Cholesterol and Aggression: An Ethnocultural Perspective

Although serum cholesterol has for several decades been linked to atherosclerosis and coronary heart disease, cardiovascular primary prevention studies that have resulted in low or lowered cholesterol have not reduced total mortality. This finding may be due in part to an increase in mortality from suicides, homicides, and accidents among people with low or lowered serum cholesterol. This article attempts to review the literature on cholesterol and aggressive behavior, examines possible links connecting the two, and suggests an ethnocultural perspective to these connections.     

Electrocortical signs of arousal in response to darkness and the assessment of type A behavior in professional drivers with and without cardiovascular disease

Background and Aims  In night driving, the fatal accident rate is about four times that in daytime. There is a lack of published studies of the effect of darkness on electrocortical responses in professional drivers (PD). Aim: Assessing relations between electroencephalographic (EEG) reactions to enforced darkness reminiscent of night driving, and untoward behavioral response patterns, notably Type A behavior. Methods  PD: 13 with ischemic heart disease, 12 hypertensives (HTN), 10 borderline hypertensives and 34 normotensives, and 23 non-PD controls. Five minutes of electroencephalographic recording with eyes closed, and subsequently 3 minutes exposure to darkness. EEG parameters were: alpha abundance, amplitude and frequent. Type A behavior (TAB) was assessed by observation and by questionnaire. Results  Alpha abundance diminished significantly for darkness compared to spontaneous recording for all groups. No between-group differences were found for EEG. There were no significant differences in EEG between drivers with IHD or HTN taking versus not taking centrally active β-blockers. Drivers with IHD were the only group to show significant increase in dominant α frequency at darkness. The IHD group also had the highest TAB questionnaire scores and the heaviest exposure to professional driving. Type A scores were significantly correlated with dominantt alpha frequency during darkness. Low availability of attachment and special driving hazards best predicted TAB scores in driven. There was a significance between group difference with respect to Symbolic Aversiveness at the work place comparing each driver group with the non-PD control group. Conclusions  Exposure to darkness reminiscent of night driving can elicit central arousal, in conflict with circadian rhythm, and in combination with other driving hazards which contribute to symbolic aversiveness, the essence of driving. And low availability of social attachment could contribute to sustained, and in turn to the development of Type A behavior in professional drivers.     

第三次医学革命与理论思维

第三次医学革命是指我们站在传染病世界危机的边缘上,各国无一幸免。传染病仍是世界范围内的第一位死亡原因。来自首次感染和重复感染的威胁是抗生素耐药菌惊人的增长。现在理论思维已从机遇思维转向逆向思维。     

Olfaction in Persons with Alzheimer's Disease

The need for low cost, noninvasive procedures for aiding in the diagnosis and understanding of Alzheimer's Disease (AD) has led to theories and procedures examining the role of olfactory disorders because of the finding that the brains of AD patients invariably exhibit neuropathology hi the hippocampus and entorhinal cortex. This loss correlates with the increase in the number of plaques and tangles and with the severity of dementia. Considered together, these findings suggest that brain structures closely related to the olfactory system demonstrate significant histopathology in AD. A comprehensive review of the literature pertaining to olfaction in persons with AD revealed that the olfactory identification ability of patients with memory disorders is impaired relative to controls. Consistency is lacking, however, when olfactory detection thresholds are investigated. Also, there is inconsistency in regards to severity of illness and olfactory function. In addition to differentiating AD patients from normals, the olfactory paradigm has shown some limited usefulness in differentiating AD patients from some other demented patients.     

Neuropsychological outcome of GPi pallidotomy and GPi or STN deep brain stimulation in Parkinson's disease

This paper highlights the neuropsychological sequelae of posteroventral pallidotomy (PVP) and deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the internal segment of the globus pallidus (GPi) at 3/6 months postoperatively. Results are based on our extensive experience with PVP and our preliminary observations with DBS. Patients with borderline cognitive or psychiatric functioning risk postoperative decompensation. Nonlateralizing attentional and hemisphere-specific impairments of frontostriatal cognitive functions followed unilateral PVP. "Frontal" behavioral dyscontrol was observed in approximately 25% of patients. Three cases of staged bilateral PVP suggest that premorbid factors may predict outcome, although lesion size and location are also critical. Older patients are at risk for significant cognitive and behavioral decline after bilateral STN DBS, while GPi DBS may be safer.     

Caregiver Attitudes About Patients Told They Have Alzheimer's Disease After Truth Disclosure

We wished to determine caregiver attitudes about telling patients they have Alzheimer's disease (AD). At a clinic visit, the patient, caregiver, and other family members were informed of the diagnosis of AD in a frank discussion. Caregivers accompanying patients to the Memory Disorders Clinic (MDC) were interviewed in a postvisit telephone survey 3–12 months after the truth disclosure visit. Of the 37 caregivers of a consecutive series of AD clinic patients we contacted, 35 agreed to the interview. Of those caregivers interviewed, 68.6% agreed that it had been a good idea to tell the patient the diagnosis, although 11.4% disagreed. 74.3% thought that the truth disclosure had not been too upsetting; 20% disagreed. Caregivers with more education were more likely to agree that patients should be informed. Neither the relationship of the caregiver to the patient, the patient's age, sex, education level, nor degree of dementia were predictive of the caregiver's attitude about informing the patient. Most Caregivers agreed with disclosing the diagnosis. Only a small group of patients were judged very upset after hearing the diagnosis. Even for those patients, caregivers generally felt that an honest discussion of the diagnosis had been helpful.     

Medical Informatics and the Concept of Disease

This paper attempts to address the general questionwhether information technologies, as applied in thearea of medicine and health care, have or are likelyto change fundamental concepts regarding disease andhealth. After a short excursion into the domain ofmedical informatics I provide a brief overview of someof the current theories of what a disease is from amore philosophical perspective, i.e. the ``valuefree' and ``value laden' view of disease. Next, Iconsider at some length, whether health careinformatics is currently modifying fundamentalconcepts of disease. To this question I will answerlargely in the negative, and I will provide the sketchof some arguments from current research programs inmedical informatics why I think this is the case. Thisargumentation is supported by a detailed account ofhow the disease profile for beriberi heart disease,used in one of the major medical informaticsdiagnostic programs, QMR (and its ancestorINTERNIST-1), was developed, and why at least thisprogram essentially follows received views oftraditional medicine.The one main exception to theconformity of this program to ``received' views of adisease occurs when the program's designers need tofine-tune a disease definition. This fine-tuning is tocomport with the expert's perspective on the disease,including his or her epistemic values, as well as theprogram's other resources for diagnosing components ofa disease.     

威胁对创造力的影响：认知与情绪双加工路径

威胁对创造力的影响颇具热点性与争议性, 总体来看, 当前存在威胁对创造力的阻碍、促进以及两者间呈倒U型关系三种观点。但三种观点分歧的原因与内在机制尚不清楚。本文从认知与情绪角度对相关研究进行了梳理, 认为以上分歧来自于威胁等级的不同, 创造力机制的差异及相关的中介/调节变量。未来研究可从认知与情绪干预的角度, 系统验证观点分歧的原因, 深入分析威胁与创造力的认知神经和基因等内在机制。     

Differential cognitive substrates of verbal episodic memory performance in semantic variant primary progressive aphasia and Alzheimer’s disease

Performance on neuropsychological measures of verbal memory requires cognitive abilities beyond memory. We examined the contribution of semantic knowledge in verbal episodic memory for semantic variant primary progressive aphasia (svPPA) or Alzheimer’s disease (AD). 415 AD and 68 svPPA participants completed measures of episodic memory (visual and verbal) and semantic knowledge. A double dissociation existed visual recall predicted verbal recognition in AD, whereas semantic knowledge contributed to verbal recognition in svPPA.     

Animal models of source memory

Source memory is the aspect of episodic memory that encodes the origin (i.e., source) of information acquired in the past. Episodic memory (i.e., our memories for unique personal past events) typically involves source memory because those memories focus on the origin of previous events. Source memory is at work when, for example, someone tells a favorite joke to a person while avoiding retelling the joke to the friend who originally shared the joke. Importantly, source memory permits differentiation of one episodic memory from another because source memory includes features that were present when the different memories were formed. This article reviews recent efforts to develop an animal model of source memory using rats. Experiments are reviewed which suggest that source memory is dissociated from other forms of memory. The review highlights strengths and weaknesses of a number of animal models of episodic memory. Animal models of source memory may be used to probe the biological bases of memory. Moreover, these models can be combined with genetic models of Alzheimer's disease to evaluate pharmacotherapies that ultimately have the potential to improve memory.