Towards a new approach to detect sleepiness: Validation of the objective sleepiness scale under simulated driving conditions

The Objective Sleepiness Scale (OSS) was developed to detect and quantify sleepiness on the basis of two direct and reliable sleepiness indicators: EEG and EOG. The present study aims to test whether the OSS can be used to detect sleepiness episodes that impair performance on driving and vigilance tasks accurately and with a good time synchronization. Forty-three healthy volunteers performed monotonous driving sessions on a simulator and the psychomotor vigilance task (PVT) in a normal sleep condition and after partial sleep deprivation. OSS reliability and time synchronization for sleepiness detection were tested on driving (standard deviation of vehicle lateral position and off-road duration) and PVT (reaction time and lapses). Inter-rater reliability of the scale was evaluated by two blinded scorers. Results show that the OSS score indicates higher sleepiness in sleep deprivation conditions (p < 0.001) and with time-on-task. Differences of performance between OSS score calculated with multiple pairwise comparisons, indicate OSS score increase when driving performance (SDLP and off-road duration) decreases (p < 0.001 for comparisons between OSS stages 0 vs 2, 0 vs 3, 1 vs 2 and p < 0.05 for 1 vs 3). Reaction time during PVT is also related to the OSS score (p < 0.05 for OSS values from 0 to 2, 0 to 3, 1 to 2 and 1 to 3). There is no proportional relation between OSS score and performance impairment, but a threshold effect between levels 1 and 2 of the scale is observed. Positive outcomes are also obtained for time synchronization of the OSS assessed on driving performance (p < 0.001 for both SDLP and off-road duration). Finally, inter-rater agreement is found to be considerable. The results allow us to consider using the Objective Sleepiness Scale as a tool for research on sleepiness.     

Physiological indicators of driver workload during car-following scenarios and takeovers in highly automated driving

This driving simulator study, conducted as a part of Horizon2020-funded L3Pilot project, investigated how different car-following situations affected driver workload, within the context of vehicle automation. Electrocardiogram (ECG) and electrodermal activity (EDA)-based physiological metrics were used as objective indicators of workload, along with self-reported workload ratings. A total of 32 drivers were divided into two equal groups, based on whether they engaged in a non-driving related task (NDRT) during automation (SAE Level 3) or monitored the drive (SAE Level 2). Drivers in both groups were exposed to two counterbalanced experimental drives, lasting ∼ 18 min each, of Short (0.5 s) and Long (1.5 s) Time Headway conditions during automated car-following (ACF), which was followed by a takeover that happened with or without a lead vehicle. Results showed that driver workload due to the NDRT was significantly higher than both monitoring the drive during ACF and manual car-following (MCF). Furthermore, the results indicated that a lead vehicle maintain a shorter THW can significantly increase driver workload during takeover scenarios, potentially affecting driver safety. This warrants further research into understanding safe time headway thresholds to be maintained by automated vehicles, without placing additional cognitive or attentional demands on the driver. Our results indicated that ECG and EDA signals are sensitive to variations in workload, which warrants further investigation on the value of combining these two signals to assess driver workload in real-time, to help future driver monitoring systems respond appropriately to the limitations of the driver, and predict their performance in the driving task, if and when they have to resume manual control of the vehicle after a period of automated driving.     

Dorsolateral prefrontal cortex mediates working memory processes in motor skill learning

Neuroimaging studies have shown that the dorsolateral prefrontal cortex (DLPFC) is recruited during motor skill learning, which suggests the involvement of the DLPFC in working memory (WM) processes, such as selection and integration of motor representations temporarily stored in WM. However, direct evidence linking activation of the DLPFC to WM storage and manipulation during motor skill learning in real-time is rare. In this study, we conducted two experiments to investigate the causal role of DLPFC activity in WM storage and manipulation during motor skill learning under low and high WM-demand conditions. Participants received continuous theta burst stimulation (cTBS) and sham stimulation (crossover design) over the left DLPFC (experiment 1) or right DLPFC (experiment 2). Before and after stimulation, participants in both experiments performed a sequential finger-tapping (SFT) task containing repeated sequence (low-WM demand) and non-repeated sequence (high-WM demand) conditions which are used to study WM processes. The number of correct sequences (NoCS) and reproduction error rate were analyzed. Learning gains in NoCS improved significantly with the practice for both sequence types in the presence of either stimulation type. Compared to sham stimulation, cTBS over the left DLPFC resulted in significantly reduced learning gains in NoCS for non-repeated sequences. These results suggest that the left DLPFC contributes to WM manipulation during motor skill learning.     

Between place and territory: Young people's emotional geographies of security and insecurity in Brussels' deprived areas

While much of literature on place attachment describes it as an affective bond between a (young) person and place, with positive psychosocial consequences such as identification, rootedness and belonging, some authors are cautious and stress that an enhanced attachment to place, termed “territoriality”, may have negative consequences such as hostility towards outsiders and a sense of non-belonging elsewhere. In this paper, I ask how we should understand this difference and how the analysis of young people's emotional geographies of (in)security can bring light to this question. The paper finds that emotional geographies of (in)security are instrumental in understanding how a “positive” attachment to place may lead to a “negative” attachment to territory, how some young people emotionally attach to places and some are inclined to claim these places against outsiders (and also at the expense of other members of the community). This explicit appropriation of public spaces in the home neighbourhood is co-constituted by feeling secure inside and insecure outside the area. Territoriality may be a response to or an expression of ontological insecurity and of the inner unease that prompts them to strange avoidance and contorted strategies for manipulating spaces and setting boundaries designed to secure the self.     

From Copenhagen to the consulting room: Pauli and Jung in Copenhagen

In this paper the city of Copenhagen is used as a starting point to highlight some critical historical events, both concerning the exchange of ideas between the physicist Wolfgang Pauli and C.G. Jung and the history of psychotherapy in Scandinavia. Pauli's years in Copenhagen under the influence of Niels Bohr and his philosophy prepared him mentally to receiveC.G. Jung's ideas. The paper also recounts the one occasion that Jung was in Scandinavia, attending the 9th conference of the General Medical Society for Psychotherapy in Copenhagen, just before going to New York in 1937 to give his final seminars on Pauli's dreams. The reason for focusing on these particular events is that they also constitute part of the history of the reception of psychodynamic psychology in Sweden and Scandinavia.     

Indigenizing CBPR: Evaluation of a Community-Based and Participatory Research Process Implementation of the Elluam Tungiinun (Towards Wellness) Program in Alaska

The process that community based participatory research (CBPR) implementation takes in indigenous community contexts has serious implications for health intervention outcomes and sustainability. An evaluation of the Elluam Tungiinun (Towards Wellness) Project aimed to explore the experience of a Yup'ik Alaska Native community engaged within a CBPR process and describe the effects of CBPR process implementation from an indigenous community member perspective. CBPR is acknowledged as an effective strategy for engaging American Indian and Alaska Native communities in research process, but we still know very little about the experience from a local, community member perspective. What are the perceived outcomes of participation in CBPR from a local, community member perspective? Qualitative methods were used to elicit community member perspectives of participation in a CBPR process engaged with one Yup'ik community in southwest Alaska. Results focus on community member perceptions of CBPR implementation, involvement in the process and partnership, ownership of the project with outcomes observed and perceived at the community, family and individual levels, and challenges. A discussion of findings demonstrates how ownership of the intervention arose from a translational and indigenizing process initiated by the community that was supported and enhanced through the implementation of CBPR. Community member perspectives of their participation in the research reveal important process points that stand to contribute meaningfully to implementation science for interventions developed by and for indigenous and other minority and culturally diverse peoples.     

IMAGO DEI,DUALISM, AND EVOLUTION: A PHILOSOPHICAL DEFENSE OF THE STRUCTURAL IMAGE OF GOD

Most contemporary theologians have distanced themselves from views that identify the image of God with a capacity or a set of capacities that humans have. This article examines three arguments against the structural view and finds them wanting. The first argument is that the structural view entails mind/body dualism and dualism is no longer viable given neuroscience and contemporary philosophy. Against this, I argue that contemporary forms of dualism are able to circumvent such worries and are at least prima facie plausible. The second claim is that structural views end up disvaluing the human body and our relatedness. Here, I argue that neither the structural view nor dualism has such consequences. The third issue consists of various evolutionary worries that have to do with the lack of a clear‐cut boundary between human capacities and the capacities of nonhuman animals. As a response, the article argues that although there might not be a clear‐cut set of capacities that all humans share, we could still have a notion of human distinctiveness that is sufficient for the structural image of God.     

难治性丙型肝炎研究新进展

随着聚乙二醇化干扰素(IFN)的普及应用和慢性丙型肝炎规范化治疗的开展,其治愈率不断提高.但疗效不佳的慢性丙型肝炎患者不断积累,难治性慢性丙型肝炎患者成为临床医生必须面对的挑战.难治性丙型肝炎患者应当分为两类,第一类为“难治疗”性慢性丙型肝炎患者,该类患者由于宿主条件限制,不能耐受IFN联合利巴韦林(RBV)的标准治疗,如儿童和老年人、慢性肾功能衰竭患者等.第二类为“难治愈”性慢性丙型肝炎患者,该类患者可以耐受标准治疗方案,但按照应答指导的治疗原则(RGT)治疗后,效果仍然不佳或复发.本文就近年关于难治性丙型肝炎的研究进展,从难治性丙型肝炎的定义、机制、治疗诸方面作一综述.     

Problematic,absent and stigmatizing diagnoses in current mental disorders classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys

This study examined English- and Spanish-speaking psychologists’ and psychiatrists’ opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders classifications (ICD-10 and DSM-IV), and their perceived need for a national classification of mental disorders. Answers to open-ended questions included in WHO-WPA and WHO-IUPsyS surveys were examined using an inductive content-analysis method. A total of 3,222 participants from 35 countries were included. The most problematic diagnostic group was personality disorders, especially among psychiatrists, because of poor validity and lack of specificity. Complex posttraumatic stress disorder was the most frequent diagnosis suggested for inclusion, mainly by psychologists, to better account for the distinct processes and consequences of complex trauma. Schizophrenia was the diagnosis most frequently identified as stigmatizing, particularly by psychiatrists, due to lack of public understanding or knowledge about the diagnosis. Of the 14.4% of participants who perceived a need for a national classification system, two-thirds were from Africa or Latin America. The rationales provided were that mental disorders classifications should consider cultural and socio-historical diversity in the expression of psychopathology, differences in the perception of what is and is not pathological in different nations, and the existence of culture-bound syndromes. Implications for ICD-11 development and dissemination are discussed.