Abnormal diurnal pattern of cortisol secretion in patients after aneurysmal subarachnoid hemorrhage

Substantial evidence suggests that impairment of the hypothalamus?pituitary system can occur following an aneurysmal subarachnoid hemorrhage (aSAH). Given that the diurnal cortisol rhythm is primarily controlled by the hypothalamus?pituitary system, this study examined whether changes in diurnal cortisol rhythm occurred after aSAH. Cortisol concentrations were measured in the saliva samples collected from patients after aSAH and other types of cerebral hemorrhage (non-aSAH) in the post-awakening period and at night (21:00?h), and the cortisol awakening response (CAR) and diurnal cortisol decline were determined. The area under the cortisol curve from immediately after to 45?min after awakening (CARauc) in the aSAH patient group was comparable to that in the non-aSAH or healthy control groups. However, an obvious cortisol peak was not found after the awakening period, and the morning/nighttime cortisol ratio in the aSAH patient group was significantly lower than that in other examined groups due to higher nighttime cortisol concentrations. In aSAH patients, the CARauc and nighttime cortisol concentrations were negatively correlated with the Fisher CT grade. These results indicate that the diurnal cortisol rhythm is not regulated normally after aSAH, and cortisol secretory activity decreases as the volume of subarachnoid bleeding increases. Our findings will be helpful to understand altered hypothalamus?pituitary?adrenal axis function after aSAH.     

Use of the estimated intraclass correlation for correcting differences in effect size by level

In a meta-analysis of intervention or group comparison studies, researchers often encounter the circumstance in which the standardized mean differences (d-effect sizes) are computed at multiple levels (e.g., individual vs. cluster). Cluster-level d-effect sizes may be inflated and, thus, may need to be corrected using the intraclass correlation (ICC) before being combined with individual-level d-effect sizes. The ICC value, however, is seldom reported in primary studies and, thus, may need to be computed from other sources. This article proposes a method for estimating the ICC value from the reported standard deviations within a particular meta-analysis (i.e., estimated ICC) when an appropriate default ICC value (Hedges, 2009b) is unavailable. A series of simulations provided evidence that the proposed method yields an accurate and precise estimated ICC value, which can then be used for correct estimation of a d-effect size. The effects of other pertinent factors (e.g., number of studies) were also examined, followed by discussion of related limitations and future research in this area.     

BETWEEN MT. MORIAH AND MT. GOLGOTHA: How Is Christian Ethics Possible?

In this paper, I explore a new way of understanding Christian ethics by critically interconnecting the theological meanings of the Aqedah (“binding”) narrative of Mt. Moriah and the Passion story of Mt. Golgotha. Through an in‐depth critical‐theological investigation of the relation between these two biblical events, I argue that Christian ethics is possible not so much as a moralization or as a literalistic divine command theory, but rather as a “covenantal‐existential” response to God's will in the impossible love on Mt. Moriah as well as in the Son's willing embrace of God's will on Mt. Golgotha.