Nupedia and Wikipedia coexisted until the former's servers were taken down permanently in 2003, and its text was incorporated into Wikipedia. Language editions were created beginning in March 2001, with a total of 161 in use by the end of 2004. Wikipedia gained early contributors from Nupedia, Slashdot postings, and web search engine indexing. Bomis originally intended it as a business for profit. Otherwise, there were initially relatively few rules, and it operated independently of Nupedia. Its integral policy of "neutral point-of-view" was codified in its first few months. The domains (later redirecting to ) and were registered on January 12, 2001, and January 13, 2001, respectively, and Wikipedia was launched on Janu as a single English-language edition at and announced by Sanger on the Nupedia mailing list. On January 10, 2001, Sanger proposed on the Nupedia mailing list to create a wiki as a "feeder" project for Nupedia. Wales is credited with defining the goal of making a publicly editable encyclopedia, while Sanger is credited with the strategy of using a wiki to reach that goal. Nupedia was initially licensed under its own Nupedia Open Content License, but before Wikipedia was founded, Nupedia switched to the GNU Free Documentation License at the urging of Richard Stallman. Its main figures were Bomis CEO Jimmy Wales and Larry Sanger, editor-in-chief for Nupedia and later Wikipedia. It was founded on March 9, 2000, under the ownership of Bomis, a web portal company. Wikipedia began as a complementary project for Nupedia, a free online English-language encyclopedia project whose articles were written by experts and reviewed under a formal process. Various collaborative online encyclopedias were attempted before the start of Wikipedia, but with limited success. Wikipedia founders Jimmy Wales (left) and Larry Sanger (right) Articles on breaking news are often accessed as a source of frequently updated information about those events. On 3 April 2018, Facebook and YouTube announced that they would help users detect fake news by suggesting fact-checking links to related Wikipedia articles. It has been censored by world governments, ranging from specific pages to the entire site. The website's coverage of controversial topics such as American politics and major events like the COVID-19 pandemic and the Russian invasion of Ukraine has received substantial media attention. The reliability of Wikipedia was frequently criticized in the 2000s, but has improved over time, as Wikipedia has been generally praised in the late 2010s and early 2020s. It has been criticized for exhibiting systemic bias, particularly gender bias against women and alleged ideological bias. Wikipedia has been praised for its enablement of the democratization of knowledge, extent of coverage, unique structure, culture, and reduced degree of commercial bias. In 2006, Time magazine stated that the policy of allowing anyone to edit had made Wikipedia the "biggest (and perhaps best) encyclopedia in the world". Its combined editions comprise more than 60 million articles, attracting around 2 billion unique device visits per month and more than 15 million edits per month (about 5.7 edits per second on average) as of January 2023. Initially available only in English, versions in other languages were quickly developed. Wales was influenced by the " spontaneous order" ideas associated with Friedrich Hayek and the Austrian School of economics after being exposed to these ideas by the libertarian economist Mark Thornton. Sanger coined its name as a blend of wiki and encyclopedia. Wikipedia was launched by Jimmy Wales and Larry Sanger on January 15, 2001. It is hosted by the Wikimedia Foundation, an American non-profit organization funded mainly through donations. It is consistently one of the 10 most popular websites ranked by Similarweb and formerly Alexa as of 2022, Wikipedia was ranked the 5th most popular site in the world. Wikipedia is the largest and most-read reference work in history. Wikipedia is a multilingual free online encyclopedia written and maintained by a community of volunteers, known as Wikipedians, through open collaboration and using a wiki-based editing system called MediaWiki. Most text is also dual-licensed under GFDL media licensing varies
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These 17 best sunscreen recommendations vary in cost, but don’t skimp on quality and have impressive online reviews to prove it. Saunders carefully combed through the digital aisles of Sephora, Amazon, Dermstore, and more, to ensure we only bring you the best sunscreens money can buy. After talking to dermatologists about what makes a fantastic sunscreen and testing out numerous products, we've determined that these are the best sunscreens of 2023 that'll help you safely enjoy the warmer months and beyond. We love using sunscreen daily, so naturally, we've done numerous deep dives and guides dedicated to all things sunscreen. And don't worry: Each sunscreen in this guide provides broad-spectrum coverage.
Part Three, The Spider’s WebĪt this point, the map opens up a bit, and the PCs are encouraged to follow up on different leads around the local area while using Phandalin as a base. Running these bandits out of town is what cements the PCs as adversaries of the secretive drow mage. The town is being terrorized by a group of bandits called the Redbrands, whose leader is revealed to work for the Black Spider. In addition to being an adventuring hub or starter town (it’s a good one, actually, and can work really well as the focal point for most low-level campaigns, regardless of whether you’re running LMoP or not) where the PCs can rest, purchase supplies, and meet interesting NPCs, Phandalin also serves as the next leg of the adventure. Hopefully, the PCs manage to rescue Gundren Rockseeker and finish the journey to Phandalin. What follows is a mini-dungeon crawl through goblin-infested caverns, culminating in a battle with a bugbear and some wolves. After fighting off their attackers, the PCs discover that their contact (one of the Rockseeker Brothers) and his bodyguard Barry Bluejeans - I mean Sildar Hallwinter - have been taken prisoner. The adventure begins with the party getting ambushed by goblins (from the Cragmaw clan, who work for the Black SPider) on the road to Phandalin. However, a drow mage known as The Black Spider (who’s something of a local gang leader with several different groups of monsters and ruffians under his command) has gotten wind of this, and the race to claim Wave Echo Cave is on. Three such adventurers, the dwarven Rockseeker brothers, have found the location of Wave Echo Cave and intend to resume mining operations. Over the subsequent centuries, the lands ravaged by orc warbands have recovered and are now a rugged mining frontier where many adventurers come to try their luck at treasure hunting. They attempted to capture Wave Echo Cave and the riches it contained, but in the ensuing battle, the cave collapsed, and the entrance was lost forever. Then, around 500 years before the adventure’s beginning, a marauding force of orcs and evil human wizards swept through the area. This power was harnessed by dwarven and gnomish miners as well as human mages to create powerful magical items. The setup to Lost Mine of Phandelver is essentially that of its dungeon and final adventure location - Wave Echo Cave, a long-lost mine which, in addition to mineral wealth, was also a source of great magical power. The introduction then concludes with a brief history of the region and events leading up to the start of the adventure followed by a summary of each of its key sections, a Hook (a reason why the players’ characters might be going on the adventure in the first place), and four pregenerated 1st-level characters. The Lost Mine of Phandelver begins with a short introduction for the Dungeon Master - including advice on the role of the Dungeon Master, how to run the game fairly, and what all those damned initialisms mean. After that, the PCs are set loose into the surrounding area, where they can have a series of smaller adventures that conclude with them storming a ruined castle full of goblins.įinally, all signs point toward the long-lost Dwarven/Gnomish mine called Wave Echo Cave, and the adventure sets the PCs on a collision course with its main antagonist, an evil Drow mage known as the Black Spider (or, for fans of The Adventure Zone, “Magic Brian”). The adventure starts with a classic goblin ambush aimed at drawing the PCs into the events going on in the area and then faces them with the problem of a gang of bandits calling themselves the Redbrands who have taken over the town of Phandalin. In comparison to other adventures and sourcebooks released for 5e, it’s much shorter and is intended to form the framework for a short campaign or adventure that can be completed in about 5-10 sessions. It is available for free on DnDBeyond grab the adventure and a copy of the Basic Rules, and you’re ready to start playing D&D right now. The 48-page adventure, which is included in the D&D 5e Starter Set Box (from 2014), takes the characters from levels 1-3 and is intended to serve as an introductory adventure for both new players and dungeon masters.
There is no solid release date or platforms listed as of right now, but Team Reptile plans to launch Bomb Rush Cyberfunk in the Jet Set Radio "Future." How apt. In absence of SEGA's interest in reviving the series, indie developers have kept the Jet Set spirit alive, with Team Reptile's previous games - such as Lethal League - and other indie titles such as Rocket Juice Game's Neon Tail evoking the Jet Set Radio style, albeit across different genres and settings. We haven't had a new Jet Set Radio game for 18 years, and fans have been clamoring for a revival ever since. His trademark style can be heard in the Bomb Rush Cyberfunk sting, which gives us our first glimpse at the game's stylish world. Bomb Rush Cyberfunk Gameplay Trailer Reveals 2022 Release Gears 5 Reveals Operation 6 With Hoffman and Queen Reyna Grand Theft Auto RP Server NoPixel Bans Popular Twitch Streamer xQc p>Much like the movie industry or an ongoing comic book series, if a video game is popular enough, it will more than likely be turned into a franchise with. 'Bomb Rush Cyberfunk' /OzHK5bhYQi- Team Reptile JThe music for the game will be provided by Hideki Naganuma, the esteemed composer behind the Jet Set Radio games, also known for his work on Sonic Rush, Ollie King, and many more. According to the description, each stage will be a "neighborhood that represents one time of day" and the game will be "focused on single-player." "Start your own cypher and dance, paint, trick, face off with the cops and stake your claim to the extrusions and cavities of a sprawling metropolis in an alternate future set to he musical brainwaves of Hideki Naganuma," the game's Steam page reads. Every stage has many spots to find where you can paint graffiti.Cyberfunk was revealed on Twitter today by Team Reptile, the developer behind Lethal League Blaze and Megabyte Punch. – The goal is to get your name up, your name up on the wall. – You can grind, slide, jump, trick and airdash to move around – Each stage is a neighborhood that represents one time of day. – In the game you can choose a character from your crew and explore the three-dimensional streets freely. Start your own cypher and dance, paint, trick, face off with the cops and stake your claim to the extrusions and cavities of a sprawling metropolis in an alternate future set to the musical brainwaves of Hideki Naganuma. In a world from the mind of Dion Koster, where self-styled crews are equipped with personal boostpacks, new heights of graffiti are reached. “ Team Reptile brings you Bomb Rush Cyberfunk, 1 second per second of highly advanced funkstyle. Bomb Rush Cyberfunk is Team Reptiles (the studio behind the hit pseudo-fighting game Lethal League) upcoming spiritual successor to SEGAs Jet Set Radio. Here’s the description ripped right from the store front. There’s no confirmed release date yet, or every platform, but the game does have a Steam listing. It certainly feels like a strong look at revitalizing the original game’s legacy, providing both and homage and a modern concept (CYBERFUNK!) to make the game still feel like its own thing. Reptile even brought on Hideki Naganuma, composer for JSR, to kick in the music here too. Bomb Rush Cyberfunk is their take on the genre, and seems to be a hearty accomplishment. SEGA’s been sittin’ on the IP and not doing much with it beyond a few re-releases and a strange sequel in 2002.įans and developers have always wanted a sequel, so Team Reptile have taken it upon themselves now, nearly 20 years later, to create a spiritual successor. Jet Set Radio is a classic experience, introducing a great mix of music and gaming’s first real cel-shaded visuals, and one that fans have been dying to play in a modern sequel. The encryption software supports TrueCrypt container files which means that you can load them in the application on your Android device. If you did initially create a VeraCrypt container, note the free EDS Lite app on your phone won't support 'hidden' Veracrypt containers. Encrypted Data Store (EDS) is an application for Android devices that is available as a free lite version and a paid version. Try a) installing the EDS full app ($4) instead of the EDS Lite app, it has more functionality and b) reformat your microSD card back to its default FAT32 or exFAT file system and use the VeraCrypt utility on your PC to create an encrypted container instead of encrypting the card itself. Check the suspect’s computer registry and drivers installed. (The issue being, an app your install, like the EDS Lite app, by you and will only have user-level permissions. The key is to detect whether the volume is TrueCrypt or VeraCrypt. The EDS Lite app will work with things like VeraCrypt containers, but when it involves encrypting the storage media itself, that's something that involves system-level permissions and interactions with the operating system itself. VeraCrypt has a variety of bug fixes and supports modern PCs with EFI system partitions, a configuration many Windows 10 PCs use.Just to clarify, did you use the VeraCrypt utility to encrypt the entire microSD card (media itself is encrypted) or did you create an encrypted container (the card is still just an unaltered FAT32/exFAT file system with the VeraCrypt container stored on it)?įrom your posting, it 'sounds' like the former which if so could be the problem. You can use it to create a virtual encrypted disk, encrypt an entire partition, or encrypt your operating system so that no one. VeraCrypt is a project based on the source code of the old TrueCrypt software, which was discontinued. VeraCrypt is a disk encryption tool for Windows, macOS, and Linux. Hard drives with hardware-based encryption. The Android app is open source, but the iOS app is not. Veracrypt is designed to work on Windows/OS X/Linux operating systems, and is a great solution for replacing TrueCrypt, which is no longer a. The program can operate in two modes: non-mounted and mounted. Third-party versions are available for Android and iOS. VeraCrypt(R), TrueCrypt(R), LUKS, EncFs, CyberSafe(R) container types are supported. VeraCrypt handles the encryption in the background, and everything else happens transparently. It can also create encrypted file containers, but we’re focusing on encrypting your system drive here. One key difference is that VeraCrypt is used to encrypt the entire USB peripheral (as well as your device’s hard drive), while AES Crypt is used to encrypt individual files. A ‘traveler disk’ contains VeraCrypt executable files and optionally the ‘autorun.inf’ script (see the section AutoRun. Note that VeraCrypt ‘traveler disk’ is not a VeraCrypt volume but an unencrypted volume. EDS (Encrypted Data Store) is a virtual disk encryption software for Android which allows you to store your files in an encrypted container. Integrated BitLocker support or help with VeraCrypt. android and iPhone and windows help center How to Mount Encrypted VeraCrypt on Android - Best Solution In this case, every user will prefer to have a solution to carry those files in a portable manner, like on your Android device. You can use this facility to prepare a special traveler disk and launch VeraCrypt from there. You use your computer normally after it boots. Lock down and protect your android phone, iOS device, PC, or tablet. It’s not complicated to use: After setting it up, you just have to enter your encryption password each time you boot your PC. RELATED: How to Secure Sensitive Files on Your PC with VeraCrypt It works on Windows 10, 8, 7, Vista, and even XP. VeraCrypt is a free and open-source tool you can use to enable full-disk encryption on any Windows PC. Of course, this doesn’t protect you against malware that attacks your PC while it’s running-just against someone stealing your PC or its hard drive and trying to view your files. Even if someone gains access to your physical hard drive, they’ll need your password (or key file) to actually see what you have on the drive. It scrambles your files into random-looking gibberish and you need a secret key to access them. RELATED: How to Enable Full-Disk Encryption on Windows 10Įncryption is the best way to ensure attackers can’t read your files. If you’d rather not, you can use the free and open-source VeraCrypt software to get full-disk encryption on any version of Windows. Its front-end looks the same and functions identically to TrueCrypt. VeraCrypt is a fork of TrueCrypt and its direct successor so don't be put off by the minor branding changes. Some Windows 10 devices ship with “Device Encryption”, but other PCs require you to pay another $99 to get BitLocker on Windows Pro for full-disk encryption. Third-party Android and iOS apps allow you to open and access data stored VeraCrypt containers. To manage problems like these, it is necessary to have a control that performs the automated review of the security posture in the cloud, in such a way that it alerts when this kind of permission change occurs and thus the corresponding actions can be taken. Let's see what files are present using AWS Cli:Īnd, of course, AWS console shows a mayor warning as publicly accesible with this bucket:Ĭhanging permissions on cloud artifacts can easily go unnoticed. It is important to note that we are doing an enumeration exercise that does not involve configuring AWS credentials, which is why we will get a warning that still does not interfere with the result we seek to obtain: The program frequently alerts you to take micro-pauses and rest breaks. For this case, I proceeded to create a bucket with a hackable name and it will be the only name that contains the file:Īfter this, we proceed with the execution of the tool. Stretch and Rest Reminder Get this Extension for Firefox (en-US) Stretch and Rest Reminder by CemKaanGuru Short break reminder reminds you to look away from your screen to stretch, get healty. For this we will use the s3scanner tool, which you can get from It requires the creation of a file containing the names of all buckets to be enumerated. No need to install a program that can potentially drain resources. No need to install an addon that can potentially slow down the browser. In this diary we will look at how to scan S3 buckets on AWS with incorrect public access permissions. Here is an alternative method: use Task Schedulerto schedule a self-closing Command Prompt window to pop up and remind you every 30 minutes: Pro: Works regardless whether Firefox is open or not. Why do people remove restrictions and allow a bucket to be public? Regardless of its intention, on many occasions it corresponds to inappropriate devops practices where objects are created from development without security measures and make their transition to production in the same way. The image would stretch to fit this space, regardless of whether the true dimensions matched or not.We frequently see news of information leaks that occur in different companies due to having information in the cloud with the wrong permissions, allowing anyone access to potentially confidential information. These "pixel" dimensions would ensure a 640x360 area would be reserved. You may notice width and height above do not include units. This would minimize reflow and re-layout. In the early days of the web, developers would add width and height attributes to their tags to ensure sufficient space was allocated on the page before the browser started fetching images. Lighthouse 6.0 impact of setting image dimensions on CLS. Images without width and height specified. This approach ensures that the browser can allocate the correct amount of space in the document while the image is loading. Manage multiple calendars, create your daily to do list, invite friends to events, and subscribe to public calendars. Alternatively, reserve the required space with CSS aspect ratio boxes. Lightning Calendar Organize your life it’s about time Organize your schedule and life’s important events in a calendar that’s fully integrated with your Thunderbird email. Summary: Always include width and height size attributes on your images and video elements. Actions waiting for a network response before updating DOM Images without dimensions #.Ads, embeds, and iframes without dimensions.The most common causes of a poor CLS are: In this guide, we'll cover optimizing common causes of layout shifts. It looks at how much visible content shifted in the viewport as well as the distance the elements impacted were shifted. They're often caused when visible elements are forced to move because another element was suddenly added to the page or resized.Ĭumulative Layout Shift (CLS) - a Core Web Vitals metric, measures the instability of content by summing shift scores across layout shifts that don't occur within 500ms of user input. Such experiences are visually jarring and frustrating. This is very common on the web, including when reading the news, or trying to click those 'Search' or 'Add to Cart' buttons. Imagine you've started reading an article when all of a sudden elements shift around the page, throwing you off and requiring you to find your place again. Layout shifts can be distracting to users. "I was about to click that! Why did it move? □" You can add support for publishing, editing,Īnd deleting web apps in your EMM console by adding the managed Google Playįor more information, see Support web apps. Support web appsĪ web app turns a web page into an Android app, making it easier to find and Private apps are automatically approved for the enterpriseįor more information, see Support private apps. Enterprises can also publish apps and mark them as private from You can integrate private app publishing capabilities into your EMM console byĪdding the managed Google Play iframe or using the Google Play Custom App For more information, see Find public apps. Or managed Google Play directly to browse publicĪpps for their enterprise. IT admins can use the search feature in the managed Google Play iframe The app management lifecycle Find public apps For example, you can receive alerts when an ITĪdmin uses managed Play to approve an app or when an app update makes a requestĪs an EMM developer, you can use these notifications to display messages, promptĪn IT admin to take certain actions, or automate processes in your console. You can subscribe to EMM notifications to receive alerts in response to events in managed Google Play thatĪffect your enterprise customers. With the Google Play EMM API, managed Google Play iframe, and managedĬonfigurations iframe, you can integrate the full app management lifecycle The most notable difference is that the user's IT adminĬontrols the apps that a user can access and install from managed Google Play. The userĮxperience is similar to Google Play-users can browse apps, view their details,Īnd install them. To end users, managed Google Play is their enterprise app store. IT admins can use managed Play to browse Android apps for their enterprise. Google Play with a set of management capabilities that are designed specifically It combines the familiar user experience and app store features of Managed Google Play is a version of Google Play that’s optimized forĮnterprises. Work together to support the app management lifecycle for your enterprise The content marketplace for Android Enterprise, and your EMM console can This page describes how managed Google Play, The Google Play EMM API gives you the ability to integrate Android app Hypnotize: Humans don’t attack and swim directly towards your mouth, providing easy kills.Unstoppable: Easily break through barriers and other obstacles not even mines can stop you!.You get another one after using the “Save Me” feature every time you die. Mega Rush: Instantly begin the match with a Mega Gold Rush.Gold Magnet: Attracts gold and other valuables into your mouth.Some of these boosters include the following: The boosters, not to be confused with the bonuses we mentioned above, are highly-useful items that you can activate, and that will help you tremendously in many different situations. The chests also contain many other goodies so you should always try to find them, especially since they refresh daily. These chests are important since they’re the only way to find the bonuses that you can activate to enjoy certain benefits such as increasing gold, food, or other stats by a certain percentage. However, if you find the map for the corresponding level, you’ll be able to easily find all the daily chests. While you can find all of them in a single run if you’re lucky, it’s likely that you’ll need to do several runs. Like many other games that offer daily quests that you must complete to earn specific rewards, Hungry Shark World has up to 5 daily chests in each map. Stick around if you want to learn more about this awesome game. Luckily, this is exactly what we’re going to share in the following paragraphs. Since the sea is as merciless to you as you are towards your prey, you’re going to need the best tips and tricks if you want to survive and score big in Hungry Shark World. Truly, this is the most fun we’ve had controlling an aquatic predator eating anything and everything that crosses our path, especially when we play Hungry Shark World on PC with our comfy mouse and keyboard! However, this makes it even more frustrating when we run headfirst into an angry shark that bites our HP down to 0 in one attack. However, the sea is riddled with plenty of hazards and hostile fish that don’t just let themselves get eaten, so you have to play smart in order to score high. True to its name, your hungry shark is constantly losing HP due to its insatiable hunger and must continue to eat in order to stay alive. The objective is to survive as long as you can and devour as much prey as possible to score tons of points before you eventually kick the bucket. Hungry Shark World is an addictive action game where you control a shark and eat everything in your path. Click the X next to your Siri Remote on the list of Bluetooth devices.Once you pair your Siri Remote to your Mac, it will no longer work with your Apple TV. Note: You cannot activate Siri on Mac using Siri Remote and SiriMote. The Play/Pause, Volume Up, and Volume Down buttons work as intended.Home button: Click this button once to show/hide the SiriMote app or press and hold for sleep options.Menu button: With this button, click to go to the previous track or press and hold to remind.The folks over at Eternal Storms Software say the app works with iTunes, Quicktime, Keynote, PowerPoint, and more. To activate SiriMote, press the Home button on the Siri Remote when you’re in an app or better yet, double-click the SiriMote’s icon in Finder or the Applications folder. Otherwise, you should click the Move SiriMote into the background button in SiriMote. To use SiriMote on your Mac, you’ll want to press the Home button whenever you’re in an app where you’d like to use the tool. With SiriMote installed and your Siri Remote paired with your Mac, the fun can begin. Your Siri Remote is now paired to your Mac. Click the lock to prevent further changes.Under Accessibility, check the box next to SiriMote.Log in with your username/password to unlock, when applicable.On the Security & Privacy screen, click on the lock at the button left side of the screen.On the popup, click the Open System Preferences button.(Instead of saying Siri Remote, it may include a series of numbers.) On the Bluetooth screen, click Connect next to the listing for the Siri Remote.On your Siri Remote, press and hold the Menu and Volume Up buttons for five seconds.On your Mac, launch System Preferences from the Dock.Unplug the Apple TV the uses the Siri Remote.To use SiriMote on your Mac, you’ll need to follow these instructions to first pair the two devices: Click Open to confirm it’s okay to use this app on your computer.It tends to fall into the Download folder instead during installation. Once installed, be sure to place the freeware in your Mac’s Applications folder. You can pick up a free version of SiriMote from the Eternal Storms Software website. The requirements are relatively lax, as you only need OS X El Capitan 10.11 (or newer) and a Mac with Bluetooth 4.0. Once SiriMote has been installed on your Mac, you can control your favorite macOS apps, including QuickTime, iTunes, Apple Keynote, Microsoft PowerPoint, and many more. It too will work with macOS devices - assuming you install a free third-party app called SiriMote for Mac. The Siri Remote, which launched in 2015, has been designed specifically for the always-on Siri capable Apple TV and serves as a replacement for the original Apple Remote. Unlike those that occur in psychotic disorders, the hallucinations tend to be associated with preserved insight that they are not real. The hallucinations are often vivid and usually visual, although other types of hallucinations are possible. Hypnopompic hallucinations, occurring upon awakening, are more common than hypnagogic hallucinations, which are experienced before falling asleep. Sleep paralysis can be associated with a sensation of fear or suffocation, especially when initially experienced. In most cases, it is manifested by inability to move the limbs or speak, lasting several seconds or, in rare cases, minutes at a time. Sleep paralysis occurs most commonly upon awakening, but sometimes just before sleep onset. Sleep paralysis and hallucinations are other features of narcolepsy that reflect this REM dissociation from sleep. 2Ĭataplexy is thought to represent intrusion of REM sleep and its associated muscle atonia during wakefulness. 8 Status cataplecticus can be spontaneous or an effect of withdrawal from anticataplectic medications. 2Ĭataplexy can worsen with stress and insufficient sleep, occasionally with “status cataplecticus,” in which repeated, persistent episodes of cataplexy occur over several hours. 9 Deep tendon reflexes disappear in cataplexy, so checking reflexes during a witnessed episode can be clinically valuable. A range of emotions can trigger cataplexy, but typically the emotion is a positive one such as laughter or excitement. 8 Episodes can last from a few seconds to 2 minutes. However, episodes can be more dramatic and, if the trunk and limb muscles are affected, can result in collapsing to the ground.Ĭataplexy usually has its onset at about the same time as the sleepiness associated with narcolepsy, but it can arise even years later. It often begins in the facial muscles and can manifest with slackening of the jaw or brief dropping of the head. 7Ĭataplexy-transient muscle weakness triggered by emotion-is a specific feature of narcolepsy type 1. 6 Napping after age 5 or 6 is considered abnormal and may reflect pathologic sleepiness. In children, sleepiness can manifest in reduced concentration and behavioral issues. Therefore, when taking a history, it is worthwhile to ask patients whether they dream during naps a yes answer supports the diagnosis of narcolepsy. Rapid eye movement (REM) latency-the interval between falling asleep and the onset of the REM sleep-is short in narcolepsy, and since the REM stage is when dreaming occurs, naps often include dreaming. Sleep attacks can come on suddenly and may be brief enough to manifest as a lapse in consciousness. Sleepiness tends to be worse with inactivity, and sleep can often be irresistible. 4 Narcolepsy is divided into type 1 (with cataplexy) and type 2 (without cataplexy). In fact, a minority of patients with narcolepsy have all these symptoms. Cataplexy, sleep paralysis, and hypnagogic or hypnopompic hallucinations can also be present, 2, 3 but they are not necessary for diagnosis. This review focuses on clinically relevant features of the disorder and proposes management strategies.Ĭlinically, narcolepsy manifests with excessive daytime sleepiness that can be personally and socially disabling. Importantly, treatments have improved and expanded, facilitating its management and thereby improving quality of life for those with the disorder. Since then, the disorder has been further characterized, and some insight into its biological underpinnings has been established. In this first description, he coined the term narcolepsie by joining the Greek words narke (numbness or stupor) and lepsis (attack). N arcolepsy was originally described in the late 1800s by the French physician Jean-Baptiste-Edouard Gélineau, who reported the case of a wine merchant suffering from somnolence. Modafinil, methylphenidate, and amphetamines are used to manage daytime sleepiness, and sodium oxybate and antidepressants are used for cataplexy. A consistent sleep schedule with good sleep hygiene is also important. Scheduled naps lasting 15 to 20 minutes can improve alertness. Total sleep time is normal, but sleep is fragmented. They go into rapid eye movement sleep soon after falling asleep. People with narcolepsy feel sleepy and can fall asleep quickly, but they do not stay asleep for long. Features of narcolepsy include daytime sleepiness, sleep attacks, cataplexy (in narcolepsy type 1), sleep paralysis, and sleep-related hallucinations. |
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