Stress profoundly impacts the immune system, functioning as both an enhancer and suppressor of immune responses. The ultimate outcome depends on a combination of individual characteristics, genetic, epigenetic, and environmental factors, and the nature of the stressor. Stress hormones influence leukocyte trafficking, activity, cytokine production, and the overall immune function, leading to immune dysregulation. This review offers a comprehensive perspective on the physiology of the stress response and its effects on immunity, particularly stress-induced alterations in immune cell function. It explores how stress contributes to immunodeficiencies, allergies, and autoimmune diseases, thereby impacting vaccine efficacy, increasing susceptibility to infections, and promoting cancer development. Stress is implicated in the onset and exacerbation of specific autoimmune disorders and contributes to allergic conditions, intensifying allergic responses in both adults and children, particularly in the context of parenting stress and domestic violence. This review also investigates immune changes associated with specific stressors, including bereavement, intimate partner violence, childhood maltreatment, caregiving stress, and post-traumatic stress disorder. This work addresses the multifaceted dimensions of psychoneuroimmunology, shedding light on the significant health consequences of stress-induced immune dysfunction, and emphasizes the need for integrative therapeutic approaches. Key words Fight and flight " Cortisol " T cells " Antibodies " PTSD.
Neurology. Clinical practiceEvelyn Berger-Sieczkowski, Gudrun Zulehner, Sigrid Klotz, Guenther Regelsberger, Lukas Haider, Silvia Bonelli-Nauer, Karin Trimmel, Ellen Gelpi
BACKGROUND AND OBJECTIVES: Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative disease characterized by significant changes in EEG and structural alterations on MRI. Both are integrated in the current World Health Organization (WHO) surveillance criteria of CJD. We aimed to re-evaluate the EEG recordings, along with clinical and MRI data, in patients with different subtypes of definite CJD by applying the adapted American Clinical Neurophysiology Society (ACNS) criteria, 2021. METHODS: Fifty-one routine EEG recordings in 16 patients with sporadic CJD were reanalyzed. RESULTS: Generalized slowing, according to standard terminology, was present in 94% of patients. Generalized periodic discharges (GPDs) and generalized rhythmic delta activity (GRDA), as defined by the 2021 ACNS criteria, occurred frequently (31% and 38%, respectively). The differentiation from ictal activity may be challenging because 25% (4/16) of the patients fulfilled the criteria of the recently proposed ictal-interictal continuum (IIC) in at least 1 EEG. By contrast, no status epilepticus (SE) was observed. The EEG alterations varied among the different CJD molecular subgroups: more cortical involvement in MM/MV1 and mixed MM/MV1 + 2C histotypes was associated with periodic discharges (PDs) (57% and 80%) and also IIC (43% and 20%). We could not detect any PD or IIC in patients with the VV1 or MV2K (predominant subcortical pathology) histotype. DISCUSSION: Assessing the EEGs according to the 2021 ACNS criteria may help prevent misdiagnosis of nonconvulsive status epilepticus, and repetitive recordings may help in earlier diagnosis of CJD.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSPAmber Ilyas, Syed Moin Ali, Urooj Fatima, Fouzia Kirmani, Sadia Iqbal
OBJECTIVE: To compare anatomy scores following retrieval practice (RP) using multiple-choice questions (MCQs) and short-answer questions (SAQs) in the head and neck and endocrinology modules. STUDY DESIGN: A quasi-experimental study. Place and Duration of the Study: Department of Anatomy, Jinnah Sindh Medical University, Karachi, Pakistan, from April 2023 to February 2024. METHODOLOGY: A total of 350 second-year MBBS students were equally divided into two groups: Group A (all the odd roll numbers) and Group B (all the even roll numbers). Group A practiced retrieval using SAQs and Group B using MCQs in the first module and vice versa in the second module. RP exercises were administered by the principal investigator at the end of lectures, followed by immediate feedback. At the end of each module, a formative assessment of 25 MCQs was administered to assess student performance. Data were entered and analysed using SPSS version 20. An independent samples t-test was used to compare scores between the groups within each module, whereas a paired samples t-test was employed to compare MCQ- and SAQ-based performance across the two modules. RESULTS: Students engaged in RP using SAQs achieved significantly higher scores (mean = 81.734 ± 17.444) than those who practiced with MCQs (mean = 70.978 ± 17.027, p = 0.024). The student deemed the RP exercises to be beneficial. CONCLUSION: RP is beneficial for improving academic performance. SAQs were more effective than MCQs in promoting retention. KEY WORDS: Retrieval practice, Multiple-choice questions, Short-answer questions, Learning, Memory.
OBJECTIVE: Stiers (2026) presented a case example of differential diagnosis in clinical neuropsychology wherein standardized testing was not possible, and discussed a structure and process for using history, behavioral observations, and disease base rates to develop a preliminary diagnosis. In response, Basso et al. (2026) state that these alone are not sufficient, and they emphasize the importance of standardized testing. METHODS: This article describes a clinical encounter where standardized norm-referenced testing was not possible because appropriate standardized tests or norms did not exist, as can occur with, for example, a patient from a rural country who speaks a local dialect and has not had any formal education, a patient with locked-in syndrome, a patient with receptive and expressive aphasia, or a patient who is poorly cooperative. RESULTS: When standardized testing is not possible because of the lack of appropriate tests and norms, what is a neuropsychologist to do? Is it best to say that we can offer no opinion as to the condition of the patient, or is it best to say that we can offer limited opinions pending further data? CONCLUSIONS: My contention is that when testing data are not available, a competent neuropsychologist can still conduct a partial, not full, assessment of brain-behavior relationships and make contributions to patient care based on history, behavioral observations, and disease base rates. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
NeuropsychologyMichael R Basso, Douglas M Whiteside, Matthew R Powell, Dennis R Combs
Stiers (2026) asserts that knowledge of brain-behavior relationships is keenly important for clinical neuropsychologists to possess. We agree wholeheartedly with this emphasis. However, Stiers seems to diminish the importance of norm-referenced testing compared to well-informed clinical observation. We refute this assertion, and we offer examples in which the reliability and validity of expert opinion based upon direct observation are surpassed by norm-referenced testing. We argue that norm-referenced testing is the hallmark virtue of clinical neuropsychologists, and such testing offers the most reliable and valid data in a clinical assessment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Advances in physiology educationYan Liu, Jia Lin, Wenzhen Yu, Chunxiang Tu, Xingui Zhang, Ling Chen, Wenrong Shi
Hands-on experience in measuring core physiological parameters like oxygen consumption (V̇o2) is essential for deep conceptual understanding, yet the prohibitive cost of commercial systems often excludes such experiments from science curricula. To bridge this gap, we developed and implemented a ready-to-use educational module centered on a simple, low-cost metabolic apparatus. The apparatus, constructed from commercially available components, enables direct measurement of V̇o2 and respiratory parameters in conscious mice by students. Moreover, the apparatus was successfully used to detect and quantify the opposing physiological effects of two classic metabolic-modulating drugs: levothyroxine sodium (increasing V̇o2 and minute ventilation) and chlorpromazine hydrochloride (decreasing V̇o2, respiratory frequency, and ventilation). This module transforms abstract principles of energy metabolism, respiratory control, and pharmacology into an investigable, inquiry-based learning experience. The apparatus features straightforward assembly and operation and is accompanied by a comprehensive instructional manual. These attributes render it particularly well suited for integration into undergraduate and graduate physiology and pharmacology laboratories, thereby broadening access to advanced physiological measurement techniques.NEW & NOTEWORTHY We developed a simple, low-cost apparatus for measuring oxygen consumption and respiratory function in conscious mice, using readily available components. This device enables students to directly observe and quantify the effects of classic metabolic-modulating drugs (levothyroxine and chlorpromazine) on energy metabolism and breathing. The apparatus provides a practical, hands-on tool for teaching core concepts in physiology and pharmacology, making sophisticated metabolic measurements accessible to undergraduate and graduate education laboratories where commercial systems are often cost prohibitive.
Advances in physiology educationGregory J Crowther
NEW & NOTEWORTHY In a recent editorial, Erica Wehrwein warns that there is a shortage of people well prepared to teach in the disciplines of anatomy (A) and systems physiology (P). Here I elaborate on Wehrwein's concerns with a personal narrative on how I as a physiologist learned to teach anatomy. My pathway from a new A&P instructor to competent anatomist included three intermediate steps: 1) substituting P for A, 2) seeking help, and 3) evolving new structures.
Advances in physiology educationJosiane Campos Cruz
NEW & NOTEWORTHY This article presents an illustrative pedagogical approach, grounded in my experience with the PhysioArt project, demonstrating how artworks can be used as teaching resources in physiology. Using thyroid physiology as an example illustrates how guided analysis of art can promote student engagement and integrative understanding. Rather than providing a comprehensive evaluation of educational outcomes, this work aims to inspire educators to explore art as a methodological strategy in physiology teaching.
Advances in physiology educationEduardo Mendonça Scheeren, Emmanuel Souza da Rocha
The force-velocity relationship, originally described by Hill (Proc Biol Sci 126: 136-195, 1938), is a foundational concept in muscle physiology and biomechanics. Despite its theoretical relevance, its instructional application remains limited in educational settings without laboratory infrastructure. Here, we present a low-cost strategy for teaching the force-velocity relationship using accessible materials and commonly available software. The procedure was implemented in a regular classroom environment and involved estimating velocity from the number of repetitions performed with different loads over a fixed time interval. Classroom-derived data were used to construct force-velocity and power-velocity curves, with the objective of illustrating expected biomechanical patterns, without evaluating learning outcomes. The activity emphasized biomechanical reasoning and graphical interpretation, incorporating simplified measurement tools as part of the instructional process. The strategy is adaptable to resource-limited contexts and may be extended to other biomechanics topics that require the operationalization of theoretical relationships.NEW & NOTEWORTHY This paper describes a low-cost, classroom-tested instructional strategy for teaching Hill's force-velocity relationship using accessible materials and commonly available software. Classroom-derived data are used to construct force-velocity and power-velocity curves, enabling the operationalization of classical biomechanical concepts without laboratory-grade equipment. The approach is adaptable to resource-limited educational settings and supports hands-on exploration of muscle mechanics.
Ecological and evolutionary physiologyCarlos A Navas, Catherine R Bevier
AbstractIn 1985, two seminal publications redefined the study of acoustic communication in frogs. By demonstrating that male frogs expend energy at rates surpassing those of vigorous locomotion when calling (Taigen and Wells 1985) and that these extreme demands are sustained by trunk muscles with oxidative enzyme profiles rivaling endothermic vertebrates (Taigen et al. 1985), they revealed what was then seen as a physiological paradox through an integrative approach that continues to inspire research. Here, we evaluate the scientific legacy of these studies four decades later using curated citation datasets and thematic analyses. We show that their influence has persisted through sustained citation across disciplines. This broad impact appears rooted in their novel integration of behavioral ecology and comparative physiology, two fields they engaged in complementary ways. Early citations emphasized mechanisms such as oxygen consumption, muscle biochemistry, and performance limits, while later work expanded toward processes and patterns, including sexual selection, ecological trade-offs, and environmental modulation of signaling. Subsequent reframings situate frog calling as an evolved strategy embedded in endocrine regulation, phenology, social responsiveness, and ecological change. The Wells-Taigen collaboration thus stands as a rare example of transdisciplinary integration where mechanistic physiology and ecological realism were jointly advanced, catalyzing enduring conceptual synthesis in evolutionary physiology. By revisiting these papers, we highlight how their intellectual lineages continue to scaffold inquiry into performance, adaptation, and the integrated study of animal behavior and its physiological bases.