Search Results (84)

Compulsive fantasy, often called “maladaptive daydreaming,” involves frequent engagement with immersive fantasies that can sometimes interfere with everyday life and cause distress. This paper expands on Christoff and colleagues’ Dynamic Framework of Thought (DFT) to offer a process-based analysis of compulsive fantasy as it relates to other mental phenomena such as daydreaming and creative thought. Drawing on the existing literature and posts on online forums by self-identified maladaptive daydreamers, we also propose an account of how compulsive fantasy episodes may unfold in terms of the oscillating dynamics of various constraints on thought, and how these dynamics may be related to a perceived struggle with agency. Automatic constraints, including affective salience and mental habits, may bring about a fantasy episode. During a fantasy episode, automatic constraints may be relatively high throughout, whereas deliberate constraints may be intermittently engaged to influence the fantasy. Our analysis supports the use of “compulsive fantasy” as a more accurate designation than “maladaptive daydreaming” for this phenomenon: compulsive fantasies are not daydreams, because they are more constrained in their mental dynamics. We show that fantasy and daydreaming are not inherently harmful but can become so when they are accompanied by relatively strong and sustained automatic constraints on thought. Full article

Introduction: Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast lesion characterized by stromal myofibroblast proliferation forming slit-like pseudoangiomatous spaces. Although most frequently diagnosed in premenopausal women, it has also been reported in adolescent girls, where it may present as a rapidly enlarging mass that mimics fibroadenoma or phyllodes tumor. The pathogenesis is thought to be hormonally influenced, particularly by progesterone, with a possible role for estrogen. Case Report: We report the case of a 14-year-old girl who presented with a painless, rapidly growing mass in the left breast, first noticed approximately six months earlier. Clinical examination revealed a mobile lesion about 10 cm in diameter without skin changes, lymphadenopathy, or nipple discharge. Ultrasound and MRI demonstrated a large, well-circumscribed solid tumor (10.4 × 11.2 × 4.2 cm³) displacing normal breast tissue but without infiltration; both were classified as BI-RADS 4. Given the tumor size, diagnostic uncertainty, and potential risk of a non-representative core needle biopsy, a decision was made to proceed with primary radical excision. The mass was completely removed with preservation of the glandular tissue. Histopathology confirmed PASH, described macroscopically as a solid, gray–yellow, encapsulated tumor and microscopically as slit-like spaces lined by spindle cells (CD34+, CD31–). Postoperatively, the breast gradually regained symmetry with the contralateral side, and at 14 months of follow-up, no recurrence was observed. Conclusions: PASH, although benign, may present as a large breast tumor in adolescents and clinically mimic both benign and malignant lesions. Histological evaluation based on an adequately performed biopsy is crucial for accurate diagnosis. Complete excision with capsule preservation is recommended to minimize the risk of recurrence. In adolescents, a watchful waiting approach after surgery may be beneficial, as breast tissue often remodels and regains symmetry spontaneously, reducing the need for reconstructive procedures. This case underscores the importance of individualized diagnostic and therapeutic strategies in managing rare benign breast lesions in pediatric patients. Full article

Trichothecenes are a family of toxic metabolites produced by multiple fungal species. All trichothecene analogs include an epoxide-containing tricyclic structure known as 12,13-epoxytrichothec-9-ene (EPT) but differ by the presence, absence and types of substituents attached to EPT. Among the 21 known genes associated with trichothecene biosynthesis, tri14 is one of only three that are universally found in all trichothecene-producing fungi. Recent studies have revealed that the tri14-encoded protein, Tri14, enhances the biosynthetic reaction that forms EPT, a reaction previously thought to occur spontaneously. In our study, we assessed the impact of tri14 deletion on the biology of Trichoderma arundinaceum, a producer of the trichothecene harzianum A (HA). The results revealed that tri14 deletion reduced HA production by 69%, an outcome that was associated with diminished antifungal activity. To our knowledge, this is the first study showing that tri14 is required for wild-type production of a trichothecene analog by a fungal organism. tri14 deletion also had moderate effects on the expression of some other trichothecene biosynthetic genes, as well as in the production of metabolites beyond HA. These results suggest that Tri14 plays a crucial role in EPT formation, leading to diverse downstream effects on the biology of T. arundinaceum. Full article

VisRep (Visualisation Report) is an AI-powered system for capturing and structuring the early stages of the visualisation design process. It addresses a critical gap in predesign: the lack of tools that can naturally record, organise, and transform raw ideation, spoken thoughts, sketches, and evolving concepts into polished, shareable outputs. Users engage in talk-aloud sessions through a terminal-style interface supported by intelligent transcription and eleven structured questions that frame intent, audience, and output goals. These inputs are then processed by a large language model (LLM) guided by markdown-based output templates for reports, posters, and slides. The system aligns free-form ideas with structured communication using prompt engineering to ensure clarity, coherence, and visual consistency. VisRep not only automates the generation of professional deliverables but also enhances reflective practice by bridging spontaneous ideation and structured documentation. This paper introduces VisRep’s methodology, interface design, and AI-driven workflow, demonstrating how it improves the fidelity and transparency of the visualisation design process across academic, professional, and creative domains. Full article

Modern society, dominated by rationalism, has led to the hollowing out of life’s meaning. In response to this predicament, the question of how to transcend instrumental rationality and reconstruct an understanding of human conditions becomes crucial. Among pre-Qin thinkers, Zhuangzi offers the most profound exploration of life-related issues. His “death-life” thought embodies unique philosophical implications, revealing the fluidity, wholeness, and infinity of life. The word order of “death-life” underscores the idea of the transformation of things (wuhua, 物化), illuminating two practical pathways toward the infinite circulation of life. This understanding of life resonates with Henri Bergson’s life philosophy in their shared reverence for life’s infinite flow through intuition. However, they diverge in their views on time and subjectivity. Despite their differences, their ideas can complement each other. Integrating Bergson’s spirit of creative evolution with Zhuangzi’s carefree and detached mindset may help dissolve modern society’s obsession with utilitarian goals, allowing individuals to engage in active creation while simultaneously embracing the spontaneity and boundless possibilities of each present moment. This synthesis provides valuable insights for reconstructing life’s meaning in contemporary society. Full article

Spontaneous coronary artery dissection (SCAD) is an uncommon but significant cause of acute coronary syndrome (ACS), predominantly affecting younger women without traditional cardiovascular risk factors. SCAD is defined as a non-atherosclerotic, non-traumatic dissection of the coronary artery, leading to the formation of an intramural haematoma or intimal tear causing obstruction to blood flow and myocardial ischaemia. Unlike traditional atherosclerotic coronary artery disease, SCAD has unique pathophysiological mechanisms. SCAD is thought to arise secondary to a bleed and/or dissection within the arterial wall, linked to hormonal influences with potential triggers of physical or emotional stress and predisposition such as an underlying connective tissue disorder. Despite being increasingly recognised, SCAD remains underdiagnosed, and knowledge regarding SCAD epidemiology is limited. In addition, the impact of SCAD extends beyond the immediate cardiac event, encompassing psychological distress, the need for rehabilitation, and long-term surveillance. This has implications not just for the patient but also their family and the healthcare system. This narrative review summarises the current knowledge of SCAD epidemiology, including the affected population, its associated risk factors, and healthcare impact. By identifying current gaps in knowledge, this review aims to encourage targeted research, public awareness, and policy initiatives to improve outcomes for individuals affected by SCAD. Full article

This paper pursues a phenomenological investigation of the nature of absorbed listening in Western, classical music concert audiences. This investigation is based on a data-set of 16 in-depth phenomenological interviews with audience members from three classical concerts with the Stavanger Symphony Orchestra and the Norwegian Radio Orchestra conducted in spring 2024. We identify seven major themes, namely “sharedness”, “attention”, “spontaneous thought/mental imagery”, “modes of listening” “absorption”, “distraction”, and “strong emotional experiences”, and interpret these in light of relevant ideas in phenomenology, cognitive psychology, and ecological aesthetics, more precisely “passive synthesis” from Husserl, the “sense of agency” from Gallagher, and “mind surfing” from Høffding, Nielsen, and Laeng. We show that, like absorbed musical performance, absorbed musical listening comes in many shapes and can be grasped as instantiating variations of passive synthesis, the sense of agency, and mind surfing. We conclude that absorbed listening circles around a kind of paradox of passivity, characterised by a sense of loss of egoic control arising from particular forms of invested, intensive perceptual, cognitive, and affective engagement. Full article

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic inflammation that affects multiple organs, with its prevalence varying by ethnicity. Intestinal dysbiosis has been observed in both SLE patients and murine models. Additionally, intestinal barrier impairment is thought to contribute to the ability of pathobionts to evade and breach immune defenses, resulting in antigen cross-reactivity, microbial translocation, subsequent immune activation, and, ultimately, multiple organ failure. Since the detailed mechanisms underlying these processes are difficult to examine using human samples, murine models are crucial. Various SLE murine models, including genetically modified spontaneous and inducible murine models, offer insights into pathobionts and how they dysregulate systemic immune systems. Furthermore, since microbial metabolites modulate systemic immune responses, bacteria and their metabolites can be targeted for treatment. Based on human and mouse research insights, this review examines how lupus pathobionts trigger intestinal and systemic immune dysregulation. Therapeutic approaches, such as fecal microbiota transplantation and dietary adjustments, show potential as cost-effective and safe methods for preventing and treating SLE. Understanding the complex interactions between the microbiota, host factors, and immune dysregulation is essential for developing novel, personalized therapies to tackle this multifaceted disease. Full article

In pre-Song Chinese thought, the afterlife, or the subterranean realm was a sacred space distinctly separate from the world of the living, an extension of the political–religious–cultural order of the Chinese empire. Even after the introduction of Buddhism to China, although the Buddhist concept of hell applied karmic retribution to the present life in an attempt to provide ethical norms for real life, the sacredness of the afterlife remained intact. Song Dynasty Chinese thought underwent a profound “modernization” transformation. Su Shi, with the concept of qing 情 [disposition] at its core, disenchanted the sacred afterlife, shaping a new, self-conscious individuality in the interplay between the living and the dead, the finite and the infinite, the mortal and the immortal. This new individuality, with its spiritual spontaneity and freedom, integrated the afterlife with the present world, internalizing infinity and immortality into a utopian spiritual homeland. This free individuality, entirely different from Song-Ming Neo-Confucianism, marking a hidden potential in the development of Chinese intellectual history that has yet to be fully revealed. Full article

In approximately half of the recurrent spontaneous abortion (RSA) cases, the underlying cause is unknown. However, most unexplained miscarriages are thought to be linked to immune dysfunction. This review summarizes the current evidence regarding the immunological evaluations of patients with RSA, with potential implications for clinical research. The immune system plays a crucial role in the successful outcome of pregnancy, as it tolerates the semi-allogeneic fetus while offering protection to both the mother and fetus from pathogens. The maternal-fetal interface is the place where the crosstalk between various immune cells such as macrophages, dendritic cells, natural killer (NK) cells, and T cells takes place. An adequate balance is required between these immune cells for pregnancy to progress. In RSA, a dysregulation between these immune players is witnessed. For example, in RSA, NK cells are not increased but also undergo a change in their activity, manifested as cytotoxic decidual NK. Similarly, regulatory T cells, which are crucial for fostering a tolerant immune environment, are decreased in RSA women. Similarly, imbalances between T-helper (Th1, Th2, Th17) cell subsets have been implicated in RSA. Furthermore, the imbalance between pro-inflammatory M1 and anti-inflammatory M2 macrophage phenotypes has been documented, with studies indicating a predominance of M1 macrophages in RSA patients. Targeting immune imbalances with therapies such as immunoglobulin administration, TNF inhibitors, and anticoagulants may improve pregnancy outcomes in women with RSA. Full article

In heart failure (HF) patients undergoing cardiac surgery, an increased activity of mechanisms related to cardiac remodeling may determine a higher risk of postoperative atrial fibrillation (POAF). Given that atrial fibrillation (AF) has a negative impact on the course and management of HF, including the need for anticoagulation therapy, identifying the factors associated with AF occurrence after cardiac surgery is crucial for the prognosis of these patients. POAF is thought to occur when various clinical and biochemical triggers act on susceptible cardiac tissue (first hit), with oxidative stress and inflammation during cardiopulmonary bypass (CPB) surgery being potential contributing factors (second hit). However, the molecular mechanisms involved in these processes remain poorly characterized. Recent research has shown that patients who later develop POAF often have pre-existing abnormalities in calcium handling and activation of NLRP3-inflammasome signaling in their atrial cardiomyocytes. These molecular changes may make cardiomyocytes more susceptible to spontaneous Ca2+-releases and subsequent arrhythmias, particularly when exposed to inflammatory mediators. Additionally, some clinical studies have linked POAF with elevated preoperative inflammatory markers, but there is a need for further research in order to better understand the impact of CPB surgery on local and systemic inflammation. This knowledge would make it possible to determine whether patients susceptible to POAF have pre-existing inflammatory conditions or cellular electrophysiological factors that make them more prone to developing AF and cardiac remodeling. In this context, the NLRP3 inflammasome, expressed in cardiomyocytes and cardiac fibroblasts, has been identified as playing a key role in the development of HF and AF, making patients with pre-existing HF with reduced ejection fraction (HFrEF) the focus of several clinical studies with interventions that act at this level. On the other hand, HFpEF has been linked to metabolic and non-ischemic risk factors, but more research is needed to better characterize the myocardial remodeling events associated with HFpEF. Therefore, since ventricular remodeling may differ between HFrEF and HFpEF, it is necessary to perform studies in both groups of patients due to their pathophysiological variations. Clinical evidence has shown that pharmacological therapies that are effective for HFrEF may not provide the same anti-remodeling benefits in HFpEF patients, particularly compared to traditional adrenergic and renin–angiotensin–aldosterone system inhibitors. On the other hand, there is growing interest in medications with pleiotropic or antioxidant/anti-inflammatory effects, such as sodium–glucose cotransporter 2 inhibitors (SGLT-2is). These drugs may offer anti-remodeling effects in both HFrEF and HFpEF by inhibiting pro-inflammatory, pro-oxidant, and NLRP3 signaling pathways and their mediators. The anti-inflammatory, antioxidant, and anti-remodeling effects of SGLT-2 i have progressively expanded from HFrEF and HFpEF to other forms of cardiac remodeling. However, these advances in research have not yet encompassed POAF despite its associations with inflammation, oxidative stress, and remodeling. Currently, the direct or indirect effects of NLRP3-dependent pathway inhibition on the occurrence of POAF have not been clinically assessed. However, given that NLRP3 pathway inhibition may also indirectly affect other pathways, such as inhibition of NF-kappaB or inhibition of matrix synthesis, which are strongly linked to POAF and cardiac remodeling, it is reasonable to hypothesize that this type of intervention could play a role in preventing these events. Full article

In recent years, dogs that appear to communicate with people by pressing buttons on soundboards that replay pre-recorded English words have become very popular on social media online. We explore how these dogs belong to a historical tradition that dates back at least to the Middle Ages and peaked in the early twentieth century. Through analyses of short videos, books, and training manuals, we identify several paradoxes inherent in this phenomenon. These include how the dogs appear to provide unmediated access to their thoughts, and yet, their button presses are typically incoherent and require interpretation. They also require months of training to “spontaneously” express themselves. There is also an anthropomorphism and -centrism in claiming that a human skill—language—is required for a dog to express mental states that it already possesses. This approach to communicating with dogs quiets canine forms of expression such as barking, whining, bodily postures, and odors and replaces them with endearing but infantile human voices. We suggest that, while this endeavor may be well intentioned and often playful, it runs the risk of skewing people’s perception of dogs towards fur-clad infants rather than adult members of a different species and of making people less attentive to canine nonverbal communication. Full article

Human CMV, regularly reactivated by simple triggers, results in asymptomatic viral shedding, powerful cellular immune responses, and memory inflation. Immunocompetent individuals benefit from a robust immune response, which aids in viral management without causing clinically significant illness; however, immunodeficient individuals are always at a higher risk of CMV reactivation and disease. Hematopoietic stem cell transplant (HSCT) recipients are consistently at higher risk of CMV reactivation and clinically significant CMV illness due to primary disease, immunosuppression, and graft vs. host disease. Early recovery of CMV-CMI responses may mitigate effects of viral reactivation in HSCT recipients. Immune reconstitution following transplantation occurs spontaneously and is mediated initially by donor-derived T cells, followed by clonal growth of T cells produced from graft progenitors. CMV-specific immune reconstitution post-transplant is related to spontaneous clearance of CMV reactivation and may eliminate the need for prophylactic or pre-emptive medication, making it a potential predictive marker for monitoring CMV reactivation. This review highlights current thoughts and therapeutic options for CMV reactivation in HSCT, with focus on CMV immune reconstitution and post-HSCT monitoring. Immune monitoring aids in risk stratification of transplant recipients who may progress from CMV reactivation to clinically significant CMV infection. Implementing this approach in clinical practice reduces the need for periodic viral surveillance and antiviral therapy in recipients who have a high CMV-CMI and thus may experience self-limited reactivation. Therefore, in the age of precision medicine, it is critical to incorporate CMV-specific cellular immune surveillance into conventional procedures and algorithms for the management of transplant recipients. Full article

One key aspect of the human experience is our ongoing stream of thoughts. These thoughts can be broadly categorized into various dimensions, which are associated with different impacts on mood, well-being, and productivity. While the past literature has often identified eye movements associated with a specific thought dimension (task-relatedness) during experimental tasks, few studies have determined if these various thought dimensions can be classified by oculomotor activity during naturalistic tasks. Employing thought sampling, eye tracking, and machine learning, we assessed the classification of nine thought dimensions (task-relatedness, freely moving, stickiness, goal-directedness, internal–external orientation, self-orientation, others orientation, visual modality, and auditory modality) across seven multi-day recordings of seven participants during self-selected computer tasks. Our analyses were based on a total of 1715 thought probes across 63 h of recordings. Automated binary-class classification of the thought dimensions was based on statistical features extracted from eye movement measures, including fixation and saccades. These features all served as input into a random forest (RF) classifier, which was then improved with particle swarm optimization (PSO)-based selection of the best subset of features for classifier performance. The mean Matthews correlation coefficient (MCC) values from the PSO-based RF classifier across the thought dimensions ranged from 0.25 to 0.54, indicating above-chance level performance in all nine thought dimensions across participants and improved performance compared to the RF classifier without feature selection. Our findings highlight the potential of machine learning approaches combined with eye movement measures for the real-time prediction of naturalistic ongoing thoughts, particularly in ecologically valid contexts. Full article

During the first and second stages of postnatal development, neocortical neurons exhibit a wide range of spontaneous synchronous activity (SSA). Towards the end of the second postnatal week, the SSA is replaced by a more sparse and desynchronized firing pattern. The developmental desynchronization of neocortical spontaneous neuronal activity is thought to be intrinsically generated, since sensory deprivation from the periphery does not affect the time course of this transition. The extracellular protein reelin controls various aspects of neuronal development through multimodular signaling. However, so far it is unclear whether reelin contributes to the developmental desynchronization transition of neocortical neurons. The present study aims to investigate the role of reelin in postnatal cortical developmental desynchronization using a conditional reelin knockout (Reln^cKO) mouse model. Conditional reelin deficiency was induced during early postnatal development, and Ca²⁺ recordings were conducted from organotypic cultures (OTCs) of the somatosensory cortex. Our results show that both wild type (wt) and Reln^cKO exhibited an SSA pattern during the early postnatal week. However, at the end of the second postnatal week, wt OTCs underwent a transition to a desynchronized network activity pattern, while Reln^cKO activity remained synchronous. This changing activity pattern suggests that reelin is involved in regulating the developmental desynchronization of cortical neuronal network activity. Moreover, the developmental desynchronization impairment observed in Reln^cKO was rescued when Reln^cKO OTCs were co-cultured with wt OTCs. Finally, we show that the developmental transition to a desynchronized state at the end of the second postnatal week is not dependent on glutamatergic signaling. Instead, the transition is dependent on GABA_AR and GABA_BR signaling. The results suggest that reelin controls developmental desynchronization through GABA_AR and GABA_BR signaling. Full article