Psychosomatic Aspects of Narcolepsy

1. After a brief discussion of the nature of psychosomatic illness and of sleep, the literature on narcolepsy was reviewed. The term narcolepsy was defined and its history discussed. 2. It was pointed out that, while most cases of narcolepsy were "idiopathic", there was much evidence suggesting an underlying pathophysiological disturbance probably in the region of the reticular activating system. 3. It was added that there was much evidence suggesting that emotional factors could precipitate if not engender the condition. There seemed to be no justification for regarding the condition as an hysterical one. 4. The literature on neurotic somnolence was discussed. The psychogenic hypersomnias were divided into two groups viz. (a) prolonged trance states in which sleep was probably intermittent. (b) shorter attacks of what was probably genuine sleep, rarely of more than a days duration provoked by extreme weariness in the face of severe neurotic conflicts. It was argued that both groups were quite distinct from true narcolepsy. In addition, much briefer spells of hysterical "sleep" (usually lasting only for minutes) were considered. Evidence was presented for these being trance states rather than physiological sleep. 5. Six narcoleptic cases of my own were then presented; these were contrasted with three of my cases of neurotic somnolence. All six narcoleptics showed excessive, intermittent and inappropriate drowsiness both clinically and in the EEG recordings. In four cases, the EEG was taken under hypoglycaemia and showed a definite diminution in the amount of drowsiness. It was argued that this might have been due to central liberation of adrenaline with stimulation of the adrenaline-sensitive part of the reticular activating system. These four patients also showed mild abnormalities of the Exton Rose glucose tolerance test. Clinically all six cases showed some evidence of emotional disturbance in childhood prior to the onset of narcolepsy, and all showed some personality change after the onset of narcolepsy* Psychological tests were definitely abnormal in five of the cases and showed some slight disturbance in the sixth. In five cases, the symptomatology was markedly aggravated by emotional upset and in particular some relationship was noted between the symptoms and inhibited aggression. The three neurotics did not show typical EEG or clinical features of narcolepsy. Only one showed even light drowsiness in the EEG and this was only occasionally present at a time when he could not be roused. Examination of his reflexes did not support the impression that this was a true sleep. 6. One of ray narcoleptic patients showed paranoid schizophrenia arising in intimate association with the sleep hallucinosis. Such cases are extremely rare. The literature was reviewed and the condition discussed. 7. The EEG in four recordings of cataplexy showed no specific change. Some drowsiness appeared. 8. It would be correct to call narcolepsy a psychosomatic Illness. Both somatic and psychological factors are of importance. The latter are important in two ways: (a) They may greatly increase the symptomatology. (b) They influence the way in which the patient handles his illness. It is essential to treat the patient rather than the disease and in many cases psychotherapy is indicated

Rural Hospital Nursing Skill Mix and Work Environment Associated with Frequency of Adverse Events.

Introduction: Though rural hospitals serve about one fifth of the United States (U.S.), few studies have investigated relationships among nursing resources and rural hospital adverse events. Objectives: The purpose was to determine relationships among nursing skill mix (proportion of Registered Nurses (RNs) to all nursing staff), the work environment and adverse events (medication errors, patient falls with injury, pressure ulcers, and urinary tract infections) in rural hospitals. Methods: Using a cross-sectional design, nurse survey data from a large study examining nurse organizational factors, patient safety, and quality from four U.S. states were linked to the 2006 American Hospital Association data. The work environment was measured using the Practice Environment Scale of the Nursing Work Index (PES-NWI). Nurses reported adverse event frequency. Data analyses were descriptive and inferential. Results: On average, 72% of nursing staff were RNs (range = 45% to 100%). Adverse event frequency ranged from 0% to 67%, across 76 hospitals. In regression models, a 10-point increase in the proportion of RNs among all nursing staff and a one standard deviation increase in the PES-NWI score were significantly associated with decreased odds of frequent adverse events. Conclusion: Rural hospitals that increase the nursing skill mix and improve the work environment may achieve reduced adverse event frequency

Nox2 dependent redox-regulation of microglial response to amyloid-β stimulation and microgliosis in aging

Microglia express constitutively a Nox2 enzyme that is involved in neuroinflammation by the generation of reactive oxygen species (ROS). Amyloid β (Aβ) plays a crucial role in Alzheimer’s disease. However, the mechanism of Aβ-induced microglial dysfunction and redox-regulation of microgliosis in aging remains unclear. In this study, we examined Nox2-derived ROS in mediating microglial response to Aβ peptide 1–42 (Aβ42) stimulation in vitro, in aging-associated microgliosis in vivo and in post-mortem human samples. Compared to controls, Aβ42 markedly induced BV2 cell ROS production, Nox2 expression, p47phox and ERK1/2 phosphorylation, cell proliferation and IL-1β secretion. All these changes could be inhibited to the control levels in the presence of Nox2 inhibitor or superoxide scavenger. Compared to young (3–4 months) controls, midbrain tissues from wild-type aging mice (20– 22 months) had significantly higher levels of Nox2-derived ROS production, Aβ deposition, microgliosis and IL-1β production. However, these aging-related changes were reduced or absent in Nox2 knockout aging mice. Clinical significance of aging-associated Nox2 activation, microgliosis and IL-1β production was investigated using post-mortem midbrain tissues of humans at young (25–38 years) and old age (61–85 years). In conclusion, Nox2-dependent redox-signalling is crucial in microglial response to Aβ42 stimulation and in aging-associated microgliosis and brain inflammation

Elastic response of a nematic liquid crystal to an immersed nanowire

We study the immersion of a ferromagnetic nanowire within a nematic liquid crystal using a lattice Boltzmann algorithm to solve the full three-dimensional equations of hydrodynamics. We present an algorithm for including a moving boundary, to simulate a nanowire, in a lattice Boltzmann simulation. The nematic imposes a torque on a wire that increases linearly with the angle between the wire and the equilibrium direction of the director field. By rotation of these nanowires, one can determine the elastic constants of the nematic.Comment: 10 pages, 8 figure

An introduction to the local-to-global behaviour of groups acting on trees and the theory of local action diagrams

The primary tool for analysing groups acting on trees is Bass--Serre Theory. It is comprised of two parts: a decomposition result, in which an action is decomposed via a graph of groups, and a construction result, in which graphs of groups are used to build examples of groups acting on trees. The usefulness of the latter for constructing new examples of `large' (e.g. nondiscrete) groups acting on trees is severely limited. There is a pressing need for new examples of such groups as they play an important role in the theory of locally compact groups. An alternative `local-to-global' approach to the study of groups acting on trees has recently emerged, inspired by a paper of Marc Burger and Shahar Mozes, based on groups that are `universal' with respect to some specified `local' action. In recent work, the authors of this survey article have developed a general theory of universal groups of local actions, that behaves, in many respects, like Bass--Serre Theory. We call this the theory of local action diagrams. The theory is powerful enough to completely describe all closed groups of automorphisms of trees that enjoy Tits' Independence Property (P). This article is an introductory survey of the local-to-global behaviour of groups acting on trees and the theory of local action diagrams. The article contains many ideas for future research projects.Comment: Survey article based on Simon M Smith's lecture at Groups St Andrews 202

Fusing Information in a 3D Chart-of-the-Future Display

The Data Visualization Research Lab at the Center for Coastal and Ocean Mapping is investigating how three-dimensional navigational displays can most effectively be constructed. This effort is progressing along multiple paths and is implemented in the GeoNav3D system, a 3D chart-of-the-future research prototype. We present two lines of investigation here. First, we explore how tide, depth, and planning information can be combined (fused) into a single view, in order to give the user a more realistic picture of effective water depths. In the GeoNav3D system, 3D shaded bathymetry, coded for color depth, is used to display navigable areas. As in ENC displays, different colors are used to easily identify areas that are safe, areas where under-keel clearance is minimal, and areas where depths are too shallow. Real-time or model-generated tide information is taken into account in dynamically color-coding the depths. One advantage to using a continuous bathymetric model, versus discrete depth areas, is that the model can be continuously adjusted for water level. This concept is also extended for planning purposes by displaying the color-coded depths along a proposed corridor at the expected time of reaching each point. In our second line of investigation, we explore mechanisms for linking information from multiple 3D views into a coherent whole. In GeoNav3D, it is possible to create a variety of plan and perspective views, and these views can be attached to moving reference frames. This provides not only semi-static views such as from-the-bridge and under-keel along-track profile views, but also more dynamic, interactive views. These views are linked through visual devices that allow the fusion of information from among the views. We present several such devices and show how they highlight relevant details and help to minimize user confusion. Investigation into the utility of various linked views for aiding realsituation decision-making is ongoin

Integrating Liberal Education Perspectives in a Transdisciplinary Design Studio

Short Abstract: In this presentation, we describe the evolution of our approach to integrating liberal education perspectives within an innovative transdisciplinary learning program. Our experiences are used to illustrate challenges in systematically incorporating liberal education perspectives, including instructional and student barriers to viewing the world from a variety of disciplinary perspectives. Full Abstract: The increasing complexity of design outcomes requires students to develop deep competence in communication and interpersonal skills, including an understanding of how technology is intertwined with societal and human needs. Locating and synthesizing information is crucial to solving interesting and worthwhile problems, but may not be obvious from a solely technical or solely humanities perspective. However, there is relatively little guidance as to how liberal education perspectives might be systematically integrated. In this presentation, we describe the evolution of our approach to integrating liberal education perspectives within an innovative transdisciplinary learning program located at the Purdue Polytechnic Institute. This evolution has included a merger of existing courses, a dual-strand seminar and studio learning experience, and most recently, an integrated studio experience that encapsulates a multiplicity of disciplinary perspectives from liberal education and technology. Our program design experiences are used to illustrate the challenges in systematically incorporating liberal education perspectives in a transdisciplinary learning environment, and the instructional and student barriers to viewing the world through multiple lenses from a variety of disciplinary perspectives

GeoZui3D: Data Fusion for Interpreting Oceanographic Data

GeoZui3D stands for Geographic Zooming User Interface. It is a new visualization software system designed for interpreting multiple sources of 3D data. The system supports gridded terrain models, triangular meshes, curtain plots, and a number of other display objects. A novel center of workspace interaction method unifies a number of aspects of the interface. It creates a simple viewpoint control method, it helps link multiple views, and is ideal for stereoscopic viewing. GeoZui3D has a number of features to support real-time input. Through a CORBA interface external entities can influence the position and state of objects in the display. Extra windows can be attached to moving objects allowing for their position and data to be monitored. We describe the application of this system for heterogeneous data fusion, for multibeam QC and for ROV/AUV monitoring