Cerebral acid-base homeostasis after severe traumatic brain injury

OBJECT: Brain tissue acidosis is known to mediate neuronal death. Therefore the authors measured the main parameters of cerebral acid-base homeostasis, as well as their interrelations, shortly after severe traumatic brain injury (TBI) in humans. METHODS: Brain tissue pH, PCO2, PO2, and/or lactate were measured in 151 patients with severe head injuries, by using a Neurotrend sensor and/or a microdialysis probe. Monitoring was started as soon as possible after the injury and continued for up to 4 days. During the 1st day following the trauma, the brain tissue pH was significantly lower, compared with later time points, in patients who died or remained in a persistent vegetative state. Six hours after the injury, brain tissue PCO2 was significantly higher in patients with a poor outcome compared with patients with a good outcome. Furthermore, significant elevations in cerebral concentrations of lactate were found during the 1st day after the injury, compared with later time points. These increases in lactate were typically more pronounced in patients with a poor outcome. Similar biochemical changes were observed during later hypoxic events. CONCLUSIONS: Severe human TBI profoundly disturbs cerebral acid-base homeostasis. The observed pH changes persist for the first 24 hours after the trauma. Brain tissue acidosis is associated with increased tissue PCO2 and lactate concentration; these pathobiochemical changes are more severe in patients who remain in a persistent vegetative state or die. Furthermore, increased brain tissue PCO2 (> 60 mm Hg) appears to be a useful clinical indicator of critical cerebral ischemia, especially when accompanied by increased lactate concentrations.

Triality, periodicity and stability of SO(8) gauged supergravity

While electromagnetic duality is a symmetry of many supergravity theories, this is not the case for the N = 8 gauged theory. It was recently shown that this rotation leads to a one-parameter family of SO(8) supergravities. It is an open question what the period of this parameter is. This issue is investigated in the SO(4) invariant sectors of the theory. We classify such critical points and find a novel branch of non-supersymmetric and unstable solutions, whose embedding is related via triality to the two known ones. Secondly, we show that the three branches of solutions lead to a π/4 periodicity of the vacuum structure. The general interrelations between triality and periodicity are discussed. Finally, we comment on the connection to other gauge groups as well as the possibility to achieve (non-)perturbative stability around AdS/Mkw/dS transitions.

Executive functions and their differential contribution to sustained attention in 5- to 8-year-old children

ABSTRACT Everyday routine in general and school settings in particular make high demands on children's abilities to sustain their focus of attention over longer time periods. School tasks thus require the child to accomplish the task on an appropriate level of performance while maintaining the focus of attention even under repetitious or distracting conditions. However, sustained attention (SA) may be a more heterogeneous construct than commonly assumed as it requires the individual not only to sustain attentional capacities but also to store and maintain the task rule (working memory), to inhibit inappropriate responses (inhibition), and to switch according to requirements (switching). It might thus involve processes counted among executive functions (EF). In the present study, performance in EF tasks (covering the core components inhibition, switching, and working memory) and in a SA task was assessed in 118 children, aged between 5;0 and 8;11 years. Similar age-dependent performance trajectories were found in EF components and SA, indicating ongoing performance improvements between 5 until at least 8 years of age in SA and in EF. Interrelations between single EF components and SA showed to be small to moderate. Finally, different patterns of SA performance predictions were found in age-homogeneous subgroups with inhibition being crucial for SA performance in the youngest and switching in the oldest age group. Taken as a whole, even though similarities in assumed developmental trajectories and substantial interrelations point to common underlying processes in EF and SA, age-dependent patterns of explained variance indicate clear discriminability.

CHARACTERIZING, ASSESSING AND IMPROVING HEALTHCARE REFERRAL COMMUNICATION

Similar to other health care processes, referrals are susceptible to breakdowns. These breakdowns in the referral process can lead to poor continuity of care, slow diagnostic processes, delays and repetition of tests, patient and provider dissatisfaction, and can lead to a loss of confidence in providers. These facts and the necessity for a deeper understanding of referrals in healthcare served as the motivation to conduct a comprehensive study of referrals. The research began with the real problem and need to understand referral communication as a mean to improve patient care. Despite previous efforts to explain referrals and the dynamics and interrelations of the variables that influence referrals there is not a common, contemporary, and accepted definition of what a referral is in the health care context. The research agenda was guided by the need to explore referrals as an abstract concept by: 1) developing a conceptual definition of referrals, and 2) developing a model of referrals, to finally propose a 3) comprehensive research framework. This dissertation has resulted in a standard conceptual definition of referrals and a model of referrals. In addition a mixed-method framework to evaluate referrals was proposed, and finally a data driven model was developed to predict whether a referral would be approved or denied by a specialty service. The three manuscripts included in this dissertation present the basis for studying and assessing referrals using a common framework that should allow an easier comparative research agenda to improve referrals taking into account the context where referrals occur.

Adult parent-child relationships: Relationship quality, support, and reciprocity

In accordance with Bengtson's model of intergenerational solidarity (e.g. Bengtson & Roberts, 1991), the interrelations between adult daughters' family values, their perception of the relationship quality with their parents, the support they reported to give to and to receive from their parents, and their perception of reciprocity in intergenerational support exchange were investigated for N = 265 middle-aged women in Germany. It was also asked whether the support given to parents and perceived reciprocity are related to daughters' felt burden as a result of their support. Cross-sectional, self-report data were examined with multiple and multinomial logistic regression analyses. The analyses revealed positive relations between family values, relationship quality, and support to parents. Perceived reciprocity was associated with the exchange of intergenerational support and imbalance in support had negative effects on the relationship quality. Felt burden was predicted by the extent of support and the perceived reciprocity. However, specific correlational patterns depending on the kind of support as well as differences in the importance of mother and father occurred. The findings are discussed against the background of the meaning of family obligations and reciprocity in a Western culture.

The relation between cognitive and motor performance and their relevance for children’s transition to school: A latent variable approach

Both theoretically and empirically there is a continuous interest in understanding the specific relation between cognitive and motor development in childhood. In the present longitudinal study including three measurement points, this relation was targeted. At the beginning of the study, the participating children were 5-6-year-olds. By assessing participants' fine motor skills, their executive functioning, and their non-verbal intelligence, their cross-sectional and cross-lagged interrelations were examined. Additionally, performance in these three areas was used to predict early school achievement (in terms of mathematics, reading, and spelling) at the end of participants' first grade. Correlational analyses and structural equation modeling revealed that fine motor skills, non-verbal intelligence and executive functioning were significantly interrelated. Both fine motor skills and intelligence had significant links to later school achievement. However, when executive functioning was additionally included into the prediction of early academic achievement, fine motor skills and non-verbal intelligence were no longer significantly associated with later school performance suggesting that executive functioning plays an important role for the motor-cognitive performance link.

Can you see me thinking (about my answers)? Using eye-tracking to illuminate developmental differences in monitoring and control skills and their relation to performance

This study focuses on relations between 7- and 9-year-old children’s and adults’ metacognitive monitoring and control processes. In addition to explicit confidence judgments (CJ), data for participants’ control behavior during learning and recall as well as implicit CJs were collected with an eye-tracking device (Tobii 1750). Results revealed developmental progression in both accuracy of implicit and explicit monitoring across age groups. In addition, efficiency of learning and recall strategies increases with age, as older participants allocate more fixation time to critical information and less time to peripheral or potentially interfering information. Correlational analyses, recall performance, metacognitive monitoring, and controlling indicate significant interrelations between all of these measures, with varying patterns of correlations within age groups. Results are discussed in regard to the intricate relationship between monitoring and recall and their relation to performance.

Der Spinozismus im Jüdenthumb, oder, Die von dem heütigen Jüdenthumb und dessen Geheimen Kabbala vergötterte Welt : an Mose Germano sonsten Johan Peter Speeth ...

befunden und widerleget von Johann Georg Wachter

Stress-induced modulation of NF-κB activation, inflammation-associated gene expression, and cytokine levels in blood of healthy men

Acute psychosocial stress stimulates transient increases in circulating pro-inflammatory plasma cytokines, but little is known about stress effects on anti-inflammatory cytokines or underlying mechanisms. We investigated the stress kinetics and interrelations of pro- and anti-inflammatory measures on the transcriptional and protein level. Forty-five healthy men were randomly assigned to either a stress or control group. While the stress group underwent an acute psychosocial stress task, the second group participated in a non-stress control condition. We repeatedly measured before and up to 120min after stress DNA binding activity of the pro-inflammatory transcription factor NF-κB (NF-κB-BA) in peripheral blood mononuclear cells, whole-blood mRNA levels of NF-κB, its inhibitor IκBα, and of the pro-inflammatory cytokines interleukin (IL)-1ß and IL-6, and the anti-inflammatory cytokine IL-10. We also repeatedly measured plasma levels of IL-1ß, IL-6, and IL-10. Compared to non-stress, acute stress induced significant and rapid increases in NF-κB-BA and delayed increases in plasma IL-6 and mRNA of IL-1ß, IL-6, and IκBα (p's<.045). In the stress group, significant increases over time were also observed for NF-κB mRNA and plasma IL-1ß and IL-10 (p's<.055). NF-κB-BA correlated significantly with mRNA of IL-1β (r=.52, p=.002), NF-κB (r=.48, p=.004), and IκBα (r=.42, p=.013), and marginally with IL-6 mRNA (r=.31, p=.11). Plasma cytokines did not relate to NF-κB-BA or mRNA levels of the respective cytokines. Our data suggest that stress induces increases in NF-κB-BA that relate to subsequent mRNA expression of pro-inflammatory, but not anti-inflammatory cytokines, and of regulatory-cytoplasmic-proteins. The stress-induced increases in plasma cytokines do not seem to derive from de novo synthesis in circulating blood cells.

Virtue, Law and Mercy

The attribution of responsibility in world society is increasingly a field of contestation. On the one hand, the perception of causal and moral links reaching far in space and time are ever more explicitly pronounced; on the other hand, the very complexity of these links often engenders a fragmentation of responsibility both in law (Veitch 2007) as well as in moral commitment. Moreover, those institutions of legal responsibility attempting to reflect some of these interrelations are often criticised as insufficient by those who follow alternative narratives of causation and moral community. Current institutions of responsibility in law appear to abstract from what could be called enabling contexts; they perform their cuts in the chains of enabling interactions at very brief intervals (Strathern 2001). The result is often “organised irresponsibility” (Veitch 2007; Beck 1996), producing appeals to a global community of concern in time and space without corresponding obligatory commitments. This talk explores alternative conceptualisations of responsibility, and enquires into their notion of the person, their temporal and socio-spatial dimensions, and their notion of liability.

No sports – no mental health? Analysis of longitudinal effects in SHP data.

Results from the Zurich study have shown lasting associations between sport practice and mental health. The effects are pronounced in people with pre-exising mental health problems. This analysis aims to replicate these results with the large Swiss Household Panel data set and to provide more differentiated results. The analysis covered the interviews 1999-2003 and included 3891 stayers, i.e., participants who were interviewed in all years. The outcome variables are depression / blues / anxiety, weakness / weariness, sleeping problems, energy / optimism. Confounding variables include sex, age, education level, citizenship. The analyses were carried out with mixed models (depression, optimism) and GEE models (weakness, sleep). About 60% of the SHP participants practise weekly or daily an individual or a team sport. A similar proportion enjoys a frequent physical activity (for half an hour minimum) which makes oneself slightly breathless. There are slight age-specific differences but also noteworthy regional differences. Practice of sport is clearly interrelated with self-reported depressive symptoms, optimism and weakness. This applies even though some relevant confounders – sex, educational level and citizenship – were introduced into the model. However, no relevant interaction effects with time could be shown. Moreover, direct interrelations commonly led to better fits than models with lagged variables, thus indicating that delayed effects of sport practice on the self-reported psychological complaints are less important. Model variants resulted for specific subgroups, for example, participants with a high vs. low initial activity level. Lack of sport practice is an interesting marker for serious psychological symptoms and mental disorders. The background of this association may differ in different subgroups, and should stimulate further investigations in this area.

Age differences in instability, contingency, and level of self-esteem across the life span

We investigated age differences in instability, contingency, and level of self-esteem from age 13 to 72 years, using data from 1386 individuals who participated in a diary study over 25 days. Instability and contingency of self-esteem decreased from adolescence to old age, whereas level of self-esteem increased. Big Five personality traits predicted the level, but not the slope, of the trajectories of self-esteem characteristics. Age differences in self-esteem characteristics did not merely reflect age differences in instability and level of positive and negative affect. Finally, self-esteem characteristics showed a stable pattern of interrelations across the life span. Overall, the findings suggest that people’s self-esteem tends to become better adjusted—i.e., more stable, less contingent, and higher—across the life course.

Descriptive/Inferential Cognitive Processes and Evaluative Cognitive Processes: Relationships Among Each Other and with Emotional Distress

We aimed to delineate key constructs from two forms of cognitive-behavioral therapy: cognitive therapy and rational-emotive behavior therapy. Furthermore, we aimed to investigate the interrelations among each other and with emotional distress. The key constructs of the underlying theories of these therapies (i.e., descriptive/inferential beliefs, evaluative beliefs) are often treated together as distorted cognitions and included as such in various scales. We used a cross-sectional design. Seventy-four undergraduate students (mean age = 24.68) completed measures of automatic thoughts and emotional distress. Three therapists trained in cognitive-behavioral therapy divided automatic thoughts into descriptive/inferential beliefs and evaluative beliefs by consensus. Correlation and mediation analyses were performed. These constructs showed medium to high associations to each other and to distress. The relationship between descriptive/inferential beliefs and distress was mediated by evaluative beliefs. Descriptive and inferential cognitions may not produce emotions without first being appraised in terms of personal relevance.

Na 1 Nachlass Max Horkheimer, 57 - Korrespondenzen u.a. mit Hilde Weiss (p. I 27, 1-185)

1 Brief von Max Horkheimer an Weiss, 18.07.1937; 27 Briefe und Beilagen zwischen Hilde Weiss und Max Horkheimer, 1934-1936, 1945 sowie Briefwechsel mit der Commission on Community Interrelations of the American Jewish Congress; 3 Briefe zwischen der Commission on Community Interrelations of the American Jewish Congress und Max Horkheimer, 02.10.1945, 1945; 2 Briefe und Beilage zwischen dem Social Science Research Council und Max Horkheimer, 04.02.1943, 18.03.1943; 1 Brief und 1 Beilage von Leo Löwenthal an Margot von Mendelssohn, 01.03.1943; 2 Briefe zwischen Ernst Weissmann und Max Horkheimer, 07.09.1945; 11 Briefe zwischen Leo H. Weissmann und Max Horkheimer, 1938-1939; 1 Brief von Max Horkheimer an Chaim Weizmann, 06.05.1941; 8 Briefe und 1 Beilage zwischen Karl Georg Wendriner, Anna Wendriner und Max Horkheimer, 1935-1938; 1 Brief von Max Horkheimer an Frederic Wertham, 18.11.1941; 2 Briefe zwischen Wertheimer und Max Horkheimer, 07.11.1934; 2 Briefe von Abr. F. Westermann an Max Horkheimer, 1932, 1934; 1 Brief von Max Horkheimer an die Western Service Corporation, 06.04.1941; 30 Briefe zwischen Wetzel und Max Horkheimer, 1937-1939; 3 Briefe zwischen Helen B. White und Max Horkheimer, 16.03.1939, 1939; 3 Briefe zwischen John Whyte und Max Horkheimer, 01.03.1941, 12.03.1941; 3 Briefe und 1 Beilage zwischen Philip Paul Wiener und Max Horkheimer, 08.12.1938, 1938; 7 Briefe zwischen Maria Wiesengrund und Max Horkheimer, 1942, 1945, 1948; 1 Lebenslauf und 2 Zeugnisse von Ilse Wiesenthal; 1 Brief vom Comité International Pour Le Placement Des Intellectuels Réfugiés an Max Horkheimer in Verbindung mit Ilse Wiesenthal, Dezember 1935; 1 Brief von Max Horkheimer an Willen; 1 Brief vom The Wimbledon Co Master Tailors an Max Horkheimer, 15.06.1937; 5 Briefe zwischen Josef Winternitz und Max Horkheimer, 1938-1939; 7 Briefe zwischen Louis Wirth und Max Horkheimer, 1937-1941; 22 Briefe zwischen Egon Wissing und Max Horkheimer, 1936-1941 sowie Briefwechsel mit dem Georg Washington Hotel, New York; 1 Brief von Lieselotte Karplen an Maidon Horkheimer, 25.04.1940; 2 Briefe zwischen dem Georg Washington Hotel und Max Horkheimer, 07.05.1936, 12.05.1936;