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Are patients under anesthesia really unconscious?

© Wavebreak Media/Thinkstock
Awake? EEG can be used to make sure you're really under.
The prospect of undergoing surgery while not fully "under" may sound like the stuff of horror movies. But one patient in a thousand remembers moments of awareness while under general anesthesia, physicians estimate. The memories are sometimes neutral images or sounds of the operating room, but occasionally patients report being fully aware of pain, terror, and immobility. Though surgeons scrupulously monitor vital signs such as pulse and blood pressure, anesthesiologists have no clear signal of whether the patient is conscious. But a new study finds that the brain may produce an early-warning signal that consciousness is returning - one that's detectable by electroencephalography (EEG), the recording of neural activity via electrodes on the skull.

"We've known since the 1930s that brain activity changes dramatically with increasing doses of anesthetic," says the study's corresponding author, anesthesiologist Patrick Purdon of Massachusetts General Hospital in Boston. "But monitoring a patient's brain with EEG has never become routine practice."

Beginning in the 1990s, some anesthesiologists began using an approach called the bispectral (BIS) index, in which readings from a single electrode are connected to a device that calculates, and displays, a single number indicating where the patient's brain activity falls on a scale of 100 (fully conscious) to zero (a "flatline" EEG). Anything between 40 and 60 is considered the target range for unconsciousness. But this index and other similar ones are only indirect measurements, Purdon explains. In 2011, a team led by anesthesiologist Michael Avidan at the Washington University School of Medicine in St. Louis, Missouri, found that monitoring with the BIS index was slightly less successful at preventing awareness during surgery than the nonbrain-based method of measuring exhaled anesthesia in the patient's breath. Of the 2861 patients monitored with the BIS index, seven had memories of the surgery, whereas only two of 2852 patients whose breath was analyzed remembered anything.

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What makes sleep paralysis scary

© Henry Fuseli (1781)
Henry Fuseli's "The Nightmare" may have been inspired by the chest-crushing sensation and hallucinations of sleep paralysis.
Imagine waking up to find you can't move a muscle. It's dark, but you're sure you feel a presence in the room, hovering near your bed - or perhaps sitting on your chest, crushing the breath out of you.

This weird phenomenon is known as sleep paralysis, and a new study finds that understanding why it happens helps people feel less distressed after an episode. Believing that sleep paralysis is brought on by the supernatural, on the other hand, makes people feel more unnerved.

Sleep paralysis occurs when the brain and body aren't quite on the same page when it comes to sleep. During rapid eye movement (REM) sleep, dreaming is frequent, but the body's muscles are relaxed to the point of paralysis, perhaps to keep people from acting out their dreams. Researchers have found that two brain chemicals, glycine and GABA, are responsible for this muscle paralysis.

Estimates of how many people experience sleep paralysis vary from 5 percent to 60 percent, likely because of differences in survey methods. Some people find themselves experiencing sleep paralysis frequently, while others wake up paralyzed only once or twice in their lifetimes. The good news is that sleep paralysis is ultimately considered harmless.

Magic Wand

What predicts distress after episodes of sleep paralysis?

Ever find yourself briefly paralyzed as you're falling asleep or just waking up? It's a phenomenon is called sleep paralysis, and it's often accompanied by vivid sensory or perceptual experiences, which can include complex and disturbing hallucinations and intense fear.

For some people, sleep paralysis is a once-in-a-lifetime experience; for others, it can be a frequent, even nightly, phenomenon.

Researchers James Allan Cheyne and Gordon Pennycook of the University of Waterloo in Canada explore the factors associated with distress after sleep paralysis episodes in a new article published in Clinical Psychological Science, a journal of the Association for Psychological Science.

The researchers used an online survey and follow-up emails to survey 293 people. They measured post-episode distress using a range of items, from post-episode rumination to interference with next-day functioning.

The level of distress following sleep paralysis episodes was associated with features of the sleep paralysis episode itself. For example, the results showed that the more fear people felt during sleep paralysis episodes, the more distress they felt afterward.

The researchers also found that sensory experiences during episodes of sleep paralysis predicted later distress. Feelings of threat and assault - such as sensing a presence in the room, feeling pressure on the chest, having difficulty breathing, or having a feeling of imminent death - were all associated with distress following sleep paralysis episodes. So, too, were vestibular-motor experiences, including feelings of floating or falling and out-of-body experiences.

Rose

The revitalizing breath

Breathing is the FIRST place not the LAST place one should investigate when any disordered energy presents itself.- Sheldon Saul Hendler, MD Ph.D., The Oxygen Breakthrough
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Arguably the most important aspect of mental and physical health and well-being is the respiratory process. This has been known throughout the history of mankind. Consider that during the course of your life you are "inspired" by ideas, "aspire" toward your goals and dreams, and finally "expire" at the end of your life. Many of the ancients developed lifestyles and physical exercises such as yoga and qui-gong that are based around the patterns of breathing and respiratory cycles. So why is breathing so important?

It has been suggested that the average individual can survive:

40 days without food

4 days without water

4 minutes without oxygen

Comment: Even better, try the Éiriú Eolas breathing program and find out for yourself how conscious breathing can heal you emotionally and physically.


Sherlock

Nasty comments change what we think

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In the beginning, the technology gods created the Internet and saw that it was good. Here, at last, was a public sphere with unlimited potential for reasoned debate and the thoughtful exchange of ideas, an enlightening conversational bridge across the many geographic, social, cultural, ideological and economic boundaries that ordinarily separate us in life, a way to pay bills without a stamp.

Then someone invented "reader comments" and paradise was lost.

The Web, it should be said, is still a marvelous place for public debate. But when it comes to reading and understanding news stories online - like this one, for example - the medium can have a surprisingly potent effect on the message. Comments from some readers, our research shows, can significantly distort what other readers think was reported in the first place.

But here, it's not the content of the comments that matters. It's the tone.

Rose

Through the nose: The 'growth of knowledge' is one breath away

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© Sioux City Journal photo by Tim Hynds
Corey Schink demonstrates Eiriu Eolas, a meditation program he will teach at Western Iowa Tech Community College as part of the Sioux City school's lifelong learning program. He is shown Monday, Feb. 4, 2013.
Corey Schink found forgiveness in the form of his late stepfather who appeared to him in a dream.

"My stepdad Jim was a big bear of a man," the Smithland, Iowa, native recalled. "We got into a fight right before he died."

Schink carried that guilt for months, along with feelings of aimlessness in life.

One night, his stepfather appeared in a dream, telling Schink that he would be all right and that all was forgiven.

"It was as if a wave of emotions flooded over me," Schink said. "I don't think I would've gotten to that point without Eiriu Eolas."

An Irish Gaelic term that means "growth of knowledge," Eiriu Eolas (pronounced Aye-Roo Oh-lahs) is a breathing and meditation program which combines modern neuroscience with ancient wisdom.

The attributes of Eiriu Eolas is that it detoxifies one mind and body while liberating one's heart.

Comment:

Try it out for yourselves!


Bulb

Amazing scientific facts about lists

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A typical list, of a format that is very familiar to the author of this blog
If you visit any popular text-based site on the internet, you'll find articles that are lists of things. People like lists, but why? Here are 10 cool facts about lists that may explain the fascination

People like lists of things. They're everywhere on the internet. You name any subject matter you can think of, odds are there's a list about it. Nowhere is safe. Even here, on the Guardian Science section, one of the most popular articles in recent months is a list. But why are lists so popular? Well, here are 10 astonishing facts about lists that may help explain it.

Mars

The first humans on Mars will spend 501 days cooped up in a tiny space... So a 'tried and tested' male-female partnership would be best

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An artist's conception of a spacecraft envisioned by Inspiration Mars, a private group funded by Dennis Tito
Research suggests a man and a woman working and living together may be better than two people of the same sex on millionaire's mission to the Red Planet

The first humans on Mars could be a married couple, after organisers of an ambitious manned mission to the Red Planet said that only a "tried and tested" male-female partnership could cope with the close confinement of a return trip.

Dennis Tito, the multi-millionaire financier and former rocket scientist behind the planned 2018 mission, said he was confident of raising the estimated $1.5bn to $2bn (£1bn- £1.3bn) needed to send a two-person mixed crew to Mars - but admitted that the total funding has yet to be found.

Mr Tito, who once worked for Nasa, promised to fund the Inspiration Mars mission for the next two years, and will ask other wealthy individuals and charitable foundations to contribute to the final cost of building and launching the manned space craft.

"I will come out a lot poorer because of this mission, but my grandchildren will come out a lot richer in terms of inspiration," Mr Tito said at a press conference in Washington DC.

In addition to charitable and personal donations, Mr Tito said that he expected to raise money from television and media rights. The choice of a mixed crew of one man and one woman would heighten media interest, he said.

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Neurons in the brain switch identity and re-route fibres

© Cajal/ Wikicommons Media
"Like the entomologist in search of colourful butterflies, my attention was drawn to the gardens of the grey matter, which contained cells with delicate and elegant forms, the mysterious butterflies of the soul, whose beating of wings may one day reveal to us the secrets of the mind" – Santiago Ramón y Cajal.
These drawings by Santiago Ramón y Cajal show the cellular structure of three different areas of the human cerebral cortex. The cortex is the seat of higher mental functions such as language and decision-making, and contains dozens of distinct, specialised areas. As Cajal's drawings show, it has a characteristic layered structure, which differs somewhat from one area to the next, so that the layers vary in thickness according to the number of cells they contain.

Cells throughout the cortex are arranged in a highly ordered manner. Those in layers 2 and 3, for example, send fibres to the other side of the brain, whereas those in layers 5 and 6 send theirs straight downwards. This organization is under genetic control and, once established, was thought to be fixed. Now, though, researchers at Harvard University report that fully matured neurons in the intact brain can be made to switch identity and re-route their fibres to acquire the characteristics of cells in other layers.

Cortical neurons are generated in vast numbers during the earliest stages of development, when the nervous system is nothing more than a hollow tube running along the back of the embryo. The inner surface of the neural tube is lined with stem cells called radial glia, which have a single fibre that comes into contact with the tube's outer surface. These cells divide to produce immature neurons, which then climb onto their mother's fibre and migrate outwards. At the front end of the tube, neurons migrate away in waves, and those produced early on form the inner-most layer of the cortex. Subsequent waves of cells migrate past the earlier ones, so that the layers form from the inside out.

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Coming back from the brink of death is possible, says doctor


When people describe seeing tunnels, white lights and deceased family members after their hearts stop, they're dead - but they can come back, believes Dr. Sam Parnia.

Parnia, a critical care doctor and the director of resuscitation research at Stony Brook University School of Medicine, writes in his new book, Erasing Death: The Science That is Rewriting the Boundaries Between Life and Death, that a person can now be resuscitated long after they previously would have been considered clinically dead.

"The advances in the last 10 years have shown us that it's only after a person dies that they turn into a corpse, that their brain cells start to die,'' Parnia told Savannah Guthrie on TODAY Tuesday. "Although most people think this takes place in only four or five minutes, we now know that actually brain cells are viable for up to eight hours."

He continued, "We now understand that it's only after a person has turned into a corpse that their cells are undergoing death, and if we therefore manipulate those processes, we can restart the heart and bring a person back to life."