Functional & integrative genomicsAdnan Amin, Wajid Zaman
Comparative physiology increasingly requires cellular resolution at the level of cell types, tissue microenvironments, and regulatory programs that associate genotype with function under environmental variation. Bulk transcriptomics and tissue-level assays have revealed pathways associated with stress responses, metabolic shifts, and developmental transitions; however, they average signals across heterogeneous cell populations and frequently obscure which cells contribute to physiological phenotypes. Single-cell RNA sequencing (scRNA-seq), single-nucleus RNA sequencing (snRNA-seq), and spatial transcriptomics (ST) address complementary aspects of this limitation by resolving transcriptional heterogeneity and, for spatial approaches, preserving tissue context. These technologies are extending beyond classical biomedical models to non-model animals, enabling discovery of cell states, comparison of cell-type evolution, and spatially informed hypotheses concerning ionoregulation, respiration, immune defense, endocrine signaling, regeneration, and symbiosis. This review provides a physiology-centered blueprint for applying these approaches to non-model species and critically evaluates dissociation and preservation bias, genome annotation, seasonal and ecological variation, biological replication, pseudoreplication, cross-species integration, and spatial resolution. We distinguish descriptive mapping, replicate-aware association, mechanistic hypothesis generation, and causal validation because expression patterns, colocalization, trajectories, and ligand-receptor predictions do not by themselves demonstrate mechanism. Practical reporting and validation standards are proposed to improve reproducibility and connect cellular maps with independent physiological measurements and perturbation experiments.
Clinical neurophysiology : official journal of the International Federation of Clinical NeurophysiologyMartijn R Tannemaat, Janne A M Luijten, Birgit Frauscher, Catalina Alvarado-Rojas, Harald Aurlien, Kristian Bernhard Nilsen, Nens van Alfen, Patrick Kwan, Sánd…
Artificial intelligence (AI) has the potential to transform clinical neurophysiology by enabling the automated analysis of complex physiological signals and large amounts of data. While traditional clinical interpretation relies heavily on expert visual inspection, which is vulnerable to subjectivity and inter-rater variability, AI models excel at identifying patterns in complex time series. This chapter provides an overview of current and emerging clinical applications of AI across various modalities in clinical neurophysiology, including EEG, EMG, NCS, and ultrasound. In EEG, AI demonstrates value in spike and seizure detection, comprehensive interpretation for routine and long-term monitoring, and automated classification in ICU and neonatal settings. In neuromuscular medicine, machine learning and deep learning are used to classify motor unit potentials, recognize specific disease patterns in NCS, and aid in automated segmentation and quantification for nerve and muscle ultrasound. Despite these promising results, multiple barriers must be overcome to reach clinical implementation. Key challenges include data heterogeneity, label noise, limited generalizability, and the lack of explainability in "black-box" deep learning approaches. Furthermore, regulatory and legal challenges, along with ethical concerns like algorithmic bias and clinical accountability, complicate widespread adoption. The use of large international datasets combined with robust validation approaches may enable the development of AI models that reduce diagnostic subjectivity. Ultimately, AI will likely serve as an augmentation and triage tool, allowing clinical neurophysiologists to focus on clinical reasoning while also supporting the training of future residents.
British journal of hospital medicine (London, England : 2005)Yumei Yang
Diagnosing and treating endocrine diseases is a highly complex endeavor requiring advanced clinical reasoning, decision-making, and practical skills. However, traditional medical teaching approaches are unable to fully cater to the cultivation of these skills among residents. Thus, reforming the current teaching model utilized in clinical endocrinology education by introducing problem-based learning (PBL) and simulation-based learning (SBL) methods is imperative. This article aims to review the current application and research progress of PBL and SBL in clinical endocrinology education and explore their potential for synergistic integration. This narrative review synthesizes findings from peer-reviewed literature identified through searches of PubMed, CNKI, and Web of Science databases. The literature was thematically analyzed to summarize implementation models, educational outcomes, and integration strategies across different training stages. Problem-based learning helps deepen the understanding of disease mechanisms and cultivate systems thinking, while simulation-based learning enables healthcare professionals to develop essential skills through practice in controlled, realistic settings. Both methods, when used individually, demonstrate effectiveness in improving learners' knowledge acquisition, skill confidence, and satisfaction, despite the presence of limitations. Research indicates that combining PBL and SBL may more effectively promote the overall development of clinical competence. In conclusion, PBL and SBL are effective methods for improving clinical endocrinology education, and their complementary advantages suggest that synergistic application represents a promising future direction. However, applying this technique necessitates revision of curriculum, more intense teacher training, and the development of new evaluation systems centered on clinical competence.
Journal of visualized experiments : JoVEJan Bielecki, Anders Garm
The box jellyfish Tripedalia cystophora combines image-forming lens eyes and well-characterized visually guided behaviors with a tractable rhopalial nervous system of approximately 1000 neurons, making it an emerging model for systems-level investigation of visual information processing and sensorimotor integration. Swim pacemaker neurons generate motor commands directly controlling bell contractions, and these signals can be recorded extracellularly from the epidermal stalk nerve of an isolated rhopalium, providing a quantitative proxy for visually driven motor output. The strength of the pacemaker response, quantified as standardized neural activity derived from pacemaker signal count and instantaneous frequency, scales with stimulus contrast above the decision transition threshold (DTT), enabling graded evaluation of visually driven sensorimotor integration. In this protocol, we cover the fabrication of extracellular suction electrodes, rhopalial isolation, recording chamber configuration, visual stimulus delivery to the lower lens eye, hardware-level stimulus timing verification, electrode placement on the epidermal stalk nerve, and synchronized electrophysiological and stimulus data acquisition using standard laboratory hardware.
Teaching membrane transport in introductory physiology is challenging because students often struggle to integrate membrane transport, electrochemical gradients, and related mechanisms into clinically meaningful reasoning. To address this problem, a case-based collaborative activity was introduced in a first-year cell physiology course for undergraduate life and medical sciences students. Small groups analyzed a membrane transport disorder, explained the underlying physiological defect, and were permitted to use AI tools during the task. After the activity and short presentation, the students completed the Cell Physiology Bridge & Interaction Survey, an adapted Likert-scale questionnaire assessing perceived links between basic physiology and pathology, perceptions of AI use, and the role of peer interaction in problem-solving. Students reported that the activity strengthened their ability to connect transport mechanisms to disease, increased their confidence in explaining mechanistic failure, and enhanced the relevance of basic physiology to their future studies. AI was viewed as a useful and efficient support tool, but peer discussion remained important for conceptual clarity and deeper understanding. When groups encountered difficulty, students most often reported turning first to AI tools, followed by group discussion. These findings suggest that students perceived a brief, clinically anchored collaborative activity as helpful for connecting mechanistic understanding with clinical reasoning in introductory physiology. Incorporating AI as a supplementary tool may enhance learning efficiency without replacing the critical role of peer collaboration.NEW & NOTEWORTHY This study describes a simple, reproducible case-based collaborative activity in an introductory undergraduate physiology course in which students were permitted to use AI tools while solving clinical problems involving membrane transport disorders. The activity was associated with stronger perceived links between membrane transport and disease, greater confidence in mechanistic explanation, and continued reliance on peer discussion for deeper understanding. These findings suggest that AI can support, but should not replace, collaborative learning in physiology education.
JMIR research protocolsHicran Besikci, Kaan Akalp, Luís Rama, Beatriz Branquinho Gomes, José Pedro Leitão Ferreira, Susana Mouga, Inês Bernardino, Miguel Castelo-Branco, Ana Rita Sou…
BACKGROUND: There is a need for efficient and engaging strategies that will mitigate the effects of aging on cognitive and physical functions while keeping users motivated for long-term adherence. OBJECTIVE: This study protocol is designed to investigate, in older adults, the advantage of integrating cognitive training with aerobic exercise (AE) in fun group sessions to potentiate the effect of training on cognition while improving physical function. The protocol explores the effects of a novel intervention, the Activ4Brain program, on cognition and physical function as well as the underlying neurobiological mechanisms. METHODS: The program consists of group AE classes that include computerized games designed to train cognition during exercise, taking advantage of exercise-induced arousal. Cognitive training task difficulty is adapted throughout the intervention as users improve their performance. Importantly, the setup allows for simultaneous body movements to maintain aerobic activation. This is a 3-arm controlled trial, using a parallel design with a 1:1:1 allocation to an experimental group that is engaged in the Activ4Brain program (24 sessions, twice a week), an active control group that is engaged in AE sessions, and a passive control group. Participants are tested at baseline and after the intervention. The main study outcome is changes in cognition. Additional outcomes include changes in brain and autonomic function, levels of inflammation and neuroprotective markers, cardiovascular and physical functional fitness, and body composition. RESULTS: Data collection started in January 2024 and finished in April 2025. Seventy-three individuals (40 women and 33 men) were enrolled in the study and assigned to the 3 groups. The average age was 66 (SD 6) years. Data analyses are ongoing, with the publication of the results estimated for 2026 and 2027. CONCLUSIONS: This study will produce knowledge important for the development of efficient strategies to fight age-related decline.
Background and Objectives: The transition from pediatric to adult endocrine care represents a vulnerable period for patients with congenital adrenal hyperplasia (CAH), given the risk of loss to follow-up and the evolving physiological and healthcare requirements associated with the transition to adulthood. This study aimed to compare structured and non-structured transition pathways in patients with CAH, focusing on the continuity of adult endocrine care and disease-specific hormonal, clinical, and treatment-related outcomes. Materials and Methods: This single-center, retrospective, observational study included patients with CAH who transitioned from pediatric to adult endocrine care and met predefined pediatric and adult follow-up eligibility criteria. Patients were classified according to whether the transition occurred through a structured multidisciplinary transition program or without participation in the structured program. Outcomes were evaluated during predefined observation periods before and after transfer and included continuity-of-care measures, 17-hydroxyprogesterone (17-OHP) and androstenedione concentrations, achievement of predefined hormonal targets, body mass index (BMI), glucocorticoid and mineralocorticoid treatment, and CAH-related clinical outcomes. Results: Among 67 patients assessed for eligibility, 29 were included: 20 in the structured transition group and 9 in the non-structured transition group. Overall, 62.1% of the study population was female. No significant between-group differences were observed in continuity-of-care measures, including the pediatric-to-adult care gap, first-year adult visit frequency, maximum visit-free interval, first-year loss to follow-up, or active adult endocrine follow-up at the study cutoff. Pre-transition and post-transfer 17-OHP and androstenedione concentrations and achievement of predefined hormonal targets did not differ significantly between groups. No significant longitudinal changes in hormonal outcomes, BMI, or body-surface-area-adjusted hydrocortisone-equivalent glucocorticoid doses were observed within either group. At the study cutoff, 85.0% of patients in the structured group and 77.8% in the non-structured group remained under active adult endocrine follow-up. Conclusions: In this small single-center cohort, no significant differences in the continuity of adult endocrine follow-up or disease-specific outcomes were observed between structured and non-structured transition pathways. Most patients remained engaged with adult endocrine care, and hormonal control showed no evident deterioration following transfer in either group. Given the small sample size and high overall retention, these findings should not be interpreted as evidence of equivalence between the two transition approaches.
Archives of clinical neuropsychology : the official journal of the National Academy of NeuropsychologistsMary K Colvin, Robert L Mapou, Christine Petranovich, Patricia Espe-Pfeifer, Robin L Peterson, Shawn K Acheson, Jeff Schaffert, Veronica J Burton, Paula A Adue…
OBJECTIVE: Learning disorders are common neurodevelopmental disorders that affect cognitive functioning across the lifespan and frequently co-occur with medical and psychiatric conditions. This updated position paper from National Academy of Neuropsychology (NAN)'s Position, Education, and Response Committee discusses the role of neuropsychologists in identifying and diagnosing learning disorders. METHOD: The history of learning disorders is reviewed, along with key legislation related to special education services and disability accommodations. Recent neuroscience, genetics, and education research related to learning disorders is integrated to outline current challenges and future goals for training, clinical practice, and advocacy. RESULTS: Key recommendations for neuropsychologists related to the assessment of learning disorders are detailed, including routine screening, understanding the interface between neuropsychological evaluations and laws regulating access to special education services and disability accommodations, advocacy for insurance coverage, and training in assessment of learning disorders and appropriate interventions. The paper also highlights the incremental value of neuropsychological assessment in complex cases, including differential diagnosis, identification of co-occurring neurodevelopmental, psychiatric, and medical conditions, clarification of mechanisms underlying poor academic performance, and development of individualized intervention recommendations when school-based evaluation or response to intervention is insufficient. CONCLUSIONS: Clinical neuropsychologists are uniquely positioned to advance the science and assessment of learning disorders by integrating academic findings with developmental, cognitive, psychiatric, and medical information to clarify why a student is struggling and to guide individualized treatment planning. Such efforts have the potential to reduce disparities that confer increased risk for lifelong neuropsychological challenges.
This article provides a conceptual overview of the methodology and design of prognostic research. It presents cohort studies as the most suitable design for prognostic investigations and discusses in detail the distinctions between traditional etio logical cohort studies and those primarily aimed at predicting outcomes. The article reviews examples of prognostic studies that focus on predicting gestational diabetes mellitus, renal failure in type 2 diabetes mellitus, osteoporotic fractures in postmenopausal women, outcomes of infertility treatment in women with elevated follicle-stimulating hormone levels, and survival in patients with adrenocortical carcinoma. The importance of adhering to the methodological standards outlined in the STROBE and TRIPOD guidelines is emphasized. It also highlights the need to avoid common design and analytical pitfalls, such as measuring predictors after the outcome has occurred or using ROC analysis without developing a multivari able prediction model. Particular attention is given to employing appropriate statistical methods, as a lack of understanding of these methods may lead to biased inferences and diminish the scientific value of the published research. Incorporating well-designed prognostic cohort studies and rigorous analytical approaches will enhance clinical practice and strengthen the evidence base in modern endocrinology.
Endocrine systems are characterised by complex dynamic behaviours-oscillations, transient responses, feedback regulation, and noise filtering-that are essential to physiological stability. Despite extensive molecular and clinical research, the quantitative principles governing these dynamics remain incompletely understood. In particular, the mechanistic relationship between the metabolic clearance rates of individual hormones and emergent system-level properties such as oscillatory frequency, damping, and stability has not been systematically integrated into endocrine theory. This paper introduces a control-theoretic framework for systems endocrinology, modelling endocrine networks as cascades of second-order negative feedback systems whose parameters are derived directly from measurable clearance-rate values. Two transfer function architectures are defined-G-type (feed-forward) and H-type (feedback)-which encode a spectrum from rapid, responsive regulation to stable, noise-rejecting maintenance. Frequency-domain analysis via Bode plots extracts biologically interpretable metrics including cutoff frequency, bandwidth, phase margin, and stability margins. The framework is demonstrated using the cortisol-HPA axis as a worked example, where model-predicted timescales are shown to be consistent with experimentally observed ultradian pulsatility (~90-minute period), ACTH-stimulation response kinetics, and dexamethasone suppression dynamics. A reference table of clearance-rate-derived parameters for 36 hormones and substrates is provided, enabling immediate application across major endocrine axes. All computational tools are implemented in R and made freely available. By translating standard pharmacokinetic data into the language of control engineering, the framework provides a candidate, testable account of questions that static endocrine models leave qualitative: why cortisol pulsatility occurs on an approximately ultradian timescale, how stable the HPA axis is, and why the timing-not just the dose-of cortisol replacement determines clinical outcome.
PsychophysiologyChad Danyluck, Nissa Doyle, Tyler Thorne, Andy Adler
Physiological synchrony-coordinated changes in physiological activity between individuals-is a frequently studied yet variably interpreted phenomenon in psychological science. Decades of research show that physiological synchrony is ubiquitous across relationship and social contexts, but consensus remains elusive about what it means psychologically. We advance an inferential framework for mapping observed synchrony to warranted psychological conclusions by importing classical principles of psychophysiological inference into the interpersonal domain. Building on Cacioppo and Tassinary's logic of inference, we treat physiological synchrony as an empirical pattern whose meaning depends on three constraints: specificity (which psychological processes remain plausible given the physiological pattern and plausible alternatives), generality (the contexts, relationships, and timescales over which an interpretation should hold), and sensitivity (detectability of the theoretically relevant dynamics given measurement and modeling choices). We ground these constraints in principles of autonomic organization, emphasizing how physiological ambiguity and modes of control shape what synchrony can and cannot mean. We use established approaches to pattern-based psychophysiological inference, including autonomic modes (i.e., configurations of sympathetic-parasympathetic control) and the biopsychosocial model of challenge and threat, to illustrate how multivariate physiological profiles and theoretically relevant contextual information can constrain psychological interpretation. We further argue that model class is an inferential commitment: choices about sampling rate, observation window, preprocessing, and whether coupling is modeled as contemporaneous, lagged, or dynamical determine which forms of coordination are detectable and which interpersonal processes remain viable candidates for interpretation. By integrating contemporary synchrony approaches within this inferential framework, we provide conceptual and methodological guidance for clarifying when physiological synchrony supports strong psychological inference and for specifying the boundary conditions under which those interpretations should generalize.
Physiological researchNikoleta Mazgutova, Daniela Mokra, Andrea Calkovska, Jana Plevkova, Zuzana Biringerova, Juraj Mokry
Simulation is widely used for training practical skills, clinical procedures, critical thinking, and communication. Its application in teaching cardiovascular physiology represents an innovative educational approach. We introduced the Cardiopulmonary Auscultation Patient Simulator (CPS) "Harvey" into the Physiology curriculum for second-year General Medicine students at Jessenius Faculty of Medicine, Comenius University. During practical sessions, students performed heart auscultation and blood pressure measurement tasks in two ways: classical investigation on each other or working with the CPS simulator in small groups (4-8 students). At the end of the practicals, students completed an anonymous questionnaire evaluating this teaching method. Respondents (n=110; 68 Slovak- and 42 English-program students) perceived the simulation-based teaching very positively. Most students reported that simulations improved their understanding of cardiovascular physiology topics previously covered in lectures. They found the activities easy to perform and expressed interest in broader use of simulation in other sessions. The main limitations reported were insufficient time for repeated practice and the relatively large group size. Students suggested longer sessions and smaller working groups. In conclusion, students considered the simulator-based practicals beneficial for learning and helpful for increasing confidence in practical skills. Based on their feedback, we plan to expand the use of simulations to additional physiology practicals and extend session duration to allow more hands-on practice.
Sheng li xue bao : [Acta physiologica Sinica]Yun Wang, Xiao-Min Wang, Ming Fan, Tai Yao, Xiong-Li Yang
The Chinese Association for Physiological Sciences (CAPS), founded in 1926, is one of the earliest and most influential national academic organizations in the field of biological sciences in China. Over the past century, the development of CAPS has been closely linked with the modernization of medical education, the growth of experimental life sciences, national scientific reconstruction, and the increasing demand for public health. Based on historical materials prepared for the centennial of CAPS, this article reviews the major stages of its development, including its foundation and institutional establishment, post-1949 reorganization and disciplinary expansion, revival after the reform and opening-up, internationalization in the new century, and modernization of governance in the new era. From 1926 to 1949, CAPS established an academic community through annual meetings, membership development, and the founding of the Chinese Journal of Physiology, providing an important platform for Chinese physiological research to communicate with the international scientific community. From 1949 to 1977, the society restored its organizational network and expanded into the Chinese Association for Physiological Sciences, reflecting the broader formation of physiology-related disciplines in the new national scientific and educational system. Since 1978, CAPS has resumed national academic conferences and journal publication, strengthened talent cultivation, teaching reform, disciplinary planning, and international cooperation, and gradually transformed from a meeting-oriented society into a comprehensive academic organization. In the new era, the establishment of Party committee, a board of supervisors, improved professional committee management, digital office systems, and international conferences has further promoted standardized, modernized, and internationalized governance. The century-long history of CAPS shows that academic excellence, service to national needs, talent development, the inheritance of scientific spirit, and open collaboration constitute the key experience for the sustainable development of a scientific society and have together shaped an organizational culture characterized by rigor, innovation, collaboration, and dedication.
Nature communicationsJesus Gonzalez-Ferrer, Julian Lehrer, Bruno Alvarez-Esteban, Avelina Moreno-Ochando, Hunter E Schweiger, Jinghui Geng, Luiz F S Eugenio Dos Santos, Sebastian H…
Neuronal classification from extracellular electrophysiological recordings is challenging due to intrinsic waveform variability, noise, and technical differences across experiments, technologies, and species. We introduce HIPPIE (High-dimensional Interpretation of Physiological Patterns In Intercellular Electrophysiology), a deep learning framework that combines self-supervised pretraining on unlabeled datasets with supervised fine-tuning to classify neurons from extracellular recordings. Using conditional convolutional joint autoencoders, HIPPIE learns technology-adjusted representations of waveforms and spiking dynamics. Here we show, across mouse, rat, and macaque recordings, that HIPPIE classifies cell types competitively with existing methods while additionally supporting generative analyses that discriminative models cannot perform, including counterfactual decoding of electrophysiological signals under changed experimental conditioning, cross-species latent interpolation, and a cross-modal analysis revealing that spike-timing modalities and waveform morphology encode largely independent dimensions of neuronal identity. HIPPIE is available as both a Python package and a coding-free web application, providing a unified framework for multimodal neuronal classification across technologies, experimental conditions, and species.
PituitaryDamla N Costa, Rozalina G McCoy, Debraj Mukherjee, Roberto Salvatori
Pituitary disorders often include complex radiology imaging, rare clinical presentations, and need for multidisciplinary decision-making and prolonged follow-up, all features that make them a natural target for artificial intelligence (AI). The resulting literature is expanding rapidly, but carries an unfamiliar vocabulary and set of methods, which can leave clinicians without a clear entry point. This short perspective offers such an entry point, succinctly outlining how AI learns from data, how a clinical AI application moves from question to deployment, providing examples, and addressing how to read the field critically.
PloS oneRashedul Hoque, Fatima H Labeed, Srdjan Cirovic, Michael Pycraft Hughes
Cell electrophysiology is a useful measure of cell function, including ionic state and channel activity, and the way these are altered by pharmacological intervention. However, measurement of whole-cell electrical properties such as resting membrane potential Vm and membrane whole-cell capacitance and conductance is difficult, which has limited the more widespread adoption of electrophysiology in cell biology and drug discovery. The gold-standard method for acquiring this data is patch clamp, a method of measuring single cells that uses a micromanipulated micropipette in contact with the cell surface. Measurement is difficult, slow, and requires a highly skilled operator, whilst automated alternatives are expensive to run. Other methods such as flow cytometry are unable to provide absolute values of Vm, or measure conductance and capacitance characteristics. Dielectrophoresis (DEP) and electrophoretic light scattering (ELS) have recently been shown to provide useful methods of directly measuring absolute Vm and other parameters, whilst examining many more cells (typically tens of thousands in under a minute). In this paper we use DEP and ELS to examine the electrophysiology of human bladder carcinoma cell line HTB-9 following treatment with ATP, glibenclamide and tetraethylammonium, and compare the results to published data obtained by patch clamp. Results indicate that DEP yields Vm and membrane conductance values that are highly comparable to data from patch clamp, at high speed and low cost, demonstrating the usefulness of techniques such as DEP and ELS for electrophysiological study.
Frontiers in endocrinologyQi Zhang, Yuchen Ma, Ying Liu, Arshad Ali, Yan Wang, Fang Zhang, Liang Chen, Xianquan Zhan
Growth hormone (GH) is a multifunctional regulator in somatic growth, metabolism, and tissue repair. Its pulsatile secretion is regulated by hypothalamic GH-releasing hormone (GHRH) and somatostatin (SST), and feedback inhibition by insulin-like growth factor 1 (IGF-1). Dysregulation of GH underlies several clinical disorders, including GH deficiency (GHD), acromegaly, and gigantism. The emerging concept of proteoformics has fundamentally reshaped the traditional view of GH: although human GH is encoded by a single gene, it gives rise to multiple proteoforms (GHPs) with distinct biological activities. In-depth study on GHPs pattern benefits understanding its precise molecular mechanism, discovering new therapeutic targets/drugs, and constructing GHPs-based biomarkers. Integration of proteoformics with multi-omics facilitates the construction of dynamic regulatory networks for GH signaling, thereby providing robust support for biomarker discovery and precision medicine strategies in GH-related diseases. Proteoform-based personalized therapy holds promise to advance current treatments such as somatostatin receptor ligands (SRLs), growth hormone receptor (GHR) antagonists, and long-acting GH formulations, with emerging therapies like antisense oligonucleotides and oral GHRH agonists showing preliminary promise. This review examines the potential role of proteoform-centered multi-omics in advancing personalized diagnosis and treatment, discusses challenges in clinical translation, and outlines a roadmap for integrating GH proteoformics into predictive, preventive, and personalized medicine (3PM).
Australian journal of primary healthJennifer Job, Caroline Nicholson, Ruby Strauss, Min-Chia Tsai, H David McIntyre, Reuben Beer, Andrew Swayne, Joel Petre, Claire Jackson
BACKGROUND: eConsultant is an asynchronous, digital, clinician-to-clinician advice service, giving general practitioners rapid remote access to specialist support for patient care. This study aimed to assess the feasibility, acceptability, and appropriateness of a model triaging selected endocrinology and neurology specialist outpatient referrals to eConsultant in an Australian healthcare setting. METHODS: The proof of concept was conducted for general practitioner (GP) referrals to Mater Hospital Brisbane. The evaluation included analysis of clinical data from the eConsultant platform, GP surveys, and qualitative interviews with patients, GPs, and specialist stakeholders. Survey data and qualitative interview transcripts were analysed to understand acceptability and appropriateness of Triaging Referrals to eConsultant (TReC) to patients and providers. RESULTS: For 11 months (October 2024-August 2025), 51 (21%) endocrinology and 77 (6%) neurology referrals were triaged to eConsultant. Specialists spent on average 20 minutes completing the response, which was provided to GPs in an average of 3.5 business days (s.d. 2.5). The predominant presenting conditions for referrals were unexpected findings on imaging and migraine for neurology, and osteoporosis and hyperthyroidism for endocrinology. Close-out surveys were received from GPs for 14.8% (n = 19) of referrals triaged to eConsultant and in nine cases GPs reported a change to patient care as a result. Interviews highlighted the benefits to patients, including reduced treatment delays, convenience, and continuity of care. The option for continuing with a face-to-face specialist appointment, following receipt of eConsultant advice, was required and preferred by some GPs and patients. CONCLUSIONS: TReC is feasible in the Australian context and has the potential to reduce treatment delays.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in CancerYuanyuan Ren, Feifei Li, Youyang Shi, Sheng Liu
Cancer-related fatigue (CRF) is a multidimensional and highly prevalent symptom that severely impairs the quality of life in patients with cancer. Due to its complex etiology and the limited effectiveness of current therapeutic options, CRF remains a major clinical challenge. Moxibustion, a traditional thermal stimulation therapy characterized by its "warming and tonifying" effects in East Asian medicine, has shown potential in alleviating CRF, however, its underlying biological mechanisms remain insufficiently defined. This review aims to reconstruct the mechanistic basis of moxibustion in the management of CRF from an integrated psychoneuroimmunology (PNI) perspective and to reposition moxibustion as a systemic modulator of the PNI network capable of restoring neuro-endocrine-immune homeostasis rather than a unidimensional warming therapy. Current evidence indicates that moxibustion may exert coordinated regulatory effects on CRF across psychological-emotional, neuroendocrine, and immune-inflammatory dimensions. By reinterpreting the traditional concept of "warming and tonifying" within a modern PNI framework, this review proposes a novel integrative paradigm for moxibustion-based interventions in CRF. This framework supports a transition from symptom-oriented management toward network-level modulation, providing a theoretical foundation for non-pharmacological precision strategies in CRF.
PURPOSE: Gamification is widely adopted in medical education, but recent systematic reviews reveal ambiguous effects on learning outcomes. It remains unclear whether engagement translates to learning or whether game mechanics impose extraneous cognitive load. This quasi-experimental crossover study investigated gamification's impact on student performance and engagement in Team-Based Learning. METHOD: 250 first-year MBBS students at a tertiary medical college (2024-2025) participated in two physiology modules (Central Nervous System, Endocrinology) using either traditional or gamified Group Readiness Assurance Tests (GRAT) in a crossover design. Primary outcomes were Individual Readiness (IRAT) and Application Exercise (AE) scores; secondary outcomes were engagement and satisfaction. RESULTS: Primary outcomes (IRAT and AE scores) did not differ significantly between formats. However, learning trajectory analysis revealed a potential mitigating trend: in Endocrinology, traditional groups showed significant IRAT-to-AE decline (-3.3 percentage points, p = 0.030, d = 0.19), whereas gamified groups' decline was non-significant (-1.9 pp, p = 0.124, d = 0.13).During the GRAT intervention phase, traditional teams outperformed gamified teams in Endocrinology (p = 0.006, d = 1.04), but not CNS (p = 0.43). Qualitative feedback was overwhelmingly positive (90% of responses), praising engagement and teamwork, though 13% cited time pressure as stressful. CONCLUSIONS: Gamification may enhance engagement and may provide a motivational buffer against performance decline in challenging content. This suggest gamification is a context-sensitive design choice requiring careful calibration to balance motivational benefits against cognitive costs.
Langenbeck's archives of surgeryAnna Mikl, M Kießler, M Berlet, M Martignoni, H Friess, C Chiapponi
INTRODUCTION: Although many surgical fields remain male dominated, the rising number of female medical students and physicians raises important questions about engagement dynamics within academic and professional settings. Endocrine Surgery (ES) currently demonstrates high rates of female representation among its fellows all over the world. This study examines gender differences in audience participation at the 43rd Workshop of the Surgical Working Group on Endocrinology (CAEK). METHODS: Lecture sessions of the 43rd Workshop of the CAEK were prospectively observed and analyzed. The study recorded the gender appearance of chairs, speakers, participants asking the first question following each lecture and whether this influenced subsequent audience participation. Gender distributions among attendees and question patterns were compared. RESULTS: A total of 385 participants (52% female, 48% male) attended the conference. 37 sessions were included. Overall, 63 questions were recorded. 34 (54%) came from women and 29 (46%) from men. The first question was posed by a male participant in 14 sessions (51.9%) and by a female participant in 13 sessions (48.1%). When discussion was started by a man, 65.9% of subsequent questions came from other men. 90.9% of follow-up questions came from women, when discussion was opened by another woman. CONCLUSION: Female participation at the 43rd Workshop CAEK was well balanced, although the gender of the first questioner influenced subsequent audience engagement, as observed in other studies. These findings suggest equitable academic engagement in endocrine surgery in Germany, while indicating that the gender of the first questioner is associated with subsequent audience participation.
BMC medical educationZhifang Zhao, Jibin Yao, Zhong Guo, Lei Song, Yihang Song, Jin Zhao
BACKGROUND: We introduced a BOPPPS-based peer instruction approach supported by the Chaoxing Xuexitong platform and examined its association with examination performance and students' learning experiences. METHODS: This study employed a total of 180 s-year undergraduate clinical medicine students from six pre-existing administrative classes at Northwest Minzu University. Three classes received lecture-based teaching (control group, n = 85), while the other three received the BOPPPS-based peer-assisted learning intervention (intervention group, n = 95). Outcomes included final examination scores and responses to end-of-course questionnaires. RESULTS: The BOPPPS-based peer instruction approach was associated with higher final examination scores than lecture-based teaching (75.29 ± 8.40 vs. 71.29 ± 9.48, P = 0.003). Students in the intervention group reported higher scores than controls across all four shared domains, including learning engagement and classroom participation, self-directed learning and learning regulation, understanding/basic-to-clinical integration, and overall learning experience (all P < 0.001). In the intervention-specific questionnaire, mean scores across the four domains were above 4.2 on a five-point scale. CONCLUSIONS: In this single-institution quasi-experimental study, a BOPPPS based peer instruction model was associated with better examination performance and more positive student-reported learning experiences than lecture-based teaching. The model appears feasible for undergraduate physiology teaching, although multicentre studies with stronger control of confounding and longer follow-up are still needed.
eLifeAlessio Paolo Buccino, Arjun Sridhar, David Feng, Karel Svoboda, Joshua H Siegle
The scale of in vivo electrophysiology has expanded in recent years, with simultaneous recordings across thousands of electrodes now becoming routine. These advances have enabled a wide range of discoveries, but they also impose substantial computational demands. Spike sorting, the procedure that extracts spikes from extracellular voltage measurements, remains a major bottleneck: a dataset collected in a few hours can take days to spike sort on a single machine, and the field lacks rigorous validation of the many spike sorting algorithms and preprocessing steps that are in use. Advancing the speed and accuracy of spike sorting is essential to fully realize the potential of large-scale electrophysiology. Here, we present an end-to-end spike sorting pipeline that leverages parallelization to scale to large datasets. The same workflow can run reproducibly on individual workstations, high-performance computing clusters, or cloud environments, with computing resources tailored to each processing step to reduce costs and execution times. In addition, we introduce a benchmarking pipeline, also optimized for parallel processing, that enables systematic comparison of multiple sorting pipelines. Using this framework, we show that Kilosort4, a widely used spike sorting algorithm, outperforms Kilosort2.5. We also show that 7× lossy compression, which substantially reduces the cost of data storage, has minimal impact on spike sorting performance. Together, these pipelines address the urgent need for scalable and transparent spike sorting of electrophysiology data, preparing the field for the coming flood of multi-thousand-channel experiments.
Military medicineAlessandro Ascani Orsini, Chang Liu, Beichen Shen, Mingfeng Cao, Haoyu Xu, Thamilezai Ananthakumar, Sung Min Cho, Nitish Thakor
INTRODUCTION: Real-time cortical and cardiac electrophysiology provides direct insight into brain and heart function, revealing early signs of neurological or circulatory instability, supporting medics with rapid triage, continuous monitoring, and intervention during transport, evacuation, or battlefield operations. However, their deployment remains limited by motion and vibration artifacts that degrade signal integrity in dynamic field settings. This study examines the feasibility of auricular (in-ear) electrode configurations for improved signal robustness compared with scalp and wrist sites under both sustained vibration and dynamic acceleration within custom-built electrodes on matched electronics. MATERIALS AND METHODS: Simultaneous recordings were obtained from the auricular canal (electroencephalogram [EEG] and electrocardiogram [ECG]), temple (F7 EEG), and wrist (ECG) in n = 5 participants across 3 motion conditions: engine off (parked), engine on (parked), and city driving (∼30 mph). Signal quality was assessed via waveform morphology, frequency-domain signal-to-noise ratio (SNR), coherence, and root mean square error (RMSE) relative to inertial measurement unit (IMU) data. RESULTS: Across 5 participants, auricular channels showed reduced 60 Hz interference (∼-8 dB) and slightly higher SNR (median increase of 2 dB during driving) compared with scalp and wrist sites. This trend may reflect mechanical and electromagnetic shielding because of the enclosure of the canal. Under motion conditions, coherence and RMSE suggest weaker coupling between IMU motion and auricular signals compared with on-body sites (∼0.03 higher RMSE and ∼0.05×10-3 lower coherence). CONCLUSIONS: Auricular recordings indicate feasible signal integrity under vehicular motion, compared to conventional scalp and wrist placements. These preliminary results indicate suitability for neurocardiac monitoring.
Journal of neuroendocrinologyPhilippe Chanson, Eduardo Spinedi, François Pralong
Rolf Christian Gaillard was a Swiss physician, scientist, and academic leader whose career contributed significantly to the development of modern European endocrinology and neuroendocrinology. Among his most remarkable qualities was an exceptional talent for organisation and institution-building. Together with his collaborators, Gaillard became internationally recognised for his work on regulation of the hypothalamic-pituitary-adrenal axis. His research demonstrated how immune mediators influence endocrine regulation during infection, inflammation, trauma, and chronic stress. His scientific interests extended beyond neuroendocrinology and included leptin physiology, obesity, appetite regulation, adrenal disorders, adult growth hormone deficiency, metabolic diseases, reproductive endocrinology, and neuroendocrine adaptation. A founding member of European Neuroendocrine Association (ENEA), he subsequently served as its Treasurer and then as its President and largely contributed the success of the ENEA Congresses and Workshops.
Archives of clinical neuropsychology : the official journal of the National Academy of NeuropsychologistsVera A Klinoff, Anthony J Giuliano
The subspecialty of forensic neuropsychology has expanded considerably over the past two decades, along with increasing involvement of neuropsychological assessment in criminal forensic evaluations. Despite this growth, the role of neuropsychology in criminal responsibility (CR) evaluations remains underexamined. This paper (a) outlines the foundational importance of specialized knowledge in forensic neuropsychology as a basis for subspecialty development; (b) examines the potential incremental validity of neuropsychological data in CR evaluations; (c) analyzes the application of neuropsychological findings to key components of CR legal standards; (d) extends this analysis to broader exculpatory doctrines; and (e) frames these discussions in ways that inform multiple forensic stakeholders, including neuropsychologists engaged in forensic practice, forensic psychologists consulting with neuropsychologists, and trainees pursuing integrated training across forensic psychology and neuropsychology.
Archives of clinical neuropsychology : the official journal of the National Academy of NeuropsychologistsHannah M Lovato, Aya Haneda, Lauren Kenney, Kara Eversole, Matthew Calamia, Erin Sullivan-Baca, Rachael L Ellison
OBJECTIVE: Admission to doctoral programs that provide clinical neuropsychology training is highly competitive. The Women in Neuropsychology committee (WIN: Society for Clinical Neuropsychology [SCN], American Psychological Association [APA] Division 40), in collaboration with New2Neuropsychology (N2N), created the Linking with Liaisons (LwL) initiative, the first neuropsychology-focused graduate application cycle initiative. LwL aimed to foster the advancement of underrepresented, minoritized, and repeat applicants through the 2024 doctoral graduate school application cycle in the USA and Canada. METHOD: Applications were matched with neuropsychology liaisons who reviewed application materials and conducted mock interviews. Additionally, applicants received informational sessions on the application process and interviewing. We present descriptive and qualitative survey data collected from 23 applicants and 17 liaisons. RESULTS: Overall, the LwL initiative was rated very highly by both applicants and liaisons for communication, making applicants feel prepared, and offering a unique opportunity. CONCLUSION: Linking with Liaisons successfully engaged the targeted applicant pool, and findings support the feasibility and participant satisfaction with this initiative's format. To date, the success of programs such as the LwL initiative reinforces the importance of developing similar programs to strengthen recruitment and retention of individuals from underrepresented and minoritized groups in the field of clinical neuropsychology.
Frontiers in endocrinologyYulan Cai, Feng Zeng, Chuyu Liu
Patients with type 2 diabetes mellitus (T2DM) have a high burden of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH), but liver fibrosis risk is still not assessed consistently in routine diabetes care. Recent guidelines now support active fibrosis risk stratification in metabolically high-risk populations, yet many endocrinology clinics lack a workable pathway for implementation. This narrative review proposes a risk-adapted outpatient pathway for MASLD/MASH assessment in patients with T2DM. The pathway starts with automated fibrosis-4 index (FIB-4) calculation using routine laboratory data, followed by second-line non-invasive assessment with FibroScan controlled attenuation parameter/liver stiffness measurement or enhanced liver fibrosis testing in patients with indeterminate or high-risk results. Patients at high risk should be referred for hepatology evaluation, with magnetic resonance imaging-proton density fat fraction or magnetic resonance elastography reserved for selected cases in which quantitative assessment or further staging would alter management. The review also addresses implementation barriers, appropriate use of non-invasive tests, treatment strategies with metabolic and liver-related evidence, and validation indicators for real-world assessment. By linking screening, referral, intervention, follow-up and quality control, the proposed pathway aims to move MASLD/MASH care in T2DM from incidental recognition toward structured, measurable and multidisciplinary risk management.
Frontiers in endocrinologyShujian Xu, Cui Zhao, Nannan Sun, Qiang Gao
Thyroid cancer is the most common endocrine malignancy, and standardized residency training is critical for cultivating competent thyroid specialists. However, traditional training faces limitations including insufficient standardized clinical exposure, patient safety concerns, and inconsistent skill assessment. This narrative review analyzes the applications, benefits, challenges, and future directions of artificial intelligence (AI) and virtual reality (VR) in thyroid disease-focused residency training. A literature search was conducted across PubMed, Scopus, and Web of Science, identifying 42 eligible English and Chinese studies published between 2015 and 2025. Results show that AI-driven systems enable objective, real-time assessment of thyroid ultrasound skills, enhance diagnostic decision-making for thyroid nodules, and support adaptive personalized learning. VR simulation platforms provide immersive, risk-free environments for repetitive practice of thyroid surgeries (e.g., thyroidectomy), with AI analytics further enabling precise skill evaluation and longitudinal progress tracking. Despite these advantages, significant obstacles persist: ethical and data security risks, technical limitations in anatomical fidelity and haptic feedback, professional acceptance and curricular integration issues, high economic costs, and potential weakening of humanistic competence. Future development should adhere to a "human-centered, technology-assisted" principle, focusing on core technological breakthroughs, standardized evaluation system construction, phased curriculum integration, and governance mechanism improvement. This review concludes that AI and VR are valuable adjuncts to traditional residency training, with the ultimate goal of cultivating thyroid specialists with both solid clinical skills and humanistic care.
Frontiers in endocrinologyAgata Bronisławska, Olivia Cyran-Stańczak, Robert Bronisławski, Alicja Solecka, Agata Berlińska, Renata Świątkowska-Stodulska, Jarosław Piotr Jendrzejewski
Macrohormones also called macromolecules or macrocomplexes are described as an antigen-antibody complex, consisting of monomeric hormones bound to immunoglobulins. These molecules exhibit minimal or no biological activity. However, their presence may falsely indicate elevation of active hormones levels which can lead to significant diagnostic challenges. Currently, polyethylene glycol precipitation (PEG) is one of the most recognized methods for identifying macrohormones and it has been widely used in diagnosing macroprolactinemia as awareness of its clinical implications is well recognized. Macrohormone assessment is particularly recommended when clinical symptoms are incompatible with laboratory findings, as it may help avoid unnecessary diagnostic procedures and treatments. Recently, there has been an increasing number of reports highlighting diagnostic challenges associated with other macrohormones, including macro-TSH, macro-FSH, macro-LH, macro-PTH, macro-GH, macro-ACTH, macro-insulin, and macro-calcitonin. The presence of these molecules can lead to overdiagnosis. This review aims to summarize the latest findings and highlight the importance of considering the presence of macrohormones in patients with discrepancies between clinical presentation and hormonal laboratory tests.
Frontiers in endocrinologyJuan J Díez, Macarena Alpañés, Pedro Iglesias, Raquel Mateo
PURPOSE: To assess the adequacy of electronic consultations (e-consults) and in-person referrals to an endocrinology department, to describe patterns and causes of inadequacy, and identify factors associated with inadequacy across different referral pathways. METHODS: All e-consults and in-person referrals received by the Department of Endocrinology of a tertiary hospital were prospectively recorded over a 52-working-day period. Consultations were classified as primary care e-consults, primary care in-person referrals, or hospital specialist in-person referrals. Each consultation was evaluated for adequacy and, when inadequate, categorized according to clinical or administrative causes. Priority assignment of primary care in-person referrals was also assessed. Univariable and multivariable logistic regression analyses were performed separately for primary care and hospital in-person referrals to identify factors associated with referral inadequacy. RESULTS: A total of 1,106 consultations were analyzed (e-consults, 187; primary care in-person referrals, 447; hospital in-person referrals, 472). Overall adequacy was 61.8%, with higher adequacy in primary care e-consults (77.5%) than in primary care (63.1%) and hospital in-person referrals (54.4%). Administrative causes predominated among inadequate e-consults, whereas hospital referrals showed both clinical and administrative causes. Among primary care in-person referrals, 46.3% were assigned priority, of which 58.5% were considered inappropriately prioritized. The association between age and adequacy did not follow a linear pattern, with the 41-64 age group showing the highest proportion of inadequacy in both primary care and hospital referrals. Referral origin outside the hospital catchment area was associated with higher inadequacy in primary care referrals. CONCLUSION: Referral inadequacy to endocrinology services is common and varies by consultation modality, diagnostic category, and organizational factors. Targeted strategies to optimize referral pathways and prioritization may improve efficiency and access to specialist endocrine care.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyMarina Gasparini, Nicola Vanacore, Valentina Moro
BACKGROUND: The procedures used for the neuropsychological assessment of patients with dementia have been undergoing significant transformations relating to technological developments and the diffusion of artificial intelligence tools. OBJECTIVES: The integration of a theoretical position and a practical approach is needed in clinical contexts so that newly available tools can enhance the fundamental principles underlying neuropsychological assessment. METHODS: Following a historical review of the various approaches to neuropsychological assessment, an analysis of the risks associated with the introduction of digital techniques, when not supervised by expert clinicians, is presented. The need to integrate new technologies in a comprehensive assessment involving clinical observation, ad-hoc tests, and other sources of information such as neuroimaging and neurophysiological data is discussed. RESULTS: The integration of new technologies with a clinical, personalised approach to the patient represents a challenge for neuropsychology that deserves ad-hoc research and discussion.
JMIR formative researchFarah Hrasnica, Sophie Pitteloud, Jessica Jacot, Maria Christina Antoniou, Inge-Lore Ruiz-Arana, Thérèse Bouthors, Kanetee Busiah, Sophie Stoppa-Vaucher, Micha…
BACKGROUND: Residents in pediatric endocrinology subspecialty units encounter diverse educational scenarios spanning theory, skills, and attitudes; yet, brief residencies frequently limit their exposure to certain clinical cases. Research in medical education demonstrates that e-learning can address such challenges efficiently. We implemented a blended learning model grounded in the Kolb learning cycle that uses structured, case-based e-learning. OBJECTIVE: We aimed to evaluate the utility and usability of blended learning using a novel e-learning tool. METHODS: We used a problem-solving approach and used the physical separation of case-based e-learning (interactive, patient scenario-based online modules) and theoretical content delivery as the educational model for residents in a pediatric endocrinology and diabetology unit. Residents worked asynchronously (on their own time, not simultaneously with others) on clinical scenarios and completed formative assessments (practice tests designed to provide feedback for learning rather than grades) with immediate feedback using a flipped classroom teaching method, in which students review material before group instruction. In addition, all cases could be discussed with specialists during face-to-face learning opportunities through a blended learning approach that combines online and in-person elements. We evaluated Kirkpatrick level 1 (reaction, how participants respond to training) and level 2 (learning, measured as an increase in knowledge or capability) outcomes using the postgraduate Medical E-learning Evaluation Survey (MEES) and the User Experience Questionnaire (UEQ), which assesses users' perceptions of e-learning platforms. RESULTS: Questionnaires from 12 pediatric residents and 1 questionnaire from a fourth-year medical student were evaluated. The main strengths identified were the tool's support for applying content to daily clinical work (12/13, 92% users), provision of timely summaries (n=9, 69% users), access to reliable information sources (n=9, 69% users), and immediate feedback on responses (n=8, 62% users). Key weaknesses included device compatibility for e-learning (n=5, 38% users), limited content personalization (n=4, 31% users), and a lack of a navigation aid (n=4, 31% users). No significant functional issues were reported. The UEQ evaluation showed that dependability received the lowest rating, while attractiveness and stimulation received the highest rating. CONCLUSIONS: Our e-learning proposal provides a practical way to apply theoretical knowledge through interactive clinical cases. Evaluations show that users are highly motivated to engage with e-learning, highlighting our tool's adaptability and effectiveness for postgraduate medical education in pediatric endocrinology. Identifying strengths and weaknesses will guide future improvements. Evaluating various aspects of e-learning remains crucial, as these aspects can affect learning outcomes. However, more longitudinal evaluations of e-learning are necessary to achieve a comprehensive understanding of its effectiveness.
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.
Journal of the history of the behavioral sciencesDavid Ceccarelli, Stefano Canali
This article examines how Italian psychophysiologists engaged with Charles Darwin's evolutionary theory of the emotions (ETE) between 1880 and 1920. Darwin's work on the natural history of emotions converged with a vibrant tradition of experimental psychophysiology that embodied Italian Positivism's scientific ambitions. The article investigates how the reception of Darwin's ETE in post-unification Italy intersected with the local construction of "emotion" as a physiological and experimental object. It first traces the dissemination of Darwin's ideas through key venues such as the Rivista di Filosofia Scientifica, which mediated between evolutionary biology and emerging psychological research. It then examines how Italian researchers operationalized emotion as a physiological object, employing experimental methods to study its somatic expressions. Finally, it analyzes the critiques directed at Darwin's model-particularly its limited account of autonomic functions and its reliance on historical reconstructions-and shows how these reflected a shift toward anatomo-functional approaches and disciplinary autonomy.
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).