Only Cervical Segments C0-C2, Not C3 Are Relevant for Subgrouping Migraine Patients According to Manual Palpation and Pain Provocation

Background and Aims: Subgrouping of migraine patients according to the pain response to manual palpation of the upper cervical spine has been recently described. Based on the neuroanatomy and the convergence of spinal and trigeminal nerves in the trigeminocervical complex, the cervical segments C1 to C3 are potentially relevant. To date it has not been investigated whether palpation results of all upper cervical segments are based on one underlying construct which allows combining the results of several tests.Methods: Seventy-one migraine patients with chronic or frequent episodic migraine diagnosed according to the IHS classification version 3 were examined by one physiotherapist. Manual palpation was performed on the upper three cervical segments unilaterally left and right. The results of the palpation according to the patients’ responses were combined using factor analysis to determine whether results from all three segments form one underlying construct. In addition, item response theory (IRT) was used to investigate the structure of the response pattern as well as item difficulty and discriminationFindings: Factor analysis (principal component) showed that the palpation of C3 loads less onto the underlying construct than the palpation of C1 and C2. Considering a cut-off value >1.0, the eigenvalues of all three segments do not represent one underlying construct. When excluding the results from C3, remaining items form one construct. The internal consistency of the pain response to palpation of C1 and C2 is acceptable with a Cronbach’s alpha of 0.69. IRT analysis showed that the rating scale model fits best to the pain response pattern. The discrimination value (1.24) was equal for all 4 items. Item difficulty showed a clear hierarchical structure between the palpation of C1 and C2, indicating that people with a higher impairment are more likely to respond with referred pain during palpation of the segment C2. Conclusion: Statistical analysis confirms that results from the palpation of the cervical segments C1 and C2 in migraine patients can be combined. IRT analysis confirmed the ordinal pattern of the pain response and showed the higher probability of a pain response during palpation of C2. Registration of main Study: German registry of clinical trials (DRKS00015995), Registered 20. December 2018, https://www.drks.de/drks_web/setLocale_EN.do

An information integration account for causal generalizations in uncertain causal networks

In reasoning about common cause networks, given that a cause generates an effect, people often need to infer how likely the cause generate another effect. This causal generalization question has not systematically been investigated in previous research. We propose the information integration account for causal generalizations in uncertain casual networks with dichotomized continuous variables. It predicts that causal generalization is the joint function of conditional probabilities of causal links and cause strength indicated by the proportion of present collateral effects. Two experiments investigated causal generalizations in uncertain causal networks with and without probability distributions, respectively. It was found that in the presence of probability distributions there was the joint effect of conditional probability and cause strength on causal generalization; in the absence of probability distributions causal generalization depend only on cause strength. The overall response pattern favors the information integration account over the other alternative accounts.

Symmetry and asymmetry between inferences between disjunctions and conditionals

How people make inferences between disjunctions and conditionals is a current important question that can test existing main psychological accounts (mental logic, the probabilistic approach, the original and revised mental model theory) for propositional reasoning. In order to test these accounts, one experiment investigated how relations (material implication, subcontrariety, contradiction, and contrariety) between two basic components (A and C) in disjunctions (e.g., A or C; not-A or C) and conditionals (e.g., if not-A then C; if A then C) and inference directions (disjunction-to-conditional versus conditional-to-disjunction) between disjunctions and their corresponding conditionals affect human inferences between both. It was found that participants’ inferences were symmetric between the two inference directions in compatible relations and incompatible relations where two basic components were on different dimensions, but not in the other relations. Which of the two inference directions was easier depended on relations between two basic components, because some relations tended to elicit particular interpretations of premises and conclusions, or belief biases. The present overall response pattern is beyond all the existing accounts for inferences between disjunctions and conditionals. Inferences between disjunctions and conditionals are complex and so there may not be a unified account for them.

Association of Chinese Visceral Adiposity Index and Its Dynamic Change With Risk of Carotid Plaque in a Large Cohort in China

Background We aimed to evaluate the association between the Chinese visceral adiposity index (CVAI) and its dynamic change and risk of carotid plaque based on a large Chinese cohort. Methods and Results This cohort included 23 522 participants aged 20 to 80 years without elevated carotid intima‐media thickness and carotid plaque at baseline and who received at least 2 health checkups. CVAI was calculated at baseline and at every checkup. The dynamic change in CVAI was calculated by subtracting CVAI at baseline from that at the last follow‐up. Cox proportional hazard regression model was used to estimate hazard ratios (HRs) and 95% CIs. The restricted cubic spline was applied to model the dose‐response association between CVAI and carotid plaque risk. During the 82 621 person‐years of follow‐up, 5987 cases of carotid plaque developed (7.25/100 person‐years). We observed a significant positive correlation between CVAI and carotid plaque risk (HR, 1.53; 95% CI, 1.48–1.59 [ P <0.001]) in a nonlinear dose‐response pattern ( P nonlinearity <0.001). The sensitivity analyses further confirmed the robustness of the results. The association was significant in all subgroup analyses stratified by sex, hypertension, and fatty liver disease except for the diabetes subgroup. The association between CVAI and carotid plaque risk was much higher in men than in women. No significant association was identified between change in CVAI and carotid plaque risk. Conclusions CVAI was positively associated with carotid plaque risk in a nonlinear dose‐response pattern in this study. Individuals should keep their CVAI within a normal level to prevent the development of carotid plaque.

Turning Tables: Offenders Feel Like “Victims” When Victims Withhold Forgiveness

When offenders apologize to victims for a wrongdoing, they often expect forgiveness in return. Sometimes, however, victims may withhold forgiveness. Across four experimental studies, we find that offenders feel like “victims” when victims respond to their apologies with non-forgiveness. This can be explained by the fact that they interpret non-forgiveness as both a norm violation and a threat to their sense of power. Together, these mechanisms can account for the relationship between non-forgiveness and negative conciliatory sentiments in offenders. These effects of non-forgiveness emerge irrespective of whether the transgression is recalled (Study 1) or imagined (Studies 2-4). They are specific to non-forgiveness rather than a lack of explicit forgiveness (Study 3), and are not qualified by subtle prods for participants to take the victim’s perspective (Study 4). These findings demonstrate a destructive response pattern in offenders that warrants further attention.

Mechanisms of hydrological responses to volcanic eruptions in the Asian monsoon and westerlies-dominated subregions

Explosive volcanic eruptions affect surface climate especially in monsoon regions, but responses vary in different regions and to volcanic aerosol injection (VAI) in different hemispheres. Here we use six ensemble members from last millennium experiment of the Coupled Model Intercomparison Project Phase 5, to investigate the mechanism of regional hydrological responses to different hemispheric VAI in the Asian monsoon region (AMR). It brings a significant drying effect over the AMR after northern hemisphere VAI (NHVAI), spatially, a distinct “wet get drier, dry gets wetter” response pattern emerges with significant drying effect in the wettest area (RWA) but significant wetting effect in the driest area (RDA) of the AMR. After southern hemisphere VAI (SHVAI), it shows a significant wetting effect over the AMR, but spatial response pattern is not that clear due to small aerosol magnitude. The mechanism of the hydrological impact relates to the indirect change of atmospheric circulation due to the direct radiative effect of volcanic aerosols. The decreased thermal contrast between the land and the ocean after NHVAI results in weakened EASM and SASM. This changes the moisture transport and cloud formation in the monsoon and westerlies-dominated subregions. The subsequent radiative effect and physical feedbacks of local clouds lead to different drying and wetting effects in different areas. Results here indicate that future volcanic eruptions may alleviate the uneven distribution of precipitation in the AMR, which should be considered in the near-term decadal prediction and future strategy of local adaptation to global warming. The local hydrological responses and mechanisms found here can also provide reference to stratospheric aerosol engineering.

Towards an ecological definition of sepsis: a viewpoint

In critically ill patients with sepsis, there is a grave lack of effective treatment options to address the illness-defining inappropriate host response. Currently, treatment is limited to source control and supportive care, albeit with imminent approval of immune modulating drugs for COVID-19-associated lung failure the potential of host-directed strategies appears on the horizon. We suggest expanding the concept of sepsis by incorporating infectious stress within the general stress response of the cell to define sepsis as an illness state characterized by allostatic overload and failing adaptive responses along with biotic (pathogen) and abiotic (e.g., malnutrition) environmental stress factors. This would allow conceptualizing the failing organismic responses to pathogens in sepsis with an ancient response pattern depending on the energy state of cells and organs towards other environmental stressors in general. Hence, the present review aims to decipher the heuristic value of a biological definition of sepsis as a failing stress response. These considerations may motivate a better understanding of the processes underlying “host defense failure” on the organismic, organ, cell and molecular levels.

Investigations of plant subfossil cuticles at a Holocene raised bog complex, northern New Zealand

<p>Subfossil plant cuticles, the very resistant waxy layer covering vascular land plants, are a neglected source of information in peat studies, despite their high preservation and identification potential. A lack of standardised methods and reference material are major contributing factors. In this thesis, a new method is introduced to test if subfossil plant cuticles from Moanatuatua Bog in the northern North Island of New Zealand can give a robust reconstruction of local bog surface vegetation changes during the Holocene. The method was successfully established and applied at coarse sampling resolution to show vegetation changes across the full length of the core and at fine sampling resolution around charcoal layers to reconstruct the post-fire response pattern of the main plant species on the bog. Additionally, bulk density and organic matter analyses were carried out to provide further insight into these changes. At the core site, towards the southern margins of Moanatuatua Bog, swamp forest had developed by 15000 cal yr BP. Until ca. 10500 cal yr BP, the vegetation assemblage was sedge-dominated, indicating swamp and/or fen conditions. A significant increase in macroscopic charcoal particles coincided with the transition to a more diversified vegetation composition. At around 4500 cal yr BP, the vegetation became restiad-dominated, indicating full raised bog conditions. The coarse resolution cuticle results were further compared to a pollen record from the same sequence, which was established independently. This comparison showed that plant subfossil cuticles can provide additional information to pollen analysis in cases where pollen is hard to identify or poorly preserved. Specifically, restiad pollen is hard to differentiate, yet cuticles of Empodisma and Sporadanthus have very distinct features. Also, Cyperaceae pollen is very poorly preserved at Moanatuatua Bog and the Cyperaceae pollen curve shows a poor match with the Cyperaceae cuticle record. It is suggested therefore that Cyperaceae pollen at this site – and potentially other peat sites – is a less reliable indicator of local sedge communities than a Cyperaceae cuticle record. At fine resolution, results were blurred across a time interval that was marginal for reconstructing response patterns due to the constraints imposed by sampling resolution and peat accumulation rate of Moanatuatua Bog. Nevertheless, two out of three charcoal layers recorded a local fire on the bog surface, with one layer displaying the expected vegetation response. After the fire, Empodisma, as a mid-successional species, re-established on the bog surface before Sporadanthus, a late-successional species. The other layer was dominated by sedges and showed no response pattern, as is to be expected due to the very fast recovery of sedges. In general, sample preparation for cuticle analysis proved to be fast with relatively little equipment or chemicals needed. With detailed reference material, identification to species level is possible due to distinctive and pronounced cuticle features. Plant cuticle analysis is therefore proposed to be a reliable tool to reconstruct long-term and short-term vegetation changes from peat sequences.</p>