原发性醛固酮增多症的临床实践与分析

探讨原发性醛固酮增多症(原醛)临床特点及诊治方面的经验,以早期诊断、根治,改善预后。对确诊的原醛53例临床资料(临床特征、实验室检查、影像学检查、病理类型、治疗情况)进行回顾性研究。男女比为1：1.65,30～49岁年龄段最多。50.9%高血压首发,15.1%低钾血症首发,并发高心痛9.4%,尿毒症1.9%,脑卒中13.2%。肾素-血管紧张素-醛固酮(RAA)系统激素检查,血浆醛固酮/血浆肾素活性比值(ARR)＞200者80.7%,ARR＞400者占半数,血浆醛固酮(PAC)＞140pg/ml者占84.6%。CT及MRI阳性率高。术后病理肾上腺皮质腺瘤占85%,结节性增生占15%(其中原发性肾上腺增生占12.5%)。手术后血压及血钾均较前改善,非手术者口服安体舒通有效。原醛是可治性内分泌性高血压之一,建议高血压和/或低血钾者应常规检查RAA系统激素,并争取行影像学检查,以使原醛得到早期诊治,改善预后。     

Measuring Spirituality as a Universal Human Experience: A Review of Spirituality Questionnaires

Spirituality is an important theme in health research, since a spiritual orientation can help people to cope with the consequences of a serious disease. Knowledge on the role of spirituality is, however, limited, as most research is based on measures of religiosity rather than spirituality. A questionnaire that transcends specific beliefs is a prerequisite for quantifying the importance of spirituality among people who adhere to a religion or none at all. In this review, we discuss ten questionnaires that address spirituality as a universal human experience. Questionnaires are evaluated with regard to psychometric properties, item formulation and confusion with well-being and distress. Although none of the questionnaires fulfilled all the criteria, the multidimensional Spiritual Well-Being Questionnaire is promising.     

Cyborgs, uploading and immortality — Some serious concerns

Transhumanism and Extropianism are two recent ‘movements’ which aspire to transcend the perceived limitations of human biological evolution. This paper takes a critical look at two of the most controversial aspects of Extropianism—Uploading and Immortality. Uploading is the process by which a human will be able to transfer the entire contents of their brain to a more suitable supercomputational medium. When the newentity exist as software, immortality is virtually assured. This should be possible, it is claimed, within the next fifty years! From both a pragmatic and philosophical perspective, I argue that these claims are at best misguided and at worst absurd.     

Does maternal prenatal stress adversely affect the child's learning and memory at age six?

Prenatal maternal stress has been shown to affect postnatal development in animals and humans. In animals, the morphology and function of the offspring's hippocampus is negatively affected by prenatal maternal stress. The present study prospectively investigated the influence of prenatal maternal stress on learning and memory of 112 children (50 boys, 62 girls, Age: M=6.7 years, SD=8.4 months), with the Test of Memory and Learning (TOMAL). Maternal stress levels were determined three times during pregnancy by self-report questionnaires. Furthermore, maternal saliva cortisol samples were used as a measure of hypothalamus-pituitary-adrenal axis functioning. Results of hierarchical multivariate regression analyses showed that maternal life events measured during the first part of pregnancy were negatively associated with the child's attention/concentration index, while controlling for overall IQ, gender, and postnatal stress. No associations were found between prenatal maternal cortisol and the offspring's learning and memory.     

Robustness of the cognitive gains in 7-month-old bilingual infants: A close multi-center replication of Kovács and Mehler (2009)

We present an exact replication of Experiment 2 from Kovács and Mehler's 2009 study, which showed that 7-month-old infants who are raised bilingually exhibit a cognitive advantage. In the experiment, a sound cue, following an AAB or ABB pattern, predicted the appearance of a visual stimulus on the screen. The stimulus appeared on one side of the screen for nine trials and then switched to the other side. In the original experiment, both mono- and bilingual infants anticipated where the visual stimulus would appear during pre-switch trials. However, during post-switch trials, only bilingual children anticipated that the stimulus would appear on the other side of the screen. The authors took this as evidence of a cognitive advantage. Using the exact same materials in combination with novel analysis techniques (Bayesian analyses, mixed effects modeling and cluster based permutation analyses), we assessed the robustness of these findings in four babylabs (N = 98). Our results did not replicate the original findings: although anticipatory looks increased slightly during post-switch trials for both groups, bilingual infants were not better switchers than monolingual infants. After the original experiment, we presented additional trials to examine whether infants associated sound patterns with cued locations, for which we did not find any evidence either. The results highlight the importance of multicenter replications and more fine-grained statistical analyses to better understand child development.

Highlights

• We carried out an exact replication across four baby labs of the high-impact study by Kovács and Mehler (2009).
• We did not replicate the findings of the original study, calling into question the robustness of the claim that bilingual infants have enhanced cognitive abilities.
• After the original experiment, we presented additional trials to examine whether infants correctly associated sound patterns with cued locations, for which we did not find any evidence.
• The use of novel analysis techniques (Bayesian analyses, mixed effects modeling and cluster based permutation analyses) allowed us to draw better-informed conclusions.

     

On the dominance of whole-word knowledge in reading aloud

The localist dual-route model of visual word recognition assumes a routine thataddresses the pronunciation of all words known to the reader (the lexical-semantic pathway) and another routine, operating in parallel, thatassembles pronunciations on the basis of sublexical spelling-sound correspondences. The present experiment exploits theexception effect (in which words that are atypical in terms of their spelling-sound correspondences are named more slowly than typical ones) because it is considered a marker of the joint operation of these two routines. Participants named high- and lowfrequency regular and exception words that were repeated across two blocks of trials. The widely reported interaction between regularity and word frequency is present in Block 1 but is reduced in magnitude in Block 2. DRC, an implemented dual-route model, simulates the data. Taken in conjunction with other reports, the results provide further evidence for a double dissociation between addressed and assembled routines and are consistent with the view that skill in recognizing printed words known to the reader reflects the dominance of orthographic over phonological processing.     

Does Maternal Prenatal Stress Adversely Affect the Child’s Learning and Memory at Age Six?

Prenatal maternal stress has been shown to affect postnatal development in animals and humans. In animals, the morphology and function of the offspring’s hippocampus is negatively affected by prenatal maternal stress. The present study prospectively investigated the influence of prenatal maternal stress on learning and memory of 112 children (50 boys, 62 girls, Age: M=6.7 years, SD=8.4 months), with the Test of Memory and Learning (TOMAL). Maternal stress levels were determined three times during pregnancy by self-report questionnaires. Furthermore, maternal saliva cortisol samples were used as a measure of hypothalamus-pituitary-adrenal axis functioning. Results of hierarchical multivariate regression analyses showed that maternal life events measured during the first part of pregnancy were negatively associated with the child’s attention/concentration index, while controlling for overall IQ, gender, and postnatal stress. No associations were found between prenatal maternal cortisol and the offspring’s learning and memory.     

Who are you and what do you want? Life aspirations,personality, and well-being

In two studies with undergraduate samples, we investigated the relations between life aspirations and personality and evaluated whether aspirations added to the prediction of psychological well-being and sexuality. Within the HEXACO framework, aspirations were highly related to Honesty–Humility. Within the Big Five framework, intrinsic aspirations were related to high Conscientiousness and Agreeableness, and extrinsic aspirations were most related to low Openness and Agreeableness. Aspirations did not add to the HEXACO’s prediction of well-being in study one, but in study two, aspirations added to the prediction of sexuality variables beyond the two personality frameworks. These results suggest that aspirations may account for beyond personality in explaining specific types of well-being.