Concordantly, mitochondrial DNA failed to show meaningful CpG methylation. Use a secondary autoclavable tray to catch any potential leakage from the bag that would otherwise leak into the autoclave. Medical records, including clearance paperwork, will be kept at the Occupational Health Clinic for the duration of the individuals participation in the Medical Surveillance Program at Stanford University. To prevent a spill, transport labeled biohazardous material in an unbreakable, well-sealed primary container placed inside of a second unbreakable, lidded container (cooler, plastic pan or pail) labeled with the biohazard symbol, biosafety level and contact information. Iodine-containing compounds or iodophors are commonly used to decontaminate metal surfaces or equipment. Bloodborne Pathogens means pathogenic microorganisms that are present in human blood and can cause disease in humans. Any laboratory medical waste which is being autoclaved shall be placed in an autoclavable red bag. This is associated with a paradoxical mitochondrial hyper-function and increased oxidative stress, possibly resulting in neurodegeneration in non-dividing cells. In many of these studies, especially bone and renal studies, the radioactive compounds are removed from the body in the urine and occasionally in the stool. The RLS+/PLM+ group was sleepier than the RLS+/PLM- group. Ph.D. Biosafety & Biosecurity Manager, Environmental Health & Safety. The APB meets the third Wednesday of each month; protocol applications that require APB review, if submitted by the first of the month, will normally be reviewed by the panel at that months meeting. Positivity was highest in patients with severe cataplexy (94.8%) and progressively decreased to 54.2% in patients with the mildest cataplexy. Our results are consistent with the hypothesis that locus coeruleus activity contributes to the maintenance of muscle tone in waking, and that reduction in locus coeruleus discharge plays a role in the loss of muscle tone in cataplexy and rapid-eye-movement sleep. Travel registration with the Office of International Affairs (https://international.stanford.edu/) is also highly recommended to aid with any medical or travel issues. Winkelmann, J., Lin, L., Schormair, B., Kornum, B. R., Faraco, J., Plazzi, G., Melberg, A., Cornelio, F., Urban, A. E., Pizza, F., Poli, F., Grubert, F., Wieland, T., Graf, E., Hallmayer, J., Strom, T. M., Mignot, E. Narcolepsy Onset Is Seasonal and Increased following the 2009 H1N1 Pandemic in China. The disease-associated allele increases EIF3G mRNA expression. The Local Bloodborne Pathogen Exposure Control Plan (Local ECP) (http://stanford.io/2CtrhTl) is designed to aid the PI/Supervisor in completing requirements for the BBP Standard. This series of experiments implicates these receptors in narcolepsy-cataplexy. As oxygen desaturation has been linked to cardiovascular consequences, we postulate this could be a viable therapy in some cases.METHODS: Eight patients with severe Obstructive Sleep Apnea (2 women, 45 [20-68] y.o. Note: If the radiation-producing machine is to be disposed of, all radiation-producing parts (e.g., x-ray tube) must be destroyed. Only essential cleaning should be done. Disrupted Sleep in Narcolepsy: Exploring the Integrity of Galanin Neurons in the Ventrolateral Preoptic Area. However, as this mutation was present in homozygous state in four dogs of other breeds with wildtype pigmentation, it seems unlikely that this mutation is truly causative for coat color dilution. Pandemrix harbored lower mutational burden than Arepanrix, indicating higher similarity to wild-type 2009 pH1N1, which could explain differences in narcolepsy susceptibility amongst the vaccines. CPT1B/CHKB or P2RY11 polymorphisms were not associated with any specific clinical characteristics.The study extends on the observation of a strong multiethnic association of polymorphisms in the TCRA and P2RY11 with narcolepsy, but does not confirm the association of CPT1B/CHKB (rs5770917) in the Chinese population. In order to further the understanding of the control of cataplexy by noradrenergic mechanisms, the involvement of central alpha-2 adrenoceptors was examined in genetically narcoleptic Doberman pinschers using in vivo pharmacology. However, glutaraldehyde is very toxic to use without the accessibility of a vented fume hood and/or personal protective equipment. However, functional roles of CSF hypocretin are largely unknown. Potassium 40, crucial for life, is one example. Vaccinations are available for some etiologic agents used in the laboratory. We examined the potential interrelationship between the hypocretin system, metabolism and sleep by measuring locomotion, feeding, drinking, body temperature, sleep/wake and energy metabolism in a mouse model of narcolepsy (ataxin-ablation of hypocretin-expressing neurons). ), p-aminoclonidine (0.0625-4.0 micrograms/kg i.v.) The diurnal patterns and the average values of all the recorded parameters for 24 h, daytime and night time were not significantly different between the genotypes, however.In conclusion, we have shown that peripherin is expressed in the tuberomammillary neurons of the mouse hypothalamus. Klein-Levin Syndrome, a periodic hypersomnia associated with cognitive and behavioral abnormalities, is also considered a separate entity with separate therapeutic protocols. Bats may also require a permit from the U.S. Department of Interior, Fish and Wildlife Services. This manual will: This Biosafety Manual represents the institutional practices and procedures for the safe use and handling of biological materials, recombinant DNA and synthetic nucleic acids at Stanford University. Common symptoms were hypersomnia (100%), cognitive changes (96%, including a specific feeling of derealization), eating disturbances (80%), hypersexuality (43%), compulsions (29%), and depressed mood (48%). Other labeling exceptions include biological samples such as urine, blood and tissue submitted to a clinical lab for analysis. Liquid media requires a shorter cycle, often 15- 20 minutes while autoclavable medical waste requires a minimum of 30 minutes in order to be effectively sterilized, To help ensure non-variability of sterilization, try to use a consistent loading pattern of materials within the autoclave (amount of material and location within autoclave), Record autoclave conditions achieved for each cycle that is used to decontaminate medical waste. Most remaining contamination will be on exposed skin and is effectively removed with soap, warm water, and a washcloth. The proposed network achieved a mean absolute error of 7.36 years and a correlation to true age of 0.857. To conclude, we discuss how these different strategies will be critical to unambiguously defining the function of sleep. View details for DOI 10.1109/EMBC46164.2021.9630145. For the situation where an individual consistently exceeds ALARA limits the health physicist may recommend work changes. The old rats continued to have less HCRT-1 even after 8 hours of prolonged waking. Because153Sm is mostly a beta particle-emitting radionuclide and beta particles are effectively shielded by the human body,153Sm does not present an external radiation hazard. In terms of disintegrations per unit time, 1 Ci = 2,220,000 dpm. The hypothalamic hypocretin/orexin neuropeptide system is able to influence each of these. Ask yourself what could go wrong?. EH&S and the Office of the Vice Provost and Dean of Research shall provide the necessary staffing and administrative assistance. Ninety-nine dogs were typed for DLA-DQB1-31 with narcolepsy and 68 control animals. A large sample of narcoleptic patients was also used to further describe symptomatology and natural history for this sleep disorder.Retrospective review of clinical data ascertained from the Stanford Sleep Inventory, polysomnography and MSLT data, as well as clinical notes. To ensure the safety of all researchers and the environment, the APB requires BSL 3 researchers to demonstrate appropriate theoretical knowledge and practical skillsets in the following areas: Training should be thoroughly documented and consist of multiple sessions that culminate in a practical test to assess the skill of the researcher. Nocturnal dipping patterns may be modulated by 2-AR polymorphisms. All researchers must demonstrate competency with a minimum base skill set along with being secure in their potential to ask questions and express concerns. Central nervous system (CNS) histamine is low in individuals with narcolepsy, a disease characterized by severe fragmentation of both sleep and wake. Polome, P., Mignot, E., Nasri, A., Kouyi, G. L., Campan, L., Hooge, C., Riviere, N. Subjective and Objective Measures of Hypersomnolence Demonstrate Divergent Associations with Depression among Participants in the Wisconsin Sleep Cohort Study, VALIDATION OF GENOTYPING METHOD FOR HUMAN LEUKOCYTE ANTIGEN BASED ON NEXT GENERATION SEQUENCING TECHNOLOGY. The written directive shall include the patients name, treatment site, radiopharmaceutical, and prescribed dose. Multiplex protein assays offer diagnostic potential and provide new insights into the biological basis of sleep disordered breathing. However, these treatments are all symptomatically based and do not target hypocretin, a major neurotransmitter involved in the pathophysiology of narcolepsy. These results suggest that TRH analogs could be a promising new form of treatment for human narcolepsy. animals infected with HIV, HBV or HCV. View details for DOI 10.1001/jamacardio.2016.4395. Other agents that have the potential for causing disease in healthy individuals, animals, or plants. 900 Quarry Road Extension DQB1*0602 was associated with interindividual differences in sleep homeostasis, physiologic sleep, sleepiness, and fatigue-but not in cognitive measures-during baseline and chronic PSD. 14. The radiation dose from consumer products is relatively small as compared to other naturally occurring sources of radiation and averages 0.1 mSv (10 mrem) per year. Although its cause is unknown, multiplex families have been described. Environmental Safety Facility (ESF) Report any CT scan of a wrong body part or repeated CT scan to Health Physics for dose estimation, except if the repeat scan is necessary due to patient motion effects. VSC-designated PPE must be worn in all ABSL2 facilities. Assess as you go and make changes as needed. We found that patients with narcolepsy with cataplexy displayed a complex array of 'negative' (hypotonia) and 'active' (ranging from perioral movements to dyskinetic-dystonic movements or stereotypies) motor disturbances. A., Asayesh, F., Spiegelman, D., Toft, M., Viken, M. K., Sharma, M., Blauwendraat, C., Pihlstrom, L., Mignot, E., Gan-Or, Z. Analyses were performed using a linear model and by PLM category using a 15 PLM/h cutoff. Universal precautions View details for Web of Science ID 000072168200004. Stanford University follows the categorizing of infectious agents into levels as described in Biosafety in Microbiological and Biomedical Laboratories(BMBL), 5th edition (https://www.cdc.gov/labs/BMBL.html), written and published by the Centers for Disease Control (CDC) and NIH. Recent studies suggest that narcolepsy is caused by degeneration of hypocretin (orexin) producing neurons. TCR-alpha/beta CDR3 motifs of HCRT54-66-NH2 and HCRT86-97-NH2 tetramers were extensively shared: notably public CDR3alpha, TRAV2-CAVETDSWGKLQF-TRAJ24, that uses TRAJ24, a chain modulated by T1N-associated SNPs rs1154155 and rs1483979. These effects are specific to neuronally-derived proteins, which suggests they are likely driven by changes in neuronal activity during disrupted sleep. Additional guidance related to the proper deactivation and move-out of Stanford University laboratories is available at: The Stanford Health Assessment Questionnaire: dimensions and practical applications. Clinical manifestation of narcolepsy might occur when the hypocretin cell damage is too advanced to be reversible. Although narcolepsy was first described in the late nineteenth century in Germany and France, much of the research on this disorder has been conducted at Stanford University, starting with Drs. Specific disruption of slow wave activity correlated with an increase in amyloid-40 (r = 0.610, P = 0.009). After a review of an Application to Import an Etiological Agent, the issuing officer may issue a Letter of Authorization rather than an importation permit. Analyzing treated narcoleptics the specificity/sensitivity was 94%/10%.Sleep stage dissociation can be used for the diagnosis of narcolepsy. Philipp, U., Hamann, H., Mecklenburg, L., Nishino, S., Mignot, E., Gunzel-Apel, A. R., Schmutz, S. M., Leeb, T. Emerging therapies in narcolepsy-cataplexy, History of the Development of Sleep Medicine in the United States. Upon awakening, transgenic and control mice displayed a similar rate of increase in locomotion and food/water intake with time. The authors measured CSF hypocretin-1 levels in six patients with anti-Ma2 encephalitis, and screened for anti-Ma antibodies in patients with idiopathic narcolepsy. View details for DOI 10.1109/EMBC46164.2021.9630098. Take action to control your risks. HLA-DQB1*06:02 was positive. The Panel is also responsible for review of biological agents as they relate to Biosecurity, identifying risks associated with the potential misuse of information, technologies, or products that may be generated. Some of these neurons may thus mediate sleep stage changes or the effect on cataplexy observed after cholinergic stimulation in the BF. The Risk Assessment process is broken down into four steps: and by sparking creative and innovative thinking. Utilize the following laboratory re-entry guidance after the power is restored before occupants resume work. ABSL2 is suitable for work involving laboratory animals infected with agents associated with human disease and pose moderate hazards to personnel and the environment. A mixture of medical waste, hazardous chemical waste, and radioactive waste is categorized as radioactive waste and is subject to the statutes and regulations applicable to radioactive waste. Waste can often involve a mixture of medical and non-medical waste. Radiation Oncology Medical Physics and Health Physics will jointly prepare information for submittal and review by RHB (submit to RHB >60 days prior to installation or upgrade) including: Shielding calculations or supported reasoning for why shielding is not required, Safety feature description such as interlocks, audible/visual beam-on indicators, RHB returns their comments and concerns or approves shielding, RHB approves energization of the beam for the purposes of obtaining applicable TG report/calibration and the environmental survey, Submit Physicists Report of Safety Inspection and Comprehensive Environmental Survey, RHB gives final approval (approval may take up to 60 days) to begin patient therapy. The record is required to be maintained for 3 years after the date of release if the radiation dose to the infant or child from continued breast-feeding could result in a total effective dose equivalent (TEDE) exceeding 5 mSv (0.5 rem). Some patients with DM1 show sleep-onset REM, similar to that observed in narcolepsy. Firing of most of the state-dependent neurons in the BF was significantly modified by physostigmine. Type 1 narcolepsy, an autoimmune disease affecting hypocretin (orexin) neurons, is strongly associated with HLA-DQB1*06:02. Neurologic autoimmune syndromes associated with anti-glutamate acid decarboxylase 65 antibodies (GAD65-Abs) are rare and mostly sporadic.We describe a niece and her aunt with GAD65-Abs neurologic syndromes. DNA molecules that result from the replication of those described above. Narcolepsy is a lifelong illness characterized by persistent sleepiness, hypnagogic hallucinations, and episodes of motor paralysis called cataplexy. Further studies with more patients are warranted to exclude the possibility that a few caucasian patients carry rare haplotypes with DQB1-0602 independently of DR2. These radionuclides on a contaminated patient will cause minimal to zero harm or cancer risk to medical responders. Moodle Academy Since narcoleptic canines are relatively few in number, we have used a specific brain freezing procedure that has been reported to allow restoration of metabolically functional tissue upon thawing. In this population, the DQB1*0602 association was always evident in the context of the DRB1*1501-DQA1*0102-DQB1*0602 haplotype. Diagnostic value of metrics in differentiating between groups was quantified by area under the receiver operating characteristic curve (AUC). In the event a CT exam is repeated without order (e.g. Streptococcal infections are known to trigger autoimmune disorders, affecting millions worldwide. Federal regulations require the local IBC (at Stanford, theAPB), upon receiving submission of a Human Gene Transfer protocol, to review the following aspects to determine if NIH Recombinant Advisory Committee (RAC) review is required: Dependent upon the above findings the protocol will be either be submitted for RAC review or the APB will state that RAC review is not required. Shepard, J. W., Buysse, D. J., Chesson, A. L., Dement, W. C., Goldberg, R., Guilleminault, C., Harris, C. D., Iber, C., Mignot, E., Mitler, M. M., Moore, K. E., Phillips, B. We conclude that increased BMI leads to lower excursions in the belt signals during event-free sleep, and that OSA and CSA events are harder to distinguish in subjects with high BMI. In conclusion, the present results do not support the hypothesis that the neurochemical imbalance in narcolepsy could result from abnormal organization, numbers, or ratio of the corresponding neuronal populations. CSF hypocretin-1 level, obtained in 222 patients, was more frequently low ( 110 pg/ml) in African Americans (93.9%) versus Caucasians (61.5%), Asians (85.7%) and Latinos (75.0%). CRSCo serves under California Department of Health Services regulations and Nuclear Regulatory Commission regulations as the Radiation Safety Committee for Stanford and Veterans Affairs Palo Alto Health Care System, and is also chartered by the Food and Drug Administration as a Radioactive Drug Research Committee. Among polymorphisms associated with the disease is single-nucleotide polymorphism rs2305795 (c.*638G>A) located within the P2RY11 gene. View details for DOI 10.1126/scitranslmed.3007762. Gelb, M., Guilleminault, C., Kraemer, H., Lin, S., Moon, S., Dement, W. C., Mignot, E. CHOLINERGIC MECHANISMS IN CANINE NARCOLEPSY .2. McNemar's test assessed changes in prevalence over time. Narcolepsy with cataplexy is most often associated with human leucocyte antigen-DQB1*0602 and is caused by the loss of hypocretin-producing neurons in the hypothalamus of likely autoimmune aetiology. (http://www.cdc.gov/mmwr/preview/mmwrhtml/su6101a1.htm). A random forest model identified REM sleep as the most important sleep stage associated with survival.Conclusions and Relevance: Decreased percentage REM sleep was associated with greater risk of all-cause, cardiovascular, and other noncancer-related mortality in 2 independent cohorts. These results demonstrate abnormalities in sleep and EEG in Ts65Dn mice and underscore a possible correlation between App overexpression and hippocampal theta oscillations. Most patients need to wait about an hour for the drug to be taken up in the body, and the PET/CT setup and scan can also be about an hour, which means, by the time a 18F patient leaves nuclear medicine the isotope has already been reduced by half due to physical half-life decay alone. See Chapter 9 for additional information on PPE. All live bats. Do not step into water since hazards are unknown. Common fractions of the curie are the millicurie (1 mCi = 1/1,000 Ci) and the microcurie (1 Ci = 1/1,000,000 Ci). Human leukocyte antigen (HLA) typing was performed in six families with multiple-case incidence of narcolepsy. Hypothalamic sections of 4 subjects with narcolepsy and 5 nonneurologic controls were examined immunohistochemically with antibodies against ubiquitin (a marker of aggregated protein), allograft inflammatory factor 1 (AIF1, a microglial activation marker), glial fibrillary acidic protein (GFAP, a reactive astrocytic marker), and hypocretin. If an annual update is not submitted the eProtocol system will close the protocol. External contamination occurs when radioactive material, in the form of dust, powder, or liquid, comes into contact with a persons skin, hair, or personal clothing. Do not use the top of the cabinet for storage. Factors considered in the risk assessment of viral vector work include the type of rDNA or viral vector, if human cells are present, and the length of time since cells were transduced, as well as the insert or envelope present. This has a major implication for the correct identification of CSA/OSA and its treatment. For questions regarding radiation safety contact. Any work using synthetic nucleic acid molecules that are deemed by the NIH to be non-exempt from the NIH Guidelines must have APB approval prior to commencing work. Research Subject to DURC Policies Does research directly involve one or more of 15 agents or toxins listed in the policy? Furthermore, the finding that small doses of D2 antagonists suppressed cataplexy and induced behavioral excitation, while small doses of D2 agonists aggravated cataplexy and induced sedation, suggests that this effect is mediated presynaptically. Systolic dipping ratios were: GG = 0.846; AG = 0.854; AA = 0.861 (P = .015). Association between apolipoprotein E epsilon 4 and sleep-disordered breathing in adults. In general, the biosafety level recommended for working with infectious agents in vivo is the same as that for working with the agents in vitro. This chapter is part of a larger conversation about shaping and defining a shared cultural approach, which integrates safety and health seamlessly with the work of our laboratories and classrooms. View details for DOI 10.1093/sleep/zsab075. To ensure that no employee exceeds regulatorily determined dose limits, Stanford Health Physics monitors occupational exposures through the Dosimetry Program (See Section 4 Personnel Monitoring). Areas subject to Universal Precautions must have appropriate signs posted on doors and equipment; these signs can be obtained from EH&S (723.0448). We now report that locus coeruleus neurons cease discharge throughout cataplexy periods in canine narcoleptics. For biological material, the flow chart in Figure 3 indicates which materials are regulated and which are not. A circadian sleep disorder reveals a complex clock, DQB1*0301 and DQB1*0601 modulate narcolepsy susceptibility in Koreans. In LD, a weak but significant fluctuation in activity and temperature but not CSF hypocretin-1 was observed in SCNx animals. Hypocretin-1 concentrations in the CSF were determined every 4 hours using radioimmunoassays.Control animals displayed robust circadian (LL, DD) and diurnal (LD) fluctuations in CSF hypocretin-1, locomotor activity, and temperature. Thalidomide is a sedative hypnotic that was widely used in the 1950s but was withdrawn due to its teratogenic properties. View details for DOI 10.1016/j.sleep.2006.08.015, View details for Web of Science ID 000246343100010. The aim of the study was to determine whether apolipoprotein E epsilon 4 genotype (APOE4) modifies the association of sleep disordered breathing (SDB) with cognitive function in a middle-aged population.Cross-sectional analysis of a community-dwelling cohort.Sleep laboratory at the Clinical Research Unit of the University of Wisconsin Hospitals and Clinics.There were 755 adults from the Wisconsin Sleep Cohort who provided a total of 1,843 polysomnography and cognitive evaluations (most participants were assessed multiple times at approximately 4-y intervals); 56% males, average age 53.9 years (range 30-81 years).None.In-laboratory overnight polysomnography was used to assess SDB. These individuals are strongly encouraged to complete and submit the LAOHP Health Questionnaire, but this questionnaire is optional for members of the RC2 participation group. When working in nuclear medicine, wear protective clothing. Last updated: January 7, 2022. View details for DOI 10.1016/j.humimm.2006.10.006, View details for Web of Science ID 000243570200007, View details for DOI 10.1016/B978-012088592-3/50068-2, View details for Web of Science ID 000310853000067, View details for Web of Science ID 000246224900634, View details for Web of Science ID 000246224900659. Multiple technologies exist to create permanent genomic modifications in in vitro cell culture and in vivo animal research models (Figure 2). Looking for an application, checklist, or poster? We hypothesize that in the absence of SDB the effect of the deletion allele alone may not be sufficient to increase blood pressure. Martin, M. P., Harding, A., Chadwick, R., Kronick, M., Cullen, M., Lin, L., Mignot, E., Carrington, M. The role of genetic factors in the development of narcolepsy and hypersomnia in childhood, DQ microsatellite association studies in three ethnic groups. Specific steps, including the bivalent booster and testing after travel and gatherings, can help protect community members against COVID-19. Hypocretin abnormalities cause narcolepsy in dogs, human and mice. Single voxel (1)H-MRS study was performed in the thalamus, hypothalamus, and parietal-occipital cortex of hypocretin deficient, narcolepsy with cataplexy patients, HLA-DQB1*0602-positive, drug free. Conditional analyses revealed additional independent cSCC associations with DQA1*05:01 and DQA1*05:05. Among thosewhose education or occupation requires significant exposure to lab animals, ALA affects approximately one in five people. Three cases with anti-Yo antibodies and peripheral neuropathy were also included. Each University School/Department shall administer the Medical Surveillance program for its employees and ensure programmatic compliance for those employees identified as potentially at risk for occupational exposure to biological agents. All are potential hazards due to the possibility of exposure. View details for Web of Science ID 000172056000004. Items of medical waste which are mixed with volatile chemical solvents or radioactive materials (this waste must be handled as either chemical waste or radioactive waste). ; idazoxan, 6-1536 micrograms/kg i.v. The criteria for these facilities are similar to Biosafety Level 3 laboratories with additional biosecurity elements. The dialysis staff will already be using universal precautions to protect themselves from the patients blood and other body fluids. The following list contains human or primate cells that are to be handled using BSL 2 practices and containment: Note that this list is not conclusive and individual cases will be determined as they occur. (See also postscript remarks). The APB protocol approval process involves a discussion of the potential hazards and risks associated with the agents listed, including any reproductive concerns. Altered hypocretin neurotransmission might therefore be involved in schizophrenia, since an involvement of dopaminergic mechanisms and an association with sleep disturbance are well demonstrated in patients with schizophrenia. The classroom sessions are held every other week and can be scheduled by contacting the VSC. Conduct a broad review of the literature. The time structure of their polysomnographically recorded LMs was analyzed by means of an approach particularly able to consider their periodicity.Nineteen patients with narcolepsy had a PLM index greater than 15. View details for Web of Science ID 000074238900003. The IRB/SCRO uses eProtocol for its reviews. It is the responsibility of all Stanford personnel to report any exposures or unauthorized research using biohazardous agents and/or recombinant and synthetic nucleic acid material to the Biosafety Manager (esegal@stanford.edu, 725.1473). If glass breaks in the autoclave, use tongs, forceps, or other mechanical means to recover the fragments; make certain that the autoclave has been cooled down to avoid surface burns. Genome editing experiments that fall under the exempt category involve the use of nonviral transfection methods (eg. The ALARA Level I Report or Level II Investigation is reviewed quarterly by the Clinical Radiation Safety Committee. Apolipoprotein E epsilon4(ApoE epsilon4) is a well-known risk factor for Alzheimer disease and cardiovascular disease. Failure of any individual to comply with requirements can jeopardize the investigation, the laboratory, and the institution. The typical flow of information to the State of California Radiological Health Branch (RHB) and ultimate RHB approval for the use of therapy machines is as follows: Report any fluoroscopy (including interventional exam) patients exposures greater than 5 Gy air kerma to Health Physics (650 723-3201) for follow up. Narcolepsy is characterized by excessive daytime sleepiness, cataplexy and other manifestations of dissociated rapid eye movement sleep. In particular, time at patients bedside should be kept to a minimum. Features characteristic of sleep stage differences were estimated from the residual sleep stage probability in the 2D space. Examples: Alcohols, solvents like Hexane or Dichloromethane, Acetonitrile, Oil, Stanford University, Stanford, California 94305. Step 3 Fit Testing and Quiz Dobermanns accounted for 78 per cent of the total. 07. Additionally, Other Potentially Infectious Materials (OPIM) are included under this standard. To study DQB1*0602 status and hypocretin-1 levels in the cerebrospinal fluid (CSF) in a cohort of patients with hypersomnolence and to test International Classification of Sleep Disorders-2 (ICSD-2) criteria for hypersomnia of central origin.Retrospective case series.One hundred sixty-three consecutive patients with unexplained sleepiness and 282 controls recruited at St. Vincent's Hospital, Korea. Sentinels and routine testing are not done in ABSL2 facilities, in PI-managed spaces, or with wild animals. Studies have established that more than 90% of patients have a genetic association with HLA DQB1*06:02. Hypocretin-1 (P < 0.01), cortisol (P < 0.001), and locomotion (P < 0.005) all increased with sleep deprivation, while ghrelin (P = 0.79) and leptin (P = 1.00) did not change with sleep deprivation. One explanation for these negative results may be that the autoimmune process is no longer active when patients present to the clinic. Zoonotic agents are those that can be transmitted between species; zoonoses that can be transmitted between humans and animals fall under the auspices of Animal Biosafety. Contact the Dosimetry Coordinator at (650) 723-3203 or your health physicist to confirm if new employees needs a dosimeter. Never disengage the alarm, as it indicates improper airflow, thereby effecting performance and endangering the researcher or the experiment. Schatzberg, S. J., Cutter-Schatzberg, K., Nydam, D., Barrett, J., Penn, R., Flanders, J., deLahunta, A., Lin, L., Mignot, E. Lesions of the suprachiasmatic nucleus eliminate the daily rhythm of hypocretin-1 release. Rapid antigen tests are available for free to faculty, staff, postdocs, and students at campus locations. Although Hepatitis B vaccine is made from parts of the hepatitis B virus, it cannot cause hepatitis B infection. Personal protective equipment (PPE) is a necessary part of laboratory safety in addition to engineering controls (i.e., laboratory ventilation and Biosafety Cabinets) and good work practices. The relative preservation of hcrtR2 expression also suggests that hypocretin based therapies are likely to be a viable therapeutic options in human narcolepsy-cataplexy. ; these are the primary methods to control exposure. At this time, there is inadequate research to develop an expert consensus or guidelines for the perioperative management of patients with narcolepsy. Brink-Kjaer, A., Mignot, E., Sorensen, H. B., Jennum, P. Robust, ECG-based algorithm for Sleep Disordered Breathing detection in large population-based cohorts using an automatic, data-driven approach. Per NIH guidelines (http://bit.ly/2B2yUDX) and the Stanford University Administrative Panel on Biosafety Charge (see below) the APB alsorequires researchers to have an approved APB protocol and follow specific guidelines for working with prions and prion-like proteins; additional information can be found in Chapter 4. Review and request all the services our department offers, from emergency preparedness to chemical disposal. Hypocretin-containing cells are located exclusively in the lateral hypothalamus, with widespread projections to the entire neuroaxis. Please refer to the CDC webpage (http://bit.ly/2zjJGmA) and the WHO GAPIII document (http://bit.ly/2yOzPBX) for more information on the upcoming requirements and conditions for poliovirus research. Forms chloroform, hydrochloric acid, chloroacetone or dichloroacetone. After adjustment for age, sex, and BMI, the presence of any APOE epsilon4 allele was associated with increased odds of OSAH (OR 1.41, 95% CI 1.06 to 1.87, p = 0.02). One polygraphic recording followed by a single multiple sleep latency test (MSLT) is used to differentiate the causes of syndromes with complaints of daytime somnolence. Use caution when handling a bag in case sharp objects have been inadvertently placed in the bag. 02. The recommended apron inspection policy is as follows: In cases of questionable condition, one can choose to use fluoroscopy or radiography to look for holes and cracks. Changes in the stress hormone cortisol were not correlated with hypocretin-1 changes. After collecting the CSF at all of the time points, the rats were kept awake by gentle handling for 8 hours (ZT 0-ZT8), and the CSF was collected again at the end of the sleep-deprivation procedure. Protect badges from impact, puncture, or compression. https://ehs.stanford.edu/forms-tools/local-aerosol-transmissible-diseases-biosafety-plan-laboratories. Mixing bleach with incompatible chemicals can produce toxic gases that can potentially damage the eyes, skin, lungs, vocal cords, nervous system, liver, and kidneys. Salomon, R. M., Ripley, B., Kennedy, J. S., Schmidt, D., Zeitzer, J., Nishino, S., Mignot, E. Stimulant medication usage in a large cohort of narcoleptic subjects. 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