False recalls, but not false recognitions, at the DRM paradigm are increased in subjects reporting insomnia symptoms: An online study.

BACKGROUND: In insomnia, poor sleep is accompanied by several cognitive impairments affecting prefrontal functioning that could affect source-monitoring processes and contribute to false memories production. By using a modified version of the Deese-Roediger-McDermott paradigm (DRM), we previously found that individuals suffering from insomnia produced more false memories than good sleepers adopting a free-recall task, especially for sleep-related stimuli. However, whether poor sleep affects false memory production in a task-dependent manner (i.e., free recall or recognition) remains unclear. METHODS: Through an online research method, we adopted the classical DRM paradigm to investigate the production of false recalls and false recognitions in 32 subjects referring insomnia symptoms (IN group) and 37 good sleepers (GS group), addressing also executive functioning and source monitoring ability in both groups. RESULTS: Compared to the GS group, the IN group produced more false memories (p = .002) and intrusions (p = .004) at the free recall task and showed a lower working memory index (p = .008). No between-groups differences emerged at the recognition task. Correlational analysis revealed significant associations between DRM performance, executive functioning and source monitoring (SM) variables. Moreover, false recalls were predicted by being in the presence of insomnia symptoms (p = .012) and intrusions by the number of correct responses to the Stroop task (p = .051) and SM task (p = .015), as well as by the presence of insomnia symptoms (p = .003). CONCLUSIONS: Our data show that the presence of insomnia symptoms can influence false memories production. Furthermore, the evidence that free recall is more affected than recognition suggests that poor sleep mainly affects performance at more cognitively demanding tasks. Finally, correlational and regression analyses support the hypothesis of a link between false memories production and both the presence of insomnia symptoms and executive functioning impairments.

Sleep and psychological characteristics in habitual self-awakeners and forced awakeners.

Previous studies described the modifications of physiological and behavioural variables associated with self-awakening, while only few studies assessed subjective sleep quality and psychological characteristics in habitual self-awakeners. Here we investigated self-reported sleep habits and features, as well as psychological variables of habitual self-awakeners and forced-awakeners, with special regard to subjective sleep quality, personality characteristics, anxiety and depression symptoms. In our sample, the prevalence of habitual self-awakeners was 15.1%. Compared to forced-awakeners, habitual self-awakeners showed more regular sleep/wake schedules and were more frequently morning types. Moreover, habitual self-awakeners referred to be more satisfied about their sleep, to wake up more easily in the morning, to need less time to get out of bed and to feel more refreshed upon awakening than forced-awakeners. We also observed an association between the habit of self-awakening and the "ability" to set the awakening to an unusual time. Concerning psychological features, habitual self-awakeners showed higher scores in Conscientiousness and Openness and lower scores in Extraversion compared to forced-awakeners, whereas no differences between groups emerged for anxiety and depression levels. In conclusion, our findings point to an association between the habit of self-awakening and good subjective sleep quality. In this perspective, future research should objectively test in detail the effects of the self-awakening habit on sleep structure and organization, taking into account also microstructural sleep features.

How MRI is changing prostate cancer management: a focus on early detection and active surveillance: Comment l'IRM est en train de révolutionner la prise en charge du cancer de la prostate : focus sur la détection précoce et la surveillance active.

INTRODUCTION: The last decade has witnessed major changes in prostate cancer management. Among these, the advent of magnetic resonance imaging (MRI), by allowing the visualisation of the cancerous lesion inside the prostatic gland, opened new management horizons. MATERIAL AND METHODS: We conducted a narrative review of the literature published since 2010, focusing on the place of MRI in the early detection, active surveillance and prostate cancer screening settings. RESULTS: Multiparametric magnetic resonance imaging (mpMRI), interpreted using the PI-RADS scoring system, has allowed a shift from systematic to mpMRI-targeted biopsies, supported by level I evidence. Studies are ongoing to evaluate the role of MRI as a triage and screening tool. The integration of mpMRI has allowed for a better selection of active surveillance candidates, reducing the risk of misclassification. The PRECISE recommendations have been created to assess the likelihood of radiological change over time from the previous or baseline mpMRI scan, and serial mpMRI appears promising to reduce the need for repeat biopsy in active surveillance. CONCLUSION: Growing evidence supports the use of MRI at all stages of the prostate cancer pathway, relying on images of optimal diagnostic quality and experience in prostate MRI reporting and biopsy targeting. © 2022 Elsevier Masson SAS. All rights reserved.

Deep learning radiomic nomogram can predict the number of lymph node metastasis in locally advanced gastric cancer: an international multicenter study.

BACKGROUND: Preoperative evaluation of the number of lymph node metastasis (LNM) is the basis of individual treatment of locally advanced gastric cancer (LAGC). However, the routinely used preoperative determination method is not accurate enough. PATIENTS AND METHODS: We enrolled 730 LAGC patients from five centers in China and one center in Italy, and divided them into one primary cohort, three external validation cohorts, and one international validation cohort. A deep learning radiomic nomogram (DLRN) was built based on the images from multiphase computed tomography (CT) for preoperatively determining the number of LNM in LAGC. We comprehensively tested the DLRN and compared it with three state-of-the-art methods. Moreover, we investigated the value of the DLRN in survival analysis. RESULTS: The DLRN showed good discrimination of the number of LNM on all cohorts [overall C-indexes (95% confidence interval): 0.821 (0.785-0.858) in the primary cohort, 0.797 (0.771-0.823) in the external validation cohorts, and 0.822 (0.756-0.887) in the international validation cohort]. The nomogram performed significantly better than the routinely used clinical N stages, tumor size, and clinical model (P < 0.05). Besides, DLRN was significantly associated with the overall survival of LAGC patients (n = 271). CONCLUSION: A deep learning-based radiomic nomogram had good predictive value for LNM in LAGC. In staging-oriented treatment of gastric cancer, this preoperative nomogram could provide baseline information for individual treatment of LAGC.

Priming effect in children with Type 1 Diabetes Mellitus.

Previous studies have evidenced cognitive difficulties across various domains in Type 1 Diabetes Mellitus (T1DM) children, but the implicit memory system has not yet been systematically explored.Taking into account that the interplay between memory and perception may be modulated by the semantic category of the stimuli and their salience, we explored explicit and implicit memory using both object and food stimuli to verify whether for T1DM children there is a feebleness in performing the function of memory as a function of the stimuli used.Eighteen T1DM children and 47 healthy children performed an explicit recognition task in which they were requested to judge whether the presented image had already been shown ("old") or not ("new") and an identification priming task in which they were asked to name new and old pictures presented at nine ascending levels of spatial filtering.Results did not reveal any differences between controls and T1DM children in the explicit memory recognition task, whereas some differences between the two groups were found in the identification priming task. In T1DM children, the priming effect was observed only for food images.The dissociation between implicit and explicit memory observed in children with diabetes seems to be modulated by the category of the stimuli, and these results underscore the relevance of taking into account this variable when exploring cognitive functions.

Audio-visual integration effect in lateral occipital cortex during an object recognition task: An interference pilot study.

BACKGROUND: Recent neuroimaging data support the hypothesis of a multisensory interplay at low-level sensory-specific cortex. OBJECTIVE: We used an on-line interference approach by rTMS to investigate the role of the left lateral occipital cortex (LOC) in audio-visual (AV) object recognition process. METHODS: Fifteen healthy volunteers performed a visual identification task of degraded pictures presented alone or simultaneously to coherent or non-coherent sounds. Focal 10-Hz rTMS at an intensity of 100% resting motor threshold was delivered simultaneously to the picture. Two blocks of 60 pictures were randomly displayed in two different experimental conditions: rTMS of the left LOC and over Cz. RESULTS: rTMS of the left LOC produced a worsening of the accuracy compared to rTMS over Cz specifically in the coherent AV condition. CONCLUSION: These data support the view that audio-visual interaction effect may occur at early stage of recognition processing.

Yawning throughout life.

Yawning is a behavior that begins in the first stages of life. It has not only been observed in infants and in newborns, but also in fetuses of 12-14 weeks' gestational age. Yawning frequency changes over the life span. In preterm infants, the number of yawns decreases between 31 and 40 weeks' postconceptional age, mainly during the day. In this period of life, yawning is an isolated behavior rarely occurring in bursts, and its frequency is quite low with respect to adults. The incidence of yawning seems to increase when children attend elementary school, whereas this is reduced in the elderly. Aged people yawn less than younger ones, mainly during morning and mid-afternoon. In adults, the time course of yawning is associated with the time course of sleepiness, except upon awakening when the high frequency of yawns is not associated with high sleepiness. In adults, yawning frequency increases in the early morning and in the late evening, whereas at the earliest stages of development (fetuses and preterm infants) yawning does not show diurnal variations. Yawning seems to be involved in the modulation of arousal process across the whole life span. In preterm infants, yawning is often followed by motor activation and it is more common during waking than sleep; in adults, yawning occurs mainly at sleep onset and upon awakening.

Sleep, sleepiness and yawning.

This chapter will discuss the relationship between yawning, sleep onset, awakening and sleepiness. Models concerning wake-sleep regulation will be discussed in relation to yawning. Yawning close to sleep, before and after, will be examined in several conditions and populations. Also, the time course of yawning and sleepiness assessed by subjective estimates will be described.

Distribution of sleep and wakefulness EEG patterns in 24-h recordings of preterm and full-term newborns.

The aim of this study was to evaluate the organisation of EEG patterns in 24-h recordings of preterm and near-term neonates. In particular, the distribution of the different EEG codes at different postmenstrual ages (PMA) and the variations of sleep-related EEG pattern organisation was studied, during day (8.00 a.m.-8.00 p.m.) and night (8.00 p.m.-8.00 a.m.) time. The age of appearance of different neonatal EEG patterns, previously described in literature for short lasting records, was confirmed in this 24-h study. The medium-voltage continuous EEG pattern (pattern "3") was less represented approaching term age, in coincidence with the appearance of the two low-voltage continuous patterns ("1" and "2"), which are also related to active sleep and wakefulness. Discontinuous pattern ("7") was also less represented with age, but in day-time only. The percentage of time occupied by this pattern, related to quiet sleep, was significantly higher during day-time hours, than at night.

Preterm infants prefer to be awake at night.

Wakefulness distribution during a 24-h period was studied in ten low-risk preterm and near term infants through video-recording. The highest amount of wakefulness was found in the night-time period between 02:00 and 05:00 h. This result is different from what was observed in infants during the first year of life, and similar to what was found in the foetus.

Polygraphic investigation of 24-h waking distribution in infants.

An evening forbidden zone for sleep has been shown for adults. This research was aimed to ascertain the prevalence of waking in the evening in early development. Twelve infants, aged between 2 weeks and 11 months 3 weeks, were each recorded once over a 24-h period. Recordings included EEG, EOG, EMG, respiration, ECG, and behavioural observation. Four states were defined by combining behavioural and electrophysiological data. Wakefulness was defined by the presence of eyes open, eye movements and additionally body movements, and irregular respiration. In infants younger than 12 months and a half, a greater amount of wakefulness was observed in the time interval between 17 and 20. Older infants show uniform high amount of wakefulness during daytime. Our data corroborate the hypothesis that evening hours are those most frequently characterised by the behavioural waking state, suggesting that a forbidden zone for sleep exists in development and that its time placement corresponds to the one observed in the adult.

Activity patterns assessed throughout 24-hour recordings in preterm and near term infants.

The motility of 10 low-risk infants, aged between 34 and 40 weeks of postmenstrual age, has been continuously recorded for 24 h. Four codes were distinguished: code 1 (absence of motility or occasional occurrence of startles), code 2 (presence of small general or isolated body movements, startles, smiles, grimaces, and other facial activity), code 3 (forceful and prolonged general movements, startles, and stretches), code 4 (vigorous and abrupt general body movements accompanied by crying). Changes with age concern mainly the increase of the duration of code 1 (quiescence) episodes. Confrontation between day and night showed higher levels of motility during the night than during the day. The last weeks before term represent a time for increase in the ability to sustain a quiet behavior and to reorganize day-night motility distribution.

The organization of rapid eye movement activity during rapid eye movement sleep is further impaired in very old human subjects.

Rapid eye movement activity (REMA) during rapid eye movement (REM) sleep was studied in seven very old ('old-old') subjects. Beyond global quantitative features (REMA density), we evaluated the organizational aspects of REMA, that is its occurrence in burst mode, which were compared to a group of younger elderly subjects ('young-old'). REMA density in 'old-old' subjects is not significantly different from that of 'young-old' subjects. The same lack of difference in the two groups is found for the number of REMA bursts. By contrast, the duration of REMA bursts is reduced in the 'old-old' subjects, as well as the 'burst state-to-burst-state' probability, i.e. the probability for successive inter-REMA time intervals to be part of the same REMA burst. Our results clearly show that the trend towards an impairment of REMA organizational aspects continues with aging. This is consistent with the hypothesis that sleep disorganization keeps worsening with age. However, it is of interest to observe that the capability of producing REMA bursts is preserved despite aging.

Spontaneous awakenings from sleep in the first year of life.

Spontaneous awakenings from nocturnal sleep were studied in a sample of 48 healthy infants (M = 26, F = 22), in four age groups (1 to 7 weeks, 8 to 15 weeks, 17 to 22 weeks, 25 to 54 weeks). Consistent with previous data, the number of awakenings is reported less frequently at later ages, owing to a lower frequency of awakenings out of REM sleep. Like young adults, infants in all age groups awake more often from REM than from quiet sleep (QS); this is particularly evident in the first 6 months of life, less so in the second. The duration of the bouts of wakefulness following awakenings remains stable with age. Awakenings out of QS are followed by longer periods of wakefulness than those out of REM sleep, although in older infants the duration is considerably reduced. Night sleep first shows a decrease in the number of awakenings out of REM sleep and then continues after the sixth month of life with the shortening of the wakefulness after awakenings out of QS. In the two younger groups, the distribution of the awakenings shows two main peaks and one main peak differently located during the night; a polymodal pattern appears in group 3, and is even more evident in group 4. It should be stressed that several changes as a function of age occur in the second 6 months of life, indicating this as a period of intense developmental change in sleep-wake rhythms.