Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy.

HIV-associated cryptococcal meningitis is by far the most common cause of adult meningitis in many areas of the world that have high HIV seroprevalence. In most areas in Sub-Saharan Africa, the incidence of cryptococcal meningitis is not decreasing despite availability of antiretroviral therapy, because of issues of adherence and retention in HIV care. In addition, cryptococcal meningitis in HIV-seronegative individuals is a substantial problem: the risk of cryptococcal infection is increased in transplant recipients and other individuals with defects in cell-mediated immunity, and cryptococcosis is also reported in the apparently immunocompetent. Despite therapy, mortality rates in these groups are high. Over the past 5 years, advances have been made in rapid point-of-care diagnosis and early detection of cryptococcal antigen in the blood. These advances have enabled development of screening and pre-emptive treatment strategies aimed at preventing the development of clinical infection in patients with late-stage HIV infection. Progress in optimizing antifungal combinations has been aided by evaluation of the clearance rate of infection by using serial quantitative cultures of cerebrospinal fluid (CSF). Measurement and management of raised CSF pressure, a common complication, is a vital component of care. In addition, we now better understand protective immune responses in HIV-associated cases, immunogenetic predisposition to infection, and the role of immune-mediated pathology in patients with non-HIV associated infection and in the context of HIV-associated immune reconstitution reactions

iMap: a novel method for statistical fixation mapping of eye movement data

Eye movement data analyses are commonly based on the probability of occurrence of saccades and fixations (and their characteristics) in given regions of interest (ROIs). In this article, we introduce an alternative method for computing statistical fixation maps of eye movements-iMap-based on an approach inspired by methods used in functional magnetic resonance imaging. Importantly, iMap does not require the a priori segmentation of the experimental images into ROIs. With iMap, fixation data are first smoothed by convolving Gaussian kernels to generate three-dimensional fixation maps. This procedure embodies eyetracker accuracy, but the Gaussian kernel can also be flexibly set to represent acuity or attentional constraints. In addition, the smoothed fixation data generated by iMap conform to the assumptions of the robust statistical random field theory (RFT) approach, which is applied thereafter to assess significant fixation spots and differences across the three-dimensional fixation maps. The RFT corrects for the multiple statistical comparisons generated by the numerous pixels constituting the digital images. To illustrate the processing steps of iMap, we provide sample analyses of real eye movement data from face, visual scene, and memory processing. The iMap MATLAB toolbox is editable and freely available for download online (www.unifr.ch/psycho/ibmlab/)

Inferior frontal cortex modulation with an acute dose of heroin during cognitive control

Impairments in inhibitory control and in stimulus-driven attention are hallmarks of drug addiction and are associated with decreased activation in the right inferior frontal gyrus (IFG). Although previous studies indicate that the response inhibition function is impaired in abstinent heroin dependents, and that this is mediated by reduced IFG activity, it remains completely unknown whether and how an acute dose of heroin modulates IFG activity during cognitive control in heroin-dependent patients. This study investigates the acute effects of heroin administration on IFG activity during response inhibition and stimulus-driven attention in heroin-dependent patients. Using a cross-over, double-blind, placebo-controlled design, saline and heroin were administered to 26 heroin-dependent patients from stable heroin-assisted treatment, while performing a Go/No-Go event-related functional magnetic resonance imaging task to assess right IFG activity during motor response inhibition, as well as during oddball-driven attention allocation. Relative to saline, heroin significantly reduced right IFG activity during both successful response inhibition and oddball-driven attention allocation, whereas it did not change right IFG activity during response inhibition after correction for the effect of attention allocation. These heroin-induced effects were not related to changes in drug craving, state anxiety, behavioral performance, or co-consumption of psychostimulant drugs. This study demonstrates that heroin administration acutely impairs stimulus-driven attention allocation, as indicated by reduced IFG activity in response to infrequently presented stimuli, and does not specifically modulate IFG activity during response inhibition