A rare case of progressive disseminated histoplasmosis with bone marrow involvement in an immunocompetent patient

Histoplasmosis is a rare entity in India and very few cases have been reported from eastern region of India like West Bengal and rarely cases from southern India as well. We hereby report a case of progressive disseminated histoplasmosis (PDH) from a non-endemic region of India (Eastern Utter Pradesh) and that too in an immunocompetent individual.

A case of rocky mountain spotted fever without eschar as a cause of pyrexia with multiple organ failure

Rocky mountain spotted fever (RMSF) is a rickettsia disease frequently reported from North America and Europe and transmitted by tick bite. This disease is very rare in India and other parts of South East Asia. Fever with rash and thrombocytopenia are the hallmark clinical presentations of viral hemorrhagic fever but other diseases like malaria, typhoid, Leptospira and rickettsia diseases should also be considered in differential diagnosis. Knowledge of geographical distribution, evidence of exposure to the vector and a high degree of clinical suspicion of rickettsia diseases are very important for early differentiation from other diseases to prevent lethal complications and institute initial treatment. We report a rare case of rocky mountain spotted fever (RMSF) from New Delhi, which was confirmed by specific indirect immunofluorescence assay (IIF).

Examining the Association between Psychiatric Illness and Suicidal Ideation in a Sample of Treatment-Seeking Canadian Peacekeeping and Combat Veterans with Posttraumatic Stress Disorder

Objective: Our study examines the association between suicidal ideation and and self-reported symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and alcohol use disorder (AUD) in a sample of treatment-seeking Canadian combat and peacekeeping veterans; and identifies potential predictors of suicidal ideation. Methods: Actively serving Canadian Forces and Royal Canadian Mounted Police members and veterans seeking treatment at the Parkwood Hospital Operational Stress Injury Clinic (n = 250) completed measures including the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, the Alcohol Use Disorder Identification Test, and the PTSD Checklist—Military Version (PCL-M) between January 2002 and December 2010. Regression analyses were used to determine the respective impact of PTSD, and self-reported symptoms of MDD, GAD, AUD, and anxiety on suicidal ideation. Results: Most people met PCL-M screening criteria for PTSD (73.6%, n = 184), while 70.8% (n = 177) screened positively for a probable major depressive episode. PTSD symptom was significantly associated with suicidal ideation (β = 0.412, P \u3c 0.001). After controlling for self-reported depressive symptom severity, AUD severity, and generalized anxiety, PTSD severity was no longer significantly associated with suicidal ideation (β = 0.043, P = 0.58). Conclusions: Although PTSD alone is associated with suicidal ideation, after controlling for common comorbid psychiatric illnesses, self-reported depressive symptom severity emerged as the most significant predictor of suicidal ideation. These findings support the importance of screening for comorbidities, particularly an MDD, as potentially modifiable conditions that are strongly related to suicidal ideation in military personnel\u27s endorsing criteria for PTSD

Validity of energy social research during and after COVID-19: challenges, considerations, and responses

Measures to control the spread of coronavirus disease 2019 (COVID-19) are having unprecedented impacts on people’s lives around the world. In this paper, we argue that those conducting social research in the energy domain should give special consideration to the internal and external validity of their work conducted during this pandemic period. We set out a number of principles that researchers can consider to give themselves and research users greater confidence that findings and recommendations will still be applicable in years to come. Largely grounded in existing good practice guidance, our recommendations include collecting and reporting additional supporting contextual data, reviewing aspects of research design for vulnerability to validity challenges, and building in longitudinal elements where feasible. We suggest that these approaches also bring a number of opportunities to generate new insights. However, we caution that a more systemic challenge to validity of knowledge produced during this period may result from changes in the kinds of social research that it is practicable to pursue

Molecular biomarkers in glioblastoma : a systematic review and meta-analysis

BACKGROUND: Glioblastoma (GBM) is a highly aggressive cancer with poor prognosis that needs better treatment modalities. Moreover, there is a lack of reliable biomarkers to predict the response and outcome of current or newly designed therapies. While several molecular markers have been proposed as potential biomarkers for GBM, their uptake into clinical settings is slow and impeded by marker heterogeneity. Detailed assessment of prognostic and predictive value for biomarkers in well-defined clinical trial settings, if available, is scattered throughout the literature. Here we conducted a systematic review and meta-analysis to evaluate the prognostic and predictive significance of clinically relevant molecular biomarkers in GBM patients. MATERIAL AND METHODS: A comprehensive literature search was conducted to retrieve publications from 3 databases (Pubmed, Cochrane and Embase) from January 2010 to December 2021, using specific terms. The combined hazard ratios (HR) and confidence intervals (95% CI) were used to evaluate the association of biomarkers with overall survival (OS) in GBM patients. RESULTS: Twenty-six out of 1831 screened articles were included in this review. Nineteen articles were included in the meta-analyses, and 7 articles were quantitatively summarised. Fourteen studies with 1231 GBM patients showed a significant association of MGMT methylation with better OS with the pooled HR of 1.66 (95% CI 1.32-2.09, p < 0.0001, random effect). Five studies including 541 GBM patients analysed for the prognostic significance of IDH1 mutation showed significantly better OS in patients with IDH1 mutation with a pooled HR of 2.37 (95% CI 1.81-3.12; p < 0.00001]. Meta-analysis performed on 5 studies including 575 GBM patients presenting with either amplification or high expression of EGFR gene did not reveal any prognostic significance with a pooled HR of 1.31 (95% CI 0.96-1.79; p = 0.08). CONCLUSIONS: MGMT promoter methylation and IDH1 mutation are significantly associated with better OS in GBM patients. No significant associations were found between EGFR amplification or overexpression with OS

Slope deviatory alignment, stream network and lineament orientation of the Sabarmati river system- neotectonic activity in the Mid -to Late Quaternary

The Gujarat alluvial plain located in the semi-arid zone is bounded by the arid Thar region in the north and the coastal/estuarine zone fringing the Arabian Sea in the south. It has been built by the rivers originating in the Aravalli Hills in the northeast. The drainages, with an average length of about 300 km, generally follow the NE-SW regional slope. However, the Sabannati River shows a flow deviating from the regional slope and follows a N-S to NNE-SSW trend in the alluvial area. The slope-deviatory trend of the Sabarmati has been investigated with regard to Late Quaternary neotectonics, fluvial-aeolian interaction and sea-level change. Lineament analysis indicates an E-W to WNW-ESE trajectory of maximum principal stress, and that drainage is primarily controlled by geodynamic processes. This is obvious from the correspondence in stress trajectories obtained from the lineament and drainage orientations, respectively. Sub-surface data indicate pre-Neogene faulting in the basin. It is inferred that these faults have been reactivated in the Mid- to Late Quaternary times. The slope-deviatory drainage of the Sabarmati River is, to a large extent, the result of fluvial adjustment to neotectonic reactivation in the region

Insomnia, Psychiatric Disorders and Suicidal Ideation in a National Representative Sample of Active Canadian Forces Members

Background Past research on the association between insomnia and suicidal ideation (SI) has produced mixed findings. The current study explored the relationship between insomnia, SI, and past-year mental health status among a large Canadian Forces (CF) sample. Method Data was obtained from the 2013 Canadian Forces Mental Health Survey (CFMHS), and included a large representative sample of Canadian Regular Forces personnel (N = 6700). A series of univariate logistic regressions were conducted to test individual associations between past-year mental health status, insomnia, and potential confounds and SI. Mental health status included three groups: 0, 1, or two or more probable diagnoses of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD) and alcohol abuse/dependence. Stepwise multivariate logistic regression was used to assess the relationship between insomnia and SI with mental health status as a moderator. Results 40.8% of respondents reported experiencing insomnia. Both insomnia and number of mental health conditions incrementally increased the risk of SI. However, past-year mental health status was a significant moderator of this relationship, such that for CF personnel with either no (AOR = 1.61, 1.37–1.89) or only one past-year mental health condition (AOR = 1.39, 1.12–1.73), an incremental increase in insomnia was associated with an increased likelihood of SI. However, in personnel with two or more past-year mental health disorders, insomnia was no longer significantly associated with SI (AOR = 1.04, 0.81–1.33). Conclusions Insomnia significantly increased the odds of SI, but only among individuals with no or one mental health condition. Findings highlight the importance of assessing insomnia among CF members in order to further suicide prevention efforts

Projective simulation for artificial intelligence

We propose a model of a learning agent whose interaction with the environment is governed by a simulation-based projection, which allows the agent to project itself into future situations before it takes real action. Projective simulation is based on a random walk through a network of clips, which are elementary patches of episodic memory. The network of clips changes dynamically, both due to new perceptual input and due to certain compositional principles of the simulation process. During simulation, the clips are screened for specific features which trigger factual action of the agent. The scheme is different from other, computational, notions of simulation, and it provides a new element in an embodied cognitive science approach to intelligent action and learning. Our model provides a natural route for generalization to quantum-mechanical operation and connects the fields of reinforcement learning and quantum computation.Comment: 22 pages, 18 figures. Close to published version, with footnotes retaine

Indigenous and Non-Indigenous People Experiencing Homelessness and Mental Illness in Two Canadian Cities: A Retrospective Analysis and Implications for Culturally Informed Action

Objectives&nbsp;Indigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessness and mental illness. We hypothesised that compared with non-Indigenous people, those who are Indigenous would demonstrate histories of displacement earlier in life, higher rates of trauma and self-medication with alcohol and other substances. Design and setting&nbsp;Retrospective data were collected from a sample recruited through referral from diverse social and health agencies in Winnipeg and Vancouver. Participants&nbsp;Eligibility included being 19 years or older, current mental disorder and homelessness. Measures&nbsp;Data were collected via interviews, using questionnaires, on sociodemographics (eg, age, ethnicity, education), mental illness, substance use, physical health, service use and quality of life. Univariate and multivariable models were used to model the association between Indigenous ethnicity and dependent variables. Results&nbsp;A total of 1010 people met the inclusion criteria, of whom 439 self-identified as Indigenous. In adjusted models, Indigenous ethnicity was independently associated with being homeless at a younger age, having a lifetime duration of homelessness longer than 3 years, post-traumatic stress disorder, less severe mental disorder, alcohol dependence, more severe substance use in the past month and infectious disease. Indigenous participants were also nearly twice as likely as others (47% vs 25%) to have children younger than 18 years. Conclusions&nbsp;Among Canadians who are homeless and mentally ill, those who are Indigenous have distinct histories and current needs that are consistent with the legacy of colonisation. Responses to Indigenous homelessness must be developed within the context of reconciliation between Indigenous and non-Indigenous Canadians, addressing trauma, substance use and family separations