Heart–Brain Relationship in Stroke

The patient presenting with stroke often has cardiac-related risk factors which may be involved in the mechanism of the stroke. The diagnostic assessment is predicated on recognition of this potential relationship. Naturally, an accurate history is of utmost importance in discerning a possible cause and effect relationship. The EKG is obviously an important clue as well as it allows immediate assessment for possible cardiac arrhythmia, such as atrial fibrillation, for possible acute ischemic changes reflective of myocardial ischemia, or there may be indirect factors such as the presence of left ventricular hypertrophy, typically seen with longstanding hypertension, which could be indicative of a hypertensive mechanism for a patient presenting with intracerebral hemorrhage. For all presentations in the emergency room, the vital signs are important. An elevated body temperature in a patient presenting with acute stroke raises concern about possible infective endocarditis. An irregular–irregular pulse is an indicator of atrial fibrillation. A markedly elevated blood pressure is not uncommon in both the acute ischemic and acute hemorrhagic stroke setting. One tends to focus on possible cardioembolic stroke if there is the sudden onset of maximum neurological deficit versus the stepwise progression more characteristic of thrombotic stroke. Because of the more sudden loss of vascular supply with embolic occlusion, seizure or syncope at onset tends to be supportive of this mechanism. Different vascular territory involvement on neuroimaging is also a potential indicator of cardioembolic stroke. Identification of a cardiogenic source of embolus in such a setting certainly elevates this mechanism in the differential. There have been major advances in management of acute cerebrovascular disease in recent decades, such as thrombolytic therapy and endovascular thrombectomy, which have somewhat paralleled the advances made in cardiovascular disease. Unfortunately, the successful limitation of myocardial damage in acute coronary syndrome, with intervention, does not necessarily mirror a similar salutary effect on functional outcome with cerebral infarction. The heart can also affect the brain from a cerebral perfusion standpoint. Transient arrhythmias can result in syncope, while cardiac arrest can result in hypoxic–ischemic encephalopathy. Cardiogenic dementia has been identified as a mechanism of cognitive impairment associated with severe cardiac failure. Structural cardiac abnormalities can also play a role in brain insult, and this can include tumors, such as atrial myxoma, patent foramen ovale, with the potential for paradoxical cerebral embolism, and cardiomyopathies, such as Takotsubo, can be associated with precipitous cardioembolic events.

Is Eliphaz a false prophet? The vision in Job 4.12-21

The night vision recounted by Job’s friend Eliphaz in Job 4.12-21 has received an extraordinary amount of scholarly attention. Among other difficulties, the core of the vision’s message (4.17) – typically interpreted as stating that humans cannot be just in God’s sight – appears to contradict Eliphaz’s statements elsewhere (e.g., 4.6-7). The relationship between 4.17 and the metaphors for death with which the vision ends has also occasioned considerable debate. In this paper, it is argued that Eliphaz’s words can be viewed as a response to Job’s speech in Chapter 3, particularly his description of the sleep of death in 3.11-19. The poet portrays Eliphaz as having perceived Job’s words as a challenge to God’s justice and has him—after implying divine inspiration for his message with the use of an extraordinary set of oracular tropes in vv. 12-16—offer in vv. 17-21 a rebuke and warning evocative of those used by biblical prophets to call sinners to repentance. As the prologue indicates, however, Job’s suffering is not due to sin but instead to his superlative goodness; Eliphaz’s words are therefore profoundly misguided and can have no salutary effect. In essence, I propose that the poet is presenting Eliphaz as an example of what Deut. 18.20 calls a ‘presumptuous prophet’, that is, one who wrongly claims that he is speaking on behalf of God. His remarks serve only to distance Job further from both the ‘friends’ and God, as Job’s sharper tone in Chapters 6-7 makes clear. This reading can help explain some of the more puzzling elements in these verses and also maintains the traditional attribution of the vision to Eliphaz (instead of to Job himself, as a growing number of scholars have proposed).

Species Egalitarianism and Respect for Nature

Lucia Schwarz urges a reconsideration of the implications of species egalitarianism, which is an essential element of the position in environmental ethics that Paul Taylor calls “respect for nature.” Species egalitarianism’s claim that every living thing has equal inherent worth appears to lead to counterintuitive conclusions, such as that killing a human being is no worse than killing a dandelion. Species egalitarians have generally responded by explaining that species egalitarianism is compatible with recognizing moral differences between killing different types of living things, and that some killing is morally permissible. Schwarz raises doubts about whether this deflationary defensive strategy is philosophically justified, and suggests that taking seriously the supposedly repugnant implications of species egalitarianism may have a salutary effect on the overall debate.

Explaining variance in perceived research misbehavior: results from a survey among academic researchers in Amsterdam

Background Concerns about research misbehavior in academic science have sparked interest in the factors that may explain research misbehavior. Often three clusters of factors are distinguished: individual factors, climate factors and publication factors. Our research question was: to what extent can individual, climate and publication factors explain the variance in frequently perceived research misbehaviors? Methods From May 2017 until July 2017, we conducted a survey study among academic researchers in Amsterdam. The survey included three measurement instruments that we previously reported individual results of and here we integrate these findings. Results One thousand two hundred ninety-eight researchers completed the survey (response rate: 17%). Results showed that individual, climate and publication factors combined explained 34% of variance in perceived frequency of research misbehavior. Individual factors explained 7%, climate factors explained 22% and publication factors 16%. Conclusions Our results suggest that the perceptions of the research climate play a substantial role in explaining variance in research misbehavior. This suggests that efforts to improve departmental norms might have a salutary effect on behavior.

Funding for start-ups in India: what shakes it?

Purpose Using a novel monthly data set, this study aims to examine the factors affecting the funding of Indian start-ups. Design/methodology/approach Given the panel structure of the data, the fixed effects regression technique has been used. Findings The findings reveal that years of operation is a key factor. Amongst others, angel investors and equity financing are the key drivers of startup financing. Government policy does not appear to have gained adequate traction, although the improvement in the business reform action by state governments has begun to exert a salutary effect. Practical implications From a policy standpoint, the study provides insights into what policies and practices can be exploited to streamline the funding bottlenecks affecting startups in the Indian context. Originality/value Notwithstanding being a country with a significant presence in the startup space, there are admittedly limited studies, which examine this issue for India. Viewed from this standpoint to the best of the knowledge, the analysis is one of the early studies to shed light on the factors driving the funding of startups in the Indian context.

Examining Nostalgia in Old Life: Antecedence and Outcome

Nostalgia is a self-conscious, bittersweet but predominantly positive and fundamentally social emotion. The regulatory model of nostalgia suggests that experiencing nostalgia can buffer against social threat (e.g. social exclusion) by providing individuals with sense of social connectedness (Sedikides, et al., 2015). In the current research, we propose that this salutary effect of nostalgia may be stronger among older adults compared to younger adults because older adults value social meaningfulness to a greater extent. Fifty-nine younger adults (Mage = 20.15, SD = 0.215) and 56 older adults (Mage = 71.02, SD = 0.679) completed daily questionnaires three times a day for ten consecutive days, and reported their emotional experience and social activities. Results showed that perceiving social threat was positively correlated with nostalgia experience reported at the subsequent time point, and this association was stronger among older adults. In addition, nostalgia positively correlated with subsequent social activities among the older participants but not among the younger participants. These findings highlight that nostalgia brings beneficial psychological (sense of social connectedness) and behavioral (social engagement) outcomes to older adults.

Losing Control: Sleep Deprivation Impairs the Suppression of Unwanted Thoughts

Unwanted memories often enter conscious awareness when individuals confront reminders. People vary widely in their talents at suppressing such memory intrusions; however, the factors that govern suppression ability are poorly understood. We tested the hypothesis that successful memory control requires sleep. Following overnight sleep or total sleep deprivation, participants attempted to suppress intrusions of emotionally negative and neutral scenes when confronted with reminders. The sleep-deprived group experienced significantly more intrusions (unsuccessful suppressions) than the sleep group. Deficient control over intrusive thoughts had consequences: Whereas in rested participants suppression reduced behavioral and psychophysiological indices of negative affect for aversive memories, it had no such salutary effect for sleep-deprived participants. Our findings raise the possibility that sleep deprivation disrupts prefrontal control over medial temporal lobe structures that support memory and emotion. These data point to an important role of sleep disturbance in maintaining and exacerbating psychiatric conditions characterized by persistent, unwanted thoughts.

Relation of Doubling Time and Reproduction Number with Testing Rate for Corona Infections in India

There is a general feeling that increased testing has a salutary effect on the course of the current coronavirus epidemic. We quantify the relationship of testing rate with the doubling time and reproduction number in India, estimate the effect, and use these relationships to make projections for the near future.

A halo of reduced dinoflagellate abundances in and around eelgrass beds

Seagrass beds provide a variety of ecosystem services, both within and outside the bounds of the habitat itself. Here we use environmental DNA (eDNA) amplicons to analyze a broad cross-section of taxa from ecological communities in and immediately surrounding eelgrass (Zostera marina). Sampling seawater along transects extending alongshore outward from eelgrass beds, we demonstrate that eDNA provides meter-scale resolution of communities in the field. We evaluate eDNA abundance indices for 13 major phylogenetic groups of marine and estuarine taxa along these transects, finding highly local changes linked with proximity to Z. marina for a diverse group of dinoflagellates, and for no other group of taxa. Eelgrass habitat is consistently associated with dramatic reductions in dinoflagellate abundance both within the contiguous beds and for at least 15 m outside, relative to nearby sites without eelgrass. These results are consistent with the hypothesis that eelgrass-associated communities have allelopathic effects on dinoflagellates, and that these effects can extend in a halo beyond the bounds of the contiguous beds. Because many dinoflagellates are capable of forming harmful algal blooms (HABs) toxic to humans and other animal species, the apparent salutary effect of eelgrass habitat on neighboring waters has important implications for public health as well as shellfish aquaculture and harvesting.

The Therapeutic Alliance Over 10 Sessions of Therapy for Borderline Personality Disorder: Agreement and Congruence Analysis and Relation to Outcome

The authors examined whether alliance dynamics are affected by tailoring the therapeutic relationship to the individual patient in brief psychotherapy of borderline personality disorder. Sixty patients were randomized to 10-session Good Psychiatric Management (GPM-BV) or GPM combined with Motive-Oriented Therapeutic Relationship techniques (MOTR+GPM-BV). Patient- and therapist-rated alliance was assessed weekly. Self-reported symptomatic distress was assessed pre-, mid-, and posttreatment. In MOTR+GPM-BV, stronger therapist-rated alliance predicted lower symptomatic distress in the same timepoint, but not in a lag, whereas symptomatic distress predicted therapist-rated alliance in a lag. Therapist-rated alliance was lower than patient-rated alliance in GPM-BV but not in MOTR+GPM-BV. In MOTR+GPM-BV, higher agreement on strong alliance tended to predict lower symptomatic distress. Patient- and therapist-rated alliances were temporally congruent, but congruence did not predict outcome. Addressing the relationship needs of patients may partly exert its salutary effect by increasing agreement between patients' and therapists' experience of the alliance.