Suppression of Helicobacter pylori infection by daily cranberry intake: A double-blind, randomized, placebo-controlled trial

BACKGROUND AND AIM

Dietary strategies that contribute to reducing incidence of Helicobacter pylori infection without negative side effects are highly desirable owing to worldwide bacterial prevalence and carcinogenesis potential. The aim of this study was to determine dosage effect of daily cranberry consumption on H. pylori suppression over time in infected adults to assess the potential of this complementary management strategy in a region with high gastric cancer risk and high prevalence of H. pylori infection.

METHODS

This double-blind, randomized, placebo-controlled trial on 522 H. pylori-positive adults evaluated dose-response effects of proanthocyanidin-standardized cranberry juice, cranberry powder, or their placebos on suppression of H. pylori at 2 and 8 weeks by ¹³ C-urea breath testing and eradication at 45 days post-intervention.

RESULTS

H. pylori-negative rates in placebo, low-proanthocyanidin, medium-proanthocyanidin, and high-proanthocyanidin cranberry juice groups at week 2 were 13.24%, 7.58%, 1.49%, and 13.85% and at week 8 were 7.35%, 7.58%, 4.48%, and 20.00%, respectively. Consumption of high-proanthocyanidin juice twice daily (44 mg proanthocyanidin/240-mL serving) for 8 weeks resulted in decreased H. pylori infection rate by 20% as compared with other dosages and placebo (P < 0.05). Percentage of H. pylori-negative participants increased from 2 to 8 weeks in subjects who consumed 44 mg proanthocyanidin/day juice once or twice daily, showing a statistically significant positive trend over time. Encapsulated cranberry powder doses were not significantly effective at either time point. Overall trial compliance was 94.25%. Cranberry juice and powder were well-tolerated.

CONCLUSIONS

Twice-daily consumption of proanthocyanidin-standardized cranberry juice may help potentiate suppression of H. pylori infection.

TRIAL REGISTRATION

ChiCTR1800017522, per WHO ICTRP.

Gender differences in functional connectivity during emotion regulation

Gender differences in emotion regulation (ER) have been postulated, yet their neural basis remains poorly understood. The goal of this study was to investigate this issue from a functional connectivity (FC) perspective. Utilizing a region of interest (ROI) analysis, we investigated whether men and women (N = 48) differed in their FC pattern while viewing versus regulating negative emotion induced by highly salient pictures, and whether this pattern related to their self-reported negative affect and suppression success. Despite women reporting more negative affect, both genders had comparable suppression success. Moreover, differences emerged between men and women's FC patterns. During the regulation of negative emotion, better suppression in women was associated with stronger FC within a cingulo-opercular network, while men exhibited stronger FC within posterior regions of the ventral attentional network. We conclude that due to their propensity for higher emotional reactivity, women may employ a frontal top-down control network to downregulate negative emotion, while men may redirect attention away from the negative stimulus by using posterior regions of the ventral attention network. The findings may have significant implications for understanding women's vulnerability for developing affective disorders and developing targeted individualized treatment.

Expressive suppression and cognitive reappraisal in veterans with PTSD: Results from the mind your heart study

OBJECTIVE

This study examined whether expressive suppression (ES), a maladaptive regulation strategy, was more strongly associated with PTSD diagnosis and symptom clusters in veterans than cognitive reappraisal (CR), an adaptive regulation strategy.

METHOD

In a cohort study, 746 participants recruited from VHA facilities completed Clinician Administered PTSD Scale-IV, Emotion Regulation Questionnaire, and Patient Health Questionnaire. Participants were categorized into groups: Current, Remitted/Lifetime, and Never PTSD.

RESULTS

One-way ANOVA revealed significant differences between Current PTSD and both Remitted and Never PTSD for ES, but not CR. The Remitted and Never PTSD groups did not vary significantly from each other and were collapsed into one group for regressions. Adjusting for sex, race, employment, and comorbid depression, binary logistic regression showed ES, but not CR, was associated with increased likelihood of Current PTSD (p < .001, OR: 1.43). ES was also significantly associated with increased odds of meeting criteria for all symptom clusters (ps < 0.001). CR was not significantly associated with meeting criteria for Current PTSD or any symptom cluster.

LIMITATIONS

Cross-sectional design and use of self-report limit causality inferences that can be drawn.

CONCLUSIONS

ES is associated with increased odds of Current PTSD diagnosis and symptom clusters. Veterans in the Remitted and Never PTSD groups did not differ significantly. Greater suppression of emotional expression is more strongly linked with PTSD criteria in veterans than decreased cognitive reappraisal.

Co-occurring mental health symptoms and cognitive processes in trauma-exposed ASD adults

BACKGROUND

Mental health problems are common amongst adults with an Autism Spectrum Disorder (ASD). Stressful and traumatic life events can trigger or exacerbate symptoms of anxiety, depression and PTSD. In the general population, transdiagnostic processes such as suppression and perseverative thinking are associated with responses to trauma and mental health symptoms.

AIMS

This study explored the relationships between thought suppression, perseverative thinking and symptoms of depression, anxiety and PTSD in ASD adults who reported exposure to a range of DSM-5 and non-DSM-5 traumatic events.

METHODS

59 ASD adults completed a series of online self-report questionnaires measuring trauma, transdiagnostic cognitive processes, and mental health symptoms.

RESULTS

Probable PTSD rarely occurred in isolation and was associated with depression and anxiety symptoms in trauma-exposed ASD adults. All cognitive processes and mental health symptoms were positively associated with one another, regardless of whether the trauma met DSM-5 PTSD Criterion A. When accounting for both cognitive processes, only thought suppression significantly predicted PTSD and anxiety symptoms, while only perseverative thinking significantly predicted depression symptoms.

CONCLUSIONS AND IMPLICATIONS

These preliminary results suggest that different cognitive processes more strongly affect anxiety/PTSD versus depression symptom severity in trauma-exposed ASD adults, although co-occurring symptoms are common. Implications for assessment, treatment and future research are discussed.

Functional coupling of the orbitofrontal cortex and the basolateral amygdala mediates the association between spontaneous reappraisal and emotional response

Emotional regulation is known to be associated with activity in the amygdala. The amygdala is an emotion-generative region that comprises of structurally and functionally distinct nuclei. However, little is known about the contributions of different frontal-amygdala sub-region pathways to emotion regulation. Here, we investigated how functional couplings between frontal regions and amygdala sub-regions are involved in different spontaneous emotion regulation processes by using an individual-difference approach and a generalized psycho-physiological interaction (gPPI) approach. Specifically, 50 healthy participants reported their dispositional use of spontaneous cognitive reappraisal and expressive suppression in daily life and their actual use of these two strategies during the performance of an emotional-picture watching task. Results showed that functional coupling between the orbitofrontal cortex (OFC) and the basolateral amygdala (BLA) was associated with higher scores of both dispositional and actual uses of reappraisal. Similarly, functional coupling between the dorsolateral prefrontal cortex (dlPFC) and the centromedial amygdala (CMA) was associated with higher scores of both dispositional and actual uses of suppression. Mediation analyses indicated that functional coupling of the right OFC-BLA partially mediated the association between reappraisal and emotional response, irrespective of whether reappraisal was measured by dispositional use (indirect effect(SE)=-0.2021 (0.0811), 95%CI_(BC)= [-0.3851, -0.0655]) or actual use (indirect effect(SE)=-0.1951 (0.0796), 95%CI_(BC)= [-0.3654, -0.0518])). These findings suggest that spontaneous reappraisal and suppression involve distinct frontal- amygdala functional couplings, and the modulation of BLA activity from OFC may be necessary for changing emotional response during spontaneous reappraisal.

The Relationship Between the Pain Experience and Emotion Regulation in Older Adults

OBJECTIVE

To investigate the relationship of emotion regulation strategies (i.e., emotional suppression and reappraisal) with pain catastrophizing, fear of pain, pain intensity, worry, and depression as function of age in samples of older and younger adults.

DESIGN

Cross-sectional design using validated questionnaires.

SETTING

Participants resided in the community. They completed validated measures using online questionnaires.

SUBJECTS

Two-hundred fifty-seven older adults and 254 younger adults with chronic pain participated.

METHODS

Participants completed validated questionnaires of emotion regulation strategies, pain-related functioning and mental health.

RESULTS

Emotion regulation varied as a function of age and gender. Among our chronic pain sample, older adult males reported lower use of reappraisal and suppression than younger adult males, while older adult females reported higher use of reappraisal than younger adult females. Emotional suppression was positively related to pain catastrophizing, pain intensity, worry, and depression. Reappraisal was negatively related to depression and worry. Interestingly, age showed a positive relationship with fear of pain, pain catastrophizing, worry, depression, and pain intensity, while gender was related to fear of pain and worry. Finally, emotional reappraisal partially mediated the relationship between the affective dimensions of pain intensity and pain catastrophizing among older adults.

CONCLUSIONS

Our results indicate that reappraisal strategies are important for older and younger adults with chronic pain, pointing to the necessity of considering these strategies when working clinically with such populations. However, given our findings as well as those in the literature, gender should also be considered.

The immune gene expression induced by Cooperia punctata in naturally infected calves with resistance and susceptible phenotype traits

The analysis of the immune gene expression was performed in Zebu × Holstein calves with resistant and susceptible phenotypes naturally infected with Cooperia punctata. Fourteen calves of 4 months old were grazed for 11 weeks under a tropical climate. The parasitic infection showed an average epg value of 1055 ± 1155 and an IgG optical density of 0.814 ± 0.0.037 with statistic differences among the different weeks (p < 0.05), and a pcv value of 24 ± 2.0 % (p > 0.05). High variation in epg value was observed, between 7 ± 7.14 and 4657 ± 1886, and, based on these differences; the infected hosts were classified as five resistant calves with epg ≤ 200 and nine susceptible calves with epg ≥ 300. Moreover, IgG levels displayed statistical differences between resistance and susceptible calves to C. punctata infection. The immune gene expression was analysed in three resistant and susceptible calves, respectively. Nine cytokine genes and the FCεR1A receptor were analysed at the 3rd and 11th weeks post-infection. In the first period upregulation was found, from 2.19- to 9.45-fold, (p < 0.05) for IL-2, -5, - 6, -10, TGF-β and FCεR1A in the resistant group; the expression was decreased at the 11th week with low level of IgG. In contrast, downregulation for susceptible calves was found for nine immune genes and upregulation for INF-γ in both periods together with increased IgG levels. In conclusion, immune gene expression was regulated at the begging infection of C. punctata in resistant grazing calves. In contrast, suppression of important genes was involved in calves susceptible to C. punctata.

Clinical Aniseikonia in Anisometropia and Amblyopia

Purpose:

Clinically, aniseikonia (a perceived difference in shape and image size between the eyes) is often neglected in anisometropic amblyopia due to assumed measurement difficulties. Therefore, we currently lack evidence on whether correction of aniseikonia is beneficial. This study aimed to determine whether subjective aniseikonia is measurable in anisometropia with or without amblyopia.

Methods:

Participants (15–52 years) with Anisometropic Amblyopia (n = 7), Anisometropia without amblyopia (n = 6) and Isometropic Controls (n = 6) were recruited. Subjective aniseikonia was measured using three clinical techniques: Robertson Technique (RT) (penlight and Maddox rod), Aniseikonia Inspector Version 3 (AI3), and the New Aniseikonia Test booklet (NAT), and a psychophysical adaptive method, the Contrast-balanced Aniseikonia Test (CAT), where dichoptic contrast adjustments compensate for any suppression.

Results:

Eighteen participants completed all tests, one Anisometropic Amblyopia participant could only complete the CAT and NAT due to fusion loss. The Anisometropic Amblyopia group exhibited the most aniseikonia (range –1.50–+10.50%) followed by Anisometropic Controls (range –3.30–+4.50%) and Isometropic Controls (range –1.50–+3.28%). There was a significant trend of more subjective aniseikonia with increasing amounts of anisometropia across all four tests (AI3 r = 0.630, p = 0.005; NAT r = 0.542, p = 0.017; RT r = 0.499, p = 0.035; CAT r = 0.440, p = 0.059. Bland Altman analysis demonstrated clinically significant levels of variability between the tests.

Conclusions:

Subjective aniseikonia can be reliably measured in patients with anisometropia and suppression. Subjective aniseikonia measurement is recommended as four of the most commonly used clinical tests did not support the 1% per dioptre rule of thumb.

Effects of Age on Emotion Regulation, Emotional Empathy, and Prosocial Behavior

OBJECTIVES

The degree to which older adults experience emotional empathy and show subsequent prosocial behavior versus experience personal distress in response to another's distress remains unclear.

METHOD

Young (n = 40; 17-29 years) and older (n = 39; 61-82 years) adults watched videos of individuals expressing pain or no pain. Pain mimicry was recorded using facial electromyography. Participants were then asked if they would spend the remaining time helping the experimenter. Self-reported tendency to suppress or reappraise emotion was assessed, as well as trait and state emotional empathy and personal distress.

RESULTS

Pain mimicry was associated with reduced trait suppression in older adults. In both age groups, greater emotional empathy, averaged across video condition, was associated with increased helping. In addition, relative to young adults, older adults reported more personal distress and emotional reactivity in response to the videos but were just as willing to help. They also put more effort into helping.

DISCUSSION

These findings contribute to clarification of mixed previous evidence regarding the experience of emotional empathy in young versus older adulthood. We discuss the importance of considering additional subcomponents of empathy such as emotion regulation, while also accounting for the relevance of the empathy induction to each age group.

Re-examining the HIV 'functional cure' oxymoron: Time for precise terminology?

For over a decade, the binary concepts of 'sterilizing' versus 'functional' cure have provided an organizing framework for the field of HIV cure-related research. In this article, we examine how the expression 'functional cure' is employed within the field, published literature, and community understanding of HIV cure research. In our synthesis of the different meanings attributed to 'functional cure' within contemporary biomedical discourse, we argue that employing the 'functional cure' terminology poses a series of problems. The expression itself is contradictory and inconsistently used across a wide array of HIV cure research initiatives. Further, the meaning and acceptability of 'functional cure' within communities of people living with and affected by HIV is highly variable. After drawing lessons from other fields, such as cancer and infectious hepatitis cure research, we summarize our considerations and propose alternative language that may more aptly describe the scientific objectives in question. We call for closer attention to language used to describe HIV cure-related research, and for continued, significant, and strategic engagement to ensure acceptable and more precise terminology.

Frequency selectivity of tonal language native speakers probed by suppression tuning curves of spontaneous otoacoustic emissions

Native acquisition of a tonal language (TL) is related to enhanced abilities of pitch perception and production, compared to non-tonal language (NTL) native speakers. Moreover, differences in brain responses to both linguistically relevant and non-relevant pitch changes have been described in TL native speakers. It is so far unclear to which extent differences are present at the peripheral processing level of the cochlea. To determine possible differences in cochlear frequency selectivity between Asian TL speakers and Caucasian NTL speakers, suppression tuning curves (STCs) of spontaneous otoacoustic emissions (SOAEs) were examined in both groups. By presenting pure tones, SOAE levels were suppressed and STCs were derived. SOAEs with center frequencies higher than 4.5 kHz were recorded only in female TL native speakers, which correlated with better high-frequency tone detection thresholds. The suppression thresholds at the tip of the STC and filter quality coefficient Q_10dB did not differ significantly between both language groups. Thus, the characteristics of the STCs of SOAEs do not support the presence of differences in peripheral auditory processing between TL and NTL native speakers.

Spatial suppression due to statistical learning tracks the estimated spatial probability

People are sensitive to regularities in the environment. Recent studies employing the additional singleton paradigm showed that a singleton distractor that appeared more often in one specific location than in all other locations may lead to attentional suppression of high-probability distractor locations. This in turn effectively reduced the attentional capture effect by the salient distractor singleton. However, in basically all of these previous studies, the probability that the salient distractor was presented at this specific location was relatively high (i.e., 65%; or a ratio of 13:1 between high- and low-probability locations). The question we addressed here was whether participants still can learn the regularities in the display even when these regularities are quite subtle. We systematically manipulated the ratio of the distractor appearing at the high- and low-probability location from 2:1 to 8:1. We asked the question whether the suppression effect would depend on the probabilities of the distractor appearing in the high-probability location. The results showed that the suppression of the high-probability location was linearly related to the high-low-probability ratio. In other words, the more evidence that a distractor appears more often at a particular location, the stronger the suppression. This indicates that the distribution of attention is optimally adapted to the statistical regularities present in the display.

Modelling the economic impact of COVID19 under different policy choices: Mitigation versus suppression when time is a scarce resource

Keogh-Brown et al.(2020) illustrate the application of economic modelling to inform and guide policy making during the COVID-19 pandemic in the UK. The methodology is based on linking a general equilibrium economic model to a simple epidemiological model of the infection. In this commentary a number of issues are discussed relating to the construction and application of the model, and the implications of the findings for government policies.

A saliency-specific and dimension-independent mechanism of distractor suppression

During everyday tasks, salient distractors may capture our attention. Recently, it was shown that through implicit learning, capture by a salient distractor is reduced by suppressing the location where a distractor is likely to appear. In the current study, we presented distractors of different saliency levels at the same specific location, asking the question whether there is always one suppression level for a particular location or whether, for one location, suppression depends on the actual saliency of the distractor appearing at that location. In three experiments, we demonstrate a saliency-specific mechanism of distractor suppression, which can be flexibly modulated by the overall probability of encountering distractors of different saliency levels to optimize behavior in a specific environment. The results also suggest that this mechanism has dimension-independent aspects, given that the saliency-specific suppression pattern is unaffected when saliency signals of distractors are generated by different dimensions. It is argued that suppression is saliency-dependent, implying that suppression is modulated on a trial-by-trial basis contingent on the saliency of the actual distractor presented.

Papa Don't Preach? : Using Lies to Expose the Truth about Who Suppresses Female Sexuality

The suppression of sexuality is culturally widespread, and women's sexual promiscuity, activity, and enjoyment are almost always judged and punished more harshly than men's. It remains disputed, however, to what end people suppress sexuality, and who benefits from the suppression of female sexuality. Different theories predict that women in general, men in general, women's intimate partners, or parents benefit most. Here we use the lies women and men tell-or imagine telling-about their sexual histories as an indirect measure of who is most involved in the suppression of sexuality. We asked men and women what they would reply if asked questions by their mother, father, current partner, attractive confederate, and various same- or opposite-sex friends and colleagues about their number of previous sex partners, age at first romantic kiss, age at first consensual sex, and cheating on a previous partner or spouse. By comparing the size and direction of the lies that subjects told, we tested competing predictions of several cultural and evolutionary theories concerning why female sexuality is suppressed and who is driving its suppression. We found that men and women told larger and more frequent lies to their parents, with women telling the largest and most frequent lies of all to their fathers. Additionally, the majority of lies by both men and women were in sexually conservative directions. Our findings suggest that mothers, and especially fathers, restrict female sexuality.

Sensitivity of UK Covid-19 deaths to the timing of suppression measures and their relaxation

In this paper I examine the sensitivity of total UK Covid-19 deaths and the demand for intensive care and ward beds, to the timing and duration of suppression periods during a 500- day period. This is achieved via a SEIR model. Using an expected latent period of 4.5 days and infectious period of 3.8 days,R 0 was first estimated as 3.18 using observed death rates under unmitigated spread and then under the effects of the total lockdown (R 0 =0.60) beginning 23 March. The case fatality rate given infection is taken as 1%. Parameter values for mean length of stay and conditional probability of death for ICU and non-ICU hospital admissions are guided by Ferguson et al. (2020). Under unmitigated spread the model predicts around 600,000 deaths in the UK. Starting with one exposed person at time zero and a suppression consistent with anR 0 of 0.60 on day 72, the model predicts around 39,000 deaths for a first wave, but this reduces to around 11,000 if the intervention takes place one week earlier. If the initial suppression were in place until day 200 and then relaxed to anR 0 of 1.5 between days 200 and 300, to be followed by a return to anR 0 of 0.60, the model predicts around 43,000 deaths. This would increase to around 64,000 if the release from the first suppression takes place 20 days earlier. The results indicate the extreme sensitivity to timing and the consequences of even small delays to suppression and premature relaxation of such measures.

Multiple large-scale neural networks underlying emotion regulation

Recent models suggest emotion generation, perception, and regulation rely on multiple, interacting large-scale brain networks. Despite the wealth of research in this field, the exact functional nature and different topological features of these neural networks remain elusive. Here, we addressed both using a well-established data-driven meta-analytic grouping approach. We applied k-means clustering to a large set of previously published experiments investigating emotion regulation (independent of strategy, goal and stimulus type) to segregate the results of these experiments into large-scale networks. To elucidate the functional nature of these distinct networks, we used functional decoding of metadata terms (i.e. task-level descriptions and behavioral domains). We identified four large-scale brain networks. The first two were related to regulation and functionally characterized by a stronger focus on response inhibition or executive control versus appraisal or language processing. In contrast, the second two networks were primarily related to emotion generation, appraisal, and physiological processes. We discuss how our findings corroborate and inform contemporary models of emotion regulation and thereby significantly add to the literature.

Learning to avoid looking: Competing influences of reward on overt attentional selection

Pairing a stimulus with large reward increases the likelihood that it will capture attention and eye-gaze, even when such capture has negative consequences. This suggests that a stimulus’s signalling relationship with reward (the co-occurrence of that stimulus and reward) has a powerful influence on attentional selection. In the present study, we demonstrate that a stimulus’s response relationship with reward (the reward-related consequences of attending to that stimulus) can also exert an independent, competing influence on selection. Participants completed a visual search task in which they made a saccade to a target shape to earn reward. The colour of a distractor signalled the magnitude of reward available on each trial. For one group of participants, there was a negative response relationship between making a saccade to the distractor and reward delivery: looking at the distractor caused the reward to be cancelled. For a second group, there was no negative response relationship, but an equivalent distractor–reward signalling relationship was maintained via a yoking procedure. Participants from both groups were more likely to have their gaze captured by the distractor that signalled high reward versus low reward, demonstrating an influence of the signalling relationship on attention. However, participants who experienced a negative response relationship showed a reduced influence of signal value on capture, and specifically less capture by the high-reward distractor. These findings demonstrate that reward can have a multifaceted influence on attentional selection through different, learned stimulus-reward relationships, and thus that the relationship between reward and attention is more complex than previously thought.

The attractiveness of salient distractors to reaching movements is task dependent

Previous studies in visual attention and oculomotor research showed that a physically salient distractor does not always capture attention or the eyes. Under certain top-down task sets, a salient distractor can be actively suppressed, avoiding capture. Even though previous studies showed that reaching movements are also influenced by salient distractors, it is unclear if and how a mechanism of active suppression of distractors would affect reaching movements. Active suppression might also explain why some studies find reaching movements to curve towards a distractor, while others find reaching movements to curve away. In this study, we varied the top-down task set in two separate experiments by manipulating the certainty about the target location. Participants had to reach for a diamond present among three circles. In Experiments 1 and 3, participants had to search for the reach targets; hence, the target's location certainty was low. In Experiments 2 and 3, the target's location was cued before the reach; hence, the target's location certainty was high. We found that reaches curved towards the physically salient, color singleton, distractor in the search-to-reach task (Experiments 1 and 3), but not in the cued reach task (Experiments 2 and 3). Thus, the saliency of the distractor only attracted reaching movements when the certainty of the target's location was low. Our findings suggest that the attractiveness of physically salient distractors to reaching movements depends on the top-down task set. The results can be explained by the effect of active attentional suppression on the competition between movement plans.

The vulnerability of working memory to distraction is rhythmic

Recent research posits that the cognitive system samples target stimuli in a rhythmic fashion, characterized by target detection fluctuating at frequencies of ~3-8 Hz. Besides prioritized encoding of targets, a key cognitive function is the protection of working memory from distractor intrusion. Here, we test to which degree the vulnerability of working memory to distraction is rhythmic. In an Irrelevant-Speech Task, N = 23 human participants had to retain the serial order of nine numbers in working memory while being distracted by task-irrelevant speech with variable temporal onsets. The magnitude of the distractor-evoked N1 component in the event-related potential as well as behavioural recall accuracy, both measures of memory distraction, were periodically modulated by distractor onset time in approximately 2-4 cycles per second (Hz). Critically, an underlying 2.5-Hz rhythm explained variation in both measures of distraction such that stronger phasic distractor encoding mediated lower phasic memory recall accuracy. In a behavioural follow-up experiment, we tested whether these results would replicate in a task design without rhythmic presentation of target items. Participants (N = 6 with on average >2500 trials, each) retained two line-figures in memory while being distracted by acoustic noise of varying onset across trials. In agreement with the main experiment, the temporal onset of the distractor periodically modulated memory performance. These results suggest that during working memory retention, the human cognitive system implements distractor suppression in a temporally dynamic fashion, reflected in ~400-ms long cycles of high versus low distractibility.

Validation of the suppression ratio from a simplified EEG montage during targeted temperature management after cardiac arrest

AIM

The Suppression Ratio (SR) estimates the percent of the electroencephalography (EEG) epoch with very low voltage, and is associated with neurological outcome after cardiac arrest. We aimed to compare the SR generated by two monitoring devices and determine the association between SR and patterns on amplitude integrated EEG (aEEG) and full conventional EEG (cEEG).

METHODS

Consecutive adult patients treated with TTM after cardiac arrest were enrolled. We compared the SR from the Medtronic Vista monitor (MSR) to the SR generated from the full montage cEEG with Persyst Magic-Marker software (PSR). A blinded neurologist, board certified in epilepsy, scored the 4-channel aEEG pattern and the cEEG background using standardized terminology. Values for SR were compared to aEEG and cEEG categories using Kruskal-Wallis ANOVA, and to each other using Altman-Bland methodology.

RESULTS

23 adults treated with TTM had a mean core temperature of 33.8 °C at the time of SR and EEG background analysis. The MSR was 0% during continuous cEEG background, 23% when cEEG was discontinuous, and 64% during cEEG burst suppression (p = 0.01). The MSR was 0% during aEEG continuous patterns, 34% during aEEG burst suppression, and 46% during flat aEEG (p < 0.001). The MSR and PSR were highly correlated (0.88, p < 0.0001), with minimal bias (0.3%) and excellent 95% limits of agreement (-2.9 to 2.4%).

CONCLUSION

The Suppression Ratio from the Medtronic Vista monitor is highly correlated with the full montage SR from Persyst software. The MSR values are valid, changing with different aEEG patterns and cEEG background categories.

Implicit attentional biases in a changing environment

The current study investigates whether statistical regularities that change over time affect attentional selection. While searching for a target singleton, the distractor singleton was presented much more often in one location than in all other locations. Crucially, the location that had a distractor much more often, changed to new locations during the course of the experiment. Here we established exactly how the bias of attention followed these changes in the display. Unlike previous studies, we show that selection was remarkably flexible as the attentional bias followed the changes in the environment incorporating contributions of previous contingencies to the current attentional bias. Importantly, the initial learning experience had a lingering and enduring effect on subsequent attentional biases. We argue that the weights within the spatial priority map of selection are adjusted to changing environments, even though observers are unaware of these changes in the environment.

Suppressive mechanisms by Heligmosomoides polygyrus-induced Tregs in C57BL/6 mice change over time and differ to that of naïve mice

Disrupting or harnessing immune suppression is leading to new therapeutic avenues in a number of immune-related diseases. Understanding the suppressive functions of regulatory T cells (Tregs) in different environments is therefore key. Parasitic worms are strong inducers of Tregs and previous research has suggested that parasite-induced Tregs are stronger suppressors than naïve Tregs. In strains susceptible to the intestinal worm Heligmosomoides polygyrus, like C57BL/6 mice, it has been hypothesized that increased Treg suppression downregulates both Th1 and Th2 responses, leading to chronic infections and high worm burden. Here, we show that the suppressive capacity of Tregs is no different between cells from infected and/or naive animals. In vitro suppression induced by CD4⁺ CD25⁺ Tregs (Peyers' Patches or the mesenteric lymph nodes), isolated early (day 7, tissue dwelling phase) or late (day 21, luminal phase) during infection was similar to that induced by cells from naïve animals. Suppression was CTLA-4 dependent in Tregs from acute but not chronic infection or in Tregs from naïve animals. This highlights the versatility of Tregs and the importance of extensive Treg characterization prior to potential in vivo manipulation of this cell type.

The Suppression of Inferences From Counterfactual Conditionals

We examine two competing effects of beliefs on conditional inferences. The suppression effect occurs for conditionals, for example, "if she watered the plants they bloomed," when beliefs about additional background conditions, for example, "if the sun shone they bloomed" decrease the frequency of inferences such as modus tollens (from "the plants did not bloom" to "therefore she did not water them"). In contrast, the counterfactual elevation effect occurs for counterfactual conditionals, for example, "if she had watered the plants they would have bloomed," when beliefs about the known or presupposed facts, "she did not water the plants and they did not bloom" increase the frequency of inferences such as modus tollens. We report six experiments that show that beliefs about additional conditions take precedence over beliefs about presupposed facts for counterfactuals. The modus tollens inference is suppressed for counterfactuals that contain additional conditions (Experiments 1a and 1b). The denial of the antecedent inference (from "she did not water the plants" to "therefore they did not bloom") is suppressed for counterfactuals that contain alternatives (Experiments 2a and 2b). We report a new "switched-suppression" effect for conditionals with negated components, for example, "if she had not watered the plants they would not have bloomed": modus tollens is suppressed by alternatives and denial of the antecedent by additional conditions, rather than vice versa (Experiments 3a and 3b). We discuss the implications of the results for alternative theories of conditional reasoning.

Goodbye SIRS? Innate, trained and adaptive immunity and pathogenesis of organ dysfunction

The novel concepts within Sepsis‑3 criteria include a focus on dysregulated host responses, removal of the systemic inflammation response syndrome (SIRS) criteria from sepsis diagnosis, the use of Sepsis-related (Sequential) Organ Failure Assessment (SOFA) scores to define organ dysfunction, and the explicit recognition of the septic shock as a subset of sepsis. Protection against infection requires a surveillance system, an effector response against "perceived" pathogens, a method for regaining immune homeostasis following an immune response, and generation of immunological memory. In comparison to normally regulated responses to infection, the innate immune system shows profoundly abnormal neutrophil and macrophage function. Similarly, the adaptive immune system is typically depleted numerically of lymphocytes and functionally with T and B cell exhaustion. Although there are numerous proposed mechanisms by which these dysregulated immune responses may be associated with organ failure, it is unclear what the unifying organ failure mechanisms in sepsis are. Furthermore, in sepsis survivors, the epigenetic changes on immune cells and widespread changes to lymphocyte populations may increase the risk of adverse events such as rehospitalisation and mortality. Finally, our current gaps in understanding of the immune response trajectory and the associated modifiable mechanisms in sepsis leave us a long way from successful immunomodulation for these patients. This article is freely available.