Problem-solving training modifies cognitive functioning and related functional connectivity in healthy adults.

Cognitive functioning evolves throughout life. Regular practice of stimulating activities maintains or even strengthens cognitive skills. This study investigated the effects of a cognitive training programme based on complex closed-ended problem solving on innovative thinking. To this end, using partial least squares variance-based structural equation modeling, we first evaluated in 83 healthy adults how inhibition, cognitive flexibility, and reasoning were related to the distinct dimensions of innovative thinking. Second, we assessed how these interactions were modified after cognitive training based on problem solving in a subgroup of 16 subjects compared to leisure activity based on crossword solving in another subgroup of 15 subjects. Third, in a pilot fMRI study, we evaluated changes in brain connectivity at rest as a result of training in the problem solving group. Data on cognitive measures showed that innovative thinking was influenced by reasoning in control subjects, whereas it was influenced by cognitive flexibility following problem-solving training. These findings highlight that a cognitive intervention based on complex closed-ended problem solving promotes innovative thinking by changing the way subjects recruit and use relevant cognitive processes. Modifications in the resting-state connectivity of attention, default mode and visual networks were observed in the problem solving group.

Perceived Stress, Personality Traits, and State of Victim's Consciousness: Impact on Tourniquet Application Time and Effectiveness.

INTRODUCTION: One of the main avoidable causes of combat-related injury death is extremity hemorrhage. Even with regular training, failure to properly apply a tourniquet is common. In this study, we sought to assess if rescuer's stress and personality traits, along with victim's state of consciousness, had a role to explain tourniquet application failure. MATERIALS AND METHODS: Eighty-seven soldiers completed a sociodemographic and personality questionnaire (perceived stress, active altruism, mindfulness, and empathy) during a forward combat casualty care course. Then, they underwent a leg hemorrhage simulation on a randomly conscious or unconscious victim. Tourniquet application time and effectiveness (using popliteal artery Doppler) were recorded. RESULTS: Tourniquet application effective rate was 37% and soldiers with higher levels of perceived stress were at greater risk of failure, especially on a conscious victim. Participants who deployed overseas and those who have undergone combat rescue training were significantly quicker to apply a tourniquet. Altruist and empathetic caregivers were slower to apply the tourniquet while mindful ones were faster. CONCLUSIONS: Combat-related injuries, even simulated, not only involve the rescuer's technical skills but also their ability to deal with stressful external stimuli. Tourniquet application speed seems to be influenced by perceived stress and personality traits of the rescuers. Frequent failures justify repeated training, and one way to pursue improvement could be to develop a personalized pedagogy adapting to the needs of the students according to their current skillset but also their perceived stress and personality determinants. In the pedagogical process (planning, goal setting, teaching, and evaluating), the state of consciousness of the victim seems to be a parameter that needs to be accounted for, but further studies are required to accurately describe its influence.

A comprehensive approach to study the resting-state brain network related to creative potential.

Studies related to creativity generally investigate cognition and brain functioning linked to creative achievement. However, this approach does not allow characterization of creative potential. To better define creative potential, we studied cognitive function related to creative processes and the associated brain resting functional connectivity. Therefore, in this pilot study, we constructed a cognitive functioning model via structural equation modeling assuming an influence of working memory (WM) and analytical thinking on creativity assessed by the Torrance Tests of Creative Thinking. On the basis of this model, we differentiated two groups with different functioning levels on the basis of their creative score. We identified one group as the high-creative potential group, with a positive correlation between WM and creativity and a negative correlation between analytical thinking and creativity. The other group was the low-creative potential group, with no correlation between WM and creativity and a negative correlation between analytical thinking and creativity. Then, we examined brain functional connectivity at rest and found that the high-creative potential group had increased connectivity in the attentional network (AN) and default-mode network (DMN) and decreased connectivity in the salience network (SN). Our findings highlight the involvement of the AN. We, therefore, linked this network to creative potential, which is consistent with cognitive theories suggesting that creativity is underpinned by attentional processes.

[COVID-19 and micronutrients to regulate the immune response]. / Covid-19 et les micronutriments en régulation de la réponse immunitaire.

Our social environment shapes our eating habits, notably our consumption of fruit and vegetables rich in micronutrients (vitamins and trace elements), essential for regulating the immune system. Ensuring a balanced intake of micronutrients could prove to be particularly beneficial for patients with severe forms of COVID-19 suffering from critical immune dysregulation.

[Improving parasympathetic functioning to contain the inflammatory response of COVID-19 infection]. / Améliorer le fonctionnement parasympathique pour contenir l'effet inflammatoire de la Covid-19.

COVID-19 infection results in an unrestrained inflammatory reaction in serious cases. The autonomic nervous system (ANS), in particular the parasympathetic branch, helps to regulate the inflammatory response. A dysfunction of this branch, frequent in people at risk of developing COVID-19, favours a pro-inflammatory effect. Reinforcing and stimulating the parasympathetic ANS is possible and accessible to paramedical and medical professionals.

[Eating better to improve resistance to sars-Cov-2]. / Mieux se nourrir pour mieux résister au Sars-CoV-2.

Eating habits are evolving. In a public health context, guidelines are regularly updated according to the nutritional status and health of the French population, but some of these recommendations go unheeded. In the context of the current epidemic, nutritional care must be provided to high risk populations as well as to patients presenting, or having presented, COVID-19, in order to favour immunity and recovery.

Resting Brain Functional Networks and Trait Coping.

This study aims to investigate the effects of individual differences in trait coping on brain networks at rest using electroencephalography (EEG) data. EEG recordings were processed using graph theory analysis. Active and passive coping styles were determined according to the factor structure of the Brief Coping Orientation to Problems Experienced questionnaire. A structural equation modeling analysis indicated that the influence of coping strategies on quality of life varies in strength and direction. In particular, active coping strategies were positively correlated with the psychological dimension. Graph measures, at both global and nodal levels, were used to identify the brain network properties in accordance with passive versus active coping styles. Preliminary evidence showed that both the global and nodal graph metrics were affected by the coping strategy in the delta band. During resting state, passive coping strategy participants had network topology characterized by a high global efficiency, indicating an important level of integration between distant brain areas and a high local efficiency and transitivity, suggesting a high local communication between adjacent regions. Various regions, such as the paracentral lobule, posterior cingulate, and other frontal or parietal areas, seemed to play a key role, suggesting that processes such as emotional load are highly solicited in passive coping individuals. In active coping participants, the superior temporal gyrus seemed to be of importance when neurons oscillated in the theta and alpha frequencies.

Influence of Personality Traits on the Effective Performance of Lifesaving Interventions: Example of the Tourniquet Application in Forward Combat Casualty Care.

Introduction: Health care delivery in military conflicts implies high-stress environments. Hemorrhage is the first cause of survivable death among combat casualties, and tourniquet application is one of the most critical lifesaving interventions on the battlefield. However, previous studies have shown high failure rates in tourniquet application. Our study aimed to assess the correlation between personality traits that may interfere with effective tourniquet application in a simulated extremity hemorrhage. Materials: Seventy-two French soldiers, previously trained to forward combat casualty care, were evaluated by self-administered questionnaires and submitted to the simulation in group of six. We focused on measuring the empathic personality of the subjects, their peer-to-peer relationships (altruism), as well as their relationship to themselves (mindfulness and self-esteem). The effectiveness of the tourniquet was evidenced by the interruption of the popliteal artery flow Doppler signal. A composite variable called "efficiency" was defined by elimination of popliteal pulse Doppler signal in less than 60 s. Results: Tourniquet application interrupted arterial flow in 37 participants (51.39%). Efficiency was obtained by 19 participants (26.39%). We observed that soldiers with high active altruism applied less-efficient tourniquet (odds ratio = 0.15; 95% confidence interval = 0.04-0.59). On the contrary, soldiers with high self-esteem scores applied more efficient tourniquet (odds ratio = 3.95; 95% confidence interval = 1.24-12.56). There was no significant difference concerning empathy and mindfulness scores. Conclusion: Tourniquet application is technically simple but painful and may involve personal sensitivity. These initial findings highlight the necessity to further explore the psychological processes involved in lifesaving interventions. Self-esteem stands out as a real asset in terms of military competence and resilience, a major prerequisite in stressful situations. Changing altruistic motivations of soldiers is likely not desirable, but being aware of its potential effects may help to develop personal adaptive strategies and to optimize collective training.

Perturbed Communication in a Virtual Environment to Train Medical Team Leaders.

The VICTEAMS project aims at designing a virtual environment for training medical team leaders to non-technical skills. The virtual environment is populated with autonomous virtual agents who are able to make mistakes (in action or communication) in order to train rescue team leaders and to make them adaptive with all kinds of situations or teams.

[Meningitis due to Capnocytophaga canimorsus without dog bite]. / Méningite à Capnocytophaga canimorsus sans notion de morsure de chien.

INTRODUCTION: Capnocytophaga canimorsus is a fusiform and filamentous gram-negative rod, part of the normal oral flora of dogs and cause rare human febrile acute meningitis, usually severe but curable. OBSERVATION: A sixty years old man presented a severe acute meningitis with fever and confusion. CSF show 4,000 cells/mm3 with 83% neutrophilis, increased protein level (5,02 g/L), very low glucose and positive Gram stain result. The patient fully and quickly recovered with antibiotherapy for 22 days. Bacteriological diagnosis was made by genomic study from CSF culture. The patient has a close contact with his dog without being recently bitten. DISCUSSION: Diagnosis, suggested by bites or contact with dog or cat, gram-negative bacilli with gram stain of CSF specimen, is possible by prolonged culture of CSF or blood sample, with if necessary genomic study. Antibioprophylaxis is strongly recommended in cases of deep bite wounds and for immunocompromised patients.