Personality and functional outcome following traumatic brain injury.

Objective: To investigate pre- to postinjury personality change in relation to outcomes following traumatic brain injury (TBI). Design: Prospective analysis of personality ratings, depression, and outcome using multiple regression analyses. Participants: Cohort of 3 clinical trauma groups (mild TBI, moderate-severe TBI, orthopedic injury) and their significant others (SO). Outcome Measures: Independent Living Scale, Vocational Independence Scale, and Mayo-Portland Adaptability Inventory, 1-2 years postinjury. Predictor Variables: Posttraumatic amnesia (PTA); patient and SO NEO Personality Inventory-Revised ratings of preinjury personality taken at 1-2 months postinjury. Results: Personality function was normal for all groups (regardless of rating source) and stable over time. Neuroticism, and specifically depression, accounted for small proportions of variance in functional outcome, beyond PTA. Conclusions: There is little empirical evidence for significant personality disturbance or change up to 2 years post-TBI. Personality and depression contribute modestly to functional outcomes. Results support a distinction between "personality change" and behavior change following TBI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physiological and subjective effects of Zen meditation and demand characteristics.

Undergraduates studied a Zen meditation exercise under 3 demand conditions: deactivation (modeling and suggesting relaxation outcome), neutral (no specific outcome), and activation (arousal outcome). Results show that Zen meditation produces small physiological changes in naive, unpracticed Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Space charge and anomalous discharge currents in crosslinkedpolyethylene

Transient currents in cross-linked polyethylene (XLPE) have been investigated by using different parameters: temperature T, electrical field E_p and hydrostatic pressure P. Anomalous discharging currents flowing in the same direction as charging currents were observed from T=30 to 70°C, P=0.1 to 30 MPa and E_p=13 to 33 kV/mm. The space charge was measured using the pressure wave propagation method (PWP). Theoretical calculation revealed that this anomalous behavior can result from charge migration under a partial blocking condition at the electrodes. We discuss theoretical results which are in reasonable agreement with our discharge current measurements     

Survival and functional status after resection of recurrent glioblastoma multiforme

OBJECTIVE: To determine the selection factors for and results of second resections performed to treat recurrent glioblastoma multiforme (GM), we studied 301 patients with GM who were treated from the time of diagnosis using two prospective clinical protocols. METHODS: The patients were prospectively followed from the time of diagnosis, using clinical and radiographic criteria after maximal surgical resection and external beam radiotherapy with or without adjuvant chemotherapy. Resection of recurrent GM was performed at the recommendation of the treating clinicians. The results of the second resections were retrospectively reviewed and analyzed using multivariate logistic regression, Kaplan-Meier-Turnbull survival analysis, Cox regression, and propensity score stratification. RESULTS: Forty-six patients underwent second resections during the study period. The actuarial rate of the second resections was 15% of the patients 1 year after diagnosis and 31% 2 years after diagnosis. Younger age (P = 0.01) and more extensive initial resection (P = 0.02), but not Karnofsky Performance Scale (KPS) score at the time of diagnosis or recurrence, predicted a higher chance of selection for reoperation after initial tumor recurrence. Twenty-eight percent of the patients had improved KPS scores after undergoing reoperation, 49% were stable, and 23% had declines in KPS scores of 10 to 30 points. There was no operative mortality. After reoperation, 85% of the patients received chemotherapy, 11% received brachytherapy or underwent stereotactic radiosurgery, and 17% underwent third resections. The median survival period after reoperation was 36 weeks. Higher preoperative KPS scores predicted longer survival periods after reoperation (P = 0.03). Age and interval since diagnosis were not significant prognostic factors. The median high-quality survival period (KPS score, > or =70) was 18 weeks. The median survival period after first tumor progression was 23 weeks for 130 patients treated using the same protocols who did not undergo reoperations. Patients who did undergo reoperations experienced clinically and statistically significantly longer survival periods. However, this was determined to be partially because of selection bias. CONCLUSION: Survival after resection of recurrent GM remains poor despite advances in imaging, operative technique, and adjuvant therapies. High-quality survival after resection of recurrence to treat GM seems to have increased significantly since an earlier report from our institution.     

Ethical conflict resolution based on an ethics of relationships for brain injury rehabilitation

An ethics of relationships for brain injury (BI) rehabilitation is described based on three principles; (1) human relationships are important; (2) human relationships are as important as individual survival; (3) human relationships are important enough to extend throughout the family of humankind. Within the context of this ethics of relationships, ethical conflict resolution (ECR) is offered as a process to address disagreements among those involved in BI rehabilitation. ECR provides a means to arrive at moral decisions in situations in which people disagree about the appropriate course of action because of differing values. ECR recognizes that, although disagreements in BI rehabilitation settings can be associated with multiple other factors, including disturbed self-awareness, emotions, communication, and interpersonal dynamics, such disagreements may also be value-based, either in whole or part. ECR invites the professional team to identify the value-based portion of these disagreements and provides a rational and supportive process to address disagreements. In this discussion of ECR, common and potentially universal areas of ethical concern in BI rehabilitation are identified, as well as potential risks. Specific examples of the application of ECR in cases of vegetative state, coma stimulation, and cognitive rehabilitation are described.     

Long-term stability and intercorrelations of cognitive abilities in older persons.

This project studied the intercorrelations and long-term stabilities of standard Wechsler Adult Intelligence Scale—Revised (WAIS—R), Wechsler Memory Scale—Revised (WMS—R), and Auditory–Verbal Learning Test (AVLT) summary indexes. It also reports similar data on the recently published Mayo Cognitive Factor Scales (MCFS), which are derivative indexes for the combined administrations of these 3 tests. These analyses challenge 2 assumptions that most psychologists make when interpreting adult cognitive tests: (a) that for cognitively normal people, performance in one cognitive domain correlates well with and predicts functioning in other cognitive domains, and (b) that in the absence of pathology, cognition is stable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Traumatic brain injury: Psychological and medical factors related to rehabilitation outcome.

Examined the relationship of medical and psychological factors of adaptive physical functioning (APF) at discharge and length of rehabilitation stay following traumatic brain injury. 32 Ss (aged 16–55 yrs) with severe traumatic brain injury underwent interdisciplinary rehabilitation evaluations, including the MMPI, WAIS, and the Wechsler Memory Scale, at admission to and discharge from an inpatient rehabilitation program. Results suggest that the actual status of APF at discharge was related to initial assessments of medical, not psychological, factors. However, psychological factors were related to relative improvement in APF when change occurred. Even Ss who were minimally aware of their physical abilities and limitations at admission improved in their APF during treatment. Length of rehabilitation stay was determined by both physical and psychological functioning. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Carbon nanotubes initiate the explosion of porous silicon

Here we show that a mixture of multi-walled carbon nanotubes (MWCNTs) and ferrocene doped with sodium perchlorate, as an oxidant, can be combusted using a camera flash as an initiator. We optimize the MWCNT to oxidant ratio by monitoring the intensity and spectral characteristics of the light emission. In addition, we construct a novel nanostructured energetic material combining MWCNTs with porous silicon (pSi) impregnated with sodium perchlorate and show that pSi can be exploded using carbon nanotubes as photosensitive initiators.