Confirmatory Evidence Research Articles

Prevelence and Incedence of Reproductive Tract Infections Among Married Women in India

Reproductive tract infections (RTI) are the infections which affects any organ related to genital tract. Reproductive tract infections are also known to act one of the risk factor for transmission of HIV, and are common yet neglected health problem affecting health and social wellbeing of women in their most productive age. The annual incidence of Reproductive tract infections and sexually transmitted infections in India is estimated at 5% or approximately 40 million every year. Although early detection and treatment of Reproductive tract infections can prevent complications and minimize the severity of long-term sequels, still RTI remains undiagnosed and untreated. Reproductive tract infections may also present as symptomatic among women who cause wide spread of disease in the community and also responsible for severe morbidity. Women show less interest on health seeking and have minimal knowledge on RTI/STI. This article provides a summary overview based on the data related to literature shows that age group of women, education, occupation, and standard of living were major factors affecting awareness on reproductive tract infections. Women who were illiterates do not seek treatment due to existing inhibitions regarding reproductive health; need targeted interventions for reproductive health messages. Need to make them aware of simple and the best confirmatory evidence of reproductive tract infections.

Endemicity of Diphtheria in Some Regions of Nigeria: Chronology of a Fourteen Month Sustained Outbreak

Diphtheria in humans is caused by exotoxin produced by Corynebacterium diphtheriae which is a gram positive bacteria. The sustained endemicity of diphtheria amongst Nigerian population from May 2022 to July 2023 is significant and has not been widely reported. Secondary data was collected from the recent data base of Nigeria Centre for Disease Control, Federal Ministry of Health, and Federal Ministry of Information then analyzed applying standard procedure. The result shows in overall a total of 4,160 suspected cases of diphtheria which spanned through a period of May 2022 to July 2023. Out of these suspected cases, 1,534 were positive, yielding a total prevalence of 36.9% and mortality of 137(8.9%). In the Northern states alone, 4,061 individuals were recorded as suspected diphtheria cases; out of which 1,525(36.6%) individuals were confirmed positive with 132(8.7%) death cases. Conversely, in the southern states, a total of 40 suspected cases were recorded. Out of these, 9(22.5%) were confirmed positive with mortality of 5(55.6%). Only one state yielded a suspected case without any conclusive confirmatory evidence. The result further showed that a total of 15 states were grouped as “others”. In this group a total of 59 cases were suspected, but none yielded positive result. The prevalence was high (36.6%) in the North when compared to the south (22.5%), and mortality was high (55.6%) in the south when compared to the North where a total mortality rate of 8.7% was recorded. Amongst the Northern states affected, prevalence was highest (75.9%; 41/54) in Bauchi and least (5.0%;5/101) in Kaduna state. This present result shows that diphtheria is endemic in some parts of Nigeria leading to sporadic outbreaks overtime, predominantly in the Northern part. High spread and prevalence in the North may be that herd immunity in the North is low or inadequate. Thus, urgent attention of Government and relevant stake holders is necessitated to eliminate this negative trend.

79 The Clinical Utility of Reliable Digit Span in Predicting Effort on the TOMM in Youth with a History of a Concussion

Objective:Performance validity testing (PVT) is important in neuropsychological evaluations to ensure accurate interpretation of performance. While research shows children pass PVTs with adult cut-offs, PVTs are more commonly used with adults (Lippa, 2018). The Test of Memory Malingering (TOMM), a standalone PVT, is commonly used with adults and children (DeRight & Carone, 2015). The Reliable Digit Span (RDS), an embedded PVT derived from the Digit Span subtest of the Wechsler Intelligence Scales (Wechsler Intelligence Scale for Children-4th Edition, WISC-IV; Wechsler, 2003), is less commonly used with children (DeRight & Carone, 2015). RDS cut-off scores are associated with an increased rate of false positives in children, indicating mixed results regarding the clinical utility in pediatric populations (Welsh et al., 2012). Research shows that youth with a history of concussion (HOC) may demonstrate suboptimal effort for many reasons (e.g., external incentives, boredom, pressure), thus highlighting the need to investigate the utility of PVTs in this population (Araujo et al., 2014; DeRight & Carone, 2015). The present study aimed to examine the clinical utility of RDS in detecting poor effort on the TOMM in youth athletes with a HOC.Participants and Methods:Participants included 174 youth athletes aged 8 to 18 (20.1% female; 42.5% people of color (POC)) who completed a baseline neuropsychological battery that included the TOMM and WISC-IV Digit Span. Of the sample, 29 youth athletes reported a HOC (13.8% female; 37.9 POC). RDS was calculated for each Digit Span administration, and sensitivity (SN) and specificity (SP) were calculated for RDS when invalid performance was operationalized by a more stringent cut-off score of <49 to increase the SN of the TOMM Trial 1 (Stenclik et al., 2013). Receiver operator characteristics (ROC) curve analysis determined whether RDS performance accurately predicted participants’ performance on the TOMM.Results:The ROC curve analysis resulted in an area under the curve (AUC) of just 0.427 for RDS. A cut-off score of <7 (as suggested by Kirkwood et al. (2011)) for RDS results in 100% SN, 8.3% SP, 5% positive predictive validity (PPV), and 95% negative predictive validity (NPV). However, a cut-off score of <9 for RDS results in 75% SN, 15% SP, 25% PPV, and 75% NPV.Conclusions:Little research shows the utility of different PVTs predicting children’s performance on other PVTs, despite evidence that children with a HOC are vulnerable to variable or insufficient effort (Araujo et al., 2014; DeRight & Carone, 2015). In a sample of 29 youth athletes with a HOC, RDS predicted TOMM performance at rates worse than chance. While RDS has advantages as an embedded PVT, its limited ability to predict performance on a standalone PVT suggests interpreting with great caution. These findings highlight the importance of implementing multiple PVTs throughout testing to ensure accurate findings and interpretations, particularly in youth with a HOC. The small sample size is a limitation that possibly impacted the ability of RDS to predict TOMM performance. Further research is needed to understand the utility of RDS as a predictor of PVT performance in different populations. Replication of these findings with a larger sample size is needed to provide confirmatory evidence of poor predictive performance of the RDS.

Neurophilosophy: A Philosophical Analysis for Interpretation of fMRI to Replace the Commonsense Psychology

For thinking, brain activity occurs, yet not every area of our brain is active when we think about various things. There are significant ramifications for cognitive psychology and neuroscience from functional brain areas. It should enable us to apply neurophilosophical theories to the brain. This review aims to draw attention to neurophilosophy and its focus on fundamental problems in neuroscientific theories to address age-old metaphysical issues, i.e., the nature of consciousness, thinking, intention, and action. There are different theories and points of view in the field of neurophilosophy, but eliminative materialists and reductive materialists (a.k.a. mind-brain identity theory) are both strong candidates. Those are very well-established in the philosophy of mind, and they run counter to the development of conceptual succession in neuroscience. Both theorists rely on neuroscience to back up their conclusions about the mind. Eliminative materialism has received a lot of attention from several philosophical points of view. It begins with a critique of commonsense psychology and offers neurophilosophy as an alternative. So, for reductive materialists, mind is brain, whereas for eliminativists mind as brain. Both theorists have different views about mental states to cohere with neurophysiology. The philosophical problem of dualism, as the body/brain (physical), and mind/cognition (mental) is discussed in psychiatry, neuropsychology, and neuroscience. Neurophilosophy deals with functional magnetic resonance imaging (fMRI) data to shed light on psychosocial problems like moral psychology, free will, social interaction, and mood disorders. An fMRI is a neuroimaging technique and an essential tool for bridging cognitive psychology and neurophilosophic theories. It is used to investigate mental resilience, impairments, changes in neural dynamics, and neuroplasticity mainly for brain trauma. I will tie this discussion by discussing fMRI and commonsense psychology as exploratory rather than confirmatory evidence in my conclusion.
 How to cite this: Sohail A. Neurophilosophy: A Philosophical Analysis for Interpretation of fMRI to Replace the Commonsense Psychology. Life and Science. 2023; 4(4): 494-500. doi: http://doi.org/10.37185/LnS.1.1.392

Cigarette smoking and thyroid cancer risk: A Mendelian randomization study.

The association between cigarette smoking and thyroid cancer has been reported in prospective cohort studies, but the relationship remains controversial. To investigate this potential correlation further, we employed Mendelian randomization methodology to evaluate the causative impact of smoking on thyroid cancer incidence. From the genome-wide association study and Sequencing Consortium of Alcohol and Nicotine use, we obtained genetic variants associated with smoking initiation and cigarettes per day (1.2 million individuals). We also extracted genetic variants associated with past tobacco smoking from the UK Biobank (424,960 individuals). Thyroid cancer outcomes were selected from the FinnGen GWAS (989 thyroid cancer cases and 217,803 control cases). Sensitivity analyses employing various approaches such as weighted median, MR-Egger, and MR-pleiotropy residual sum and outlier (MR-PRESSO) have been executed, as well as leave-one-out analysis to identify pleiotropy. Using the IVW approach, we did not find evidence that any of the three smoking phenotypes were related to thyroid cancer (smoking initiation: odds ratio (OR) = 1.56, p = 0.61; cigarettes per day: OR = 0.85, p = 0.51; past tobacco smoking: OR = 0.80, p = 0.78). The heterogeneity (p > 0.05) and pleiotropy (p > 0.05) testing provided confirmatory evidence for the validity of our MR estimates. The MR analysis revealed that there may not exist a causative link between smoking exposure and elevated incidence rates of thyroid malignancies.

Quantitative Sensory Testing to Characterize Sensory Changes in Hidradenitis Suppurativa Skin Lesions

Pain is the most impactful symptom in patients with hidradenitis suppurativa (HS). Characterization of sensory profiles may improve understanding of pain mechanisms in HS and facilitate identification of effective pain management strategies. To characterize somatosensory profiles in patients with HS at clinically affected and nonaffected sites compared with pain-free reference data. This cross-sectional study was conducted at the Emory University Dermatology Clinic. It was hypothesized (1) that patients with HS would demonstrate hypersensitivity to pain in HS lesions and (2) that some patients would have sensory profiles consistent with complex pain mechanisms. Therefore, adults with dermatologist-diagnosed HS and at least 1 painful HS lesion at the time of testing were enrolled between September 10, 2020, and March 21, 2022. Patients with other diagnoses contributing to pain or neuropathy were excluded. Data analysis was conducted between March and April 2022. Quantitative sensory testing was performed on HS lesions and control skin according to a standardized protocol. Quantitative sensory testing outcomes included innocuous thermal and mechanical sensitivity (cold, warmth, and light touch detection thresholds), noxious thermal and mechanical sensitivity (cold, heat, pinprick, and deep pressure pain thresholds and suprathreshold pinprick sensitivity), temporal summation of pinprick, paradoxical thermal sensations, and dynamic mechanical allodynia (pain upon light stroking of the skin). Sensitivity in HS lesions was compared with sensitivity in a control location (the hand) and in pain-free controls using t tests. This study included 20 participants with a median age of 35.5 (IQR, 30.0-46.5) years, the majority of whom were women (15 [75%]). In terms of race and ethnicity, 2 participants (10%) self-identified as Asian, 11 (55%) as Black, 6 (30%) as White, and 1 (5%) as more than 1 race or ethnicity. Compared with site-specific reference values from healthy, pain-free control participants, HS lesions were insensitive to innocuous cold and warmth, noxious heat, and light touch (t = -5.69, -10.20, -3.84, and 4.46, respectively; all P < .001). In contrast, HS lesions also demonstrated significant hypersensitivity to deep pressure pain (t = 8.36; P < .001) and cutaneous pinprick (t = 2.07; P = .046). Hypersensitivity to deep pressure pain was also observed in the control site (t = 5.85; P < .001). A subset of patients with HS displayed changes in pain processing that are often seen in neuropathic and nociplastic pain conditions, including hypersensitivity to repetitive pinprick (5 [26%]), paradoxical thermal sensations (3 [15%]), and pain upon light stroking of the skin (10 [50%]). The findings of this cross-sectional study suggest that HS involves local changes in the skin or its free nerve endings, possibly leading to peripheral neuropathy and alterations in the transduction of innocuous and noxious thermal and mechanical stimuli. For some patients, central nervous system changes in somatosensory processing may also occur, but confirmatory evidence is needed. Better understanding of neuropathic and nociplastic mechanisms in HS pain could lead to individually tailored treatments.

A Mega-Analysis of the Relationship Between Breath Counting Test Performance and Subscales of the Five Facet Mindfulness Questionnaire

ObjectivesThe assessment of mindfulness has relied predominantly on self-report questionnaires, indicating a need for alternative methods based on objective data. The Breath-Counting Task (BCT) has been proposed as a viable candidate by several mindfulness researchers, but has been subject to relatively little scientific scrutiny.MethodWe conducted a mega-analysis using combined data from five separate studies, using multiple linear regression models to examine the relationship between BCT performance and self-reported mindfulness after controlling for age and gender. We examined associations with trait mindfulness as indexed by the Five Facet Mindfulness Questionnaire (FFMQ) and Mindful Attention Awareness Scale (MAAS).ResultsAccuracy on the BCT correlated only with a combined dataset of z-scores derived from FFMQ-Acting with Awareness and MAAS. We also examined associations with two different types of task errors: miscounts (uncaught errors) and resets (self-caught errors). While reset rates correlated with FFMQ-Acting with Awareness, miscount rates did not correlate with any mindfulness measure.ConclusionsOur analyses provide confirmatory evidence that BCT performance is related to the attentional aspects of trait mindfulness and not its attitudinal aspects – however the relevant correlations are fairly small. In seeking an objective measure of mindful attention, the weak association observed with BCT resets and the lack thereof with BCT accuracy suggests more promise in paradigms based on self-monitoring lapses of attention, while sustained attention tasks such as the present BCT may be of limited application among individuals new to meditation due to their lack of prior practice.

Teplizumab: A Disease-Modifying Therapy for Type 1 Diabetes That Preserves β-Cell Function.

In November 2022, teplizumab-mzwv became the first drug approved to delay the onset of stage 3 type 1 diabetes in adults and children age ≥8 years with stage 2 type 1 diabetes on the basis of data from the pivotal study TN-10. To provide confirmatory evidence of the effects of teplizumab on preserving endogenous insulin production, an integrated analysis of C-peptide data from 609 patients (n = 375 patients receiving teplizumab and n = 234 control patients) from five clinical trials in stage 3 type 1 diabetes was conducted. The primary outcome of the integrated analysis, change from baseline in stimulated C-peptide, was significantly improved at years 1 (average increase 0.08 nmol/L; P < 0.0001) and 2 (average increase 0.12 nmol/L; P < 0.0001) after one or two courses of teplizumab. An analysis of exogenous insulin use was also conducted, showing overall reductions of 0.08 (P = 0.0001) and 0.10 units/kg/day (P < 0.0001) at years 1 and 2, respectively. An integrated safety analysis of five clinical trials that enrolled 1,018 patients with stage 2 or 3 type 1 diabetes (∼1,500 patient-years of follow-up for teplizumab-treated patients) was conducted. These data confirm consistency in the preservation of β-cell function, as measured by C-peptide, across multiple clinical trials. This analysis showed that the most common adverse events included lymphopenia, rash, and headache, a majority of which occurred during and after the first few weeks of teplizumab administration and generally resolved without intervention, consistent with a safety profile characterized by self-limited adverse events after one or two courses of teplizumab treatment.

Detection and characterisation of oxocyclohexan[b]indoles by combined application of vibrational spectroscopy and mass spectrometry

The vibrational and mass spectra of a representative set of nine oxocyclohexan[b]indoles (tricyclic indoles with a 6,5,6 ring pattern) with a carbonyl group in each of the four positions of the third non-aromatic ring and up to two methyl substituent(s) attached to the carbon atoms in the other positions of this ring are reported and discussed. Particular attention is focused on the use of infrared spectroscopy to determine whether these compounds may best be described as ketoindoles or hydroxyindolenines. Most of these spectra indicate that the tricyclic heterocycles exist preferentially at ketoindoles, but the solid state infrared spectra of oxocyclohexan[b]indoles with the oxygen function in the 4-position are highly unusual, giving the initial impression that these compounds are hydroxyindolenines. Computational modelling supports the interpretation that the 4-ketoindole tautomer has a lower energy than either of its most stable isomeric indolenines conformers. Mass spectrometry is shown to provide valuable confirmatory evidence to differentiate the isomeric ionised oxocyclohexan[b]indoles, which dissociate via distinctive and informative fragmentation routes, in which the stability of intermediate distonic ions appears to be profoundly influenced by participation of the lone pair of electrons on the nitrogen atom. Many of these fragmentations are better described by stepwise mechanisms, rather than as concerted cycloreversions.

Effects of excavation and construction sequence on behavior of existing pile groups

In congested urban areas, new structures are regularly constructed next to high-rise buildings. At different stages of excavation for the new structures, settlement and tilting of the adjacent piled buildings may be occurred. Thus, attention here will be focused on the interaction behavior between deep excavation and adjacent piled foundations. Accurate prediction of soil movement and pile response plays an important role in preventing damages to adjacent buildings. Finite-element models are employed to compute the pile group responses. The parametric study has been performed by varying pile group configurations, center-to-center pile spacing, and new building load. Two, four, and six capped head pile groups next to excavation sites have been examined. In this paper, discussion centers on settlement and tilting of the pile groups nearby an excavation in fully saturated sand. The influence of pile group configuration and new building loads are systematically investigated. New building can be constructed in the excavated area after completion of the excavation. The effect of new building construction sequences is also investigated. Results provide confirmatory evidence that, excavation depth has the most significant effect on pile settlement and pile cap tilting. High pile cap tilting and small pile group settlement are apparent in case of two piles near the excavation. For the four pile group, the induced tilting of pile cap decreases as spacing between the piles increases. Due to construction of the new building, the settlement is exacerbated but the tilting is moderated.

Validation of the recording of idiopathic pulmonary fibrosis in routinely collected electronic healthcare records in England

BackgroundRoutinely-collected healthcare data provide a valuable resource for epidemiological research. Validation studies have shown that for most conditions, simple lists of clinical codes can reliably be used for case finding in primary care, however, studies exploring the robustness of this approach are lacking for diseases such as idiopathic pulmonary fibrosis (IPF) which are largely managed in secondary care.MethodUsing the UK’s Clinical Practice Research Datalink (CPRD) Aurum dataset, which comprises patient-level primary care records linked to national hospital admissions and cause-of-death data, we compared the positive predictive value (PPV) of eight diagnostic algorithms. Algorithms were developed based on the literature and IPF diagnostic guidelines using combinations of clinical codes in primary and secondary care (SNOMED-CT or ICD-10) with/without additional information. The positive predictive value (PPV) was estimated for each algorithm using the death record as the gold standard. Utilization of the reviewed codes across the study period was observed to evaluate any change in coding practices over time.ResultA total of 17,559 individuals had a least one record indicative of IPF in one or more of our three linked datasets between 2008 and 2018. The PPV of case-finding algorithms based on clinical codes alone ranged from 64.4% (95%CI:63.3–65.3) for a “broad” codeset to 74.9% (95%CI:72.8–76.9) for a “narrow” codeset comprising highly-specific codes. Adding confirmatory evidence, such as a CT scan, increased the PPV of our narrow code-based algorithm to 79.2% (95%CI:76.4–81.8) but reduced the sensitivity to under 10%. Adding evidence of hospitalisation to the standalone code-based algorithms also improved PPV, (PPV = 78.4 vs. 64.4%; sensitivity = 53.5% vs. 38.1%). IPF coding practices changed over time, with the increased use of specific IPF codes.ConclusionHigh diagnostic validity was achieved by using a restricted set of IPF codes. While adding confirmatory evidence increased diagnostic accuracy, the benefits of this approach need to be weighed against the inevitable loss of sample size and convenience. We would recommend use of an algorithm based on a broader IPF code set coupled with evidence of hospitalisation.

A STUDY ON PERFORMANCE OF STOCKS OF BLUE CHIP COMPANIES IN INDIA

The main aims of this paper are to explain the discriminatory variables between the top 10 blue chip companies stocks in stock markets of the India. . Since there is relatively less empirical research on the stock selection in markets, with even less studies on the markets in the transition economies of India, this paper is designed to shed some light on the identification of blue chip stocks from Indian stock market. Results presented in this paper provide confirmatory evidence that the blue chip stocks from the selected stock markets of the Indian stock market can be identified by examining their dividend payout , Market price of share , EPS and relevant ratios were analyzed and research tools like Mean etc. The variables were tested with the help of hypothesis testing on the basis of ANNOVA to determine the performance of the selected stocks.

An exploratory analysis examining differences in physical activity and motor competence in children with and without asthma: brief report

ABSTRACT: Objective: The purpose of this pilot study was to examine potential differences in motor competence (MC) and physical activity (PA) between children with and without asthma. Methods: Thirty-seven children and adolescents completed the Exercise for a Healthy Asthma Lifestyle and Enjoyment study (46% with asthma, 51% female, 11.1 ± 0.4 y, and 46% White). Motor competence was assessed using the Movement Assessment Battery for Children 2nd edition (MABC-2). PA was assessed using accelerometry. Results: Children with asthma had significantly lower MC in the domain of aiming and catching (with asthma: 8.2 ± 0.4 vs. without asthma: 9.9 ± 0.5; p = 0.03) and fewer daily minutes spent in moderate-to-vigorous PA (MVPA) (with asthma: 18.0 ± 2.3 min vs. without asthma: 27.2 ± 3.6 min; p = 0.047). There were no significant group differences in manual dexterity, balance, total MABC-2 score, or total daily PA (all ps > 0.05). Conclusion: This study provides confirmatory evidence that children with asthma display lower MC and spend less time in MVPA compared to children without asthma. Because MC is a prerequisite for engaging in PA, future research should seek to determine if the differences observed in MC contribute to disparities in MVPA observed in this clinical population.

An Appraisal of the Tissue Injury and Repair (TIAR) Theory on the Pathogenesis of Endometriosis and Adenomyosis.

As understanding their pathogenesis remains elusive, both endometriosis and adenomyosis are often referred to as "enigmatic diseases". The uncertainty and heightened interest are reflected in the range of expressed views and opinions. There is a sense of urgency because of the entailed patient suffering. The plethora of opinions calls for a critical analysis of proposed theories, both old and new. A series of papers published since 2009 proposed that both endometriosis and adenomyosis originate from the same aberrations occurring within the uterus. This came to be recognized as the tissue injury and repair theory, and the newly coined term "archimetrosis" posits that the two diseases share the same origin. While the theory opens an interesting channel for exploration, its claim as a unifying theory necessitates a critical appraisal. We, thus, undertook this review of the theory and analyzed its underpinnings based on a comprehensive review of the literature. Our appraisal indicates that the theory is open to a range of criticisms. Chief among these is the need for confirmatory evidence of features of abnormal uterine contractility and the lack of data addressing the question of causality. In addition, the theory has, as yet, no supporting epidemiological evidence, which is a major weakness. The theory suffers as it is not open to the test of falsifiability, and it lacks the ability to make useful predictions. It has not addressed the questions, such as why only a small percentage of women develop adenomyosis or endometriosis, given the ubiquity of uterine peristalsis. On the other hand, the triggers and prevention of hyper- or dys-peristalsis become critical to a theory of causation. We conclude that additional supportive evidence is required for the theory to be accepted.

Psychological and medical treatments for binge-eating disorder: A research update

Binge-eating disorder (BED), characterized by recurrent binge eating in the absence of regular weight-compensatory behaviors, is the most common eating disorder, associated with pronounced mental and physical sequelae. An increasing body of research documents the efficacy of diverse approaches to the treatment of this disorder, summarized in meta-analyses. This research update narratively reviewed randomized-controlled trials (RCTs) on the psychological and medical treatment of BED published between January 2018 and November 2022, identified through a systematic literature search. A total of 16 new RCTs and 3 studies on previous RCTs providing efficacy- and safety-related data were included. Regarding psychotherapy, confirmatory evidence supported the use of integrative-cognitive therapy and, with lower effects, brief emotion regulation skills training for binge eating and associated psychopathology. Behavioral weight loss treatment was revealed to be efficacious for binge eating, weight loss, and psychopathology, but its combination with naltrexone-bupropion did not augment efficacy. New treatment approaches were explored, including e-mental-health and brain-directed treatments, mostly targeting emotion and self-regulation. Additionally, different therapeutic approaches were evaluated in complex stepped-care models. In light of these advances, future research is necessary to further optimize effects of evidence-based treatments for BED, through improvement of existing or development of new treatments, based on mechanistic and/or interventional research, and/or tailoring treatments to personal characteristics in a precision medicine approach.

Psychogenic Nonepileptic Seizures-High Mortality Rate Is a 'Wake-Up Call'.

Patients with epilepsy have an elevated mortality rate compared to the general population and now studies are showing a comparable death ratio in patients diagnosed with psychogenic nonepileptic seizures. The latter is a top differential diagnosis for epilepsy and the unexpected mortality rate in these patients underscores the importance of an accurate diagnosis. Experts have called for more studies to elucidate this finding but the explanation is already available, embedded in the existing data. To illustrate, a review of the diagnostic practice in epilepsy monitoring units, of the studies examining mortality in PNES and epilepsy patients, and of the general clinical literature on the two populations was conducted. The analysis reveals that the scalp EEG test result, which distinguishes a psychogenic from an epileptic seizure, is highly fallible; that the clinical profiles of the PNES and epilepsy patient populations are virtually identical; and that both are dying of natural and non-natural causes including sudden unexpected death associated with confirmed or suspected seizure activity. The recent data showing a similar mortality rate simply constitutes more confirmatory evidence that the PNES population consists largely of patients with drug-resistant scalp EEG-negative epileptic seizures. To reduce the morbidity and mortality in these patients, they must be given access to treatments for epilepsy.

ACE-2, TMPRSS2, and Neuropilin-1 Receptor Expression on Human Brain Astrocytes and Pericytes and SARS-CoV-2 Infection Kinetics.

Angiotensin Converting Enzyme 2 (ACE-2), Transmembrane Serine Protease 2 (TMPRSS-2) and Neuropilin-1 cellular receptors support the entry of SARS-CoV-2 into susceptible human target cells and are characterized at the molecular level. Some evidence on the expression of entry receptors at mRNA and protein levels in brain cells is available, but co-expression of these receptors and confirmatory evidence on brain cells is lacking. SARS-CoV-2 infects some brain cell types, but infection susceptibility, multiple entry receptor density, and infection kinetics are rarely reported in specific brain cell types. Highly sensitive Taqman ddPCR, flow-cytometry and immunocytochemistry assays were used to quantitate the expression of ACE-2, TMPRSS-2 and Neuropilin-1 at mRNA and protein levels on human brain-extracted pericytes and astrocytes, which are an integral part of the Blood-Brain-Barrier (BBB). Astrocytes showed moderate ACE-2 (15.9 ± 1.3%, Mean ± SD, n = 2) and TMPRSS-2 (17.6%) positive cells, and in contrast show high Neuropilin-1 (56.4 ± 39.8%, n = 4) protein expression. Whereas pericytes showed variable ACE-2 (23.1 ± 20.7%, n = 2), Neuropilin-1 (30.3 ± 7.5%, n = 4) protein expression and higher TMPRSS-2 mRNA (667.2 ± 232.3, n = 3) expression. Co-expression of multiple entry receptors on astrocytes and pericytes allows entry of SARS-CoV-2 and progression of infection. Astrocytes showed roughly four-fold more virus in culture supernatants than pericytes. SARS-CoV-2 cellular entry receptor expression and "in vitro" viral kinetics in astrocytes and pericytes may improve our understanding of viral infection "in vivo". In addition, this study may facilitate the development of novel strategies to counter the effects of SARS-CoV-2 and inhibit viral infection in brain tissues to prevent the spread and interference in neuronal functions.

Promoter Methylation of Two HOXA9 and NISCH Genes in Opium Users.

Opiate abuse has been critically increased in the world, especially in Iran. Owing to the association of opiate use with multiple human cancers and neurological disorders, seeking for genetic and epigenetic effects of opium can pave the way for early diagnosis of major health defects in addicted users. Accordingly, the present study aimed to determine the methylation status of the promoter of two genes, which are actively involved in neurodevelopment and cancer evolution. DNA was isolated from peripheral blood of 28 opium abusers and 19 healthy controls and then subjected to sonication. Sonicated DNAs undergone methylated DNA immunoprecipitation-real time polymerase chain reaction (MeDIP-Real Time PCR) using specific primer pairs designed for HOXA9 and NISCH genes. Obtained data were analyzed using SPSS software. HOXA9 and NISCH genes were found to be significantly methylated in addicted users compared to controls (P<0.001) which was significantly associated with the mean of the age regarding HOXA9 gene (P=0.002). Neither opium amount nor duration or route of using was associated with the methylation status of HOXA9 or NISCH genes. Hypermethylation of HOXA9 and NISCH genes as tumor suppressor in opium-addicted individuals can be considered as confirmatory evidence for carcinogenesis of opium. Further studies are required to figure out the role of epigenetic alterations in cancer evolution among opium users.

Resting State Dynamic Reconfiguration of Spatial Attention Cortical Networks and Visuospatial Functioning in Non-Verbal Learning Disability (NVLD): A HD-EEG Investigation.

Nonverbal learning disability (NVLD) is a neurodevelopmental disorder characterized by deficits in visuospatial processing but spared verbal competencies. Neurocognitive markers may provide confirmatory evidence for characterizing NVLD as a separate neurodevelopmental disorder. Visuospatial performance and high-density electroencephalography (EEG) were measured in 16 NLVD and in 16 typically developing (TD) children. Cortical source modeling was applied to assess resting-state functional connectivity (rs-FC) in spatial attention networks (dorsal (DAN) and ventral attention networks (VAN)) implicated in visuospatial abilities. A machine-learning approach was applied to investigate whether group membership could be predicted from rs-FC maps and if these connectivity patterns were predictive of visuospatial performance. Graph theoretical measures were applied to nodes inside each network. EEG rs-FC maps in the gamma and beta band differentiated children with and without NVLD, with increased but more diffuse and less efficient functional connections bilaterally in the NVLD group. While rs-FC of the left DAN in the gamma range predicted visuospatial scores for TD children, in the NVLD group rs-FC of the right DAN in the delta range predicted impaired visuospatial performance, confirming that NVLD is a disorder with a predominant dysfunction in right hemisphere connectivity patterns.

Support for increasing low-wage workers' compensation: The role of fixed-growth mindsets about intelligence.

Approximately 44% of U.S. workers are low-wage workers. Recent years have witnessed a raging debate about whether to raise their minimum wages. Why do some decision-makers support raising wages and others do not? Ten studies (four preregistered) examined people's beliefs about the malleability of intelligence as a key antecedent. The more U.S. human resource managers (Study 1) and Indian business owners (Study 2) believed that people's intelligence can grow (i.e., had a growth mindset), the more they supported increasing low-wage workers' compensation. In key U.S. swing states (Study 3a), and a nationally representative sample (Study 3b), residents with a more growth mindset were more willing to support ballot propositions increasing the minimum wage and other compensation. Study 4 provided causal evidence. The next two studies confirmed the specificity of the predictor. People's beliefs about the malleability of intelligence, but not personality (Study 5a) or effort (Study 5b), predicted their support for increasing low-wage workers' compensation. Study 6 examined multiple potential mechanisms, including empathy, attributions for poverty, and environmental affordances. The relationship between growth mindset and support for raising low-wage workers' wages was explained by more situational rather than dispositional attributions for poverty. Finally, Studies 7a and 7b replicated the effect of growth mindset on support for increasing low-wage workers' compensation and provided confirmatory evidence for the mediator-situational, rather than dispositional, attributions of poverty. These findings suggest that growth mindsets about intelligence promote support for increasing low-wage workers' wages; we discuss the theoretical and practical implications. (PsycInfo Database Record (c) 2022 APA, all rights reserved).