Springtime migratory restlessness and departure orientation of Great Knots(Calidris tenuirostris)in the south compared to the north Yellow Sea

Background: The motivation of birds to proceed with migration is associated with both endogenous and exogenous factors. According to their migratory situation and to the characteristics of stopover sites, birds might exhibit migratory motivation differently among sites. Although migratory motivation of migrating birds has been well studied in many species, the investigation of the same species in different migratory situations and at different stopover sites is still limited. We predicted that birds at different stopover sites could differ in migratory disposition, including expression of migratory restlessness and responses to environmental cues.Methods: Here we compared migration motivation and orientation of Great Knots(Calidris tenuirostris) at two stopo ver sites, Chongming Dongtan in the south Yellow Sea, which is a temporary rest site, and Yalujiang Estuary Wetland in the north Yellow Sea, which is a critical refuelling site, during northward migration. Modified Emlen funnels, with thermal paper inside to record scratches of the birds, were used to detect activity(intensity and direction) of birds. Environmental conditions, including wind direction and speed, cloud cover, tide condition, times of the day(before and after sunset) were recorded during experiments. Generalized linear models were used to detect the effects of endogenous and exogenous factors on the migratory motivation of the birds.Results: In the south Yellow Sea, the migratory activity intensity of Great Knots was positively related to wind assistance. In the north Yellow Sea, where birds exhibited higher intensity of migratory activity than in the south, the intensity increased and the motivation to initiate migration grew stronger as the season advanced. The Great Knots exhibited wind-related orientation behaviour in the funnels at both sites.Conclusions: The results suggest that the intensity of migratory motivation differed between the two sites. Departure decisions of Great Knots appear to be affected mainly by external factors at the temporary rest site in the south Yellow Sea but possibly by endogenous factors at the final pre-breeding refuelling site in the north Yellow Sea.

A clinical investigation of the relationship between different sedation depths and the restlessness after using midazolam as an adjuvant during regional anesthesia

Objective： To investigate the relationship between different sedation depth and the restlessness after using midazolam as an adjuvant during regional anesthesia. Methods ： One hundred and fifty patients undergoing regional anesthesia were randomly divided into three groups. In group A, the patients were sedated at the level of OAA/S IV with midazolam during regional anesthesia. In group B and C, the sedation depths were kept at the levels of Ⅲ and Ⅱrespectively. The changes of BP, HR and SpO2 were recorded before and after midazolam. The rate of restlessness was also evaluated. Results： Blood pressures decreased in certain degree at 5 and 10 min after midazolam compared with those before in all three groups. BP decreased over 20% of the baseline in 4 cases in group A, in 5 cases in group B, and in 5 cases in group C. There was no significant difference in BP dropping among three groups. Compared with group B and C SpO2 dropped significantly at 3 and 5 rain after midazolam in group C, in which SpO2 was less than 93% in 8 cases. The restlessness rate in group C was 22%, which was significantly higher than those in group A （2% ,P〈0.01） and group B（4% ,P〈0.05）. Conclusion： The sedation depth is related to the rate of restlessness when midazolam is used as an adjuvant during regional anesthesia. It is suggested that the appropriate sedation depth for the patients under regional anesthesia is OAA/S Ⅲ.

Investigation of the mechanism of action of Sanwu Huangqin Tang in the treatment of restless leg syndrome based on network pharmacology,molecular docking technology and molecular dynamics simulation

Background:Through the use of network pharmacology and molecular docking approaches,this study will examine the pharmacological effects of Sanwu Huangqin Tang on restless legs syndrome in order to better understand the mechanism of action of Traditional Chinese medicine(TCM)on RLS.Method:Utilise the TCMSP database to collect and select the drug components of Sanwu Huangqin Tang,and the Uniprot database to identify pertinent targets;RLS-related disease targets were obtained from GeneCards,DrugBank,and OMIM databases;and STRING and Cytoscape 3.9.1 software were used to generate an interaction network.KEGG pathway analysis and GO enrichment analysis were performed utilizing the DAVID database.Use Autodock for analyzing the relationships between targets and core components.Result:By using a network pharmacology approach,83 active ingredients and 50 drug-disease intersecting targets were derived for Sanwu Huangqin Tang.The molecular docking results showed that the drug components had strong affinity with the average target targets.Conclusions:This study provides new insights into the mechanism through which Traditional Chinese Medicine(TCM)treats Restless Legs Syndrome(RLS).Furthermore,it lays the foundation for additional research into the mechanism of treatment for RLS through the intervention that addresses various targets and pathways using the active ingredients identified by Sanwu Huangqin Tang.

Sleep disorders and chronic kidney disease

Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease(CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.

Dopamine agonist responsive burning mouth syndrome:Report of eight cases

BACKGROUND Burning mouth syndrome(BMS)is characterized by burning sensation of the oral mucosa.There is a lack of effective treatment.In recent years,a special subtype of BMS has been reported,in which oral burning sensation is alleviated after chewing,speaking,or dopaminergic drug delivery.Currently,there are few reports about the subtype of BMS in China.This study was a retrospective analysis of the clinical data of BMS patients sensitive to dopamine agonist at our hospital,aiming to improve the recognition on this disease.CASE SUMMARY Eight patients diagnosed with dopamine agonist responsive BMS at the Liaocheng People's Hospital from January 1,2017 to June 30,2020 were recruited.The clinical manifestations,treatment,and prognosis were retrospectively analyzed.There were three male and five females in the eight patients.The median age was 56 years(range,46-65 years).All the eight patients showed burning pain in the mouth.The symptoms were mild in the morning and severe in the evening,and alleviated after chewing,talking,and other oral activities.Four patients were accompanied by restless legs syndrome(RLS).Family history of RLS was positive in two patients.All patients were treated with pramipexol,and symptoms were basically relieved after 2-8 wk.CONCLUSION Dopamine agonist responsive BMS is a special subtype of BMS,which is alleviated after oral activities.Dopamine receptor agonist is an effective treatment.

QoS-Aware Dynamic Resource Management in Heterogeneous Mobile Cloud Computing Networks

In mobile cloud computing(MCC) systems,both the mobile access network and the cloud computing network are heterogeneous,implying the diverse configurations of hardware,software,architecture,resource,etc.In such heterogeneous mobile cloud(HMC) networks,both radio and cloud resources could become the system bottleneck,thus designing the schemes that separately and independently manage the resources may severely hinder the system performance.In this paper,we aim to design the network as the integration of the mobile access part and the cloud computing part,utilizing the inherent heterogeneity to meet the diverse quality of service(QoS)requirements of tenants.Furthermore,we propose a novel cross-network radio and cloud resource management scheme for HMC networks,which is QoS-aware,with the objective of maximizing the tenant revenue while satisfying the QoS requirements.The proposed scheme is formulated as a restless bandits problem,whose "indexability" feature guarantees the low complexity with scalable and distributed characteristics.Extensive simulation results are presented to demonstrate the significant performance improvement of the proposed scheme compared to the existing ones.

Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients

AIM To examine whether hemodialysis(HD) patients with restless legs syndrome(RLS) are subjects of greater fatigue and impaired quality of life(QoL) compared to HD patients without RLS.METHODS Eighty five stable HD patients participated in this study. According to their RLS status, the patients were dividedinto the RLS group(n = 23) and the non-RLS group(n = 62). QoL, fatigue, sleep quality, daily sleepiness and depression symptoms were assessed by using various questionnaires. Finally, biochemical parameters including iron, ferritin, hemoglobin, hematocrit and parathormone were assessed. RESULTS The HD patients with RLS scored worse in all the questionnaires used in the study(P < 0.05). The patients with RLS were more likely to receive the HD therapy on the morning shift, whilst 43.5% of the RLS patients reported to experience the RLS symptoms also during HD. The severity of RLS was correlated with fatigue, depression score and sleep quality(P < 0.05). CONCLUSION HD patients with RLS are subject to lower QoL related parameters and greater fatigue compared to HD patients without RLS. RLS should be successfully managed in order to improve the QoL of the sufferers.

Management of restless legs syndrome in chronic liver disease:A challenge for the correct diagnosis and therapy

AIM To investigate the association between restless legs syndrome(RLS) and well-defined chronic liver disease, and the possible therapeutic options. METHODS Two hundred and eleven patients with chronic liver disease, complaining of sleep disturbances, painful leg sensation and daily sleepiness, were included. Patients with persistent alcohol intake, recent worsening of clinical conditions, or hepatitis C virus were excluded. Diagnosis of RLS was suggested by the Johns Hopkins questionnaire and verified by fulfilling the diagnostic criteria by Allen. All patients were tested, both at baseline and during follow-up, with the Hamilton rating scale for depression, sleep quality assessment(PSQI), Epworth sleepiness scale(ESS), International Restless Legs Syndrome Study Group evaluation, and international RLS severity(IRLS) scoring system. Ironfree level, ferritin, folate, vitamin B12 and D-OH25 were detected. Neurological examinations and blood testoccurred at the beginning of the therapy, after 2 wk, and at the 28^(th), 75 th, 105 th, 135 th, 165 th and 205 th day. Regarding therapy, pramipexole or gabapentin were used.RESULTS Patients were moderately depressed, with evident nocturnal sleep problems and concomitant daily sleepiness. Sleep problems and involuntary leg movements had been underestimated, and RLS s yndrome had not be e n c ons ide re d be fore t he neurological visit. All(211/211) patients fulfilled the RLS diagnostic criteria. Twenty-two patients considered their symptoms as mild, according to IRSL, but 189 found them moderate to very severe. No correlation was found between ammonium level and ESS or PSQI. Augmentation was rather precocious in our patients(135 th day), and more frequent(35%) than previous data(8.3%-9.1%). The dosage of dopamine agonists was found to be associated with augmentation and appears in range with the literature. Previous intake of alcohol and lower levels of vitamins have been related to the phenomenon in our study.CONCLUSION RLS is a common disorder, requiring rapid diagnosis and treatment. Further research is therefore fundamental.

Prevalence of restless legs syndrome in patients with irritable bowel syndrome

AIM:To determine the prevalence of restless legs syndrome(RLS)in patients with irritable bowel syndrome(IBS).METHODS:Patients with diarrhea-predominant IBS(n=30),constipation-predominant IBS(n=30),or mixed-symptom IBS(n=30)were recruited from the community between March 2008 and February 2009.Rifaximin 200 mg three times daily was administered empirically to alleviate small intestinal bowel over-growth in all patients.The presence of RLS was assessed via an RLS questionnaire and polysomnography.RESULTS:Twentysix patients with IBS(29%)were diagnosed with RLS using the RLS questionnaire.Twenty-four of the 26 patients(92%)underwent polysomnog-raphy,and all had confirmation of RLS.A greater percentage of patients with RLS had diarrhea-predominant IBS(62%)compared with patients with constipation-predominant IBS(4%)or mixed-symptom IBS(33%).CONCLUSION:Restless legs syndrome is prevalent in patients with IBS,especially those with diarrheal symptoms.Assessment of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.

Age of Transmission-Optimal Scheduling for State Update of Multi-Antenna Cellular Internet of Things

Timely information updates are critical for real-time monitoring and control applications in the Internet of Things(IoT). In this paper, we consider a multi-antenna cellular IoT for state update where a base station(BS) collects information from randomly distributed IoT nodes through time-varying channel.Specifically, multiple IoT nodes are allowed to transmit their state update simultaneously in a spatial multiplex manner. Inspired by age of information(AoI),we introduce a novel concept of age of transmission(AoT) for the sceneries in which BS cannot obtain the generation time of the packets waiting to be transmitted. The deadline-constrained AoT-optimal scheduling problem is formulated as a restless multi-armed bandit(RMAB) problem. Firstly, we prove the indexability of the scheduling problem and derive the closed-form of the Whittle index. Then, the interference graph and complementary graph are constructed to illustrate the interference between two nodes. The complete subgraphs are detected in the complementary graph to avoid inter-node interference. Next, an AoT-optimal scheduling strategy based on the Whittle index and complete subgraph detection is proposed.Finally, numerous simulations are conducted to verify the performance of the proposed strategy.

Acupuncture Treatment of Restless Leg Syndrome

Case HistoryMr. Michael Fischer, aged 55 years, a German electrical engineer, paid his first visit on Dec. 7th, 1997, with the chief complaint of pain in the right lower limb for two months.

CLINICAL STUDY OF 108 RESTLESS LEGS CASES BY ACUPUNCTURE OR EAR ACUPUNCTURE

108 cases of restless legs syndrome were treated , out of which, 56 cases withacupuncture, 52 cases with ear acupuncture. The therapeutical effects of acupuncture are superior tothat of ear acupuncture.

A DISTRIBUTED COOPERATIVE RELAYING OPTIMIZATION SCHEME FOR SECONDARY TRANSMISSION IN COGNITIVE RADIO NETWORKS

In Cognitive Radio(CR) networks,cooperative communication has been recently regarded as a key technology for improving the spectral utilization efficiency and ensuring the Quality of Service(QoS) for Primary Users(PUs).In this paper,we propose a distributed joint relay selection and power allocation scheme for cooperative secondary transmission,taking both Instantaneous Channel State Information(I-CSI) and residual energy into consideration,where secondary source and destination may have different available spectrum.Specifically,we formulate the cognitive relay network as a restless bandit system,where the channel and energy state transition is characterized by the finite-state Markov chain.The proposed policy has indexability property that dramatically reduces the computation and implementation complexity.Analytical and simulation results demonstrate that our proposed scheme can efficiently enhance overall system reward,while guaranteeing a good tradeoff between achievable date rate and average network lifetime.

Sleep-associated movement disorders and the risk of cardiovascular disease: A systematic review and metaanalysis

AIM:To investigate whether an association exists between sleep-associated movement disorders and cardiovascular disease(CVD).METHODS:Several studies have observed the relationship of sleep-associated movement disorders such as restless legs syndrome(RLS)and periodic limb movements during sleep with CVD,but the results were still contradictory.We performed an extensive literature search on Pub Med,Medline and Web of Science published from inception to December 2014.Additional studies were manually searched from bibliographies of retrieved studies.Meta-analyses were conducted with Stata version 12.0(Stata Corp,College Station,Texas).Pooled odds ratios(ORs)and 95%CIs were calculated to assess the strength of association using the random effects model.Sensitivity and subgroup analyses were performed to explore the underlying sources of heterogeneity.The publication bias was detected using Egger’s test and Begg’s test.RESULTS:A total of 781 unique citations were indentified from electronic databases and 13 articles in English were finally selected.Among these studies,nine are cohort studies;two are case-control studies;and two are cross-sectional studies.The results showed that the summary OR of CVD associated with sleepassociated movement was 1.51(95%CI:1.29-1.77)in a random-effects model.There was significant heterogeneity between individual studies(P for heterogeneity=0.005,I2=57.6%).Further analysis revealed that a large-scale cohort study may account for this heterogeneity.A significant association was also found between RLS and CVD(OR=1.54,95%CI:1.24-1.92).In a fixed-effects model,we determined a significant relationship between sleep-associatedmovement disorders and coronary artery disease(CAD)(OR=1.34,95%CI:1.16-1.54;P for heterogeneity=0.210;I2=30.0%).Our meta-analysis suggests that sleep-associated movement disorders are associated with prevalence of CVD and CAD.CONCLUSION:This finding indicates that sleep-associated movement disorders may prove to be predictive of underlying CVD.

Sleep Disorders in Menopause: Review of the Literature and Occurrence through Menopausal Stages

We here review principal literature data about sleep disorders in menopause and we compared it with data obtained from a systematical screening of a sample of 161 menopausal women through questionnaires and clinical evaluation. Our data reveal high occurrence of sleep disorders in this group of women if compared to literature data about general population, in the absence of statistically significant differences among the three menopausal stages: we find only a trend toward a higher risk of OSAS (Obstructive Sleep Apnea Syndrome) in PM versus early PM and MT. However, none of women in our survey underwent PSG (polysomnography), essential to confirm the diagnosis of OSAS and none was diagnosed with RLS (Restless Legs Syndrome) (prior to our survey) by the Gynecologist or General Pratictioner: these data reveal the issue of too low attention towards sleep disorders in this contest. Generic “sleep complaints” are clearly associated with depressed mood and worse-quality life along the menopausal process. In our sample, a non-specific definition of insomnia shows a peculiar relationship with a mood disorder: it is only variable not associated with higher BDI and KI scores, in fact. This might suggest that the conditions linked to depression of these women could be more specific sleep disturbances, such as RLS and OSAS.

Prevalence of Restless Legs Syndrome in Patients Treated with Peritoneal Dialysis: Clinical and Biochemical Characteristics among Patients with and without Restless Legs Syndrome

Introduction and Aims:This is a prospective study identifying prevalence of Restless Legs Syndrome (RLS) in patients ongoing peritoneal dialysis (PD) due to end stage renal disease (ESRD) and comparing clinical and biochemical characteristics among patients with and without RLS. Methods: Two hundred ESRD patients who received PD at least six months assessed by neurologist and nephrologist with regards to presence of RLS. Also, clinical and biochemical features of these patients are determined. One hundred and forty four patients were excluded from study because they had other secondary causes of RLS except for ESRD. Results: Thirteen of 56 patients (23.2%) had RLS. The use of vitamin B + folic acid supplements was significantly lower in patients with RLS than in those without RLS (69.2% vs 97.7%;p = 0.008). There was no significant difference between patient groups with and without RLS in terms of age, gender, body mass index, cause of ESRD, peritoneal membrane transport characteristic, smoking, consuming alcohol, use of erythropoietin, duration of PD, hemoglobin, serum calcium, serum phosphorus, serum albumin, levels of serum iron, total iron binding capacity, ferritin, folic acid and vitamin B12, transferrin saturation, weekly Kt/V urea value, and amount of residual urine volume (p > 0.05). Conclusion: RLS is more common among PD patients than general population. Although essential cause is not exactly known, use of folic acid and vitamin B complex decrease the RLS prevalence in this particular patient group.

Restless Legs Syndrome in Liver Transplant Recipients

Background: The prevalence of restless legs syndrome (RLS) is approximately 10% in general population. This condition is more prevalent in certain diseases and we previously reported the prevalence of RLS in chronic liver disease population to be 62%. Objectives: Our aim was to assess the self-reported prevalence of RLS using an RLS symptom specific questionnaire in liver transplant patients. Methods: Subjects were a convenience sample in transplant clinic. They completed a validated survey for core RLS symptoms and if positive went on to completed a telephone survey using the validated International RLS Severity Scale Questionnaire (IRLS) and the Johns Hopkins RLS QoL survey to measure the effect of RLS symptoms on daily activities. Results: 40 patients surveyed, RLS was found in 16 subjects (40%) with moderate severity {17 (SD + 7.2, high score 31)}. Hepatitis C as indication for liver transplant was more likely associated with RLS (p = 0.05). Calcium channel blockers were protective (p = 0.032) while antidopaminergic agent use was statistically significant for RLS symptom (p = 0.005). On multiple linear regression analysis, diabetes (p = 0.024) and use of antidepressants/antihistamines (p = 0.049) were associated with RLS. Quality of Life (QoL) surveys specific to RLS suggested RLS symptoms resulted in significantly diminished QoL, with an average QoL score of 80 (SD + 11.7). Conclusion: There was a very high prevalence of RLS in our liver transplant patients with majority experiencing moderate or severe symptoms. The explanation for this higher prevalence is likely due to combination of comorbidites as well as medications that can trigger RLS.

On the Elementary Mechanical Effects of the Space-Time-Symmetry Relativity

This paper is an addendum to the article “On the Evolution of Approaches to the Space- Time Symmetry”, Natural Science, Vol. 10, No. 3, pp. 81-84, 2018. The analysis is based on the Galileo’s postulate that all inertial reference frames are equal. The postulate results immediately in the absolute speed limit, which is identical for all bodies in all reference frames. Two kinds of elementary particles are admitted: unhurried and restless ones (ex-emplified, accordingly, with electrons and photons). Any particle may be treated as wave packet, the particle mass and momentum depending on the reference frame. Thus, space-time-sym- metry is the natural background for the relativistic and quantum theo-ries.

That Restless Feeling

Mrs.Feldmeyer found her inher bedroom crying.She stood inthe doorway and said seriously,“Icame over to borrow your vacuumcleaner,Carolyn. Mine’s broken.The door was open,so I just walkedin.What on earth is the matter?”Carolyn sat up and dried

An Analysis of Medication Rules of Chinese Medicine for Restless Legs Syndrome Based on Data Mining

Objective: Based on data mining, to explore the medication rules of Chinese medicine for the treatment of restless legs syndrome(RLS). Methods: The CNKI, WANFANG, and VIP were taken as data sources, and "restless legs syndrome, RLS" as the key words, and "Chinese medicine, Chinese materia medica, traditional Chinese medicine(TCM), traditional Chinese and Western medicine" as sub key words, the data was extracted from the journals and literature related to the treatment of RLS by TCM from the establishment of the database to 2020, and data mining techniques(frequency analysis, cluster analysis, association rules) were used to analyze the core drugs and drug pair(group) rules. Results: A total of 87 prescriptions met the requirements of this study, involving 142 Chinese herbal medicines. The top 5 Chinese herbal medicines with a higher frequency of use were Radix Paeoniae Alba, Radix Glycyrrhizae, Radix Angelicae Sinensis, Fructus Chaenomelis and Radix Astragali seu Hedysari. The four Qi(气) of the medicine were mainly warm and neutral, the five flavors were mainly sweet, bitter, and pungent. The main channels of the meridian were mainly the liver meridian, spleen meridian and heart meridian. The medication categories were mainly tonifying deficiency herbs, blood activating and removing blood stasis herbs, and eliminating wind and dampness herbs. The association rule analysis yielded 24 Chinese medicine combinations with high support, and the hierarchical cluster analysis yielded a total of 5 clusters. Conclusion: TCM treatment of RLS is based on tonifying deficiency herbs, especially to replenish Qi and blood throughout the course of the disease, supplemented by herbs for promoting blood circulation and removing blood stasis, and herbs for eliminating wind and dampness, as well as combined with herbs for reliving superficies and herbs for calming the liver to stop the wind.