjects in the patient or healthy groups based on the estimates of RBD prevalence using CNN. The prevalence estimation based on our proposed automated algorithm is considered effective for the primary screening for RBD.

Attitudes towards favoring the fall of Tall Poppies: The role of Social Dominance Orientation, Authoritarianism, Political Ideologies, and Self-Esteem.

Individuals occupying high-status positions are sometimes victims of the tall poppy syndrome where people want to see them cut down to size. These attitudes reflect a tension between achievement, authority, and equality. In a pre-registered study (Study 1: N = 47,951), and a replication (Study 2: N = 5,569), of two representative New Zealand samples we investigated how social dominance orientation, right-wing authoritarianism, political ideologies and self-esteem predicted favoring the fall of the tall poppy. Novel findings showed individuals high in social dominance orientation favored the fall of the tall poppy. In both studies, high authoritarian aggression and submission, and low conventionalism (in Study 1 only) were also associated with negative tall poppy attitudes. So too were individuals with lower self-esteem and who were less conservative in their political ideology. These findings advance our understanding of how group-based hierarchy and inequality relate to attitudes toward individuals in high-status positions.

Video-polysomnography procedures for diagnosis of rapid eye movement sleep behavior disorder (RBD) and the identification of its prodromal stages: guidelines from the International RBD Study Group.

Video-polysomnography (v-PSG) is essential for diagnosing rapid eye movement (REM) sleep behavior disorder (RBD). Although there are current American Academy of Sleep Medicine standards to diagnose RBD, several aspects need to be addressed to achieve harmonization across sleep centers. Prodromal RBD is a stage in which symptoms and signs of evolving RBD are present, but do not yet meet established diagnostic criteria for RBD. However, the boundary between prodromal and definite RBD is still unclear. As a common effort of the Neurophysiology Working Group of the International RBD Study Group, this manuscript addresses the need for comprehensive and unambiguous v-PSG recommendations to diagnose RBD and identify prodromal RBD. These include: (1) standardized v-PSG technical settings; (2) specific considerations for REM sleep scoring; (3) harmonized methods for scoring REM sleep without atonia; (4) consistent methods to analyze video and audio recorded during v-PSGs and to classify movements and vocalizations; (5) clear v-PSG guidelines to diagnose RBD and identify prodromal RBD. Each section follows a common template: The current recommendations and methods are presented, their limitations are outlined, and new recommendations are described. Finally, future directions are presented. These v-PSG recommendations are intended for both practicing clinicians and researchers. Classification and quantification of motor events, RBD episodes, and vocalizations are however intended for research purposes only. These v-PSG guidelines will allow collection of homogeneous data, providing objective v-PSG measures and making future harmonized multicentric studies and clinical trials possible.

Piglet Gut and in-Barn Manure from Farms on a Raised without Antibiotics Program Display Reduced Antimicrobial Resistance but an Increased Prevalence of Pathogens.

In response to new stringent regulations in Canada regarding the use of antibiotics in animal production, many farms have implemented practices to produce animals that are raised without antibiotics (RWA) from birth to slaughter. This study aims to assess the impact of RWA production practices on reducing the actual total on-farm use of antibiotics, the occurrence of pathogens, and the prevalence of antimicrobial resistance (AMR). A 28-month longitudinal surveillance of farms that adopted the RWA program and conventional farms using antibiotics in accordance with the new regulations (non-RWA) was conducted by collecting fecal samples from 6-week-old pigs and composite manure from the barn over six time points and applying whole-genome sequencing (WGS) to assess the prevalence of AMR genes as well as the abundance of pathogens. Analysis of in-barn drug use records confirmed the decreased consumption of antibiotics in RWA barns compared to non-RWA barns. WGS analyses revealed that RWA barns had reduced the frequency of AMR genes in piglet feces and in-barn manure. However, metagenomic analyses showed that RWA barns had a significant increase in the frequency of pathogenic Firmicutes in fecal samples and pathogenic Proteobacteria in barn manure samples.

Ubiquitylome analysis reveals the involvement of ubiquitination in the bast fiber growth of ramie.

MAIN CONCLUSION: A total of 249 sites from 197 proteins showed a differential ubiquitination level in the fiber development of ramie barks. The function of two differentially ubiquitinated proteins for fiber growth was demonstrated. Ubiquitination is one of the most common post-translational modifications of proteins, and it plays essential roles in plant growth and development. However, the involvement of ubiquitination in the growth of plant fibers remains largely unknown. We compared the ubiquitylome of the top and middle stems of ramie bark, with different fiber growth stages. We identified 249 differentially ubiquitinated sites in 197 proteins in fiber-developing barks in the stems and found that seven were homologs of Arabidopsis proteins associated with fiber growth. Overexpression of the differentially ubiquitinated proteins, RWA3 homolog whole_GLEAN_10024150 and MYB protein whole_GLEAN_10015497, significantly promoted fiber growth in transgenic Arabidopsis, indicating their involvement in this process. We also found that the abundance of these proteins decreased when their ubiquitination levels increased and vice versa in the fiber-developing bark. These results indicated that the abundance of these two proteins was adjusted through ubiquitin-dependent degradation. Collectively, our findings provide important insights into the involvement of ubiquitination in the growth of ramie fibers.

Flexor digitorum superficialis muscular activity is more reliable than mentalis muscular activity for rapid eye movement sleep without atonia quantification: A study of interrater reliability for artifact correction in the context of semiautomated scoring of rapid eye movement sleep without atonia.

STUDY OBJECTIVES: To evaluate interrater reliability for artifact correction in the context of semiautomated quantification of rapid eye movement (REM) sleep without atonia (RWA) in the mentalis and flexor digitorum superficialis (FDS) muscles. METHODS: We included video-polysomnographies of 14 subjects with apnea-hypopnea index in REM sleep (AHIREM) < 15/h and 11 subjects with AHIREM ≥ 15/h. Eight subjects had isolated REM sleep behavior disorder. A validated algorithm (www.osg.be) automatically scored phasic and "any" EMG activity in the mentalis muscle, and phasic EMG activity in the FDS muscles. Four independent expert scorers performed artifact correction according to the SINBAR (Sleep Innsbruck Barcelona) recommendations. Interrater reliability for artifact correction was computed with B-statistics. The variability across scorers of four RWA indices (phasic mentalis, "any" mentalis, phasic FDS and SINBAR-i.e. "any" mentalis and/or phasic FDS-EMG activity indices) was computed. With Friedman tests, we compared B-statistics obtained for mentalis and FDS muscles, and the variability of the RWA indices. Influence of AHIREM and REM sleep behavior disorder (RBD) diagnosis on the RWA indices variability was evaluated with linear regressions. RESULTS: Interrater reliability for artifact correction was higher in the FDS than in the mentalis muscle (p < 0.001). Phasic FDS activity was minimally affected by artifacts. Accordingly, the phasic FDS EMG activity index had the lowest variability across scorers (p < 0.001). Variability across scorers of the RWA indices including the mentalis muscle increased with AHIREM and was independent from RBD diagnosis. CONCLUSIONS: Due to the consistently found low number of artifacts, phasic FDS activity is a reliable measure of RWA.

Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia are more frequent in advanced versus early Parkinson's disease.

STUDY OBJECTIVES: To evaluate macro sleep architecture and characterize rapid eye movement (REM) sleep without atonia (RWA) by using the SINBAR excessive electromyographic (EMG) montage including mentalis and upper extremity muscles in early and advanced Parkinson's disease (PD). METHODS: We recruited 30 patients with early- and advanced-stage of PD according to Movement Disorder Society (MDS) Clinical Diagnostic Criteria. Participants were classified as early-stage PD if they were treatment-naïve or had no motor complications and had been diagnosed with PD within the previous 6 years. Advanced PD was defined as a disease duration equal to or >6 years with or without motor complications. RESULTS: There was significantly shorter REM sleep latency in early as compared to the advanced stage of PD. We found that the sleep Innsbruck Barcelona (SINBAR) EMG index and tonic EMG activity of the mentalis muscle in advanced-stage PD were significantly higher than in early-stage PD with a trend in phasic EMG activity of the flexor digitorum superficialis muscles. The SINBAR EMG index, tonic and any EMG activity of the mentalis muscle, and phasic EMG activity of flexor digitorum superficialis muscles significantly correlated with disease duration. CONCLUSIONS: This study analyzed RWA using the SINBAR EMG montage in early- and advanced-stage of PD and showed higher RWA in mentalis and flexor digitorum superficialis muscles and SINBAR EMG index in advanced-PD patients compared to patients in the early stage. Also, polysomnography-confirmed REM sleep behavior disorder was more common in advanced versus early-stage patients. Our findings suggest that RWA worsens or is more intense or more frequent with disease progression.

Rapid Eye Movement Sleep Behavior Disorder-like Symptoms Due to Arousal Responses Associated with Severe Obstructive Sleep Apnea-hypopnea.

A 78-year-old man suspected of having α-synucleinopathies received a high score on a validated questionnaire for rapid eye movement (REM) sleep behavior disorder (RBD). Although he did in fact have unpleasant dreams and vigorous behaviors, polysomnography (PSG) found only obstructive sleep apnea-hypopnea (OSAH). The RBD-like symptoms corresponded with arousal responses, namely augmented inspiratory effort and leg movements, to his frequent apnea-hypopnea events during REM sleep. Thus, severe OSAH might cause RBD-like symptoms. PSG can discriminate real RBD from RBD-like symptoms associated with severe OSAH and therefore may be essential for determining an appropriate course of treatment in certain patients.

No man is an island: Psychological underpinnings of prosociality in the midst of the COVID-19 outbreak.

In response to the COVID-19 outbreak, sustainable forms of collective resilience help societies coping cohesively with unprecedented challenges. In our empirical contribution, we framed collective resilience and cohesion in terms of prosociality. A study carried out in the midst of the COVID-19 outbreak in the UK (N = 399) articulated basic individual values, ideological orientations (i.e., authoritarianism and social dominance orientation), and core political values in a comprehensive framework to predict bonding and bridging forms of prosocial intentions, and prosocial behaviors directed towards vulnerable groups. According to our findings, people whose worldview incorporates collective and collaborative principles cared more about others' welfare. Jointly, self-transcendence, equality, and accepting immigrants predicted more prosociality, whereas social dominance orientation predicted less prosociality. Over and beyond all other predictors, self-transcendence uniquely predicted prosocial intentions and behaviors alike. To conclude, we suggest interventions to promote and sustain prosociality among people motivated by a larger array of life goals and worldviews.