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ObjectiveIndividuals with temporal lobe epilepsy (TLE) often experience diminished quality of life (QoL). Although comorbid depression is one of the most recognized predictors of poor QoL in TLE, impairments in verbal memory (VM) and executive functioning (EF), have also been identified as risk factors, independent of other biological and psychosocial factors. In this study, we examine the contribution of depression, VM, and EF to QoL in 52 well-characterized medically-refractory TLE patients.MethodsQuality of life was assessed with the Quality of Life in Epilepsy (QOLIE-31) questionnaire and depression symptomatology was evaluated with the Beck Depression Inventory-II (BDI-II). Tests of VM included the California Verbal Learning Test-Second Edition and the Wechsler Memory Scale-Third Edition, Logical Memory and Verbal Paired Associates subtests. Tests of EF included the D-KEFS Category Switching and Color Word Interference Tests, and the Trail Making Test. Using these measures, a principal component (PC) was derived for VM and for EF. Hierarchical multiple linear regression analysis was used to evaluate the unique contributions of BDI-II Score, VM PC, and EF PC to the QOLIE-31 Total Score, while controlling for important clinical and demographic variables. Post-hoc analyses were also performed to examine the contribution of each variable to specific QOLIE subscales.ResultsOf the clinical variables, only number of antiepileptic drugs contributed to QOLIE scores. As expected, severity of depressive symptoms was the most significant predictor of QOLIE Total Score, explaining 43.4% of the variance in total QoL. The VM PC did not contribute to the QOLIE Total Score. Rather, our EF PC emerged as an important predictor of QoL, explaining an additional 5% of the variance, after controlling for clinical variables, depression severity, and VM performance.SignificanceThese findings suggest that a combination of clinical, affective, and cognitive factors influence QoL in patients with TLE. Designing interventions with careful attention to depression and EF may be needed to optimize QoL in patients with refractory TLE and potentially other epilepsy syndromes.

BackgroundMolecular markers of WHO grade II/III glioma are known to have important prognostic and predictive implications and may be associated with unique imaging phenotypes. The purpose of this study is to determine whether three clinically relevant molecular markers identified in gliomas-IDH, 1p/19q, and MGMT status-show distinct quantitative MRI characteristics on FLAIR imaging.MethodsSixty-one patients with grade II/III gliomas who had molecular data and MRI available prior to radiation were included. Quantitative MRI features were extracted that measured tissue heterogeneity (homogeneity and pixel correlation) and FLAIR border distinctiveness (edge contrast; EC). T-tests were conducted to determine whether patients with different genotypes differ across the features. Logistic regression with LASSO regularization was used to determine the optimal combination of MRI and clinical features for predicting molecular subtypes.ResultsPatients with IDH wildtype tumors showed greater signal heterogeneity (p = 0.001) and lower EC (p = 0.008) within the FLAIR region compared to IDH mutant tumors. Among patients with IDH mutant tumors, 1p/19q co-deleted tumors had greater signal heterogeneity (p = 0.002) and lower EC (p = 0.005) compared to 1p/19q intact tumors. MGMT methylated tumors showed lower EC (p = 0.03) compared to the unmethylated group. The combination of FLAIR border distinctness, heterogeneity, and pixel correlation optimally classified tumors by IDH status.ConclusionQuantitative imaging characteristics of FLAIR heterogeneity and border pattern in grade II/III gliomas may provide unique information for determining molecular status at time of initial diagnostic imaging, which may then guide subsequent surgical and medical management.

Taking my trip to a maternity ward to visit my newborn niece as a "clinical case," I visit the phenomenon of digitally surveilling neonates with the self-same devices that were designed to enforce the house-arrest of would-be felons whose noisy place in the cultural imaginary has rendered the neonate's ankle a transgenerational "risk object" in the unconscious collective. In conversation with the ever-emergent genre known as autotheory, I invite the reader to be an accomplice as I "dramatize my unsettlement" contrasting autotheory with Laplanchean "self-theorization" via interludes about temporality, expertise, birth, gender, race, and place that come to life in the tale of The Stork. [ABSTRACT FROM AUTHOR]

With the republication of Adrienne Harris' classic essay, "You must remember this" (Harris, 2009), Psychoanalytic Dialogues continues our new feature, Après Coup. By putting a paper from the early years of the journal in conversation with contemporary readers and writers, we hope to dive into the ways in which psychoanalysts forge relationality in spaces of complexity and contradiction over time, as our experiences- collective, dyadic, or solitary – are always nonlinear and multiply configured. This Apres Coup includes commentaries by Cleonie White, Ph.D. Ken Corbett, Ph.D. Shubha Herlekar, Psy.D. MFT, Victor Donas, M.D. Donnel Stern, Ph.D. and Giuseppe Civitarese, M.D. Ph.D. [ABSTRACT FROM AUTHOR]

Psychoanalytic Dialogues is proud to present a groundbreaking panel on autotheory that pairs Leigh Lyndon's essay, The Ice is Melting, with responses by Gila Ashtor, Masha Borovikova Armyn, Adam Blum, and Maxine Chung Chow. In this brief introduction, autotheory is introduced to frame an emergent conversation that launches from the page, through the potential space carved by readers and writers, to forge an ever more open-source mode of sharing personal experience. [ABSTRACT FROM AUTHOR]

The article discusses the historical hierarchy and division of tasks among mental health practitioners in the United States, particularly in psychoanalytic settings. It highlights the role of psychiatrists as team leaders and primary investigators, social workers as attending to systems, and psychologists as data scientists. The article emphasizes the need to move away from these hierarchical structures and embrace diversity in personal and professional backgrounds and practices. It also explores the themes of belonging, home, and transformation in the context of a chaotic and unsettled world. The article includes personal reflections, autotheoretical essays, and discussions on the work of Adrienne Harris. [Extracted from the article]

We investigated the role of Bruton's tyrosine kinase (Btk) in FcepsilonRI-dependent activation of mouse mast cells, using xid and btk null mutant mice. Unlike B cell development, mast cell development is apparently normal in these btk mutant mice. However, mast cells derived from these mice exhibited significant abnormalities in FcepsilonRI-dependent function. xid mice primed with anti-dinitrophenyl monoclonal IgE antibody exhibited mildly diminished early-phase and severely blunted late-phase anaphylactic reactions in response to antigen challenge in vivo. Consistent with this finding, cultured mast cells derived from the bone marrow cells of xid or btk null mice exhibited mild impairments in degranulation, and more profound defects in the production of several cytokines, upon FcepsilonRI cross-linking. Moreover, the transcriptional activities of these cytokine genes were severely reduced in FcepsilonRI-stimulated btk mutant mast cells. The specificity of these effects of btk mutations was confirmed by the improvement in the ability of btk mutant mast cells to degranulate and to secrete cytokines after the retroviral transfer of wild-type btk cDNA, but not of vector or kinase-dead btk cDNA. Retroviral transfer of Emt (= Itk/Tsk), Btk's closest relative, also partially improved the ability of btk mutant mast cells to secrete mediators. Taken together, these results demonstrate an important role for Btk in the full expression of FcepsilonRI signal transduction in mast cells.

The article discusses the concept of arriving and not arriving alone, as well as the importance of being counted in various aspects of life. It explores the obstacles, challenges, risks, and rewards of belonging and changing one's circumstances. The issue of Psychoanalytic Dialogues presented in the article includes panels that delve into the questions of arriving at new emotional, material, political, and social places and what counts in those situations. The article also highlights the work of David Eng and Shinhee Han on racial melancholia and their exploration of the Asian triple consciousness. Additionally, it discusses Stephen Hartman's examination of digitally surveilling neonates and the politics of theory, as well as the papers by Bettina von Lieres and Afarin Kohan on political activation and trauma work. The article concludes by emphasizing the intersections of politics, action, and trauma and the potential for psychoanalysis to shed light on these areas. [Extracted from the article]

The article discusses the process of producing a peer-reviewed journal and the importance of representing a range of voices and perspectives within the field of psychoanalysis. The concept of "holding the center" is explored, which involves fostering controversy and comparative thought while respecting different theoretical schools and interpretations of core concepts. The article also highlights the diverse and chaotic world in which we live and the need to feature a variety of voices to stretch beyond complacency and demagoguery. The issue of Psychoanalytic Dialogues presented in the article includes panels on topics such as splitting, the more-than-human in psychoanalytic theory, the work of Françoise Dolto, and the impact of socio-political trauma on the psyche. [Extracted from the article]