A rare case of atypical intradural extramedullary glioblastoma diagnosed utilizing next-generation sequencing and methylation profiling: illustrative case.

BACKGROUND: Primary spinal cord tumors, especially primary spinal cord glioblastoma multiforme (PSC-GBM), are exceptionally rare, accounting for less than 1.5% of all spinal tumors. Their infrequency and aggressive yet atypical presentation make diagnosis challenging. In uncertain cases, a surgical approach for tissue diagnosis is often optimal. OBSERVATIONS: A 76-year-old male presented with a rapidly progressing clinical history marked by worsening extremity weakness, urinary retention, and periodic fecal incontinence alongside diffuse changes on neuraxis imaging. The patient, in whom subacute polyneuropathy was initially diagnosed, received multiple rounds of steroids and intravenous immunoglobulin without clinical improvement. Histopathological review of the biopsy tissue yielded an initial diagnosis of spindle cell neoplasm. Next-generation sequencing (NGS) is done routinely on all neuropathology specimens at the authors' institution, and methylation profiling is pursued in difficult cases. Ultimately, NGS and methylation profiling results were essential to an integrated final diagnosis of GBM. LESSONS: PSC-GBM is a rare but highly aggressive occurrence of this tumor. Prolonged back pain, rapid neurological decline, and imaging changes warrant the consideration of lesional biopsy for precise disease characterization. In inconclusive cases, NGS has proved invaluable for clinical clarification and diagnosis, underscoring its importance for integrated diagnoses in guiding appropriate treatment strategies.

Wildfires as legacies of agropastoral abandonment: Gendered litter raking and managed burning as historic fire prevention practices in the Monte Pisano of Italy.

Agropastoral practices that historically reduced the flammability of Mediterranean landscapes are poorly understood due to state prohibitions and lack of scientific interest. Oral histories, analysis of agronomical writings, transect walks, and ethnographic study of fire managers and community members in the Monte Pisano of Italy, find legacies of traditional agropastoral practices in present-day landscapes. Forest leaf litter raking, largely carried out by women, combined with fire wood cutting and burning to greatly reduce fire risk. Historic stigmatization of traditional burning and ignoring gendered peasant labor have reduced contemporary scientists' and fire managers' understandings of ecological processes and of options for reducing fire risk. Fire managers in the Mediterranean, and in areas around the world affected by rural depopulation, would benefit from a better understanding of traditional agropastoral and fire management practices. Litter raking has been understudied outside Central Europe, is often gendered, and may have important ecological consequences around the world.

Operative planning for a functional precision medicine assay of recurrent high-grade glioma: illustrative case.

BACKGROUND: Functional precision medicine (FPM) represents a personalized and efficacious modality for treating malignant neoplasms. However, acquiring sufficient live tissue to perform FPM analyses is complicated by both difficult identification on imaging and radiation necrosis, particularly in cases of recurrence. The authors describe a case of planning biopsy trajectories for an FPM assay in a patient with recurrent high-grade glioma. OBSERVATIONS: A 25-year-old male with a history of recurrent high-grade glioma was scheduled for laser ablation and biopsy with ChemoID assaying after regions of potential recurrence were identified on follow-up imaging. Preoperative magnetic resonance (MR) spectroscopy of the regions showed areas of high choline/creatine ratios within lesions of radiation necrosis, which helped in planning the biopsy trajectories to selectively target malignancies for FPM analysis. ChemoID results showed high tumor susceptibility to lomustine, which was implemented as adjuvant therapy. LESSONS: FPM therapy in the setting of recurrence is complicated by radiation necrosis, which can present as malignancy on imaging and interfere with tissue acquisition during biopsy or resection. Thus, operative approaches should be carefully planned with the assistance of imaging modalities such as MR spectroscopy to better ensure effective tissue acquisition for accurate FPM analysis and to promote more definitive treatment of recurrence.

Spirotetramat resistance in Myzus persicae (Sulzer) (Hemiptera: Aphididae) and its association with the presence of the A2666V mutation.

BACKGROUND: Chemicals are widely used to protect field crops against aphid pests and aphid-borne viral diseases. One such species is Myzus persicae (Sulzer), a global pest that attacks a broad array of agricultural crops and transmits many economically damaging plant viruses. This species has evolved resistance to a large number of insecticide compounds as a result of widespread and repeated chemical use in many parts of the world. In this study, we investigated the evolution of resistance to a new plant protection product, spirotetramat, following reported chemical control failures. RESULTS: Our study provides clear phenotypic and genotypic evidence of spirotetramat resistance in populations of M. persicae from Australia. We show there is cross-resistance to other insecticides within the same chemical group, namely spiromesifen and spirodiclofen. We also demonstrate that resistance is associated with the previously reported mutation, A2226V in the target site of spirotetramat, acetyl-CoA carboxylase. Our genetic analysis found all resistant M. persicae populations belong to the same multi-locus clonal type and carry the A2226V mutation, which appears to be inherited as a dominant trait in this species. CONCLUSION: Our findings provide new insight into the resistance conferred by A2226V and have implications for the control of M. persicae in Australia and worldwide. A diagnostic assay developed in this study should serve as a valuable tool for future resistance monitoring and to support the implementation of pest management strategies. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Internet-delivered interpretation training reduces worry and anxiety in individuals with generalized anxiety disorder: A randomized controlled experiment.

Objective: Generalized anxiety disorder (GAD) is a debilitating condition, characterized by negative interpretations about ambiguous situations. This study tested whether entirely internet-delivered interpretation training [cognitive bias modification (CBM)] versus control promotes positive interpretations and reduces worry and anxiety in individuals with GAD, with or without depression. Method: A two-arm (CBM; control) parallel-group randomized controlled experiment. Assessments were preintervention (T0), postintervention (T1), 1-month (T2) postintervention, and 3-month (T3) postintervention. Participants with GAD (with or without comorbid depression) were randomly allocated to either CBM (n = 115) or control (n = 115). Participants, but not researchers, were blind to allocated condition. Participants completed up to 10 online CBM or control sessions across 1 month. Interpretation bias [coprimary outcomes: scrambled sentence test (SST), recognition test (RT)], and number of negative thought intrusions during a breathing focus task were measured at T0 and T1. Self-reported levels of worry [Penn State Worry Questionnaire-trait (PSWQ trait); Penn State Worry Questionnaire-past week (PSWQ weekly)], anxiety [Generalized Anxiety Disorder scale (GAD-7)], depression [Patient Health Questionnaire (PHQ-9)], rumination [Ruminative Response Scale (RRS)], and repetitive negative thinking [RNT; Repetitive Thinking Questionnaire-trait (RTQ-trait)] were assessed at T0-T3. Results: The per-protocol analyses included N = 186 participants (CBM n = 94; control n = 92). As predicted, we found moderate-to-large training effects on the primary outcome of interpretation bias at T1. Secondary outcomes of negative thought intrusions at T1 and self-reported symptoms at T2 were all significantly lower in the CBM versus control condition. All but one effect (trait RNT) were sustained at T3. Conclusions: In this randomized controlled study, we found that fully online interpretation training ameliorated core features of GAD in individuals with or without comorbid depression up to 3 months posttraining. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Effects of modifying interpretation bias on transdiagnostic repetitive negative thinking.

OBJECTIVE: Repetitive negative thinking (RNT; e.g., worry and rumination) is common across emotional disorders, as is the tendency to generate negative interpretations (interpretation bias). Ameliorating negative interpretations via cognitive bias modification of interpretations (CBM-I) reduces worry/rumination, and improves mood in people diagnosed with generalized anxiety disorder (GAD) or depression. We investigated whether these findings generalize to high worry or rumination populations, irrespective of diagnosis, and whether effects are increased by enhancing emotional engagement with training with active generation of positive resolutions of ambiguity and imagery. METHOD: Community volunteers with excessive worry and/or rumination, who were above clinical cut-off on anxiety and/or depression measures, were allocated to an active control condition (n = 54), interpretation training condition with prior activation of RNT (CBM_RNT; n = 54), or training condition augmented with positive outcome generation and imagery (CBM_ENH; n = 53). Interpretation bias, RNT, and mood were assessed before and following 10 Internet-based sessions completed within a 1-month period. RNT and mood questionnaires were also completed at 1-month follow-up. RESULTS: After training, both forms of CBM-I (vs. control) facilitated more positive interpretations and reduced negative intrusions during a worry task. At 1-month follow-up, anxiety, depression, RNT, and worry in the past week were lower in the CBM-I than control conditions, but not rumination or trait worry. Compared with standard CBM-I, the augmented form facilitated more positive interpretations, reduced negative intrusions after training, and reduced trait rumination at 1-month follow-up, but it did not augment effects on trait worry, anxiety or depression. CONCLUSIONS: Interpretation bias maintains transdiagnostic RNT and Internet-based CBM-I can reduce longer-term RNT. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Interpretation training to target repetitive negative thinking in generalized anxiety disorder and depression.

OBJECTIVE: Repetitive negative thinking (RNT) for example, worry in generalized anxiety disorder (GAD) and rumination in depression, is often targeted during psychological treatments. To test the hypothesis that negative interpretation bias contributes to worry and rumination, we assessed the effects of inducing more positive interpretations in reducing RNT. METHOD: Volunteers diagnosed with GAD (66) or depression (65) were randomly allocated to one of two versions of cognitive bias modification for interpretation (CBM-I), either with or without RNT priming prior to training, or a control condition, each involving 10 Internet-delivered sessions. Outcome measures of interpretation bias, a behavioral RNT task and self-reported worry, rumination, anxiety and depression were obtained at baseline, after home-based training and at 1-month follow-up (self-report questionnaires only). RESULTS: CBM-I training, across diagnostic groups, promoted a more positive interpretation bias and led to reductions in worry, rumination, and depressive symptoms, which were maintained at follow-up. Anxiety symptoms were reduced only in the GAD group at follow-up. There were no differences between CBM-I versions; brief priming of RNT did not influence CBM-I effectiveness. Level of interpretation bias post training partially mediated the effects of CBM-I on follow-up questionnaire scores. CONCLUSIONS: In contrast to some recent failures to demonstrate improvements following Internet-delivered CBM, we found that self-reported RNT and negative mood were reduced by CBM-I. This is consistent with a causal role for negative interpretation bias in both worry and rumination, suggesting a useful role for CBM-I within treatments for anxiety and depression. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Automaticity of Attentional Bias to Threat in High and Low Worriers.

Individuals with high levels of worry are more likely than others to attend to possible threats, although the extent of top-down attentional control processes on this bias is unknown. We compared the performance of high (n = 26) and low worriers (n = 26) on a probe discrimination task designed to assess attention to threat cues, under cognitive load or no-load conditions. The expected difference between groups was confirmed, with high worriers being more likely to attend to threat cues than low worriers. Importantly however, there were no significant effects involving condition (cognitive load vs. no-load), nor any significant association with self-perceived attentional control ability. These results suggest that pathological worriers are more likely to attend to threat than are individuals with low levels of worry, regardless of task demands on limited cognitive control resources. This finding is consistent with the dominance of habitual bottom-up influences over top-down control processes in biased attention to threat.

Cognitive bias modification for interpretation with and without prior repetitive negative thinking to reduce worry and rumination in generalised anxiety disorder and depression: protocol for a multisession experimental study with an active control condition.

INTRODUCTION: Worry and rumination are two forms of repetitive thinking characterised by their negative content and apparently uncontrollable nature. Although worry and rumination share common features and have been conceptualised as part of a transdiagnostic repetitive negative thinking (RNT) process, it remains unclear whether they share the same underlying cognitive mechanisms. This multisession experimental study investigates the tendency to make negative interpretations regarding ambiguous information as a cognitive mechanism underlying RNT. We compare multisession cognitive bias modification for interpretations (CBM-I) with an active control condition to examine whether repeatedly training positive interpretations reduces worry and rumination in individuals with generalised anxiety disorder or depression, respectively. Further, we examine the potential modulatory effects of engaging in RNT immediately prior to CBM-I. DESIGN, METHODS AND ANALYSIS: A community sample of individuals meeting diagnostic criteria for either generalised anxiety disorder (n=60) or current major depressive episode (n=60) will be randomly allocated to CBM-I with prior RNT, CBM-I without prior RNT (ie, standard CBM-I), or an active control (no resolution of ambiguity) condition. All conditions receive a 3-week internet-based intervention consisting of one initial session at the first study visit and nine home-based sessions of CBM-I training (or active control). We will assess and compare the effects of CBM-I with and without prior RNT on 'near-transfer' measures of interpretation bias closely related to the training as well as 'far-transfer' outcomes related to RNT and emotional distress. Impact on questionnaire measures will additionally be assessed at 1-month follow-up. Multigroup analyses will be conducted to assess the impact of CBM-I on near-transfer and far-transfer outcome measures.

Magnitude of negative interpretation bias depends on severity of depression.

The present study investigated the hypothesis that the magnitude of negative interpretation bias displayed by those with depression is related to the degree of depression they experience. Seventy one depressed participants (scoring 14 and above on the Beck Depression Inventory II) completed tasks spanning three domains of possible negative interpretations: semantic ambiguity; nonverbal ambiguity and situational ambiguity. Regression analyses revealed that just under half of the variance in depressive symptom severity was explained by the combination of negative interpretation bias tasks, with the strongest predictor of depressive symptom severity being negative interpretation of semantic ambiguity when reading ambiguous text descriptions. Subsidiary group analyses confirmed that severely depressed individuals interpreted emotionally ambiguous information in a more negative way than did their mildly or moderately depressed counterparts. These findings indicate that the degree of negative interpretive bias is closely related to depression severity and that bias manifests especially strongly at the most severe levels of depression. Our findings may help us to refine cognitive theories of depression and be helpful in guiding therapy.

The power of positive thinking: Pathological worry is reduced by thought replacement in Generalized Anxiety Disorder.

Worry in Generalized Anxiety Disorder (GAD), takes a predominantly verbal form, as if talking to oneself about possible negative outcomes. The current study examined alternative approaches to reducing worry by allocating volunteers with GAD to conditions in which they either practiced replacing the usual form of worry with images of possible positive outcomes, or with the same positive outcomes represented verbally. A comparison control condition involved generating positive images not related to worries. Participants received training in the designated method and then practiced it for one week, before attending for reassessment, and completing follow-up questionnaires four weeks later. All groups benefited from training, with decreases in anxiety and worry, and no significant differences between groups. The replacement of worry with different forms of positive ideation, even when unrelated to the content of worry itself, seems to have similar beneficial effects, suggesting that any form of positive ideation can be used to effectively counter worry.

Mechanisms of Selective Attention in Generalized Anxiety Disorder.

A well-established literature has identified different selective attentional orienting mechanisms underlying anxiety-related attentional bias, such as engagement and disengagement of attention. These mechanisms are thought to contribute to the onset and maintenance of anxiety disorders. However, conclusions to date have relied heavily on experimental work from subclinical samples. We therefore investigated individuals with diagnosed generalized anxiety disorder (GAD), healthy volunteers, and individuals with high trait anxiety (but not meeting GAD diagnostic criteria). Across two experiments we found faster disengagement from negative (angry and fearful) faces in GAD groups, an effect opposite to that expected on the basis of the subclinical literature. Together these data challenge current assumptions that we can generalize, to those with GAD, the pattern of selective attentional orienting to threat found in subclinical groups. We suggest a decisive two-stage experiment identifying stimuli of primary salience in GAD, then using these to reexamine orienting mechanisms across groups.

Positive Imagery-Based Cognitive Bias Modification as a Web-Based Treatment Tool for Depressed Adults: A Randomized Controlled Trial.

Depression is a global health problem requiring treatment innovation. Targeting neglected cognitive aspects may provide a useful route. We tested a cognitive-training paradigm using positive mental imagery (imagery cognitive bias modification, imagery CBM), developed via experimental psychopathology studies, in a randomized controlled trial. Training was delivered via the Internet to 150 individuals with current major depression. Unexpectedly, there was no significant advantage for imagery CBM compared with a closely matched control for depression symptoms as a whole in the full sample. In exploratory analyses, compared with the control, imagery CBM significantly improved anhedonia over the intervention and improved depression symptoms as a whole for those participants with fewer than five episodes of depression and those who engaged to a threshold level of imagery. Results suggest avenues for improving imagery CBM to inform low-intensity treatment tools for depression. Anhedonia may be a useful treatment target for future work.

How can we enhance cognitive bias modification techniques? The effects of prospective cognition.

BACKGROUND AND OBJECTIVES: Cognitive bias modification for interpretation, a computerized program which manipulates biased interpretations, has shown therapeutic promise, including evidence that negatively biased interpretations can be reduced, leading to corresponding improvements in symptoms. Cognitive bias modification for cognitive errors (CBM-errors) is a second generation CBM-I procedure which manipulates seven types of cognitive error and is especially relevant to depressive cognition. The aim of this study was to investigate whether the effects of the CBM-errors manipulation would be enhanced by adding a component facilitating prospective cognition to help embed and extend newly acquired interpretations. METHODS: A sample of 80 volunteers completed a single session experiment. With a pretraining-posttraining design, we compared the effects of enhanced CBM-errors (targeting cognitive errors plus prospective cognition) with standard CBM-errors (targeting cognitive errors without prospective cognition), on interpretations of new material and mood. RESULTS: Significant differences between enhanced and standard CBM-errors revealed that enhanced positive training was more effective at decreasing negative interpretations compared to the standard procedure. LIMITATIONS: Extending the current investigation to a sample dysphoria or depression is needed for an appropriate next step. CONCLUSION: The findings serve as 'a proof of principle' for the potential of prospective cognition to enhance the effects of CBM-errors and other similar CBM procedures. Further work to enhance the effectiveness of CBM procedures is needed.

Delineating the Role of Negative Verbal Thinking in Promoting Worry, Perceived Threat, and Anxiety.

Worry is characterized by streams of verbal thoughts about potential negative outcomes. Individuals with high levels of worry (and particularly those with generalized anxiety disorder) find it very difficult to control worry once it has started. What is not clear is the extent to which verbal negative thinking style maintains worry. Our study aimed to disentangle the effects of verbal versus imagery based thinking, and negative versus positive worry-related content on subsequent negative intrusive thoughts. High worriers were trained to engage in imagery or verbal processing, focusing on either negative or positive outcomes of their current main worry. Both thinking style and valence of worry content influenced later negative intrusive thoughts that play a role in initiating worry episodes. In contrast, only valence influenced subjective ratings of worry outcomes (i.e., cost, concern, and ability to cope, although not probability), with positive valence leading to lower ratings, irrespective of thinking style.

Verbal worry facilitates attention to threat in high-worriers.

BACKGROUND AND OBJECTIVES: Worry is predominantly a verbal-linguistic process with relatively little imagery. This study investigated whether the verbal nature of worry contributes to the maintenance of worry by enhancing attention to threat. It was hypothesised that verbal worry would lead to greater attentional bias to threat than imagery-based worry. METHODS: Fifty high-worriers were randomly assigned to one of two groups, one in which they were instructed to worry in a verbal way and one in which they worried in an imagery-based way, before completing a dot probe task as a measure of attention to threat-related words. RESULTS: Those who worried in verbal form demonstrated greater attentional bias to threat than did those who worried in imagery-based form. These findings could not be accounted for by group differences in personal relevance of or distress associated with worry topics, state mood following worry, levels of the relatedness of participants' worries to stimuli on the dot probe task, trait anxiety, general propensity to worry, nor adherence to the worry training. LIMITATIONS: The present study only included word stimuli in the dot probe task; inclusion of images would allow for firmly rejecting the hypothesis that the attention effects observed following verbal worry were merely a result of priming verbal threat representations. Also, future studies could include a further control group that does not engage in any form of worry to ascertain that verbal worry increased attentional bias rather than imagery decreasing pre-existing attentional bias. CONCLUSIONS: Possible mechanisms underlying this effect of verbal worry on attention to threat are discussed, together with clinical implications of the current findings.

Scandals, audits, and fictions: Linking climate change to Mexican forests.

Over the past 10 years, Mexican officials and scientists have promoted the project of protecting Mexican forests in order to mitigate climate change, forests acting to absorb carbon dioxide from the atmosphere. This article compares existing policies around mass reforestation and markets for environmental services, and their relationships to a policy in construction - Reduced Emissions through Degradation and Deforestation. Mass reforestation policies collapsed in the face of politicized audits and stories about corruption; markets for environmental services continued with little criticism, stabilized in part by the charisma of Reduced Emissions through Degradation and Deforestation policies. I explain the collapse of mass reforestation policies as being due to failed knowledge performances by officials and scientists; such failures are assessed by more or less skeptical publics who expect specific ways of performing credible public knowledge. Areas of nonknowledge can be tamed as calculable uncertainty, or alternatively transformed into ontological indeterminacy, scandals, and stories of corruption. Areas of nonknowledge are not pathological: they may support, as well as undermine, climate science, the authority of institutions, or the credibility of carbon accounts.

Characteristics of worry in generalized anxiety disorder.

BACKGROUND & OBJECTIVES: Groups of clients and community volunteers with Generalized Anxiety Disorder (GAD) and clients with Panic Disorder were compared to a group with elevated worry but without GAD on a range of measures, to identify individual differences beyond a high propensity to worry. METHOD: Participants completed standardised questionnaires and a behavioural worry task that assesses frequency and severity of negative thought intrusions. RESULTS: Relative to high worriers, clients with GAD had higher scores on trait anxiety, depression, more negative beliefs about worry, a greater range of worry topics, and more frequent and severe negative thought intrusions. Relative to community volunteers with GAD, clients in treatment reported poorer attentional control. Compared to clients with Panic Disorder, clients with GAD had higher trait anxiety, propensity to worry, negative beliefs and a wider range of worry content. CONCLUSIONS: Results confirmed expectations of group differences based on GAD diagnostic criteria, but also revealed other differences in mood, characteristics of worry, and perceived attentional control that may play a role in the decision to seek treatment.

Feels like the real thing: imagery is both more realistic and emotional than verbal thought.

The production of mental images involves processes that overlap with perception and the extent of this overlap may contribute to reality monitoring errors (i.e., images misremembered as actual events). We hypothesised that mental images would be more confused with having actually seen a pictured object than would alternative representations, such as verbal descriptions. We also investigated whether affective reactions to images were greater than to verbal descriptions, and whether emotionality was associated with more or less reality monitoring confusion. In two experiments signal detection analysis revealed that mental images were more likely to be confused with viewed pictures than were verbal descriptions. There was a general response bias to endorse all emotionally negative items, but accuracy of discrimination between imagery and viewed pictures was not significantly influenced by emotional valence. In a third experiment we found that accuracy of reality monitoring depended on encoding: images were more accurately discriminated from viewed pictures when rated for affect than for size. We conclude that mental images are both more emotionally arousing and more likely to be confused with real events than are verbal descriptions, although source accuracy for images varies according to how they are encoded.

A comparison of cognitive bias modification for interpretation and computerized cognitive behavior therapy: effects on anxiety, depression, attentional control, and interpretive bias.

OBJECTIVE: Computerized cognitive behavioral therapy (cCBT) and cognitive bias modification for interpretation (CBM-I) both have demonstrated efficacy in alleviating social anxiety, but how they compare with each other has not been investigated. The present study tested the prediction that both interventions would reduce anxiety relative to a no-intervention comparison condition, but CBM-I would be particularly effective at modifying threat-related cognitive bias under high mental load. METHOD: Sixty-three primarily Caucasian adults (mean age = 22.7, SD = 5.87; 68.3% female) with high social anxiety, randomly allocated to 3 groups: CBM-I (n = 21), cCBT (n = 21), and a no-intervention control group (n = 21) provided complete data for analysis. Pre- and postintervention (4 sessions lasting 2 weeks, control participants only attended the pre-post sessions) self-report measures of anxiety, depression, attentional control, and threat-related interpretive bias were completed. In addition, interpretive bias under high versus low cognitive load was measured using the Scrambled Sentences Test. RESULTS: Both CBM-I and cCBT groups reported significantly reduced levels of social anxiety, trait anxiety, and depression and improved attentional control, relative to the control group, with no clear superiority of either active intervention. Although both active conditions reduced negative bias on the Scrambled Sentences Test completed under mental load, CBM-I was significantly more effective at doing so. CONCLUSIONS: The results suggest that although not differing in therapeutic efficacy, CBM-I and cCBT might differ in the resilience of their effects when under mental load.