Narcolepsy and emotional experience: a review of the literature

Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis. This disease affects significantly the overall patient functioning, interfering with social, work, and affective life. Some symptoms of narcolepsy depend on emotional stimuli; for instance, cataplectic attacks can be triggered by emotional inputs such as laughing, joking, a pleasant surprise, and also anger. Neurophysiological and neurochemical findings suggest the involvement of emotional brain circuits in the physiopathology of cataplexy, which seems to depending on the dysfunctional interplay between the hypothalamus and the amygdala associated with an alteration of hypocretin levels. Furthermore, behavioral studies suggest an impairment of emotions processing in narcolepsy-cataplexy (NC), like a probable coping strategy to avoid or reduce the frequency of cataplexy attacks. Consistently, NC patients seem to use coping strategies even during their sleep, avoiding unpleasant mental sleep activity through lucid dreaming. Interestingly, NC patients, even during sleep, have a different emotional experience than healthy subjects, with more vivid, bizarre, and frightening dreams. Notwithstanding this evidence, the relationship between emotion and narcolepsy is poorly investigated. This review aims to provide a synthesis of behavioral, neurophysiological, and neurochemical evidence to discuss the complex relationship between NC and emotional experience and to direct future research

The spectroscopic evolution of the γ\gamma-ray emitting classical nova Nova Mon 2012. I. Implications for the ONe subclass of classical novae

Nova Mon 2012 was the first classical nova to be detected as a high energy $\gamma$-ray transient, by Fermi-LAT, before its optical discovery. We study a time sequence of high resolution optical echelle spectra (Nordic Optical Telescope) and contemporaneous NOT, STIS UV, and CHIRON echelle spectra (Nov 20/21/22). We use [O III] and H$\beta$ line fluxs to constrain the properties of the ejecta. We derive the structure from the optical and UV line profiles and compare our measured line fluxes for with predictions using Cloudy with abundances from other ONe novae. Mon 2012 is confirmed as an ONe nova. We find E(B-V)=0.85$\pm$0.05 and hydrogen column density $\approx 5\times 10^{21}$ cm$^{-2}$. The corrected continuum luminosity is nearly the same in the entire observed energy range as V1974 Cyg, V382 Mon, and Nova LMC 2000 at the same epoch after outburst. The distance, about 3.6 kpc, is quite similar to V1974 Cyg. The line profiles can be modeled using an axisymmetric bipolar geometry for the ejecta with various inclinations of the axis to the line of sight, 60 \le i \le 80 degrees, an opening angle of \approx$70 deg, inner radius$\Delta R/R(t)\approx 0.4$for permitted lines and less filled for forbidden lines. The filling factor$f\approx 0.1-0.3$implying M(ejecta)$\leq 6\times 10^{-5}$M$_\odot$. The ONe novae appear to comprise a single physical class with bipolar high mass ejecta, similarly enhanced abundances, and a common spectroscopic evolution within a narrow range of luminosities. The detected$\gamma$-ray emission may be a generic phenomenon, common to all ONe novae, possibly to all classical novae, and connected with acceleration and emission processes within the ejecta (abstract severely truncated).Comment: Submitted to A&A 9/1/2013; Accepted 27/2/2013 (in press

The spectroscopic evolution of the recurrent nova T Pyxidis during its 2011 outburst. II.The optically thin phase and the structure of the ejecta in recurrent novae

We continue our study of the physical properties of the recurrent nova T Pyx, focussing on the structure of the ejecta in the nebular stage of expansion during the 2011 outburst. The nova was observed contemporaneously with the Nordic Optical Telescope (NOT), at high resolution spectroscopic resolution (R ~ 65000) on 2011 Oct. 11 and 2012 Apr. 8 (without absolute flux calibration), and with the Space Telescope Imaging Spectrograph (STIS) aboard the Hubble Space Telescope, at high resolution (R ~ 30000) on 2011 Oct. 10 and 2012 Mar. 28 (absolute fluxes). We use standard plasma diagnostics (e.g. [O III] and [N II] line ratios and the H$\beta$ line fluxes) to constrain electron densities and temperatures. Using Monte Carlo modeling of the ejecta, we derive the structure and filling factor from comparisons to the optical and ultraviolet line profiles. The ejecta can be modeled using an axisymmetric conical -- bipolar -- geometry with a low inclination of the axis to the line of sight, i=15+/-5 degrees, compatible with published results from high angular resolution optical spectro-interferometry. The structure is similar to that observed in the other short orbital period recurrent novae during their nebular stages. We show that the electron density scales as $t^{-3}$ as expected from a ballistically ejected constant mass shell; there is no need to invoke a continuing mass outflow following the eruption. The derived mass for the ejecta with filling factor f ~ 3%, M_ej ~ 2E-6$M_sun is similar to that obtained for other recurrent nova ejecta but inconsistent with the previously reported extended optically thick epoch of the explosion. We suggest that the system underwent a common envelope phase following the explosion that produced the recombination event. Implications for the dynamics of the recurrent novae are discussed. (truncated)Comment: accepted for publication in A&A (10 Nov. 2012), 10 pgs, 16 fig

The use of intraoperative ultrasound for diagnosis and stadiation in pancreatic head neoformations

The intraoperative staging of the pancreatic cancer is important to make a proper treatment. For this reason the intraoperative echography is playing an important role in the right treatment choice. The intraoperative echography, that can be performed with an open or laparoscopic probe, is used to confirm the preoperative diagnosis and assess the pancreatic cancer resecability. The intraoperative echography (IOUS) or laparoscopic intraoperative echography (LIOUS) are useful to identify the patients with a non resecable cancer and perform a faster neoadjuvant treatment. The LIOUS can also avoid an useless laparotomy. The aim of this study is to assess, both in our experience and in the cited literature, the concordance rate between the pancreatic cancer preoperative staging, performed with TC and MRI (when it is available), and intraoperative staging, performed with intraoperative laparotomic or laparoscopic echography. Material and methods: We have analyzed the treatment management of 34 patients, who were candidate to major surgery for suspected pancreatic head cancer and who underwent to intraoperative LIOUS or IOUS staging from 2001 to 2012. Results: LIOUS and IOUS have allowed to detect cases in which preoperative diagnosis, proved by CT and MRI, was not agreeing with intraoperative diagnosis (22 patients on 34, 64% discordance rate), avoiding the execution of a demolitive and uneseful surgery in order to guarantee the surveillance and life's quality of patients. Conclusion: We suggest to perform in every patients undergone to pancreatic surgery an intraoperative ultrasound exam, to detect unresecable and unpredicted lesions

Surgical Treatment Following Failed Medical Treatment of an Interstitial Pregnancy

Interstitial pregnancy (IP) is a type of ectopic pregnancy in which the embryo implants in the interstitial part of the Fallopian tube. It accounts for 2% of all ectopic pregnancies. Signs and symptoms appear later than the other forms of ectopic pregnancies because of its peculiar location. The gold standard for its diagnosis is transvaginal ultrasound. The treatment can be medical or surgical. Medical treatment is based on the systemic or local injection of methotrexate (MTX); a dose of mifepristone can be added with a reported 85-90% success rate. The surgical option is laparoscopic unilateral cornuostomy or unilateral salpingectomy. The therapeutic choice is based on symptoms, serum β-human chorionic gonadotropin (β-hCG) values, and sonographic features. Furthermore, the patient's fertility perspectives should be considered. We report a case of IP in a Caucasian woman of 29 years old, with a previous salpingectomy for ectopic pregnancy medically treated by a double dose of intramuscular MTX 50 mg/m2 combined with a single dose of leucovorin 15 mg and a single dose of mifepristone 600 mg orally. Medical therapy failed as suggested by the sudden onset of intense pelvic pain after 10 days. Because of the clinical symptoms and the sonographic suspicious of pregnancy rupture due to the modest amount of fluid in the pouch of Douglas, clinicians decided on an urgent unilateral laparoscopic salpingectomy. The hemoperitoneum was drained. The patient was discharged two days later and β-hCG serum levels became negative after 45 days. The advantages of fertility sparing should be weighted according to the patient's reproductive perspectives. Appropriate counseling is therefore key in managing the treatment of interstitial pregnancy

Revived Fossil Plasma Sources in Galaxy Clusters

© 2020 ESO.It is well established that particle acceleration by shocks and turbulence in the intra-cluster medium can produce cluster-scale synchrotron emitting sources. However, the detailed physics of these particle acceleration processes is still not well understood. One of the main open questions is the role of fossil relativistic electrons that have been deposited in the intracluster medium (ICM) by radio galaxies. These synchrotron-emitting electrons are very difficult to study as their radiative lifetime is only tens of Myr at gigahertz frequencies, and they are therefore a relatively unexplored population. Despite the typical steep radio spectrum due to synchrotron losses, these fossil electrons are barely visible even at radio frequencies well below the gigahertz level. However, when a pocket of fossil radio plasma is compressed, it boosts the visibility at sub-gigahertz frequencies, creating what are known as radio phoenices. This compression can be the result of bulk motion and shocks in the ICM due to merger activity. In this paper we demonstrate the discovery potential of low-frequency radio sky surveys to find and study revived fossil plasma sources in galaxy clusters. We used the 150 MHz TIFR GMRT Sky Survey and the 1.4 GHz NVSS sky survey to identify candidate radio phoenices. A subset of three candidates was studied in detail using deep multi-band radio observations (LOFAR and GMRT), X-ray obserations (Chandra or XMM-Newton), and archival optical observations. Two of the three sources are new discoveries. Using these observations, we identified common observational properties (radio morphology, ultra-steep spectrum, X-ray luminosity, dynamical state) that will enable us to identify this class of sources more easily, and will help us to understand the physical origin of these sources.Peer reviewedFinal Accepted Versio