Outcome of acute stroke patients without visible occlusion on early arteriography

BACKGROUND: The aim of this study was to determine the clinical and radiological outcome of acute stroke patients who had no vessel occlusion on arteriography and to define predictors of clinical outcome. METHODS: We analyzed clinical and radiological data of stroke patients whose arteriography performed within 6 hours of symptom onset did not visualize any vessel occlusion. RESULTS: Twenty-eight of 283 consecutive patients (10%) who underwent arteriography with the intention to perform intraarterial thrombolysis did not show any arterial occlusion. Their median baseline National Institutes of Health Stroke Scale (NIHSS) score was 7. Time from symptom onset to arteriography ranged from 115 to 315 minutes; on average, it was 226 minutes. Presumed stroke cause was cardiac embolism in 11 patients (39%), small artery disease in 6 (21%), coronary angiography in 1 (4%), and undetermined in 10 patients (36%). After 3 months, modified Rankin Scale score (mRS) was < or =2 in 21 patients (75%), indicating a favorable outcome. Six patients (21%) had a poor outcome (mRS 3 or 4) and 1 patient (4%) had a myocardial infarction and died. Twenty-seven patients had follow-up brain imaging. It was normal in 5, showed a lacunar lesion in 8, a striatocapsular infarct in 2, a small or medium-sized anterior circulation infarct in 6, multiple small anterior circulation infarcts in 2, and multiple posterior circulation infarcts in 4. No predictors of clinical outcome were identified. CONCLUSIONS: Most acute stroke patients with normal early arteriography show infarcts on brain imaging; however, clinical outcome is usually favorable.

Brain electric microstates and momentary conscious mind states as building blocks of spontaneous thinking: I. Visual imagery and abstract thoughts

Prompted reports of recall of spontaneous, conscious experiences were collected in a no-input, no-task, no-response paradigm (30 random prompts to each of 13 healthy volunteers). The mentation reports were classified into visual imagery and abstract thought. Spontaneous 19-channel brain electric activity (EEG) was continuously recorded, viewed as series of momentary spatial distributions (maps) of the brain electric field and segmented into microstates, i.e. into time segments characterized by quasi-stable landscapes of potential distribution maps which showed varying durations in the sub-second range. Microstate segmentation used a data-driven strategy. Different microstates, i.e. different brain electric landscapes must have been generated by activity of different neural assemblies and therefore are hypothesized to constitute different functions. The two types of reported experiences were associated with significantly different microstates (mean duration 121 ms) immediately preceding the prompts; these microstates showed, across subjects, for abstract thought (compared to visual imagery) a shift of the electric gravity center to the left and a clockwise rotation of the field axis. Contrariwise, the microstates 2 s before the prompt did not differ between the two types of experiences. The results support the hypothesis that different microstates of the brain as recognized in its electric field implement different conscious, reportable mind states, i.e. different classes (types) of thoughts (mentations); thus, the microstates might be candidates for the `atoms of thought'.

Action crisis and cost–benefit thinking: A cognitive analysis of a goal-disengagement phase

The present research is based on the notion that disengagement from goals is not a discrete event but a process (Klinger, 1975). A critical phase in this process is when difficulties and setbacks in striving for a goal accumulate. This critical phase is termed here as an action crisis. Given the profound effects that people's thoughts have on their self-regulatory efficiency, it is essential to understand the cognitive correlates of an action crisis. In two experimental lab and two correlational field studies, the hypothesis that goal-related costs and benefits become cognitively highly accessible during an action crisis was tested and supported. Participants who were experiencing an action crisis in such diverse goal areas as intimate relationships, sports, and university studies, thought about goal-related costs and benefits more intensively and frequently in comparison to participants who were not in an action crisis. In an incidental learning task they recognized more of cost–benefit-items and less of implementation-items than the control group. Results are interpreted in terms of action phase specific mindsets (Gollwitzer, 1990, 2012).

Do untrustworthy faces facilitate the recognition of antonyms? A critical analysis of thinking the opposite under distrust

Distrust should automatically activate a "thinking the opposite". Thus, according to Schul, Mayo and Burnstein (2004), subjects detect antonyms of adjectives faster when confronted with untrustworthy rather than trustworthy faces. We conducted four experiments within their paradigm to test whether the response latency of detecting antonyms remains stable. We introduced the following changes: the paradigm was applied with and without an induction phase, faces were culturally adapted, the stimuli were presented according more to priming rules, and the canonicity of antonyms was controlled. Results show that the response latency of detecting antonyms is difficult to predict. Even if faces are culturally adapted and priming rules are applied more strictly, response latency depends on whether the induction phase is applied and on the canonicity of antonyms rather than on the trustworthiness of faces. In general, this paradigm seems not to be appropriate to test thinking the opposite under distrust.

Visible and Infrared Spectroscopical Applications

Spectra in the visible (VIS) and infrared (IR) region contain a wide variety of information about inorganic and organic substances in sediments. The information from the spectra enables a wide array of applications that allow quantitative, semiquantitative, and qualitative characterization of sediment. Due to the fact that instrument/experimental setups are simple, rapid, and cost-saving and that only small sample quantities are required, the technique has become valuable in paleolimnological and Quaternary science. This article summarizes the theoretical background of VIS and IR spectroscopy, explains the analytical process, introduces statistical tools used for interpretation of spectra, and provides examples of applications in Quaternary science.

Anatomic pathways of peripancreatic fluid draining to mediastinum in recurrent acute pancreatitis: visible human project and CT study

BACKGROUND In past reports, researchers have seldom attached importance to achievements in transforming digital anatomy to radiological diagnosis. However, investigators have been able to illustrate communication relationships in the retroperitoneal space by drawing potential routes in computerized tomography (CT) images or a virtual anatomical atlas. We established a new imaging anatomy research method for comparisons of the communication relationships of the retroperitoneal space in combination with the Visible Human Project and CT images. Specifically, the anatomic pathways of peripancreatic fluid extension to the mediastinum that may potentially transform into fistulas were studied. METHODS We explored potential pathways to the mediastinum based on American and Chinese Visible Human Project datasets. These drainage pathways to the mediastinum were confirmed or corrected in CT images of 51 patients with recurrent acute pancreatitis in 2011. We also investigated whether additional routes to the mediastinum were displayed in CT images that were not in Visible Human Project images. PRINCIPAL FINDINGS All hypothesized routes to the mediastinum displayed in Visible Human Project images, except for routes from the retromesenteric plane to the bilateral retrorenal plane across the bilateral fascial trifurcation and further to the retrocrural space via the aortic hiatus, were confirmed in CT images. In addition, route 13 via the narrow space between the left costal and crural diaphragm into the retrocrural space was demonstrated for the first time in CT images. CONCLUSION This type of exploration model related to imaging anatomy may be used to support research on the communication relationships of abdominal spaces, mediastinal spaces, cervical fascial spaces and other areas of the body.

Thinking Time : a multidisiplinary perspective on time

"Time" has been much less widely studied in psychology and related disciplines than has "space". This book offers theoretical and empirical insights into the study of time-related perception, memory, identity, learning, and reasoning. With carefully selected chapters by a truly international and interdisciplinary team of authors, this book provides an unterstanding of time and mind that goes beyond psychophysiology and experimental psychology to encompass wider phenomena, both social and eduational. By providing a philosophical basis for understanding how the mind "graps" the concept of time and the timing of behavior in a cultural context, this unique book should help promote a cross-fertilization of research on this important dimension, which ist so often neglected in cognitive and sociocultural research.

Re-thinking resuscitation: leaving blood pressure cosmetics behind and moving forward to permissive hypotension and a tissue perfusion-based approach

Definitions of shock and resuscitation endpoints traditionally focus on blood pressures and cardiac output. This carries a high risk of overemphasizing systemic hemodynamics at the cost of tissue perfusion. In line with novel shock definitions and evidence of the lack of a correlation between macro- and microcirculation in shock, we recommend that macrocirculatory resuscitation endpoints, particularly arterial and central venous pressure as well as cardiac output, be reconsidered. In this viewpoint article, we propose a three-step approach of resuscitation endpoints in shock of all origins. This approach targets only a minimum individual and context-sensitive mean arterial blood pressure (for example, 45 to 50 mm Hg) to preserve heart and brain perfusion. Further resuscitation is exclusively guided by endpoints of tissue perfusion irrespectively of the presence of arterial hypotension ('permissive hypotension'). Finally, optimization of individual tissue (for example, renal) perfusion is targeted. Prospective clinical studies are necessary to confirm the postulated benefits of targeting these resuscitation endpoints.

Analytical thinking under distrust - better not to know that one distrusts

It is widely known that people utter an untruth from time to time. Our ability to detect and recognize deception and lies and, in the next step, to respond appropriately is not very far-reaching. We were interested in finding out if distrust triggers non-routine, analytical thought processes and therefore improves the detection of lies without dismissing the truth. We conducted two experiments to investigate the influence of an unconscious form of distrust on our thought processes. In the first experiment, participants had to determine whether a report is truthful or false. The aim of this second experiment was to investigate if this enhanced ability to detect a falsified report correctly is based on analytical thinking taking place. To examine our assumptions, we applied the paradigm of belief bias. The results of the second experiments strongly point out the fact that an unconscious form of distrust triggers and fosters analytical thinking.

The Deep Blue Color of HD 189733b: Albedo Measurements with Hubble Space Telescope/Space Telescope Imaging Spectrograph at Visible Wavelengths

We present a secondary eclipse observation for the hot Jupiter HD 189733b across the wavelength range 290-570 nm made using the Space Telescope Imaging Spectrograph on the Hubble Space Telescope. We measure geometric albedos of Ag = 0.40 ± 0.12 across 290-450 nm and Ag < 0.12 across 450-570 nm at 1σ confidence. The albedo decrease toward longer wavelengths is also apparent when using six wavelength bins over the same wavelength range. This can be interpreted as evidence for optically thick reflective clouds on the dayside hemisphere with sodium absorption suppressing the scattered light signal beyond ~450 nm. Our best-fit albedo values imply that HD 189733b would appear a deep blue color at visible wavelengths.