Twitter? Yep, it's so cheese It's so cheese It's true I also have a personal YouTube channel, it's right down there Funny thing, I used to have my ears pierced And then my job Wait, what? Yeah, high school probably When you knew me But the job I had shows you how like Why didn't you wear them to class? Well, because my job, like I got them And then my job was like I can't have them That's stupid It shows you how dumb and prejudice jobs are Like between genders It's like seriously Girls can have, they're like, yeah girls That's okay Well, that was then Yeah, things have changed a little bit I bet it wouldn't have been the same thing now Well, it's still Texas That's the same in Texas Yep Anyways, today we are doing a video This is a tribute to the late great Mathemat Titian, prodigy Say her name Yes Shakuntala Devi Devi, and I'm coming by a pic with Vidya, Vidya Yeah, so this is an actual I think video of her A tribute to her An actual video of the woman So I think she's being interviewed Or performing Where did we hear Was it a comment on a tweet or something About, forgive me, the stupid babies Who have sent this information Because remember when we reacted to the trailer We were wondering if she was quirky And the response was, yes she was She was the way you saw her She was different Some did were upset though That the film is overtly Like making it like Overtly over the top Making that the situation Obviously the film sent out So we haven't seen it yet They don't know But this is a tribute So we can learn a little more about the person Awesome She's a great mathematician So let us See if I need to turn on subs here Here we go Welcome, you are watching Our South Asian programming We are delighted to open this show With a human computer Yes I did say human computer She is the world renowned Computer's world first human Ms Shakuntala Devi A mathematical prodigy From Bangalore, India She is one of those rare people Who possesses a skill with figures That amazes computer visits Intrigues, academics And dumbfounds Those of us who have difficulty Balancing our checkbooks She is an English book of world records For a 1980 feet at a London university Multiplying two 13 digit numbers In 28 seconds Fast superior to anything Previously reported She can add, subtract, multiply And divide any and all figures Offered She can also name the day of the week For any date within 2,000 years She has looked upon As a good will ambassador for India Going around the world Spreading a mathematical message And also showing that the human mind Is still superior to the computer Mr. Ankarad Jensen Professor of Education and Psychology University of Berkeley After studying Shakuntala Devi Very carefully Said that her skills with numbers Were like those of a writer Who did not think about the location Of typewriter keys Or a musician Who read music And simultaneously Sounded the correct notes The actual calculations Are almost automatic, he said He concluded that no one knew Exactly how she did these things Nor did she He is convinced it is not magic As you can see We are all set for Chandrasekhar Ms. Shakuntala Devi And our panel To sit in Welcome to a special on Shakuntala Devi The internationally well known person From the Guinness Book of World Records Joining us as part of a panel here Is Mr. Roger Allen He is the head of the department From mathematics From the Upper Canada College Also joining us is Mr. Samin Siddiqui A third year student From the University of Toronto Who is taking commerce and economics When he was in mathematics He was born in Toronto And his parents came originally From Pakistan And also with us is Mr. Christopher Angel A member of the leading class And outstanding brilliant student From the Upper Canada College Welcome to the program gentlemen And you also have Mr. Baj Devi The president of Computerized Business Systems A leading computer firm In the Toronto community And he is going to be helping us He looks nervous Yes, less is harder Welcome to the program Baj Now who is ready to go With the first question By the way To Shakuntala Devi Well shall I start Why don't you do that We'd rather start With the head of the department From mathematics Okay, yes Now I wonder if you'd like To have a go at this one I think it is best The thing is written on the blackboard Alright Okay I've got it written out here Perhaps I can just give it to you And you can put it on before Baj, would you please Do us a favor And write it on the board Very much so Okay I love that No need to write the words Please don't write the words It confuses me Kindly give me a favor No commerce Okay Just put a root over sign I should be saying only the numbers Okay So to this number 692 Yes Is that correct Yes, that's correct Thank you very much 692 That's the answer Okay Are you getting me right now? Now tell me something In normal circumstances To calculate that Suppose the computers were not available What are the alternative methods of doing this Well you'd have to do it by Long vision You'd have to do it by trial and error You'd have to split it up Into three groups of three That's an easy question I mean it's an easy long question If you could write it out The number would be But to be absolutely sure Again the correct answer Would be very very difficult And to do it that quickly Is unbelievable But just amazing Just amazing Normally how much time Would you have taken For even a brilliant student To do that for instance Certainly a few minutes Of very very clever students Would certainly take a few minutes And that would be Remarkable in itself I think Wonderful Congratulations You had another question Well yes I've got Another one here How about finding the value Of 7 to the power of 7 7 raised to the power of 7 Yes yes 7 raised to the power of 7 49 Yes you've got the answer You see the answer is 8 Please write down 8 2 3 5 4 3 This is the answer Would you like me to do it Step by step It's not is that the answer I'm going to do it Step by step You've got a computer video Let's say let's race against it Come on Come on I got to 49 Come on let's say 7 multiplied by 7 Is equal to 49 49 multiplied by 7 Is equal to 343 343 multiplied by 7 Is equal to 2401 2401 Multiplied by 49 Is equal to 1176 4 9 That's correct 117649 multiplied by 7 Is equal to 823543 My god My goodness That is fantastic Congratulations Thank you Roger do you have another one to You said something I hope my students are not listening to this We'll keep it strictly confidential What day of the week was I born If I was born on the 10th of March 1940 We have a same birthday Not the same year That's what my mother tells me I guess it's Brian That's wonderful Sami let's go to you now Right now Sami Okay Here's a very messy question Okay Massey do you want to say Massey Not because I'm never messy Why do you say not because I'm messy Okay Sami is a second A third year student At the University of Toronto Commerce and Economics Right Go ahead with your question Okay The first one Right The first one thing When you say messy Does it have any decimals? It does Because the decimals are there People call it messy Because you get the decimals She's freaking me with those decimals Because sometimes what happens You take the closest approximation And you don't get the same decimal places I'll try to get the same as yours I love her Let's see To do that You want it to do Why not more That's sufficient That's sufficient To do Well if you would like If at all I want to do something messy Let me make it very very messy All right Okay All right It's so bad But I love Let's see Great Let's go with it That sounds messy Or that looks messy Or right there 6, 5, 4 3, 2, 1, 6 The cube to this number Multiplied by the fourth root of 3, 8 And 4, 5, 6 Divide it by this Is it? Yes Divide You forgot to put this See That could land me in a mess now Okay Now 6, 5, 4 You can do it It's number multiplied by the fourth root of 3, 8, 9, 4, 5, 6 All thing divided by this Quite a lot of 4, 9, 4, 8 6, 4, 6 Right Right 6 places of this Okay, I only have it 2 I'll give you 6 Okay I can do it 4. Correct 8 Right Right 4.8 5 places more 0, 0, 0, 0 That was just a 0 Wonderful, wonderful Great Let's go with the next one What about, you know Let's have Christopher You had some interesting questions From what I understand I saw you in the hallway You were all bubbly And excited about this whole thing Christopher Let's come up with your question Okay, this is quite a complex one So I've got the answer down Is it here? You haven't got the answer yet No, I have it here Good Okay All right 118 machines 118 machines Yes Can produce 73 items Yes In 7 and a half days I see Yeah, this is before pre-create Right Yeah How many items can 217 machines Produce in 11 and 3 quarter days 11 and 3 quarter days 11 and 3 quarter days What? These questions stress me out Oh my stars Right Thank you You can even clean Okay Are you impressed by that Any chance, Christopher? Yes, I don't think half my class could get that Even with calculators It's an under time Thank you We wanted to now see A bit of a demonstration With respect to the calendar And the dates during the year 1989 Shall we go for it? Okay Okay Yes, why don't you start the Get the boundaries Tell me a date Tell me a date What about right here? Right here Okay I'll go backwards December to January How about that? Okay All right How about Thursday? All the Thursdays December to January Yes, backwards December Thursday 7, 14, 21st, 28th November Thursday 7, 9, 16, 24th, 30th October Thursday 5, 19, 26th September Thursday 7, 14, 21st, 28th August Thursday 3, 10, 17, 24, 31st July Thursday 6, 30, 28, 27th June Thursday 1st, 8, 15, 22nd, 29th May Thursday 4, 18, 25th April Thursday 6, 30, 28, 27th March Thursday 2nd, 9, 16, 23rd 3rd, 8, February Thursday 2nd, 9, 16, 23rd January Thursday 5, 19, 26th Oh my God If I ask you That was interesting Because even though you're going backwards You gave the dates of the month Going forwards Each month You gave You went 5, 12, 19, 26 That's interesting So even though you're going backwards You're still picking forwards I'm going backwards and forwards Yes, practically No, I'm not Last time I did From backwards Would you like to give a date? Can you do the 13th? 13th, why not? December 13th Wednesday November 13th Monday October 13th Friday September 13th Wednesday August 13th Sunday July 13th Tuesday May 13th Saturday April 13th Thursday How's the brain even do that? Monday, January 13th Friday Well, let's talk about the Friday and the 13th Before going any further We're really impressed I'm sorry we've come to the end of the show Shakuntala, our hearty congratulations Thank you Very quick reaction What do you think of Shakuntala Devi Raja? Well, absolutely amazing The only relationship I can think of Between Shakuntala is the Very well known Indian mathematician Romano Jan Who died about 30 or 40 years ago Who was world famous And he's the only other person I can think of Who has the same or similar talents Just so I'm just amazed To be in honor Thank you, Shakuntala Thank you very much It's been a great pleasure Thank you very much indeed It's been a pleasure Thank you Thank you all I feel stupid It actually Like the fact that her brain can work that way And mine can't remember what I had for breakfast Yeah, no, no, no That's way beyond comparative intelligence That's way, way, way, way, way beyond Comparative intelligence That is, that is gifting That is miraculous That is like Remember when we first saw The level of artistic genius That is Estadio Zakir Hussein Who just were like Right? Or turning in Multiply that Times about 10, 15,000 I don't know that I've ever seen Anybody exhibit a level of proficiency And skill in anything In the human experience That I've come across in my life Like what I just saw Yeah, and the fact that one Obviously she can do numbers Just that fast Obviously with math And then also dates She can apparently go back 2,000 years And she's Can tell you in an instant Yeah Like, so obviously it's a math equation That she can easily do in her head That Like it's just like Math is obviously She's more than fluid attendant It It makes me emotional To think that And it makes me want this movie To do her justice in a big freakin' way now If this becomes some light fluff Well, that's what I think a lot of people When I saw it I was like Okay, so this is And obviously she's quirky And we saw it in the video Oh, I love her She's very quirky Like anytime anybody says anything She's like, oh, I'll do it Yeah, yeah, I'll do it Do you want me to do it even better? I can do it And she obviously has this confidence Because she has no reason Right, but no arrogance Great confidence with no arrogance So there's that bubbliness But I was worried When I saw the trailer I'm like, okay So this is genius Yeah Maybe literal genius It is giftedness that transcends The human understanding Can't make her into this fluff movie Yeah And I don't know if they did No Because it's not out yet But that's what the concern is Like when you have a genius Like whether it's in NASA or wherever You want to do that person a justice It's comparable And I don't mean to be hyperbolic But I really mean this It would be comparable to Having somebody in the room talk to us And they tell us Yeah, I can will myself to be Anywhere on earth at any time I like You can do what?  No one does that Even like these other three I'm assuming all professors All of them I bet were brilliant clients Genius mathematician professors Right, brilliant And this person's just blowing them away Leaving them in the dust Like I'm There's, I don't have a superlative To describe how utterly Astonished I am by the gift Of this woman's brain The days of the week I'm just blabbering Goofball right now I've never seen anything Well, I hope the movie does a justice Oh, man And better And I'm sure obviously Vidya did her homework Obviously in trying to replicate Obviously Vidya's playing a younger version As you can see here What a monumental task to play that woman Yeah, that's a pretty big task But if there's more videos That she's just showing her genius That was almost as fun as like watching Like you said And you start just saying Just do what he does Yeah, and it's better than like When you watch a great magician Right, you get your mind blown You're like, how did they do it? This is way, way, way, way beyond that This is like, okay I just want to marvel At what the human This human being is capable of It's inspiring And she's so matter of fact And confident And, man That was cool It's incredible I hope you enjoyed that magic video As much as we did We're just like Let us know more videos down below Thank you for watching


In this lab, you're going to be looking at the energies involved in a pendulum that is swinging back and forth. First, we're going to measure the mass of the bob. For this lab, please take a bob that is around 50 grams. Then, you're also going to measure the diameter of the bob. Now you're going to set up the photogate as low as possible, and you're going to put some protective blocks in front of it, so that when we're swinging the pendulum, that there is no risk of actually hitting the photogate itself. It's quite expensive equipment, and we don't want to destroy it. When you turn on the photogate and put it on gate position, you will see that the timer will count for as long as the pendulum is obstructing the photogate. We will use this to calculate the speed of the pendulum at the lowest point by using some kinematics. We already measured the diameter, we know the time, or we can measure the time that it will take to pass, so we can calculate the speed. After each time, just put the reset button to be able to measure again. Now before we can start the experiment, we have to measure the lowest height of the pendulum. Try to measure the height of the center of mass. So if your pendulum doesn't have a marking yet, maybe you want to put a marker somewhere where you think the center of mass is. So here I would measure my lowest height at around 11.1 cm. And then you're going to put the photogate back into the lowest position of the pendulum. Now you're going to put your pendulum to a certain initial height, and you release it from there. You repeat this about three times so that we get three different time measurements for the same height. Now it's time to do the analysis. So you start by putting your data in your excel sheet, put the mass of the bob, its diameter, then for each run you put the height from where you released it, the lowest height of the bob, which is actually going to be, if you don't change your pendulum, set up the same for all the runs. And then the three times you measured. Over here you're calculating the average of those three times. Please use Excel formulas, don't calculate it outside of Excel. Then here you're calculating the velocity, or actually better the speed, based on the average time and the diameter of the bob. Based on that speed you're going to calculate the kinetic energy at the bottom. The potential energy of the bottom you're calculating it based on the lowest height and the mass of the bob. Then you add those two up to get the total mechanical energy at the bottom and the potential energy at the top. You're calculating this one based on your height at the highest point and the mass of the bob. Once you're done with that you're repeating the whole thing for six different heights. So use different heights and redo the whole calculation and hopefully you will see a pattern if you're comparing the potential energy at the top, which as there is no kinetic energy is the mechanical energy at the top and the total mechanical energy at the bottom. The question that I wanted to answer in the end in this lab is is the energy conserved in the system, in each of those rods? So you answer one for yes, zero for no, and of course there are uncertainties here which we didn't look at so consider if they are within the significant figures. See I used some useful amount of significant figures to see if within significant figures it's conserved. So when you calculate your energies please consider the significant figures here. We're not going to do a full error analysis which is going to base it on the number of sig figs. And then that's it for the first part of the lab.


In this third lecture of module 5, we continue to discuss the surface reactions. Today we look into catalytic effects, reactions in emulsions and complex formation in monolers. We had seen for alkaline hydrolysis of octadexyl acetate, long chain quaternary compounds like amines could facilitate attraction for negatively charged hydrolytic hydroxyl ions and thereby accelerate the reaction. And addition of a neutral salt could modify that behavior. For instance, if we had only octadexyl acetate alone, the rate constant would be about 0.93 into 10 raise to minus 2 minutes inverse. Whereas, if you have a concentration of about 12.5 percent of the long chain quaternary amine compound, the rate constant would jump to 7.4 into 10 raise to minus 2 minute inverse. And if we increase that amine concentration to about 33 percent, then the rate constant would rise to about 15 into 10 raise to minus 2 minutes inverse. What it means is that we achieve here acceleration of reaction by the quaternary ions by a factor as high as 16 to 17 times. That is a significant increase in the reaction rate and order of magnitude increase will always be desirable. One could rationalize these effects of charge on film through the equations by identifying the surface potential psi by the Goethe potential for which we know the expressions. That is genetic expression and the corresponding expressions at 20 and 25 degree centigrade are the ones which you will already know. As you recall, the Goethe equations are based on a model where there is a uniformly charged plane and the counter ions are all represented as point charges. Alternatively, we could take Donut treatment wherein not just the monolayer which may be insoluble, but an immediate layer of subjects and solution would be regarded as the surface phase and that would be of non-zero thickness. And within this finite region, the counter ions are all presumed to be concentrated. And with that presumption, the monolayer effect of neutral salt concentration on the rate constant is the one corresponding to the curvilinear line shown in that diagram. Now, one may discuss this a little further and catalysis by an electrical charge has found applications in degradation of large molecules. As shown in the work of Steinhart and Fugit in 1942, we could achieve hydrolysis in the hydrolysis of protein by a factor of 100 or more by using Lorel's sulphonic acid in comparison to HCl. Now, this is something I would like you to think for a minute. Think of protein being hydrolyzed and you take a weak looking acid Lorel's sulphonic acid. Contrast it against the hydrolysis, acid hydrolysis you may achieve with the strong hydrochloric acid solution. And you find this unusual unexpected result, the hydrolysis of proteins is a lot quicker 100 times, two orders of magnitude quicker than with HCl. How would this possibly explain? Any ideas? Please remember the basic tenets are very few. I mean most of what we will retain as take home message from the lectures on reactions apart from the details of reaction are very few. So, and I would like you to connect with that understanding of generic features at every stage. It looks counterintuitive, right? Lorel's sulphonic acid achieving 100 times quicker hydrolysis of protein than HCl. The example we just discussed the quaternary long chain quaternary ions adsorbed in the monolayer attracting hydroxyl ions may serve as a hint. If you want you want to build on that hint, how could we explain the protein hydrolysis? Sir protein by HCl won't get absorbed, but in the case of Lorel acid the part which is hydrofoam will be get absorbed on that particular. So, there will be more interactions. It's a part, part of the explanation. What will be the effect of that adsorption? That's the question we should ask. One thing is clear this is acid hydrolysis. Protein is attacked by acid and it is hydrolyzed. The strong HCl is unable to do it as quickly as this Lorel's sulphonic acid. So, the complete explanation will be following that on top of protein these Lorel's sulphate ions will adsorbed, will get adsorbed and attract hydrogen ions to that region. There by achieving a lot higher concentration of H plus in the vicinity of protein, in the vicinity of protein. Acid is H plus is what is responsible for hydrolysis. Whereas, in case of HCl there is no adsorption driven concentration of H plus ions near the protein. So, that will not be able to break it down. So, the principle is very simple. In a surface reaction we are achieving a very high concentration of the reactive species. In the monolayers it will be a location in the surface phase in case of proteins it would be at the surface of proteins. And we will build up this understanding little further with other examples. But, let us note in passing that when you compare peptide linkages peptide bonds with amide groups. Amide groups are CO NH 2 groups. The peptide bonds are CO NH CHR. We find that these amide groups are preferentially broken whereas, the peptide bonds are more resistant. Selective catalysis of this kind possible in surface reactions can therefore be an important tool in investigating other large molecules, how they react. And these large molecules could be in one of these forms. They could be in solution if the material is soluble or else it could be spread in surfaces such as of foams or emulsions. Examples would be pterulin, nylon or polyamino acids they are insoluble. They could be spread at the interface and then the reaction could occur. With this we move on to discuss reactions and emulsions. I brush the topic of reactions and emulsions in the very first lecture. We recapitulate that emulsions of oil and water can provide very large areas. Because that large interfacial area is there we might be able to achieve reactions which require surface. They could be of two kinds reactions like saponification or emulsion polymerization. So let us look into the reactions and emulsions in these two categories as we go along. First we think about emulsion polymerization. It would require an intimate contact between the monomer surface and a water soluble catalyst. And the reaction rate can be affected greatly because we may now be able to achieve a high reaction rate even at room temperature. What is an immediate advantage of having a practicable rate of reaction at room temperature? First and foremost is that we will be able to avoid the undesirable product formation. Generally these are branch in compounds which are not desirable but get produced at high temperature by achieving feasible reactions at room temperature making use of high interfacial area and energy of the interface we might be able to overcome that first undesirable part. The second part is of course if you can carry out a reaction at room temperature it is an energy saving. So that means the cost of your process could be brought down. Could there be a potential application in block polymerization? You could think of an example like this supposing that you want to produce a block copolymer of species A monomer A and species B or the monomer B. Say that monomer A may be water soluble and monomer B may be oil soluble. So you basically looking at making a copolymer of A and B with certain repetition of the monomers of A and monomers of B. One could get this started conveniently in an emulsion as shown by Dunn and Melville in 1952. He started with a monomer A which is water soluble and the polymer radicals which are generated in this phase will first create short chains like one indicated here a few A's and when these come in contact with the water insoluble monomer B they would add a B unit. An example of this is acrylic acid could be dissolved in water. It would form oligomer molecule species in water and then add the other species like styrene from the oil phase. You would need obviously to catalyze the reaction of acrylic acid molecules of photosensitizer like urinal nitrate. So you could get a copolymer of acrylic acid and styrene in emulsions this way. The fats may be hydrolyzed also in emulsions. You all know how soaps are produced. You react a vegetable oil with alkali at a high temperature and that would result in formation of soap. The speed of saponification or the total soap formation rate in terms of amount per time will obviously depend on the fineness of emulsion or the total interfacial area available in your system. Finer the emulsion better will be this fat hydrolysis. You could think of another example of emulsion polymerization that of styrene. Here there is a slight difference. In case of emulsion polymerization of styrene, the polymerization does not occur in or on emulsion droplets. Rather we have to look at this situation. Could we have the visualizer please? So at first look at this. Let us say we have air and water and we are thinking of now adding surfactant long chain hydrophobic and the hydrophilic head group. If you keep adding surf such amphiphilic molecules you would find that first these all get adsorbed at the surface. When this surface is completely occupied under given conditions, any additional amount will require these surface active molecules to occupy position inside bulk of water and you know that energetically that is not variable. So one may expect that probably there may be some further adsorption at the surface, but that cannot be indefinite. Once the capacity of the interface to pick up or contain these molecules is exceeded then these added molecules will have no option but to be inside the bulk. But we know energetically this is not variable because this is this disrupting the hydrogen bonded structure of water. So what these molecules do is the following. Hydrophilic head groups are fine, water can take them, but hydrophobic tails are not preferred. So there is a self assembly now wherein all these additional amphiphilic molecules rearrange themselves in a shape like this. This is a two dimensional picture just a cross section of a self assembled structure made by molecules of surface active agent. Actually it will be a spherical three dimensional structure and that is what is my cell. So lots of these my cells will form depending on the properties and concentrations, temperature, we may get different geometries. These may be spherical or they may be cylindrical, lamellar, many other geometries are possible. But the important point to understand is now these head groups make those additional molecules which were not favorable energetically to be reassembled in an acceptable manner because spears of hydrophilic external surface will be completely acceptable by water. The tails are in vicinity of each other hiding away from water. So this is an intelligent arrangement that the molecules are realizing making my cells. Now if that is the case then apart from this hydrophilic exterior surface we see that in the bulk of this we have hydrophobic environment. These are all tails right. So within the bulk of water we have these my cells with hydrophilic external surface and hydrophobic bulk. If you incorporate now other species like styrene, styrene being hydrophobic species will be not acceptable in water, but it will be acceptable in the bulk of my cells. So we might be able to get the styrene molecules here which will make these my cells swell. So we will have this swollen my cells with the interior hydrophobic region now solubilizing styrene. So that kind of situation would arise in the emulsion polymerization where now the polymerization will have to be initiated in the my cells of the surfactant or soap molecules. So that is a different kind of surface reaction we have. What advantage could we possibly have in such a different kind of system? Think of one. Could there possibly be an advantage in achieving reaction in the core of a my cell? What would that be? Shorter. That is hopefully the my cells are all of comparable size and because their size will be more or less similar the inner core hydrophobic core will have similar volume and a capacity to take up styrene or similar species and achieve the reaction. So you would be hopefully limiting the maximum polymer molecule size to the dimension of the interior of a my cell and that thereby you will be able to have a more uniform molecular weight distribution. What else? Apart from that, suppose I coin a different situation. Maybe I tailor make my cells in a different manner so that the interior is hydrophilic then I may be able to carry out a reaction like precipitation and I may be able to create particles. Maybe even micro or nano dimension particles either those particles or the polymer particles you are producing what advantage would have apart from narrow size distribution. The obvious one the distribution has these two characteristics. How much is the spread and what is the absolute size? Because the my cells are going to be molecular level assemblies the particles are going to be very small. Each my cell is like a reactor. The dimensions of that reactor will limit the maximum size of the particles produced. So because these dimensions are very small the particle sizes produced are also very small. So there could be some advantages of carrying out reactions in this fashion. Some of the methods of making nanoparticles producing nanoparticles are based on micellar reactions. There could be limitations on amount of particles you can make depending on the micellar concentration. And again to talk in general about interfacial engineering and our technological evolution with the mind and technology rate of evolution has jumped a million fold or more. And although we have realized the significance of surface and interfaces for very long time the details scrutiny at atomic scale has been difficult not just because the interfaces are very small regions close to the surface but also because the properties are very drastically different from bulk materials. But now there are techniques increasingly sophisticated techniques which can give more insight into the composition and surface of a wide variety of these surface or interface systems. And as we become better in the characterization and manipulation of the surfaces we should be able to create new applications perhaps learn more about this facending new science. Returning to the surface reactions I take another example I had talked about making fibers. There is one example in natural systems which I had given. We could think of another laboratory example here involving interfacial polymerization. You require a simple experiment in which you take two solutions one of 1.5 cc of sebacoil chloride in 50 cc of per chloroethylene. And the other solution is in 50 cc of water 4 grams of sodium carbonate and 2.2 grams of hexamethylene diamine. Looking at the molecules I am talking of you would already have an idea. If I add the second solution of carbonate and hexamethylene diamine in water on top of this sebacoil chloride in per chloroethylene very carefully so that there is no mixing and the interface is planar you would see the interface becomes milky white. A film forms which is a milky white film and if you can carefully cache that film with a pair of tongs and pull it out you would be able to continuously pulling out a nylon rope very thin one. Now obviously this kind of excellent can be fully automated and could be used for producing fibers very thin fibers of other polymers also like polyesters or polyurethanes. We then take up a topic of complex formation in monolayers. Now this is a different scenario. We are talking now about very small concentrations of heavy metal ions present in water and the modification of monolayer of steric acid present at the surface of such water. The monolayer of steric acid when contacted with this very small level of impurities of heavy metals will eventually create a difference. The heavy metal ions could be brought to the monolayer through the usual processes of diffusion and convection. We are not going to discuss mass transfer yet, but then what difference is can be created by presence of these heavy metal ions at such low concentrations for the monolayer. Look at the numbers here one part in 2 billion parts of water or 0.5 ppb of aluminum 3 plus is sufficient to alter physical properties of steric acid monolayer. So, one could think of this effect to be made use of in let us say sensing the metal impurities. You might be able to use monolayers as sensors for ultra low concentrations of metals. In similar fashion, copper ions are also very effective in forming salts of steric acid. Once again the properties will be very different. Now such studies which not only display or demonstrate the effect of very small quantities of impurities could also help us understand better the sensitization of monolayer reactions. And for example, a course of a photochemical reaction could be completely altered by the presence of heavy metal ions. We take an example for decomposition to proceed in films of alpha hydroxy steric acid on 0.01 normal HCl under the action of radiation of 2537 angstroms sub analytical quantities of nickel ions must be present. The mechanism involves one molecule of alpha hydroxy steric acid combining with one nickel ion before CO2 can be split off. But if you do not have nickel ions then alpha hydroxy steric acid cannot be decomposed or one could think of interaction of monolayers of fatty acids and long chain sulphates with ions of heavy metals which are injected below them. We would expect this interaction to be very much affected by pH. If pH is such that basic metal ions are formed in the solution such as for example, for calcium a complex formation takes place. But for basic ions no such complex is formed because of steric hindrance. Or you could think of adsorption of long chain ionic compounds from solution on surfaces of solid metals or their minerals. This could take place under certain pH conditions and steric chemistry. This would be similar to the conditions required by monolayer interactions which means the monolayers can be a model or guide to investigate the possibility of the monolayer interaction possibility of flotation as a means of removal of particular mineral with the long chain compounds under consideration. So, one may not require to actually do the much larger scale flotation experiments. But insights into how that flotation, planned flotation may work may be guided by the experiments under a miniscule scale at the level of monolayers. That brings us to the last topic that we will get started with today, but not finish. If under a monolayer another species is injected then what may happen? You have monolayer and you are injecting under the monolayer another molecular species. The simplest interaction between the two types of molecules will be mainly electrostatic. It will mean that this will lead to changes in surface potential with very small alterations in surface pressure. We could think of injecting very dilute solutions of long chain salts under many monolayers. To get an idea we could look at this diagram. You have the monolayer first over here and the added molecules are anchored into the monolayer, but it is just below this. This will be one situation. Another situation could be the added molecules could actually go on to penetrate the monolayer and these are the species then finally making their way into a film. So, these are two possibilities. The added molecules may be anchored or they might be able to penetrate into a film. How this achieves as in first there is water and with the monolayer then we how do we inject such a thing? We could do that with a micro syringe. You just take this other species the ions from the other solution and then you inject it below the monolayer. Once it goes under the monolayer it will be brought to the surface by whatever convection there might be. If there is no convection diffusion will bring it. Eventually these other molecules will come in the vicinity of the monolayer. They could be anchored here or they might be able to make their way into the monolayer. Now if the energy of desorption is not very high especially for the diagram shown over here under compression you might be able to eject these anchored molecules. It might happen even here. It depends on interaction among the molecules of two kind. So, if one is at soft in much stronger manner at the interface increase in surface pressure could lead to the desorption of the other species. Now the penetration if it is achieved in the monolayer it is characterized by large changes in both surface pressure as well as surface potential. And the second aspect is not surprising because we did think of surface potentials as an effective way of monitoring surface reactions with some molecular species contribution of each to the surface pressure and potential are independent. That is the two species are contributing independent of each other to the surface pressure and surface potential. In which case we may regard the resulting film of two species as a simple mixture of two components. So, this kind of behavior is shown by astacin and oleic acid spread on 0.01 normal HCl. At low pressures we have the film behaving as simple mixture of two components. But you do not expect that independence to be always true. More often than not the contributions of the two species to the surface pressure and surface potential is not simply additive. What do we interpret it then as? The same way if monolayer properties are different monolayer probably is a compound. It is not a simple mixture of two species which would give additive properties. But here they must be something more to that and that is what we imply by formation of a molecular complex. The two species in the monolayer interact in a much stronger way producing a behavior which is very different now is not a linear combination of the contributions to the surface pressure and surface potential. So these molecular complexes and their formation is something that we would like to study in more detail in the next lecture. I will just prime that discussion by citing a few details here. Such complex formation which would be function of the polarity of the head groups, lengths of the hydrocarbon tails and shapes of the hydrocarbon tails. These would all come into picture. An example is when you inject dilute solutions of substances of the general structure C H 3 C H 2 11 times X under monolayers of say cholesterol or proteins at air water surface. The reactivity is found to follow the following order. If X is NH 3 plus is most reactive, more reactive than sulphate, more reactive than SO 3 minus, more reactive than CO O minus and lastly N CH 3 3 plus. So complex formation could be actually studied on similar lines as we understand chemical reactions in terms of order in the reactivities of the group which matters X over here. So we will stop here for today and resume the discussion further on surface reactions in next lecture.


Hi, Tati Korba, the head women's soccer coach here at Stevenson, here to remind you to take good notes in class. Just a couple of tips. Be an active listener in class means that you are paying attention and trying to understand the material as it's being presented to you. Tip two, make sure you're taking notes. This will keep your mind from wandering and help you see what the professor thinks is actually important as opposed to the stuff that, you maybe isn't going to be as important. Tip three, know and identify what's most important. If it's on the board, if they're spending a lot of time with it, it's probably essential, so write it down. And lastly, leave wider than average margins in your notes so that you can go back and add notes as you review when it's time to study for the big day.


Dear colleagues My name is Sam Wackney, and I'm the author of Malignan self-love Narcissism Revisited and other books about personality disorders I'm also a visiting professor of psychology in Southern Federal University, Wostov-on-Don, Russian Federation and a professor of finance and psychology in CS CS the Center for International Advanced and Professional Studies Welcome to the fourth world congress on neuro-psychiatry sleep disorders and medicine held in November 2019 Rome, Italy This is my video presentation and it will focus on psychosis delusions and personality disorders But first, let us try to understand the very concept of psychosis Psychosis is a chaotic form of thinking That is a result of a severely impaired reality test The patient cannot tell inner fantasy from outside reality and internal objects from external objects Some psychic states are short-lived and transient. They're called micro episodes These last from a few hours or three minutes even to a few days and sometimes there are reactions to stress Psychotic micro-episodes are common in certain personality disorders, most notably borderline and schizotypal personality disorders But even narcissists have psychotic micro-episodes if they are deprived of narcissistic supply Something I will discuss later Persistent psychosis are a Kind of fixture of the patient's mental life and manifests for months or years Psychotics are fully aware of events and people out there They cannot however separate data and Experiences originating in the outside world from information generated by internal mental processes It's like they have no boundary Like they kind of flow into reality and reality flows into them They confuse the external universe with their inner emotions Cognitions beliefs free conceptions fears expectations and representations Similarly patients suffering from narcissistic personality disorder and to a lesser extent antisocial and histrionic personality disorders These patients fail to grasp others as full-fledged entities They regard even their nearest and dearest as cardboard cutouts to dimensional Representations introjects or symbols they treat other people as instruments of gratification functional automata or extensions of themselves Consequently both psychotics and the personality disordered have a distorted view of reality They are not rational No amount of objective evidence can cause them to doubt or to reject their like their Hypothesis and convictions full-fledged psychosis Involves complex and ever more bizarre delusions and the unwillingness to confront and consider Contrary data and information a kind of confirmation bias gun or eye It's a preoccupation with subjective rather than objective Thought becomes utterly disorganized and fantastic There is a thin line separating most like the non-psychotic from the psychotic perception and ideation on This spectrum on this spectrum. We also find schizotypal and paranoid personality disorders the diagnostic and statistical manual defines psychosis as restricted to delusions or Prominent hallucinations with the hallucinations occurring in the absence of insight into their pathological nature But what are delusions and hallucinations and how do they differ a? Delusion is a false belief based on incorrect inference about external reality That is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and Obvious proof or evidence to the contrary A hallucination is a sensory perception that has the compelling sense of reality of a trope exception But that occurs without external stimulation of the relevant sensory organ Delusion is therefore a belief It's an idea or a conviction firmly held despite abundant information to the contrary The partial or complete loss of reality test is the first indication of a psychotic state or a psychotic episode Beliefs ideas or convictions shared by other people members of the same collective are not Strictly speaking delusions conspiracy theories for example are not delusions Although they may be hallmarks of a form of psychosis called shared psychotic disorder in cults for example There are many types of delusions Start with the paranoid delusion the belief that one is being controlled or persecuted by stealth powers and conspiracies This is common in the paranoid Antisocial narcissistic borderline avoidant and dependent personality disorders then there is the grandiose Magical kind of delusion it is a conviction that one is important omnipotent possessed of occult powers or a historic figure Narcissists invariably harbor such delusions Another form of delusion is the referential delusion also known as idea of reference or referential ideation The belief that external objective events carry hidden or quoted messages or that one is the subject of Discussion derision or opprobrium even by total status. This is common in avoidant schizoid Schizo-tipo narcissistic and borderline personality disorder Hallucinations are false perceptions Based on false sensor false sensory input not triggered by any external event or entity The patient is usually not psychotic. He's aware that What he sees smells feels or hears is not there Still some psychotic states are accompanied by hallucinations for example for mucation The feeling that bugs or hands are crawling over or under one's skin There are a few classes of hallucinations this auditory hallucinations the false perception of voices sounds such as buzzing humming radio transmissions whispering motor noises and so on There's gastatory hallucination the false percept perception of taste All factorial hallucinations the false perception of smell and scent burning flesh candles Somatic hallucinations the false perception of processes and events that are happening inside the body or to the body Example piercing objects electricity running through one's extremities and so on Usually somatic hallucinations are supported by an appropriate and relevant delusion of content tactile hallucination is the false sensation of being touched or Crawled upon or that events and processes are taking place under one skin Usually supported by appropriate and relevant delusional content Then there's visual hallucination the false perception of objects people or events in force in broad daylight or in an illuminated environment with eyes wide open There is hypnagogic and hypnagogic and hypnopompic hallucinations images and trains of events experience while falling asleep or when waking up Not hallucinations in the strict sense of the word so hallucinations are common in schizophrenia affected disorders and Mental health disorders with organic origins hallucinations are also common in drug and alcohol withdrawal and among substance abusers Pathological narcissism is a defense mechanism Intended to isolate the narcissists from his environment and to shield him from pain hurt injury both real and imagined hence the construct of false self and Or pervasive psychological concept which generally or gradually Displaces the narcissist true self. It is a work of fiction intended to elicit praise and reflect criticism The unintended consequence of his fictitious existence is a diminishing ability to grasp reality correctly and to cope with it effectively self-efficacy is affected and the sense of agency narcissistic supply replaces genuine veritable and tested feedback analysis Disagreement and uncomfortable facts are screened out layers of bias and prejudice distorts the narcissist experience Yet deep inside the narcissists is aware that his life is an artifact a confabulated sham a vulnerable cocoon The world is inexorably and repeatedly Intrusive intrudes upon these ramshackle battlements Reminding the narcissist of the fantastic and feeble nature ofiosity and this is a much-graded Grandiosity gap to avoid the agonizing realization of his failed Defeats true in biography the narcissist resorts to reality Substitutes the dynamics are simple as the narcissist grows older if sources of supply become scarcer and his grandiosity gap he owns wider mortified by the prospect of facing this Actuality the narcissist withdraws even deeper Into a dreamland of concocted accomplishments feigned omnipotence and omniscience and a kind of Brattish entitlement The narcissist reality substitutes fulfill two functions. They help him to rationally ignore pain from realities With impunity and they prefer an alternative universe a virtual reality in which the narcissist reigned supreme an emergence triumphant all the time The most common form of denial involved to secretary delusions and a per-secretary object. I Describe these in very in several of my videos on my YouTube channel The narcissist perceives Slides and insults when none were intended he is he is hyper vigilant He becomes subject to ideas of reference people are gossiping about him mocking him crying into his affairs I don't know cracking his email. He's convinced that he's the center of malign and malintentioned attention People are conspiring to humiliating to punish him to have scorned with his property to dilute him to impoverish him to Confine him physically or intellectually to censor him to impose on his time to force him to action or to inaction To frighten him coerce him surround and besiege him changes mind part with his values murder him I've scorned with this property and so on and so forth The narcissist paranoid narrative Serves as an organizing principle. It's structures He's here and now and gives meaning to his life. It aggrandizes him as worthy of being persecuted The mere battle with his demons is an achievement not to be sniggered it Like overcoming his so-called enemies the narcissist emerges vixx and powerful a happy ending a happy grandiose ending The narcissist self-inflicted paranoia projections of threatening internal objects and processes of the secretary option legitimizes Justifies and explains he's abrupt comprehensive and rude withdrawal from anomalous and unappreciative world Narcissist pronounce misanthropy Fortified by these oppressive thoughts renders him a schizoid of devoid of all social contact Except the most necessary and the in the lactable But even as a narcissist divorces his environment He remains aggressive or even violent the final phase of narcissism involves verbal psychological Situational and mercifully more rarely physical abuse Directed at his foes at his inferiors It is a combination of a creeping mode of psychosis the sad and unavoidable outcome of a choice made long ago To forego the real in favor of the surreal One of the most important symptoms of pathological narcissism Narcissistic personality disorder is grandiosity grandiose fantasies the developmental conclusions of grandeur permeate every aspect of the narcissist personality they are the reason that the narcissist feels entitled to special treatment Which is typically in commensurate with his real life accomplishments The grandiose at the gap is the abyss between the narcissist self-image as reified by the false self and reality When narcissistic supply is deficient the narcissist Decompensates and he acts out in a variety of ways Narcissist of an experienced psychotic micro-episodes in therapy for example, or when they suffer narcissistic injuries in life prices But can the narcissists go over the edge do narcissists ever become truly and fully psychotic? Let's start with some terminology as we said the nearest definition of psychosis is Respected to delusions of prominent hallucinations with the hallucinations occurring the absence of insight into the pathological nature And we have defined delusions and hallucinations before Granted the narcissist hold on reality is tenuous Narcissist sometimes failed the reality test They have an impaired reality test admittedly narcissists often seem to believe in their own confabulations They are unaware of the pathological nature and origin of their self-illusions and are therefore Technically delusional though they rarely suffer from hallucinations disorganized speech or disorganized or catatonic behavior in the strictest sense of the world narcissists do appear to be psychotic though But actually in my view they are not There is a quantitative and qualitative difference between the nine though well-entrenched self-deception Malignant colon artistry and losing it Pathological narcissism should be construed as a form of Psychosis only because the narcissist is usually fully aware of the difference between true and false Real and make-believe they invented in the extant right and wrong the narcissists Consciously chooses to adopt one version of the events and aggrandizing narrative fairy tale evidence What if counterfactual life is emotionally invested in this person of myth the narcissist feels better at as fiction Than as fact, but he never was a side of the fact that it is all just fiction So the pathological narcissism should not be construed as a form of psychosis And throughout the narcissists is in full control of his faculties Cognizant of his choices and goal oriented his behavior is intentional Directional is Manipulating and his delusions are in the service of these strategists Hence his chameleon like ability to change geysers is called up and his convictions on a dime again not typical of psychotics Narcissistic delusions rarely persist in the face of blanket opposition and reams of evidence to the contrary The narcissist usually tries to convert his social milieu to his point of view He attempts to condition his nearest and nearest to positively reinforced its illusion of false self But if he thinks he modifies his profile on the fly he plays it by ear His false self is extemporaneous the perpetual work of art permanently reconstructed in a reiterative process Designed around intricate and complex feedback loops again utterly and atypical when when we deal with psychotics So I would say that narcissism is not psychosis Through the narcissistic personality though the narcissistic personality is rigid its content is always in flux Narcissists forever reinvent themselves adopt their consumption of narcissistic supply to the marketplace Narcissists are attuned to the needs of their suppliers like the performance that they are They resonate with their audience. They give the audience what it expects and wants They are efficient instruments for the extraction and consumption of human reactions As a result of this interlunable process of fine-tuning Narcissists have no loyalties no values no doctrines no affiliations no beliefs and no convictions The only constraint is their addiction to human attention positive or negative Psychotics by comparison are fixated on a certain view of the world and their place in it They ignore any known in all information that might challenge their delusions Gradually psychotics retreat into the inner resources of their tormented minds and they become dysfunction Narcissists cannot afford to shut out the world because they so heavily depend on the world for their regulation of their They buy the sense of self-worth Owing to this dependence narcissists are hypersensitive hyper-vigilant Alert to every bit of new data They are continuously busy rearranging their self delusions to incorporate new information in an egocintonic manner And this is why narcissistic personality disorder is insufficient grounds for claiming diminished capacity in an insanity defense Narcissists are never divorced from reality the way psychotics are They crave reality. They need it to consume it in order to maintain the precarious balance of their disorganized borderline psychotic personality All narcissists even the freakiest ones can tell right from wrong Act with intent and are in full control of their faculties and actions Ferensia and such undo wrote in notes and fragments international journal of psychoanalysis for you 30 1949 page 234 I Quote a surprising fact in the process of self-splitting is the sudden change of the object relation that has become intolerable into narcissism The man abandoned by all gods escapes completely from reality and creates for himself another world in which he can achieve everything that he wants has Been unloved even tormented He now splits off from himself a part of which is the form of a helpful loving often motherly mind Commiserates with the tormented remainder of the self Nurses him besides for him and this with the deepest wisdom the most penetrating intelligence He is a guardian angel that is the suffering or murder child from the outside He wanders through the whole universe seeking help invents fantasies for the child that cannot be saved in any other way But in the moment of a very strong repeated trauma Even this guardian angel must confess his own helplessness and well-meaning deceptive swings and then nothing else remains, but Suicide Study of narcissism is a century old and the two scholarly debates central to its conception are still undecided Is there such a thing as healthy adult narcissism as cohort says or are all the manifestations of narcissism in otherhood? Pathological as Freud and Cranberg postulate promulgated Moreover is pathological narcissism the outcome of verbal sexual physical of psychological abuse overwhelming View or on the contrary the set result of spoiling the child and idolizing it as Milan and the late Freud said The second debate is easier to resolve if one agrees to adopt a more comprehensive definition of abuse over winning Smothering spoiling over valuing and idolizing the child putting him on the pedestal. They are all forms of a rental abuse Actually, this is because as her Karen Borne pointed out The child is dehumanized and instrumentalized when the child is spoiled and put on a pedestal His parents loved the child not for what he really is But for what they wish and imagine him to be the fulfillment of their dreams and frustrated wishes The child becomes the vessel of his parents discontented lives a tool Magic brush with which they can transform their failures into successes the humiliation To victory their frustrations into happiness the child is taught to ignore reality and to occupy the parental fantastic space Such an unfortunate child feels only but an omniscient perfect and brilliant worthy Evaluation and entitled to special treatment true the faculties that are home by constantly brushing against bruising reality empathy compassion realistic assessment of one's abilities and limitations realistic expectations of oneself and of others Personal boundaries teamwork social skills perseverance and goal orientation Not to mention the ability to postpone gratification and to work hard to achieve it via impulse control These are all lacking or missing altogether The child turned adult sees no reason to invest in his skills and education Convinced that is inherent genius with shy through and should suffice The child turned adult feels entitled for merely being rather than for actually doing Rather than rather as the mobility in days gone by felt entitled by virtue of its merit But as the inevitable for ordained outcome of its birthright in other words In other words, the child turns adult is not meritocratic, but aristocratic Narcissist is born But such a mental structure evidently is brittle susceptible to criticism to disagreement vulnerable to the incents in sense incessant encroachment and encounter with harsh and intolerant world deep inside Narcissist of both kinds those wrought by classic abuse and those yielded by being idolized Both of them feeling adequate phoning fake inferior the imposter syndrome and deserving of punishment This is Millan's mistake. He makes a distinction between several types of narcissists He wrongly assumes that the classic narcissists is the outcome of overvaluation Idealization idolization and spoiling and thus is possessed of swim and chance of confidence and is devoid of self doubt According to Millan It is a compensatory Narcissist that falls prey to nagging set outs feelings of superiority and a masochistic desire for self-puncture Yet this distinction is both wrong and unnecessary There's only one type of narcissists, but there are two developmental paths to it And all narcissists are besieged by deeply ingrained though at times not conscious feelings of inadequacy fears of failure Masochistic desires to be penalized fluctuating sense of self-worth Regulated by narcissistic supply and an overwhelming sensation of fakeness The grandiosity gap between a fantastically grandiose and unlimited self-image and an actual limited The actual limited accomplishments and achievements of life The grandiosity gap because between the ego ideal and the false self is grating Its recurrence threatens a precariously balanced house of cards that is a narcissistic personality The narcissists finds to his chagrin that people out there are much less admiring accommodating an esteem of him than his parents were As he grows old the narcissists often become the target of constant derision and mockery a sorry sighting heat His claims for superiority appear less plausible and substantial the more and longer he makes them A theological narcissism originally a defense mechanism intended to shield the narcissist from an injurious world Becomes a liability the main source of hurt the generator of injuries counterproductive and dangerous Overwhelmed by negative or absent narcissistic supply The narcissist to his force to let go of his grandiosity the narcissist then resorts to self-delusion Unable to completely ignore Contrarian opinion data and reality the narcissist transmutes them Unable to face the dismal failure that he is the collapsed narcissists Partially withdraws from reality to soothe and solve the pain of disillusionment The narcissists administers to his aching soul and mixture of lies Distortions half-truths confobulations and outlandish interpretations of events around him These solutions can be classified this way the delusional narrative solution The narcissist constructs a narrative in which he figures as the hero Brilliant perfect saintly irresistibly handsome Destined for great things entitled powerful wealthy the center of attention etc The bigger the strain of this delusional charade The greater the gap between fantasy and reality the more the delusion coalesces and solidifies Finally, if it is sufficiently protracted it replaces reality and the narcissist reality test deteriorates He withdraws his bridges may become schizotypical cathetonic or schizoid The other solution is the antisocial solution The narcissists renounce his reality to his mind those who pusing Pucillanimously failed to recognize his unbound talents The nature of priority overarching brilliance benevolent nature Entitlement cosmically important mission perfection and so on these people do not deserve consideration The narcissist natural affinity with the criminal is lack of empathy is compact in compassion His deficient social skills his defiance his disregard for social laws and morays and morals These criminal affinities now erupt and blossom. He becomes a full-fledged antisocial sociopath or psychopath He ignores the wishes and needs of others. He breaks the law.  The narcissist develops paranoid narratives So directed confabulations which plays a narcissism at the center of others allegedly maligned intention and attention Narcissist becomes his own His own audience and self-sufficient as his own sometimes exclusive source of narcissistic supply Narcissist develops persecretary delusions. He perceives lights and injuries and insults when none were intended or exist He becomes subject to ideas of reference Mentioned before he is convinced that he is the center of my mind and my intention People are conspiring to humiliate him punish him and so on so forth Some narcissists withdraw completely from a world populated with such menacious and ominous objects These are really projections of internal objects and processes, of course These narcissists avoid all social contact except the most necessary They refrain from meeting people from falling in love from having sex from talking to others or even from corresponding with others In short, they become schizoids Not out of social slack shyness, but out of what they feel to be their choice This evil hopeless world does not deserve me goes the inner refrain and I shall waste none of my time and resources on it The paranoid aggressive or explosive solution is when Other narcissists who develop persecretary delusions when they resort to an aggressive stance a more violent resolution of their internal conflict They become verbally, psychologically, situationally, physically abusive They insult, castigate, chastise, berate, demean and deride and decry their nearest and dearest Often well-wishers, often loved ones They explode in unprovoked displays of recognition, righteousness, condemnation and blame Thus is an exegetic bedlam they interpret it in Even the most innocuous inadvertent and innocent comments as designed to provoking me later They so fear, revulsion, hate and malignant envy everyone They flail against the windmills of reality, a pathetic, forlorn sight But often they cause real and lasting damage Fortunately mainly to themselves There is a masochistic avoidance solution. The narcissist is angered by the lack of narcissistic supply He directs some of this fury inwards punishing himself for his failure becomes depressed This masochistic behavior has the added benefit of forcing the narcissist's closest To assume the roles of dismayed spectators or of persecutors and thus either way to pay him the attention that he craves Self-administered punishment often manifests as self-handicaping masochism a narcissistic co-op By undermining his work, his relationships and his efforts The increasingly fragile narcissist avoids additional criticism and censure negative supply Self-inflicted failure is a narcissist doing and thus proves that he is the master of his own fate Masochistic narcissists keep finding themselves in certainly fitting circumstances which render success impossible And they they maintain a kind of an objective assessment of their performance And make it improbable as Milan said They act carelessly that we draw in mid-effort the constantly fatigued bored or disaffected and thus passive aggressively support our lives The suffering is defined and by deciding to abort they reassert their omnipotence The narcissists pronounce and public misery and self-pity are compensatory and as Milan said they reinforce His self-esteem against overwhelming convictions of worthlessness They maintain again an objective as they again make an objective assessment of their performance improbable The narcissistic tribulations and anguish render the narcissist in his eyes unique certainly virtuous righteous resilient and significant These narcissists are in other words Generators of self-supply They are in other words All these all these tribulations and anguish or this pain or this hurt or these injuries They are a form of self-generating narcissistic supply As paradoxically the worst is anguish and unhappiness The more relieved and related such a narcissist fears. I refer you all to Theodomilans and Roger Davis's Seminole told personality disorders in modern life second edition Year 2000 Thank you for listening


Complementary and alternative medicine, CAM, has become increasingly popular in recent years due to its potential to treat various diseases. Patients with serious conditions like cancer, Alzheimer's, diabetes, and lower back pain often turn to CAM biological products for relief. Healthcare professionals must be aware of the available clinical evidence regarding CAM-based therapies before advising their patients or making recommendations. This paper reviews the recent clinical data on the efficacy of CAM therapies for managing certain diseases. Several cancer drugs derived from natural sources have recently received approval from the European Medicines Agency and Food and Drug Administration after successful clinical trials. Additionally, the most commonly used CAM therapies and the degree of improvement in quality of life reported by patients are discussed. This article was authored by Al-Jawara Al-Kathima.


All right, before I get started, I just wanted to take the time to introduce one of our new international guests. This is Dr. Badr Dean. She's actually from Mongolia, so if everybody could say hi, that would be really nice. All right, so I'll get started with my presentation. The title is, Which Would You Pick? All right, so we'll start out with the case presentation. We had a 38-year-old female. She comes in complaining of a blurry spot in their center of vision in the ride-eye since the morning. She had poor vision in her left eye for the past 10 years due to a choreo-retinal scar of unknown etiology. She denied any phutopsias, floaters, headaches, or any eye pain associated with this. Her pastoral history was significant for diabetes type 2 asthma, high blood pressure, fibromyalgia, depression. She also had a history of valley fever, but no history of autoimmune diseases. The rest of her history was non-contributory. So on exam, her visual acuity with correction was 2050 in the ride-eye and then 2200 in the left eye. Her pressures were normal. She had an ather and pupillary defect in the left eye. On confrontational visual field, she had this central scatoma mainly in her left eye. On slit-lamp exam, her external exam was completely unremarkable, as well as her anterior segment exam. Most notably, her anterior chamber had no cellar flare, basically no inflammation in that area. She also had no vitreous inflammation either. However, on dilated fundus exam, she had these yellowish-white lesions in the macula, as well as multiple punched-out scars out in the mid-periphery. This was in the ride-eye. In the left eye, she had some evidence of sub-retinal fibrosis in the center of her macula, as well as multiple punched-out lesions in the mid-periphery as well. On fundus autofluorescence, corresponding to lesions, you see these areas of hypo-autofluorescence and this surrounding halo of hyper-autofluorescence. You can see something similar in the left eye, but a little bit more extensive. On fluorescine angiogram, many of those lesions exhibited early hyperfluorescence with late staining and leakage in the ride-eye. On left eye, it was staining due to the sub-retinal fibrosis and scarring. On OCT, through one of the lesions in the ride-eye, what you see is the sub-RP accumulation of material, oftentimes extending into the inner retina. This was in the ride-eye through another one of those lesions. On left eye, exhibited sub-retinal fibrosis atrophy and some cysts overlying that area. So our differential diagnosis at this point includes many of the white dots and drums, such as multifocal corditis and panubiatis, PIC, bird shot, like Reese was talking about, diffuse sub-retinal fibrosis, mutes, should always think about sarcoidosis as well, or an infectious etiology, something that's bacterial, fungal, or even viral. Pancerology and imaging testing was done, which came back all negative, including the chest x-ray. At this point, she was given a diagnosis of punctate interchloridopathy with an associated chloride on the obascular membrane in the ride-eye. She was given an avast injection in the ride-eye. We decided to start her on methotrexate with an oral steroid taper because she had a monocular status. Also, the lesions were very proximate to herphobia. The instituted INT therapy. Two months later, her visual acuity improved to 2020 in the ride-eye. She had a quiescent exam. Over the next year, she had recurrent activity of the lesion nasal to the phobia, despite continued injections of osoridex and avastin. And that's why we escalated care to switching her from methotrexate to cellsept, and she obtained a successful quiescence. In the subsequent year, she had new active lesions in the phobia of the ride-eye. Therefore, cyclosporin was added, along with continued avastin and osoridex injections. So, what exactly is punctate interchoreography? It's considered an idiopathic inflammatory disorder, where it was first described by Walski and colleagues back in 1984. They described 10 patients who were myopic and Caucasian that complained of utopias, blurred vision, as well as scatomas in the center of their vision. What they characterized were the small, discrete yellowish-white lesions at the level of the interchoreoid and the RPE, and it was mostly localized to the posterior pole. Most importantly, there was no associated anterior chamber inflammation or any vitreous inflammation as well. Now, who gets PIC? Well, a global case series showed that 97% of their patient population who had PIC were women, 90% were Caucasian, 85% were myopic, and they had a median age of 30 years old, and there was no associated systemic disorders. On presentation, they'll complain of metamorphopsia, paracentral scatoma, photopsias, and asymmetric loss of central acuity. Fundus findings, as we discussed, there's this yellowish-white choreoretinal lesions. They can typically range between the size of 50 to 200 microns. They rarely extend to the mid-peripherate, and over time they progress to form these atrophic scars with associated pigmentation. Sometimes you can see serous retinal detachment over confluent active PIC lesions, and most importantly, by definition, there's an absence of vitritus or AC inflammation, anterior chamber inflammation. On fluorescein angiogram, you typically see early hyper fluorescence of lesions with late staining. On ICG, you see these mid-phase hypo fluorescence of lesions, oftentimes more numerous than you would see on clinical exam or even FA. And on OCT, you see the sub-RPE accumulation of material, oftentimes extending into the inner retina. The most vision-threatening complications associated with PIC include carotoneobasperate, carotoneobasperin membrane formation, and subretinal fibrosis. And the treatment choices really depends on the clinical presentation, so you would typically observe there are no visual manifestations. You can institute periocular and systemic cortical steroids if there's poor initial visual acuity or the acute PIC lesions are very proximate to the phobia, as it was in our case. And IMT, or immunomodulatory therapy, is reserved for persistent or recurrent PIC. Anti-vegeth laser and PDT, which is photodynamic therapy, is administered for carotoneobascularization that's associated sometimes with this. So at this point in my talk, I want to segue into the discussion section of the two prevailing theories regarding PIC. Some experts believe that PIC and multifocal coriditis are part of the same disease spectrum. The reason why they think this is because there's a lot of overlap in the clinical presentation between these two diseases. Also, there was a genome-wide association study done in the United Kingdom showing that patients with multifocal coriditis and PIC shared the same haplotype for interleukin-10. The other prevailing theory is that PIC and multifocal coriditis and panubiitis are completely separate disease entities, and this is mostly because of the way they've been described historically. Now what are some of these differences? The main one is that in PIC, the lesions are typically smaller. They're localized mainly to the posterior pole, and they very rarely extend out to mid periphery. Also in PIC, there's no associated anterior chamber inflammation and detritus as I've been hammering. Also, there's no structural complications due to recurrent inflammation as occurs in multifocal coriditis. Some of those include cystoid macular edema, epiretinal membrane formation, as well as cataract formation. Now it's this recurrent inflammatory, chronic nature of multifocal coriditis that distinguishing these two diseases clinically sometimes is important because studies have shown that early IMT, or Immunomodulatory Therapy for patients with multifocal coriditis, can decrease the risk of complications associated with recurrent inflammation. Actually, one study done by Thorne and colleagues down at Johns Hopkins showed that if you actually institute early IMT therapy in patients with multifocal coriditis, there's an 83% decreased risk of getting posterior pole complications due to recurrent inflammation. So since the advancement of imaging technology, distinguishing these two diseases has become much easier. So on fluorescein angiogram and multifocal coriditis, the active PIC lesions typically show up in the early phase as hypo fluorescent lesions, and in the later phase they become hyper fluorescent. And PIC, as I already stated before, there's early hyper fluorescence and then late staining or late hyper fluorescence. And then you'll see some leakage as well, as you can see in the center, in the center of the macula there with associated carotidoneovascular membranes. On ICG, you'll see in the mid phase that the lesions typically show a hypo fluorescence. Oftentimes, many times it's more numerous than you see on a clinical exam, and that's very similar to what you see in PIC as well, but the lesions are typically smaller, as we said in PIC. Fundus autofluorescence is where things get really interesting because FAF has been used to delineate subclinical lesions. So if you see here in panel A, there's no... You don't see any lesions along that branch of the... I don't want this vascular, this branch of the vascular, okay, right here. So you don't see lesions there in the red free photograph or on clinical exam. However, on the fundus autofluorescence, you see these hypo autofluorescent lesions. Three years later, these lesions actually show up on clinical exam as well as on the red free photograph, and the lesions on fundus autofluorescence actually are larger than they were three years ago. And PIC, fundus autofluorescence, is also very interesting. What happens is that it's used to mark areas or identify areas that has uncontrolled inflammation and are prone to reactivation, and they typically show up as this hyper-autofluorescent halo. So you see this patient here with an active PIC lesion in panel A, and you have this surrounding hyper-autofluorescent halo. However, after instituting cell cell for a month later, this hyper-autofluorescent halo has actually decreased in size as well as in intensity. Contrast that to the two panels below where you see a patient with persistent PIC. And what you see is this hyper-autofluorescent halo, and this patient didn't respond to therapy, and over time, that hyper-autofluorescent halo has actually increased in size and intensity as well as consistent with the progression of the disease, as you can see in the area of the hypo-autofluorescent lesion. On OZT, multifocal coriditis, you can see the lesions that typically have a disruption of the ISOS or outer rental layers. Also, they can exhibit this sub-RP accumulation of material, overlying vitreous, indicated by the blue arrows there, and this hyper-reflective band in the coroidal layer. On PIC, inactive lesions show a sub-RP accumulation of material as well as loss of the ISOS or outer rental layers. OZT can also be used to track response to treatment. Here in the above image in panel C, you see the sub-RP accumulation of material after prompt treatment and good response to treatment. You actually see that that area has actually decreased in size. So what are the take-home points? First one, imaging utility. Multimodal imaging can help distinguish between these two disease entities, and this is really important because you want to identify multifocal coriditis because instituting early immunomodulatory therapy can help prevent a lot of the posterior pole complications that are associated with this chronic recurrent nature of this disease. Some other take-away points. PIC should always be considered and all the white dots in the differential diagnosis. Coroidal neovascularization and sub-retinal fibrosis are the most vision of threatening complications of PIC. And IMT or immunomodulatory therapy should be instituted. You should consider this in patients with PIC that's persistent and recurring, as was in our case. And lastly, but not least, PIC and multifocal coriditis should be considered, may be considered as part of the same disease, but further studies need to be completed in order to test this hypothesis. On that note, I'd like to thank Dr. Vitale for giving me the opportunity to present this case as I've learned a lot from this. Thank you. Really. I have a question. This is on one of your early slides. You said that the incidence is 110 cases per year in the U.S. Yeah, in the U.S., from one study. That sounds incredibly low. I mean, I've seen a couple cases. That would imply that there would be one new case a year in each of them. Yeah, so there is a bias for that in the earlier studies because a lot of times these diagnoses have been diagnosed improperly as pose, presumed ocular histoplasmosis syndrome, or even other white dot syndrome. So when they finally get to the UBIBIS center, it's possible that a lot of the other ones that have been misdiagnosed haven't actually been diagnosed as pigs. So it was a study that was done in the 80s or so. Yeah, I think that's definitely wrong. It's much more common. Yeah, that would be an incredible disease. You know, it's actually a very interesting disease. I think that part of the kind of controversy in terms of are they the same disease or not and stuff that it has to do with who's seeing them and who's reporting them. So, I mean, multi-fogal corditis comes to the UBIBIS people, so more advanced diseases with inflammation and various, I think in a retina practice, you might be more optimistic to see a pig. So I think that people are thinking, well, we are seeing different things. Patients with multi-fogal corditis, as Renee pointed out, present with many more structural complications than patients with a pig. So cataracted at the rebel membrane, macular demon, as opposed to a pig. The most common presentation is with curly vascular membrane, really, and decreased vision. You might pick up multi-fogal corditis in a patient that has macular demon or inflammation in the eye. And the importance of this and why I put these two together, we're starting out with birch. That really requires systemic therapy. You pretty soon have to be on set. With multi-fogal corditis and panugasin pick, you might, if a patient came in with character secretions of pick, they're inactive, there's no inflammation, you might be through a bad patient. And one about any menopause, patient with multi-fogal corditis and panugasin, you might treat them with periac or steroids, but you have a lower threshold to treat them with immunomotor. And the other thing is that I think that the distinction in terms of treating the patient, sometimes it's artificial because if we had a patient, this patient of pick had really advanced disease, they're already behind the curve with a very poor outcome in one eye, and in the fellow eye, they've got a lesion that's threatening their phobia. So we are presuming that this entity is an inflammatory cause and that placing the patient on an anti-inflammatory course, in addition to treating it according to the master membrane seems to make sense. Historically, patients, people were treated with periac or steroids for inflammatory part of the master membranes. And the membranes, as Paul, as you know, are different in pick than they are in AMD, so these are type two type of membranes that are usually above the red pigment epithelium, are more classic in nature and respond pretty well to any veggie therapy. Okay, so... Thank you.