Long-term survival of patients with glioblastoma multiforme (GBM)

Long-term survival is an often used, yet poorly defined, concept in the study of glioblastoma multiforme (GBM). This study suggests a method to define a time-point for long-term survival in patients with GBM. Data for this study were obtained from the Surveillance, Epidemiology and End-Results database, which was limited to the most recent data using the period approach. Relative survival measures were used and modelled using piecewise constant hazards to describe the survival profile of long-term survivors of GBM. For patients with GBM, the first quarter of the second year (5th quarter) post-diagnosis is considered to be the peak incidence of mortality with an excess hazard ratio of 7.58 (95% confidence interval = 6.54, 8.78) and the risk of death due to GBM decreases to half of its rate at 2.5 years post-diagnosis. The 2.5-year cumulative relative survival (CRS) for all patients is approximately 8%, with a CRS of approximately 2% at 10 years. Using the definition of long-term survival suggested here, the results indicate that long-term survivors are patients who survive at least 2.5 years post-diagnosis. The most likely time period for patients with GBM to die is the 5th quarter post-diagnosis.     

Psychosis in a cocaine-dependent patient with ADHD during treatment with methylphenidate

Objective

The objective was to report a case of experienced psychosis during the treatment with methylphenidate (MPH) in a cocaine-dependent adult treated for attention-deficit/hyperactivity disorder (ADHD) with comorbid cocaine dependence.

Conclusion

ADHD is a frequent comorbidity in substance use disorder (SUD) patients. MPH may be effective in treating ADHD symptoms in SUD patients, thus preventing possible adverse outcomes. Cocaine-induced psychosis may be a risk factor for development of psychosis in the presence of a concurrent treatment with MPH.     

A fatal case with disseminated Myceliophthora thermophila infection in a lymphoma patient

We report a lethal Myceliophthora thermophila infection in an immunocompromised patient. Based upon the clinical and mycological presentation, an initial diagnosis of invasive aspergillosis was made, possibly delaying optimal management in the patient. Melanized fungi are emerging pathogens that require early identification to improve their unfavorable prognosis.     

Sensitivity of functional tympanic membrane thermometry (fTMT) as an index of hemispheric activation in cognition

The measure of hemispheric activation in cognitive and clinical studies remains out of reach of many scientists due to cost, analysis complexity, and practical consideration of the techniques available such as fMRI, EEG, or EMG. The present study was conducted to determine whether infrared functional tympanic membrane thermometry (fTMT) is a measure of lateralised activation sensitive enough to be used in typical cognitive and clinical experiments. A total of 24 participants had their tympanic membrane temperature measured while performing a letter-matching task. Activation in the two hemispheres was manipulated by changing the proportion of matches occurring in the left and right visual fields and by varying the task complexity. Changes in fTMT due to the greater proportion of matches presented in one visual field and due to the modulation in task complexity were detected. These findings suggest that fTMT is a measure of broad lateralised cerebral activation sensitive enough for use in typical psychological studies.     

Optimizing the human learnability of abstract network representations

Precisely how humans process relational patterns of information in knowledge, language, music, and society is not well understood. Prior work in the field of statistical learning has demonstrated that humans process such information by building internal models of the underlying network structure. However, these mental maps are often inaccurate due to limitations in human information processing. The existence of such limitations raises clear questions: Given a target network that one wishes for a human to learn, what network should one present to the human? Should one simply present the target network as-is, or should one emphasize certain parts of the network to proactively mitigate expected errors in learning? To investigate these questions, we study the optimization of network learnability in a computational model of human learning. Evaluating an array of synthetic and real-world networks, we find that learnability is enhanced by reinforcing connections within modules or clusters. In contrast, when networks contain significant core–periphery structure, we find that learnability is best optimized by reinforcing peripheral edges between low-degree nodes. Overall, our findings suggest that the accuracy of human network learning can be systematically enhanced by targeted emphasis and de-emphasis of prescribed sectors of information.

From a young age, humans demonstrate the capacity to learn the relationships between concepts (1–3). During the learning process, humans are exposed to discrete chunks of information that combine and interconnect to form cognitive maps that can be represented as complex networks (4–9). These chunks of information often appear in a natural sequential order, such as words in language, notes in music, and abstract concepts in stories and classroom lectures (10–14). Further, these sequences are encoded in the brain as networks, with links between items reflecting observed transitions (see refs. 15–18 for empirical studies and 19 for a recent review). Broadly, the fact that many different types of information exhibit temporal order (and therefore network structure) motivates investigations into the processes that underlie the human learning of transition networks (8, 19, 20).To understand the network-learning process, recent studies have investigated how humans internally construct abstract representations of associations (21–23). Using a variety of approaches, from computational models to artificial neural networks, such studies have consistently found that the mind builds network representations by integrating information over time. Such integration enables humans to compress exact sequences of experienced events into broader, but less precise, representations of context (24). These mental representations allow learners to make better generalizations about new information, at the cost of accuracy (22). Here, we focus on one particular modeling approach that accounts for the temporal integration and inaccuracies inherent in human learning. In particular, we build upon a maximum-entropy model, which posits that the mind learns a network representation of the world in a manner guided by a tradeoff between accuracy and complexity (21, 25). Specifically, in order to conserve mental resources, humans will tend to reduce the complexity of their representations at the cost of accuracy by allowing for errors during the learning process.While inaccuracies in human learning can aid flexibility across contexts, they present fundamental obstacles for the human comprehension of transition networks. Thus, a clear question emerges: What strategies should be employed to most effectively communicate the structure of a network to an inaccurate human learner? Prior studies of animal communication and behavior have demonstrated the utility of exaggerating the presentation of certain signals to receivers in offsetting erroneous information processing (26, 27). Similarly, one could imagine that, by emphasizing some features of a network over others, one may be able to correct for errors in human learning. Such an approach of targeted modulation of emphasis may be helpful not only in learning a whole network, but also in optimally learning particularly challenging parts of a network. In fact, humans show consistent difficulties in learning certain motifs in networks, such as the connections between modules (21, 28–30). Taken together, these observations suggest that disproportionately weighting specific network features that are difficult to learn may facilitate human network learning.     

Emergence of a Reassortant 2.3.4.4b Highly Pathogenic H5N1 Avian Influenza Virus Containing H9N2 PA Gene in Burkina Faso,West Africa,in 2021

Since 2006, the poultry population in Burkina Faso has been seriously hit by different waves of Highly Pathogenic Avian Influenza (HPAI) H5N1 epizootics. In December 2021, three distinct regions of Burkina Faso, namely, Gomboussougou, Bonyollo, and Koubri, detected HPAI H5N1 viruses in poultry. Whole genome characterization and statistical phylogenetic approaches were applied to shed light on the potential origin of these viruses and estimate the time of virus emergence. Our results revealed that the HPAI H5N1 viruses reported in the three affected regions of Burkina Faso cluster together within clade 2.3.4.4b, and are closely related to HPAI H5N1 viruses identified in Nigeria and Niger in the period 2021–2022, except for the PA gene, which clusters with H9N2 viruses of the zoonotic G1 lineage collected in West Africa between 2017 and 2020. These reassortant viruses possess several mutations that may be associated with an increased zoonotic potential. Although it is difficult to ascertain where and when the reassortment event occurred, the emergence of a H5N1/H9N2 reassortant virus in a vulnerable region, such as West Africa, raises concerns about its possible impact on animal and human health. These findings also highlight the risk that West Africa may become a new hotspot for the emergence of new genotypes of HPAI viruses.     

Impact of COVID-19 Lockdown on Food Consumption and Behavior in France (COVISTRESS Study)

The COVID-19 pandemic and subsequent lockdowns modified work environments, lifestyles, and food consumption. Eating habits and mood changes in a French population during the first lockdown were examined using an online self-reported questionnaire with REDCap software through the COVISTRESS.ORG website. In 671 French participants, the main changes during lockdown were increased stress levels (64 [23; 86] vs. 3 [0; 18]) and sedentary behavior (7 [4; 9] vs. 5 [3; 8] hours per day), a deterioration in sleep quality (50 [27; 83] vs. 70 [48; 94]) and mood (50 [30; 76] vs. 78 [50; 92]), and less physical activity (2.0 [0.5; 5.0] vs. 3.5 [2.0; 6.0]). Mood was modified, with more anger (56 [39; 76] vs. 31 [16; 50]), more sadness (50 [34; 72] vs. 28 [16; 50]), more agitation (50 [25; 66] vs. 43 [20; 50]), and more boredom (32 [7; 60] vs. 14 [3; 29]). A total of 25% of the participants increased their consumption of alcoholic beverages, 29% their consumption of sugary foods, and 26% their consumption of cocktail snacks. A multiple-correspondence analysis highlights four different profiles according to changes in eating habits, food consumption, lifestyle, and mood. In conclusion, eating habits and lifestyle changes during lockdown periods should be carefully monitored to promote healthy behaviors.     

Establishing Normative Dynamic Postural Control Values in Elite Female Handball Players

BackgroundLower extremity injuries among young female handball players are very common. The modified Star Excursion Balance Test (mSEBT) is a valid clinical tool to assess dynamic postural control and identify athletes with higher risk of injury. However, its interpretation is difficult since performance on this test is highly sport dependent. No normative values on the mSEBT exist in handball.PurposeThe aim of this investigation was to establish normative ranges of mSEBT performance in young, healthy female handball players to help practitioners when interpreting risk estimates.Study designCross-Sectional StudyMethodsAthletes from 14 elite teams were recruited during a national tournament and performed 3 trials in the anterior (ANT), posteromedial (PM), posterolateral (PL) directions of the mSEBT. Means, standard deviations and 95% confidence intervals (95%CI) of normalized reached distances were calculated for each direction and the composite score (COMP). Level of asymmetry between dominant and non-dominant limbs were calculated for each direction using Bland Altman analyses. Group differences were weighed against the established mSEBT minimum detectable differences (MDD) to compare scores between limbs and across different player positions.ResultsOne-hundred and eighty-eight females (16.8±0.9 years) were tested. Mean reach distances were 65.2±5% (64.7-65.7), 110.0±6.2% (109.3-110.6), 107.1±6.2% (106.5-107.8) and 94.1±4.9% (93.6-94.6) for the ANT, PM, PL directions and COMP score respectively. Bias and limits of agreement for limb asymmetry were -0.23% (-5.85%, 5.38%) for ANT, -0.83% (-8.80%, 7.14%) for PM, 0.33% (-8.51%, 9.17%) for PL and -0.27% (-4.88%, 4.33%) for COMP score. No meaningful differences were observed between limbs or across player positions since the values did not exceed the MDD and all 95%CIs overlapped.ConclusionThis study provides normative performance values for dynamic postural control as measured by the mSEBT among young, healthy, elite female handball players. Considering the high incidence of injury in this population, these values can be used for injury risk reduction and return to sport decisions. Further prospective studies are needed to established specific cut-off scores in this population.Level of evidence2c