Weinstein et al. demonstrate that the transcription factors T-bet and STAT4 are necessary for Tfh cell expansion with secretion of IFN-γ and IL-21 and consequent robust germinal center output during acute viral infection.

Rationale and Objectives: To assess the immediate impact of the COVID-19 pandemic on Diagnostic and Interventional Radiology education, and to propose measures to preserve and augment trainee education during future crises. Materials and Methods: Diagnostic Radiology (DR) studies and Interventional Radiology (IR) procedures at a single tertiary-care teaching institution between 2015 and 2020 were reviewed. DR was divided by section: body, cardiothoracic, musculoskeletal (MSK), neuroradiology, nuclear medicine, pediatrics, and women's imaging. IR was divided by procedural types: arterial, venous, lymphatic, core, neuro, pediatrics, dialysis, cancer embolization or ablation, noncancer embolization, portal hypertension, and miscellaneous. Impact on didactic education was also assessed. ANOVA, t test, and multiple comparison correction were used for analysis. Results: DR and IR caseloads decreased significantly in April 2020 compared to April of the prior 5 years (both p < 0.0001). Case volumes were reduced in body (49.2%, p < 0.01), MSK (54.2%, p < 0.05), neuro (39.3%, p < 0.05), and women's imaging (75.5%, p < 0.05) in DR, and in arterial (62.6%, p < 0.01), neuro IR (57.6%, p < 0.01) and core IR (42.6%, p < 0.05) in IR. IR trainee average caseload in April 2020 decreased 51.9% compared to April of the prior 5 years (p < 0.01). Utilization of online learning increased in April. Trainees saw significant increases in overall DR didactics (31.3%, p = 0.02) and no reduction in IR didactics, all online. Twelve major national and international DR and IR meetings were canceled or postponed between March and July. Conclusion: Decreases in caseload and widespread cancellation of conferences have had significant impact on DR/IR training during COVID-19 restrictions. Remote learning technologies with annotated case recording, boards-style case reviews, procedural simulation and narrated live cases as well as online lectures and virtual journal clubs increased during this time. Whether remote learning can mitigate lost opportunities from in-person interactions remains uncertain. Optimizing these strategies will be important for potential future restricted learning paradigms and can also be extrapolated to augment trainee education during unrestricted times.

Driving is an important part of everyday life for most adults, and restrictions on driving can place a significant burden on individuals diagnosed with epilepsy. Although sensorimotor deficits during seizures may impair driving, decreased level of consciousness often has a more global effect on patients’ ability to respond appropriately to the environment. Better understanding of the mechanisms underlying alteration of consciousness in epilepsy is important to decision making for people with epilepsy, their physicians, and regulators in regards to the question of fitness to drive. Retrospective cohort and cross-sectional studies based on surveys or crash records can provide valuable information about driving in epilepsy. However, prospective objective testing of ictal driving ability during different types of seizures is needed to more fully understand the role of impaired consciousness and other deficits in disrupting driving. Driving simulators adapted for use in the epilepsy video/EEG monitoring unit may be well-suited to provide both ictal and interictal data in patients with epilepsy. Objective information about impaired driving in specific types of epilepsy and seizures can provide better-informed recommendations regarding fitness to drive, potentially improving quality of life for people living with epilepsy.

In an unfamiliar environment, searching for and navigating to a target requires that spatial information be acquired, stored, processed, and retrieved. In a study encompassing all of these processes, participants acted as taxicab drivers who learned to pick up and deliver passengers in a series of small virtual towns. We used data from these experiments to refine and validate MAGELLAN, a cognitive map-based model of spatial learning and wayfinding. MAGELLAN accounts for the shapes of participants’ spatial learning curves, which measure their experience-based improvement in navigational efficiency in unfamiliar environments. The model also predicts the ease (or difficulty) with which different environments are learned and, within a given environment, which landmarks will be easy (or difficult) to localize from memory. Using just two free parameters, MAGELLAN provides a useful account of how participants’ cognitive maps evolve over time with experience, and how participants use the information stored in their cognitive maps to navigate and explore efficiently.

PurposeLong noncoding RNAs (lncRNAs) play an important role in the tumorigenesis and progression of human cancer. This research was performed to investigate the role of LINC01296 in clinical characteristics, biological functions and molecular mechanisms of bladder cancer.Materials and methodsIn this study, expressions of LINC01296 in cancer tissues and normal tissues were firstly compared using the Gene Expression Profiling Interactive Analysis database. Subsequently, a microarray data analysis was performed to compare lncRNA and mRNA expression profiles in four pairs of human bladder cancer samples. Then, quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of LINC01296 in bladder cancer tissues. The association between LINC01296 expressions and clinicopathological characteristics of bladder cancer was analyzed by Kaplan–Meier analysis and the Cox proportional-hazard model. The biological functions and molecular mechanisms of LINC01296 in bladder cancer were studied by MTT assay, colony-formation assay, cell cycle analysis, transwell migration assay, wound healing assay, qRT-PCR analysis and Western blot assay.ResultsThe expression of LINC01296 was significantly higher in most cancer tissues than that in adjacent normal tissues, and was positively correlated with clinical stages of the cancer (P=0.016), lymph node metastasis (P=0.034), and pathologic grades (P=0.012). The increased level of LINC01296 was associated with a poorer prognosis and shorter survival of the patients. Multivariate analysis showed that the LINC01296 expression was an independent predictor of overall survival in bladder cancer. Additionally, LINC01296 knockdown inhibited the proliferation, migration and progression of cell cycle of bladder cancer cells, and was involved in the regulation of epithelial-mesenchymal transition.ConclusionThe findings of this study suggested that LINC01296 promotes progression of bladder cancer, and potentially acts as a biomarker and therapeutic target of bladder cancer.

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Objective: Clinicians rely on patient self-report of impairment during seizures for decisions including driving eligibility. However, the reliability of patient reports on cognitive and behavioral functions during seizures remains unknown. Methods: We administered a daily questionnaire to epilepsy patients undergoing continuous video-EEG monitoring, asking about responsiveness, speech, memory, awareness, and consciousness during seizures in the preceding 24 hours. We also administered a questionnaire upon admission about responsiveness, speech, and awareness during seizures. Subjective questionnaire answers were compared with objective behavioral ratings on video review. Criteria for agreement were Cohen's kappa >0.60 and proportions of positive and negative agreement both >0.75. Results: We analyzed 86 epileptic seizures in 39 patients. Memory report on the daily questionnaire met criteria for agreement with video review (j = 0.674 for early, 0.743 for late recall). Subjective report of awareness also met agreement criteria with video ratings of memory (j = 0.673 early, 0.774 late). Concordance for speech was relatively good (j = 0.679) but did not meet agreement criteria, nor did responsiveness or consciousness. On the admission questionnaire, agreement criteria were met for subjective report of awareness versus video ratings of memory (j = 0.814 early, 0.806 late), but not for other comparisons. Interpretation: Patient self-report of memory or awareness showed the best concordance with objective memory impairment during seizures. Self-report of impairment in other categories was less reliable. These findings suggest that patient reports about impaired memory during seizures may be most reliable, and otherwise determining functional impairments should be based on objective observations.

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