An urgent need for COP27: confronting converging crises.

The last 12 months have provided further evidence of the potential for cascading ecological and socio-political crises that were warned of 12 months ago. Then a consensus statement from the Regional Action on Climate Change Symposium warned: "the Earth's climatic, ecological, and human systems are converging towards a crisis that threatens to engulf global civilization within the lifetimes of children now living." Since then, the consequences of a broad set of extreme climate events (notably droughts, floods, and fires) have been compounded by interaction with impacts from multiple pandemics (including COVID-19 and cholera) and the Russia-Ukraine war.

Persistent SARS-CoV-2 Alpha Variant Infection in Immunosuppressed Patient, France, February 2022.

We describe persistent circulation of SARS-CoV-2 Alpha variant in an immunosuppressed patient in France during February 2022. The virus had a new pattern of mutation accumulation. The ongoing circulation of previous variants of concern could lead to reemergence of variants with the potential to propagate future waves of infection.

Progressive multifocal leukoencephalopathy: MRI findings in HIV-infected patients are closer to rituximab- than natalizumab-associated PML.

Objectives: To compare brain MRI findings in progressive multifocal leukoencephalopathy (PML) associated to rituximab and natalizumab treatments and HIV infection.

Materials And Methods: In this retrospective, multicentric study, we analyzed brain MRI exams from 72 patients diagnosed with definite PML: 32 after natalizumab treatment, 20 after rituximab treatment, and 20 HIV patients. We compared T2- or FLAIR-weighted images, diffusion-weighted images, T2*-weighted images, and contrast enhancement features, as well as lesion distribution, especially gray matter involvement.

Beyond 2020: converging crises demand integrated responses: Statement by the RACC International Advisory Committee following the RACC-12 International Forum.

The COVID-19 pandemic illustrates how the impacts of climate change are beginning to converge with other developing challenges with a likely peak with global population, requiring more integrated responses locally, regionally and globally.

Fiber optic CO-laser induced emphysema of the supraglottis.

Subcutaneous emphysema is a rare but well-defined surgical complication. However, emphysema of the supraglottic mucosa has not been described in the literature. We present a case of a 2-year-old male who suffered supraglottic emphysema secondary to fiber optic CO-laser use during laryngeal cleft repair.

Influence of Arctic sea-ice variability on Pacific trade winds.

A conceptual model connecting seasonal loss of Arctic sea ice to midlatitude extreme weather events is applied to the 21st-century intensification of Central Pacific trade winds, emergence of Central Pacific El Nino events, and weakening of the North Pacific Aleutian Low Circulation. According to the model, Arctic Ocean warming following the summer sea-ice melt drives vertical convection that perturbs the upper troposphere. Static stability calculations show that upward convection occurs in annual 40- to 45-d episodes over the seasonally ice-free areas of the Beaufort-to-Kara Sea arc.

Surgically-Relevant Anatomy of the External Auditory Canal Bulge and Scutum.

Hypothesis: Anatomic study of the external auditory canal's (EAC) anterior bulge, scutum, and ossicular chain will generate knowledge applicable to safe ear surgery and instrument design.

Background: The EAC contains two structures that obscure view of the middle ear: the anterior bulge and the scutum. The dimensions of these structures and their relationships to the ossicular chain have not been previously described.

Differential Expression of Mucins in Murine Olfactory Versus Respiratory Epithelium.

Unlabelled: Mucins are a key component of the surface mucus overlying airway epithelium. Given the different functions of the olfactory and respiratory epithelia, we hypothesized that mucins would be differentially expressed between these 2 areas. Secondarily, we evaluated for potential changes in mucin expression with radiation exposure, given the clinical observations of nasal dryness, altered mucus rheology, and smell loss in radiated patients.

Easy Stapes Subluxation in 22q11.2 Deletion Syndrome: A Clinical Capsule and Literature Review.

Objectives: This report describes iatrogenic stapes subluxation in a 22q11 deletion syndrome patient and reviews the human and murine literature for evidence that these patients have stapes malformations. We aim to alert otologic surgeons regarding the possibility of stapes footplate abnormalities in 22q11 deletion patients.

Patient: An adult woman with known 22q11 deletion syndrome.

[Aneurysm of the portal venous system: A rare and unknown pathology].

Introduction: Portal vein aneurysms are rare, representing 3% of venous aneurysms, with about 200 cases described in the literature, probably underestimated.

Case Report: A 66-year-old man, suspect of splenomegaly, underwent an abdominal ultrasound and a thoraco-abdomino-pelvic CT scan showing a 40mm portal vein aneurysm. Final diagnosis was T-cell hemopathy.

Auditory reafferences: the influence of real-time feedback on movement control.

Auditory reafferences are real-time auditory products created by a person's own movements. Whereas the interdependency of action and perception is generally well studied, the auditory feedback channel and the influence of perceptual processes during movement execution remain largely unconsidered. We argue that movements have a rhythmic character that is closely connected to sound, making it possible to manipulate auditory reafferences online to understand their role in motor control.

The perception of natural and modulated movement sounds.

The motor system is engaged when we perceive movement in the environment, even when we have no sensorimotor experience of that movement. It has been suggested that this ability relies on internal models that comprise specific exteroceptive representations, such as audition and vision. It has been shown that, for human movements, the quality of perception depends on the closeness between the perceived movement and the perceiver's own capability of reproducing it.

Non convulsive status epilepticus masquerading as stroke.

This case describes a patient with multiple stroke risk factors—including prior stroke—who presented to the emergency department with symptoms suggestive of stroke and who received a rapid stroke work up but was later found to be in non convulsive status epilepticus (NCSE). This case report highlights the challenge and importance of making an accurate diagnosis in NCSE, and we have included teaching points to help clinicians understand the clinical manifestations and diagnosis of NCSE as well as how it may impact a patient's prognosis. Given the growing attention to rapid stroke protocols in emergency departments across the country, it is important to remember that not all that appears as stroke is stroke, even in people who are at high risk for stroke or in whom stroke is the most likely cause of their neurologic deficits.

The Brief Assessment of Cognition In Affective Disorders (BAC-A):performance of patients with bipolar depression and healthy controls.

Background: Cognitive deficits in bipolar disorder are significant enough to impact everyday functioning. A key question for treatments aimed at cognition is which cognitive domains are most affected by bipolar disorder and which cognitive tests have the best psychometric characteristics for this population.

Method: 432 patients assessed at study entry in a treatment study of bipolar depression were assessed with a version of a new cognitive measure - the Brief Assessment of Cognition in Affective Disorder (BAC-A), which assesses traditional cognitive constructs with six subtests measuring memory, processing speed, working memory, and reasoning and problem solving, and a new measure of affective processing.

Potential side effect of propofol and sevoflurane for anesthesia of anti-NMDA-R encephalitis.

Background: Many anesthetic drugs interact with the NMDA receptor and may therefore alter the clinical presentation of anti-NMDA-R encephalitis.

Case Presentation: A 24-year-old woman was admitted to hospital for decreased consciousness and hyperthermia. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, and elevated protein.

Norms and standardization of the Brief Assessment of Cognition in Schizophrenia (BACS).

According to the recommendations of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Neurocognition Committee, one of the desired characteristics of a cognitive battery for assessing cognition in schizophrenia studies and clinical trials is the availability of normative data. This report describes normative data collected on the Brief Assessment of Cognition in Schizophrenia (BACS) from 404 healthy controls with demographic characteristics matching the 2005 United States Census of English-speakers. The six test measures demonstrated the expected pattern of correlations with age, gender, and education.

Evaluation of the use of six diagnostic X-ray spectra computer codes.

A knowledge of photon energy spectra emitted from X-ray tubes in radiology is crucial for many research domains in the medical field. Since spectrometry is difficult because of high photon fluence rates, a convenient solution is to use computational models. This paper describes the use of six computer codes based on semiempirical or empirical models.