Treatment of surgical and non-surgical septic multiorgan failure with bicarbonate hemodialysis and sequential hemofiltration.

OBJECTIVE: Hospital mortality of patients with septic multiorgan failure (MOF) is still around 95%. The present study investigates whether this high mortality could be significantly reduced by the addition of sequential hemofiltration (SH) with bicarbonate hemodialysis (HD) to the currently used life supportive measures. DESIGN: 35 (18 surgical and 17 nonsurgical) patients, with 3 or more organ failures, had daily sessions of zero balance SH, for periods ranging from 2-22 days. MEASUREMENTS AND RESULTS: SH induced significant improvement of PaO2/100 FIO2, Apache II score, MAP, as well as blood chemistry in survivors. Dying patients had less marked improvement of blood oxygenation, non-significant changes in other variables, in addition to low MAP before and after SH, as well as marked hemodynamic unstability during the procedure. The observed hospital mortality was 38% for the surgical group, and 35.3% for the medical patients (n.s.). CONCLUSIONS: Mortality observed in this retrospective, uncontrolled study was significantly lower than that currently observed with conventional supportive therapy, with or without the addition of other forms of blood purification, e.g. CAVH and CAVHD. This improvement in results appears to be related to the property of SH to completely clear 90% of the blood from mediators of inflammation in only one passage through the hemofilter, and to better tolerance of HD done using bicarbonate buffer. A definite evaluation of this technique will be eventually reached by a programmed, appropriate sample size study, which is out of reach for one individual ICU.

Comment on Birgegard and Sohlberg's (1999) suggestions for research in subliminal psychodynamic activation.

Methodological changes in subliminal psychodynamic activation experiments based on the assumption that multiletter messages can be encoded automatically (Birgegard & Sohlberg, 1999) are questioned. Their contention that partial experimental messages and appropriate nonsense anagram controls (Fudin, 1986) need not be presented in every experiment is supported, with a reservation. If the difference between responses to the complete message and its control is significant in the predicted direction, then Fudin's procedure should be used. A nonsignificant difference between the response to each partial message and its control is needed to support the assumption of proponents of subliminal psychodynamic activation that successful outcomes are effected by the encoding of the meaning of a complete message. Experiments in subliminal psychodynamic activation can be improved if their methodologies take into account variables that may operate when subliminal stimuli are presented and encoded.

Relationship between the presentation of the MOMMY AND I ARE ONE stimulus and mood.

In 1992 Weinberger suggested the effects of the presentation of MOMMY AND I ARE ONE might be mediated by its capacity to produce positive mood changes. Later support for this idea is unconvincing because these experiments lack the converging operations required to support the assumption that participants can encode the complete meaning of MOMMY AND I ARE ONE. Furthermore, without justification, they bypassed several variables of importance in prior research. Wide acceptance of findings in this area requires convincing evidence that participants can encode much more information from MOMMY AND I ARE ONE than from other types of subliminal stimuli and from supraliminal stimuli presented briefly. Until such evidence is available. attempts to explore individual differences in neurophysiological responses to MOMMY AND I ARE ONE, after it has been assumed to be encoded, are premature.

Re-examination of evidence questions Christman's (1989) report of moderate experimental support for the visual spatial frequency hypothesis.

The visual spatial frequency hypothesis contends that perceptual characteristics of stimulus arrays can affect the magnitude and direction of hemispheric asymmetries in laterality experiments. In a 1989 literature review, Christman reported that 45 of 79 experimental comparisons yielded significant interactions for side of hemispheric advantage x perceptual characteristic which supported the visual spatial frequency hypothesis, a level of support he characterized as moderate. Re-examination of those 45 outcomes shows that in 20 of them either a significant interaction for side of hemispheric advantage x perceptual characteristic was not found or, if it was, the particulars do not agree fully with predictions of the visual spatial frequency hypothesis as presented by Christman in the 1989 paper. These findings suggest that experimental support for the visual spatial frequency hypothesis is weak, not moderate as characterized by Christman.

Reading efficiency and the development of left-to-right writing by the ancient Greeks.

Ancient Greeks added vowels to a consonantal language and changed their horizontal writing direction from right-to-left to left-to-right. The idea that the dextral majority in ancient Greece developed left-to-right writing solely because writing efficiency was greater is questioned. Cerebral hemispheric functions that might be involved during fixation pauses in reading suggest that horizontal ancient Greek was read more efficiently from left to right than from right to left, the other direction in which it usually was written. The same considerations suggest that horizontal consonantal scripts are read more efficiently from right to left than from left to right. The importance of boustrophedon, a continuous writing style, in the development of left-to-right writing and aspects of the reciprocity between cerebral hemispheric functioning and writing direction of vocalic scripts are discussed.

Comments on Hudesman and Page's reply to Fudin's comments on Hudesman, Page and Rautianen's subliminal psychodynamic activation experiment.

Hudesman and Page's contention that Gustafson and Källmén's 1991 results indicate that subsequent subliminal psychodynamic activation experiments do not require the controls suggested by Fudin in 1986 is questioned. The rationale for Fudin's 1993 comment concerning the limited generalizability of Hudesman, et al.'s (1992) results, a comment Hudesman and Page contended is unfounded, is discussed.

Analysis of superiority of the right visual field in bilateral tachistoscopic word-recognition.

McKeever and Huling questioned procedures in experiments on lateral differences in the recognition of horizontally oriented multi-letter stimuli, tachistoscopically exposed bilaterally. They effected three major changes in this method and found superior scores for material in the right than left visual field, a result in the opposite direction of prior findings. Ideas from directional scanning and cerebral dominance accounts of lateral asymmetries suggest that McKeever and Huling's methodological innovations produced their result. Directional scanning notions indicate that horizontal targets impede measures of differences in processing skills of the cerebral hemispheres. These obstacles can be overcome by exposing vertically oriented targets.

Problems in Silverman's work indicate the need for a new approach to research on subliminal psychodynamic activation.

The basic assumption in subliminal psychodynamic activation research is that participants can unconsciously perceive the psychodynamic meaning of a complete message as it is intended by the experimenter. In attempts to account for negative findings Silverman contended that this assumption holds only under certain luminance conditions and visual field positions of a message. Paradoxically, almost all of his findings, his major evidence in support of the basic assumption, came from experiments in violation of those strictures. Further, Silverman never presented MOMMY AND I ARE ONE under a critical condition required for it to be effective. These and other considerations identify the need for an account of empirical findings other than his and for changes in his experimental method. Such research must take into account the encoding of subliminal stimuli, an area neglected almost completely by Silverman. Shevrin and his colleagues' 1996 work is outlined as a model for the use of subliminal stimuli to investigate psychoanalytically generated hypotheses.

Comments on Hudesman, Page, and Rautiainen's (1992) subliminal psychodynamic activation experiment.

Hudesman, et al.'s (1992) contention that their finding and those of Ariam (1979), Parker (1982), and Cook (1985) show that subliminal psychodynamic activation (SPA) can improve academic performance is questioned. Results obtained from experiments using methodological innovations (Fudin, 1986) would allow a clearer interpretation of positive SPA outcomes.

Final comments on Hudesman, Page, and Rautiainen's (1992) subliminal psychodynamic activation experiment.

Hudesman, et al.'s (1992) contention that their finding shows that subliminal psychodynamic activation (SPA) improved academic performance is questioned. That experiment lacked controls outlined by Fudin in 1986 which are needed to support the assumption that a positive SPA outcome is effected because the meaning of an entire experimental message is encoded. In 1993 Hudesman and Page argued that Gustafson and Källmén's 1991 results, obtained with such controls, indicated that the controls do not have to be used in subsequent SPA experiments. The 1990 results of Greenberg and of Kothera, Fudin, and Nicastro, however, do not support those of Gustafson and Källmén. From a different perspective, it is argued that good experimental controls are needed in all SPA experiments because they increase internal validity. Given that Hudesman, et al.'s subjects scored in a limited range on the mathematics portion of the 1978 CUNY Skills Assessment Test, the implication that their result can be generalized to all subjects is questioned.

Research in subliminal psychodynamic activation: note on Masling (1998).

Masling (1998) questioned Malik, Apel, Nelham, Rutkowski, and Ladd's 1997 suggestion that subliminal psychodynamic activation research with MOMMY AND I ARE ONE should be restricted. Problems in Masling's paper and the scope of research with MOMMY AND I ARE ONE are discussed. His position that such research should not be restricted is supported on the condition that subliminal psychodynamic activation research with MOMMY AND I ARE ONE (and other messages) use Fudin's 1986 procedure that could clarify the interpretation of successful experimental outcomes.

Subliminal psychodynamic activation: methodological problems and questions in Silverman's experiments.

Analyses of procedures in Lloyd H. Silverman's subliminal psychodynamic activation experiments identify problems and questions. Given the information provided, none of his experiments can be replicated, and none of his positive results were found under luminance conditions he reckoned in 1983 were typical of such outcomes. Furthermore, there is no evidence in any of his experiments that all stimuli were presented completely within the fovea, a condition critical to the production of positive findings (Silverman & Geisler, 1986). These considerations and the fact that no experiment using Silverman's procedures can yield unambiguous positive results (Fudin, 1986) underscore the need to start anew research in this area. Such research should be undertaken with a greater appreciation of methodological issues involved in exposing and encoding subliminal stimuli than that found in all but a few experiments on subliminal psychodynamic activation.

Review of auditory subliminal psychodynamic activation experiments.

Subliminal psychodynamic activation experiments using auditory stimuli have yielded only a modicum of support for the contention that such activation produces predictable behavioral changes. Problems in many auditory subliminal psychodynamic activation experiments indicate that those predictions have not been tested adequately. The auditory mode of presentation, however, has several methodological advantages over the visual one, the method used in the vast majority of subliminal psychodynamic activation experiments. Consequently, it should be considered in subsequent research in this area.

Sinistrality and reduced longevity: reply to Coren and Halpern's replay.

Coren and Halpern's response to Fudin, Renninger, Lembessis, and Hirshon's 1993 report of a nonsignificant difference in longevity between left-handed and right-handed baseball players contained errors of fact, theory, and omission. Especially disturbing is that they ignored the fact that our negative findings were found not only with parametric tests but with the same nonparametric tests that they had used. We defend our use of parametric tests given the particular data we analyzed, and we comment on the databases that we and Halpern and Coren considered and the results of studies of handedness and longevity.

Can caffeine antagonize alcohol-induced performance decrements in humans?

Design aspects and results of experiments that investigated the effects of caffeine on alcohol-induced performance decrements in humans are discussed. Simple conclusions concerning those outcomes are unwarranted because they seem to depend on the tasks used and the dosages of both drugs, with both antagonism and potentiation of alcohol-induced effects having been reported. Results indicate that legally intoxicated individuals cannot antagonize alcohol-induced, driving-related decrements with caffeine prior to driving an automobile, thought to be the major behavior for which caffeine is used in attempts to antagonize alcohol-induced decrements. We offer suggestions for research concerning subjects' habitual use or nonuse of caffeine and typical alcohol consumption levels, the interval between alcohol and caffeine ingestion, and the effects of caffeine and alcohol alone on performance tasks. We also suggest that statistical analyses should allow for a differentiation of results in which caffeine partially offsets an alcohol-induced decrement from more positive results in which caffeine returns functioning to its normal level.

Subliminal psychodynamic activation: updated comprehensive list of experimental results and comments on previous lists.

A comprehensive list of results from visual subliminal psychodynamic activation experiments is presented. This list includes results reported since the publication of the last comprehensive list by Weinberger and Hardaway in 1990 and several results not found on that list. On the present list, SPA results are categorized according to criteria that we contend are more objective than those used previously. In contrast to conclusions drawn from previous lists prepared by Silverman in 1980 and 1983, by Weinberger and Hardaway in 1990, and by Weinberger and Silverman in 1987, the present list indicates that the results of a majority of experiments do not clearly support hypotheses tested by the subliminal psychodynamic activation method. Aspects of Hardaway's meta-analyses from 1987 and 1990 for major areas of research on subliminal psychodynamic activation are discussed in terms of suggestions for further research.

Note on criteria for writing posture used to test Levy and Reid's cerebral organization hypotheses.

Apparent ambiguities in Levy and Reid's writing posture criteria and dissimilar criteria used by other investigators are discussed. Classification of inverted writing postures by a diagram which, as Levy and Reid indicated in 1976, depicts typical writing positions is questioned because their 1978 paper suggests that these diagrammed positions were only an intermediary stage in the classification of some inverters. Results of studies using dissimilar criteria for writing posture appear to be difficult to compare because subjects who may differ in cerebral organization might be placed in the same category. Some of these studies introduced another possible source of confounding because different tasks were used to test lateralization of function. Since different tasks seem to study distinctive facets of language, lateralization of one function in sinistrals, thought to be less lateralized than dextrals, does not predict lateralization of any other function. These considerations suggest that an adequate test of Levy and Reid's ideas concerning the relationship among handedness, hand posture during writing, sex, and cerebral organization requires the development of a standard set of valid criteria for writing posture.

Perception of geometrical arrays tachistoscopically exposed in right and left visual fields.

Geometrical stimuli (48 6-item arrays of familiar forms, e.g., circle), tachistoscopically presented in the right or left visual field, were more accurately perceived in the right than left visual field by 15 college students. Targets about half the length of the displays exposed here were perceived with equal facility in both visual fields (Bryden, 1960). Results suggest that length of array might affect the difference in perceptual accuracy of forms shown in the right and left visual fields. Figures in the right visual field were predominantly processed from left to right, and forms in the left visual field from right to left. Since more symbols were identified in the right than left visual field, the left to right encoding sequence may be more efficient than a right to left movement. Limited experience of most Ss in reading symbols from left to right is probably only one factor. Extensive experience reading alphabetical material from left to right might have developed the physiological mechanism underpinning this sequence more than the one serving the opposite movement.

Integration of post-exposural directional scanning and cerebral dominance explanations of lateral differences in trachistoscopic recognition.

Post-exposural directional scanning and cerebral dominance are major postualtes which account for lateral differences in tachistoscopic perception. These ideas can be intergrated when tachistoscopic perception is viewed as a short-term memory task. Briefly exposed stimuli not only have to be scanned, but also rehearsed, subvocally, before they can be encoded. Since most Ss are left-hemisphere dominant for language, scanned information arriving in the right hemisphere has to be sent to the left hemisphere for rehearsal. This transmission effects a loss of scanned information because it is held in a rapidly dissipating storage. These ideas account for lateral differences found with vertically and horizontally oriented targets, but methodological considerations are discussed which indicate that these notions are more clearly demonstrable with the former than latter displays .

Analysis of data from Reichler's (1979) The Baseball Encyclopedia: right-handed pitchers are taller and heavier than left-handed pitchers.

In 1989 Coren concluded right-handed Major League pitchers whose careers began up to 1975 are significantly taller and heavier than left-handed pitchers. His source of data, Reichler's 1979 edition of The Baseball Encyclopedia, however, lists heights and weights for pitchers whose careers began through 1978 and for individuals who pitched but who almost always appeared at a different position or positions. Coren did not indicate why he did not analyze all of the relevant data in Reichler nor did he explain how he decided that an individual's usual position was that of pitcher. Further, there is evidence from Topp which suggests that the era during which the pitchers began their careers should be considered when comparing their heights and weights because relatively recent rookies (from 1980 through 1986) are taller and heavier than rookies who began their careers 50 and 100 years prior to that era. Classifying an individual as a pitcher if he pitched in at least 50% of the games in which he played at a position, using all relevant data in Reichler, and considering the era during which dextral and sinistral pitchers began their careers, we found strong corroborative evidence for Coren's 1989 findings.