Endovaskuläre Therapie des akuten ischämischen Schlaganfalls

Endovascular therapy of acute ischemic stroke represents a supplementary or (in cases of contraindications to systemic lysis) alternative therapy option to intravenous thrombolysis for patients with severe clinical deficits and proximal vascular obstruction. Currently, (in cases with no contraindications to systemic lysis) the combination with mechanical thrombectomy in the form of so-called stent retrievers has proven to be effective and safe. Until superiority over intravenous thrombolysis alone has been proven in certain patient groups, patients who have received endovascular therapy should be carefully documented in register-based studies.     

Is Political Cognition Like Riding a Bicycle? How Cognitive Neuroscience Can Inform Research on Political Thinking

Our understanding of political phenomena, including political attitudes and sophistication, can be enriched by incorporating the theories and tools of cognitive neuroscience—in particular, the cognitive neuroscience of nonconscious habitual cognition (akin to bicycle riding). From this perspective, different types of informational "building blocks" can be construed from which different types of political attitudes may arise. A reflection-reflexion model is presented that describes how these blocks combine to produce a given political attitude as a function of goals, primes, expertise, and inherent conflict in considerations relevant to the attitude. The ways in which neuroimaging methods can be used to test hypotheses of political cognition are reviewed.     

The pitch of “real” and “rhetorical” questions directed by a father to his daughter: A longitudinal case study

A longitudinal study of a father and his daughter examined pitch-variation of “real” and “rhetorical” questions. Although the father asked “real” and “rhetorical” questions from the start of the recordings, he did not distinguish them through differential pitch height until the baby was 15 months old.     

Valuable and pernicious collective intellectual self-trust1

Recent years have seen a shift in epistemological studies of intellectual self-trust or epistemic self-trust: intellectual self-trust is not merely epistemologists’ tool for silencing epistemic skepticism or doubt, it is recognized as a disposition of individuals and collectives interesting in its own rights. In this exploratory article I focus on a particular type of intellectual self-trust—collective intellectual self-trust—and I examine which features make for valuable or pernicious collective intellectual self-trust. From accounts of the value of individual intellectual self-trust I take three frameworks for evaluating collective intellectual self-trust: an epistemically consequentialist, a virtue-theoretic and a prudential/pragmatic framework (§2). Then I introduce collective intellectual self-trust (§3). Against this background I explain what is distinctive of valuable collective intellectual self-trust (§4) and pernicious collective intellectual self-trust (§5) within the three frameworks. I close by discussing the relation between the three frameworks and argue that evaluating intellectual self-trust requires a multi-perspectival approach constituted by the three frameworks.     

A Population-Based Twin Study of Parentally Reported Tactile and Auditory Defensiveness in Young Children

  Some adults and children exhibit defensive behaviors to tactile or auditory stimulation. These symptoms occur not only in subsets of children with ADHD, autism, and Fragile X syndrome, but also in the apparent absence of accompanying disorders. Relatively little research explores the correlates and antecedents of sensory defensiveness. Using a population-based sample of 1,394 toddler-aged twins, mothers reported on tactile and auditory defensiveness, temperament, and behavior problems. The incidence of defensive symptoms was widely distributed, with some accumulation of cases in the extreme range. Girls were overrepresented in the extreme tactile defensiveness group. Both auditory and tactile defensiveness were modestly associated with fearful temperament and anxiety, but they were relatively distinct from other common dimensions of childhood behavioral dysfunction. Twin correlations for the full range of scores and concordance rates for the extremes suggested moderate genetic influences, with some indication that the tactile domain might be more heritable than the auditory domain.     

Interactive effect of long-term mental stress and cardiac stress reactivity on carotid intima-media thickness: the Cardiovascular Risk in Young Finns study

The present study examined the interaction between vital exhaustion and cardiac reactivity and recovery on preclinical atherosclerosis assessed by carotid intima-media thickness (IMT) in young men and women. We measured heart rate (HR), respiratory sinus arrhythmia (RSA), and pre-ejection period (PEP) in response to mental arithmetic and speech tasks. Vital exhaustion and carotid IMT were also measured. Significant associations were observed for men aged 28-37 years, but not for men aged 22-25 years, nor for women in these age groups. It was shown that, among highly exhausted men in the older age group, lower HR reactivity was related to greater IMT. Our results also imply that, among non-exhausted men in this age group, slow HR and RSA recovery after acute stress predicted higher IMT. These results suggest that long-term stress as assessed by vital exhaustion is a risk only if it has resulted in ineffective cardiac stress reactivity. Autonomic imbalance resulting from chronic stress may be the common mechanism linking vital exhaustion and cardiac responsiveness to an increased risk of atherosclerosis.     

The retrieval of controlled and automatic aspects of meaning on direct and indirect tests

The literature concerning implicit memory presents conflicting evidence on the importance of meaning in recovering recently studied words. When the same cues are used during testing, indirect instructions reduce levels of processing effects relative to those obtained with direct instructions, suggesting that meaning is not as likely to be retrieved on indirect tests. However, with certain cues, meaning set size of the studied words affects performance even under indirect instructions, suggesting that meaning is retrieved on such tests. The purpose of the present experiments was to resolve this apparent inconsistency. In Experiment 1, the effects of levels of processing and meaning set size were evaluated under direct and indirect test instructions, with the use of stem and word-fragment cues. In other experiments, beginning and ending stem cues were compared, and levels, set size, and instructional effects were evaluated using meaning cues. The findings indicated that levels effects were determined more by test instructions than by test cues, and that set size effects were determined more by test cues than by test instructions. Implications are discussed for transfer-appropriate processing viewpoints and for a model in which it is assumed that performance is determined by searching either explicit or implicit memories.     

Clinical teaching: The difficulty of learning

Physicians-in-training face major barriers to effectively learning both the technical and artistic sides of medicine. In both hospital and office settings, inadequate attention has been paid to the context and work environment for learning. The system of care itself is one of the major teachers of the practice of medicine; it must be optimized to produce maximal learning.