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Purpose: Chronic inflammation is integral to myeloproliferative neoplasm (MPN) pathogenesis. JAK inhibitors reduce cytokine levels, but not without significant side effects. Nutrition is a low-risk approach to reduce inflammation and ameliorate symptoms in MPN. We performed a randomized, parallel-arm study to determine the feasibility of an education-focused Mediterranean diet intervention among patients with MPN., Experimental Design: We randomly assigned patients with MPN to either a Mediterranean diet or standard U.S. Dietary Guidelines for Americans (USDA). Groups received equal but separate education with registered dietician counseling and written dietary resources. Patients were prospectively followed for feasibility, adherence, and symptom burden assessments. Biological samples were collected at four timepoints during the 15-week study to explore changes in inflammatory biomarkers and gut microbiome., Results: The Mediterranean diet was as easy to follow for patients with MPN as the standard USDA diet. Approximately 80% of the patients in the Mediterranean diet group achieved a Mediterranean Diet Adherence Score of ≥8 throughout the entire active intervention period, whereas less than 50% of the USDA group achieved a score of ≥8 at any timepoint. Improvement in symptom burden was observed in both diet groups. No significant changes were observed in inflammatory cytokines. The diversity and composition of the gut microbiome remained stable throughout the duration of the intervention., Conclusions: With dietician counseling and written education, patients with MPN can adhere to a Mediterranean eating pattern. Diet interventions may be further developed as a component of MPN care, and potentially incorporated into the management of other hematologic conditions., Significance: Diet is a central tenant of management of chronic conditions characterized by subclinical inflammation, such as cardiovascular disease, but has not entered the treatment algorithm for clonal hematologic disorders. Here, we establish that a Mediterranean diet intervention is feasible in the MPN patient population and can improve symptom burden. These findings warrant large dietary interventions in patients with hematologic disorders to test the impact of diet on clinical outcomes., (© 2024 The Authors; Published by the American Association for Cancer Research.)

Evidence exists that the pandemic has brought about stress, and altered study habits and academic performance. No evidence exists regarding whether metacognition has also been altered. The present field study examined the accuracy and confidence with which college students make grade predictions in a general education course after the pandemic. It tested whether one of three types of biases affected students' predictions as a way to cope with the uncertainty of a final exam's outcome: illusion-of-knowing, optimism, and pessimistic bracing. Students made predictions both before and after completing the final exam (summative assessment) to determine the impact of each of the hypothesized biases on estimates made in a context of varying uncertainty. Accuracy was computed as the difference between expected and actual grades on the final exam. Confidence in the predictions made was measured on a Likert scale. Exam performance was categorized as good, poor, or inadequate. In this study, less-than-desirable performance was accompanied by overestimations. However, overestimations were made with little confidence and benefited from the information acquired from completing the exam. This pattern of results suggests that students who are not doing well are not under the spell of the illusion-of-knowing phenomenon. Indeed, their optimistic predictions are punctured by the awareness of a likely undesirable outcome (as indicated by their weak confidence in the predictions made). Implications and applications of these findings are discussed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Pilotti, El Alaoui and Waked.)

This study examined whether differences exist in the emotional state of students whose approach to undergraduate courses is either preferentially learning-oriented or grade-oriented. It focused on an understudied population of female college students of Saudi Arabian descent who were enrolled in a challenging writing course. Their emotional state was assessed both globally, through the appraisal of their degree of happiness, and locally, through the appraisal of their writing anxiety (a task-specific emotional state). The study contributed to the extant literature by examining whether the association between goal orientation and emotional state, which is predicted by goal orientation theory, could be found in the selected understudied student population. Results illustrate differences between STEM and non-STEM learners. For STEM students, a grade orientation was associated with declining self-reported happiness and increasing writing anxiety. In contrast, for both STEM and non-STEM students, a learning orientation was associated with increasing happiness and declining writing anxiety. Differences existed in the particular type of writing anxiety that was experienced by STEM and non-STEM students. These findings suggest that interventions for students who are struggling academically may need to address personal dispositions if such interventions are to foster subjective well-being (including positive emotions).

Spontaneous periodic hypothermia (SPH) is an exceptionally rare condition characterised by paroxysmal episodes of spontaneous hypothermia. While commonly associated with Shapiro syndrome, which includes SPH, hyperhidrosis and agenesis of the corpus callosum, there are also cases of SPH that do not exhibit these defining characteristics, known as 'Shapiro syndrome variant'. These variants may present with diverse brain imaging findings but no agenesis of the corpus callosum, suggesting different potential aetiologies. Notably, the association of SPH with epilepsy has only been reported in a few cases, and confirming epileptic activity in the context of SPH remains a challenge. In line with this, our report presents two exceptional cases of SPH without significant brain malformation, where we successfully confirmed the presence of epilepsy. The confirmation of epilepsy in these cases is particularly noteworthy, as it adds to the limited documentation of SPH cases with confirmed epilepsy. These findings contribute valuable insights into the association between SPH and epilepsy, enhancing our understanding of this rare condition. Our report also addresses the broader clinical presentations and the physiopathological mechanisms of SPH. By providing comprehensive insights into these aspects, we aim to advance the existing literature and improve our understanding of SPH and its association with epilepsy., Learning Points: SPH is a rare condition, characterised by paroxysmal episodes of spontaneous hypothermia.A dysregulation of the hypothalamic thermostat is thought to be involved in the pathogenesis.Epilepsy may contribute to the pathogenesis of SPH, potentially by involving the hypothalamus., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2023.)

The "Dunning-Kruger effect" refers to the tendency of poor performers to overestimate test outcomes. Although a widespread phenomenon, questions exist regarding its source and sensitivity to countermeasures. The present field study aimed to (a) examine whether practice with tests used in previous classes can enhance students' ability to estimate test outcomes, (b) determine the main source of the effect (i.e., is it unawareness of one's readiness or wishful thinking?), and (c) assess the extent to which particular individual differences can be used as predictors of test performance. In this study, participants practiced with old tests and then completed the final exam. Before and after the exam, they predicted their grades and indicated their subjective confidence in the predictions made. Furthermore, participants' emotional intelligence and self-efficacy about their academic abilities were surveyed. Results suggested that poor performers were not unaware of their test preparation, but rather engaged in wishful thinking. In fact, although they overestimated their test grades, their estimates not only improved after completing the final test but also were regarded with little confidence. Overall, estimation bias was a good predictor of students' final test performance, whereas subjective confidence and emotional intelligence only weakly predicted such performance. Thus, if proactive interventions are to be developed for at-risk students, performance-estimation tasks may offer valuable information regarding such students' future performance in a course much more than emotional intelligence and self-efficacy measures.

The capacity of the human microbiome to modulate inflammation in the context of cancer is becoming increasingly clear. Myeloproliferative neoplasms (MPNs) are chronic hematologic malignancies in which inflammation plays a key role in disease initiation, progression, and symptomatology. To better understand the composition of the gut microbiome in patients with MPN, triplicate fecal samples were collected from 25 MPN patients and 25 non-MPN controls. Although most of the variance between the microbial community compositions could be attributed to the individual (permutational analysis of variance [PERMANOVA], R 2  = 0.92, P  = 0.001), 1.7% of the variance could be attributed to disease status (MPN versus non-MPN). When a more detailed analysis was performed, significantly fewer reads mapping to a species of Phascolarctobacterium , a microbe previously associated with reduced inflammation, were found in MPNs. Further, our data revealed an association between Parabacteroides and tumor necrosis factor alpha (TNF-α), an inflammatory cytokine elevated in MPNs. Taken together, our results indicate a significant difference in the microbiome of MPN patients compared to non-MPN controls, and we identify specific species which may have a role in the chronic inflammation central to this disease. IMPORTANCE MPNs are chronic blood cancers in which inflammation plays a key role in disease initiation, progression, and symptomatology. The gut microbiome modulates normal blood development and inflammation and may also impact the development and manifestation of blood cancers. Therefore, the microbiome may be an important modulator of inflammation in MPN and could potentially be leveraged therapeutically in this disease. However, the relationship between the gut microbiome and MPNs has not been defined. Therefore, we performed an evaluation of the MPN microbiome, comparing the microbiomes of MPN patients with healthy donors and between MPN patients with various states of disease.

In the present study, the tendency to overestimate performance (illusion of knowing) was examined in college students whose educational past experiences had emphasized verbatim learning. Female students enrolled in core curriculum classes were sampled. Classes taught by the same instructor were randomly assigned to a self-assessment practice condition, where students predicted their test and class performance and were asked to reflect on discrepancies between predictions and actual performance, or to a control condition. At the end of the semester, irrespective of condition, as performance declined on the final test, predictions of final test grades became more inflated, but less confident, indicating that students were aware of their own deficiencies. Overall, students in the practice condition displayed not only greater prediction accuracy, but also greater final test performance than students in the control condition. Practice, however, benefited the most self-assessment accuracy of students whose final test grades were just above the passing grade. Although the responses to self-assessment practice of students with a teacher-centered educational past were largely similar to the responses of students from Western countries reported in the extant literature, differences in impact and meaning could be inferred., Competing Interests: The authors have declared that no competing interests exist.

We report the case of a 28-year-old man who presented with recurring episodes of high fever, pleural and pericardial effusions and bilateral hydrocele. He was diagnosed with familial Mediterranean fever (FMF) and responded well to colchicine therapy. Genetic testing showed variants of the MEFV gene (p.Pro369Ser and p.Glu148Gln) previously independently described as having a more benign course of the disease. Their association is very rarely reported. Our patient and our review of the literature suggest that these genetic variants are associated with indolent courses but might also trigger the classic symptoms seen in severe FMF, probably in a compound heterozygous fashion. The combination of these variants should be taken into consideration in the diagnosis and management of patients., Learning Points: Familial Mediterranean fever is characterized by recurring episodes of fever with serositis, arthritis or abdominal pain.Many mutations of the MEFV gene are responsible for the syndrome, but some variants are still of uncertain clinical significance.The p.Pro369Ser and p.Glu148Gln variants are rarely described together and can be pathogenic., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interest, (© EFIM 2019.)

Hematopoietic stem cells (HSCs) maintain an organism's immune system for a lifetime, and derangements in HSC proliferation and differentiation result in hematologic malignancies. Chronic inflammation plays a contributory if not causal role in HSC dysfunction. Inflammation induces HSC exhaustion, which promotes the emergence of mutant clones that may be resistant to an inflammatory microenvironment; this likely promotes the onset of a myeloid hematologic malignancy. Inflammatory cytokines are characteristically high in patients with myeloid malignancies and are linked to disease initiation, symptom burden, disease progression, and worsened prognostic survival. This review will cover our current understanding of the role of inflammation in the initiation, progression, and complications of myeloid hematologic malignancies, drawing from clinical studies as well as murine models. We will also highlight inflammation as a therapeutic target in hematologic malignancies., Competing Interests: The authors declare no conflict of interest.

Background: Viral hepatitis is a serious public health problem affecting billions of people globally. Limited information is available on this issue in Morocco. This cross-sectional study was undertaken with the aim of determining the seroprevalence and risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) among the general population and among blood donors., Methods: Blood samples from volunteers, have been screened with ELISA tests for detecting the hepatitis-B surface antigen (HBsAg) and anti-HCV. Within the seroreactive patients for HCV in the general population, RT-PCR was performed by the Cobas Ampliprep/Cobas Amplicor., Results: HCV and HBV-seropositivity was documented in 1.58% and 1.81% out of 41269 and 23578 participants respectively from the general population. Two patients were found to be co-infected. HCV-RNA was detected by PCR in 70.9% of the 195 anti-HCV positive subjects. The anti-HCV prevalence was not different among males and females (P = 0.3). It increased with age; the highest prevalence was observed among subjects with >50 years old (3.12%). Various risk factors for acquiring HCV infection were identified; age, dental treatment, use of glass syringes and surgical history. In addition to these factors, gender and sexual risk behaviors were found to be associated with higher prevalence of hepatitis B. The HBV positivity was significantly higher among males than females participants in all age groups (P < 0.01). The peak was noticed among males aged 30-49 years (2.4%). None of the 152 persons younger than 20 years had HBsAg or anti-HCV. The prevalence of anti-HCV and HBsAg among 169605 blood donors was 0.62% and 0.96% respectively., Conclusions: Our study provided much important information concerning hepatitis B and C prevalence and risk factors; it confirmed the intermediate endemicity for HCV infection and pointed to a decreasing trend of HBV incidence, which might reclassify Morocco in low HBV endemicity area. This could be attributed primarily to the universal HBV vaccination among infants and healthcare workers over the past 13 years. HCV and HBV infections in the present survey were mainly associated with nosocomial exposures. Prevention and control of HBV infection are needed to reduce HBV transmission between adults.

Introduction: Central nervous system involvement is rare in Wegener granulomatosis. Stroke is the most common event suggestive of the disease., Comment: A 35-year-old woman, who was followed for rhinitis and mild asthma, described gradual decline of visual acuity in the right eye over two months, persistent nasal obstruction and fronto-orbital headache since a few weeks. She presented left hemiparesis due to a stroke, associated with exophthalmos and deficits of the optic nerve and abducens of the right eye. The otolaryngological examination found signs of crusty rhinitis and right nasal stenosis. The diagnosis of Wegener's granulomatosis was established on the basis of the clinical findings, radiological aspects and the presence of ANCA. The patient was treated by antiplatelet agents and high-dose corticosteroids associated with immunosuppressive drugs including cyclophosphamide in a monthly bolus., Discussion: This case illustrates two of the three pathogenic mechanisms that may account for central nervous system involvement in Wegener granulomatosis: vasculitis, extension by contiguity of granulomatous tissue from the nasal cavity or sinuses, and in situ formation of a granuloma into the brain parenchyma or meninges., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)