Neuropsychological deficits in scuba divers: An exploratory investigation

Objective: To investigate whether divers with varying levels of experience and without a history of reported decompression sickness (DCS) show neuropsychometric alterations possibly as a result of socalled repetitive silent paradoxical gas embolisms. Methods: Using reaction time as a psychometric measure, 17 experienced military divers (ED, logging between 150 and 1,200 diving hours) and eight very experienced military divers (VED, logging between 2,800 and 9,800 diving hours) with no decompression sickness (DCS) in their medical histories were compared to 23 healthy controls without any diving history, matched as closely as possible with respect to age for the two diving groups. Motor reaction time, decision reaction time and error rates were measured during completion of both simple and complex reaction time tasks. Results: Compared to their control group, VED showed significantly higher motor reaction times on both tasks and significantly higher decision reaction times in the complex task. ED were not found to be different from their respective controls. No changes in performance quality in terms of increased errors were observed in any of the tasks for either diving group. Conclusions: The findings support the proposed possibility that minimal cerebral lesions occur after diving even without DCS. Further studies with this highly selective population of very experienced divers using more elaborate neurocognitive and neuromotor tasks seem warranted. Copyright © 2011 Undersea & Hyperbaric Medical Society, Inc

Depressivität und Wert­orientierungen im Verlauf von militärischen Auslands­einsätzen

Zusammenfassung : Depressivität und andere psychische Erkrankungen sind eine häufige Begleiterscheinung militärischer Auslandseinsätze. Ein neueres Forschungsfeld befasst sich mit persönlichen Wert­orientierungen und moralischen Verletzungen und deren Rolle bei der Entstehung psychischer Einsatzfolgen. In der vorliegenden Studie wurden Bundeswehrsoldaten vor und unmittelbar nach einem Auslandseinsatz in Afghanistan im Hinblick auf Wertorientierungen, moralische Verletzungen, posttraumatische Symptomatik sowie Depressivität psychometrisch getestet und mit einer Kontrollgruppe ohne Auslandseinsatz verglichen. In der Einsatzgruppe veränderte sich das umfassende Wertebewusstsein (Wert­e­index) signifikant weniger als in der Kontroll­gruppe. Dieser Werteindex sowie auch die Werte Konformität und Tradition waren signifikant mit der Entwicklung von Depressivität in der Einsatzgruppe ­assoziiert. Wertorientierungen sollten zukünftig in der Einsatzvorbereitung von Soldaten, aber auch in der Therapie einsatzbezogener psychischer Erkrankungen vermehrt berücksichtigt werden. = Abstract : Depression and Value ­Orientation in the Course of Military ­Operations Abroad Depression and other psychic disorders are a common side effect of military missions abroad. A relatively new field of research investigates personal value orientations and moral injuries and inquires into the role they play in the onset of psycholo­gical problems following involvement in military operations. In the present study, German Bundeswehr soldiers were tested psychometrically before and immediately after a mission in Afghanistan for value orientations, moral injuries, posttraumatic symptoms and depression. They were compared with a control group that had not undergone a military assignment abroad. Value awareness (value index) changed significantly less in the task force than in the control group. Both this value index and the values «conformity« and «tradition« were significantly associated with the onset of depression in the task force. In future, value orientations should be given closer attention both in the preparation of soldiers for deployment and in therapy for psychic disorders associated with deployment

IDHwt glioblastomas can be stratified by their transcriptional response to standard treatment, with implications for targeted therapy

Background: Glioblastoma (GBM) brain tumors lacking IDH1 mutations (IDHwt) have the worst prognosis of all brain neoplasms. Patients receive surgery and chemoradiotherapy but tumors almost always fatally recur.Results: Using RNA sequencing data from 107 pairs of pre- and post-standard treatment locally recurrent IDHwt GBM tumors, we identify two responder subtypes based on longitudinal changes in gene expression. In two thirds of patients, a specific subset of genes is upregulated from primary to recurrence (Up responders), and in one third, the same genes are downregulated (Down responders), specifically in neoplastic cells. Characterization of the responder subtypes indicates subtype-specific adaptive treatment resistance mechanisms that are associated with distinct changes in the tumor microenvironment. In Up responders, recurrent tumors are enriched in quiescent proneural GBM stem cells and differentiated neoplastic cells, with increased interaction with the surrounding normal brain and neurotransmitter signaling, whereas Down responders commonly undergo mesenchymal transition. ChIP-sequencing data from longitudinal GBM tumors suggests that the observed transcriptional reprogramming could be driven by Polycomb-based chromatin remodeling rather than DNA methylation.Conclusions: We show that the responder subtype is cancer-cell intrinsic, recapitulated in in vitro GBM cell models, and influenced by the presence of the tumor microenvironment. Stratifying GBM tumors by responder subtype may lead to more effective treatment.</p

Longitudinal molecular trajectories of diffuse glioma in adults.

The evolutionary processes that drive universal therapeutic resistance in adult patients with diffuse glioma remain unclear1,2. Here we analysed temporally separated DNA-sequencing data and matched clinical annotation from 222 adult patients with glioma. By analysing mutations and copy numbers across the three major subtypes of diffuse glioma, we found that driver genes detected at the initial stage of disease were retained at recurrence, whereas there was little evidence of recurrence-specific gene alterations. Treatment with alkylating agents resulted in a hypermutator phenotype at different rates across the glioma subtypes, and hypermutation was not associated with differences in overall survival. Acquired aneuploidy was frequently detected in recurrent gliomas and was characterized by IDH mutation but without co-deletion of chromosome arms 1p/19q, and further converged with acquired alterations in the cell cycle and poor outcomes. The clonal architecture of each tumour remained similar over time, but the presence of subclonal selection was associated with decreased survival. Finally, there were no differences in the levels of immunoediting between initial and recurrent gliomas. Collectively, our results suggest that the strongest selective pressures occur during early glioma development and that current therapies shape this evolution in a largely stochastic manner