The effects of real vs simulated high altitude on associative memory for emotional stimuli.

INTRODUCTION: This study aimed to investigate the effects of normobaric hypoxia (NH) and hypobaric hypoxia (HH) on associative memory performance for emotionally valenced stimuli. METHODS: Two experiments were conducted. In Study 1, n=18 undergraduates performed an associative memory task under three NH conditions (FiO2= 20.9%, 15.1%, 13.6%) using a tent with a hypoxic generator. In Study 2, n=20 participants were assessed in a field study at various altitudes on the Himalayan mountains, including the Pyramid Laboratory (5,000 meters above sea level), using functional Near-Infrared Spectroscopy (fNIRS) and behavioral assessments. RESULTS: Study 1 revealed no significant differences in recognition accuracy across NH conditions. However, Study 2 showed a complex relationship between altitude and memory for emotionally valenced stimuli. At lower altitudes, participants more accurately recognized emotional stimuli compared to neutral ones, a trend that reversed at higher altitudes. Brain oxygenation varied with altitude, indicating adaptive cognitive processing, as revealed by fNIRS measurements. CONCLUSIONS: These findings suggest that hypoxia affects associative memory and emotional processing in an altitude-dependent manner, highlighting adaptive cognitive mechanisms. Understanding the effects of hypobaric hypoxia on cognition and memory can help develop strategies to mitigate its impact in high-altitude and hypoxic environments.

The Use of Event Related Potentials to Predict Amyloid PET Status Among Patients from a Memory Disorders Clinic.

Background: Amyloid positron emission tomography (PET) scans provide in vivo evidence of Alzheimer's disease (AD); however, their high cost limits their use in standard clinical care. Event related potentials (ERPs) may represent an inexpensive and non-invasive additional method for detecting AD pathology. Objective: We investigated whether ERPs, along with neuropsychological data, serve as predictors of amyloid PET status in patients with memory complaints. Methods: Veterans aged 50-100 were recruited from a memory disorders clinic. Participants underwent a neuropsychological battery and an ERP auditory oddball protocol. Twenty-eight patients had a positive amyloid PET scan, and thirty-nine patients had a negative scan. Results: ERP-P200 target amplitude and P200 standard latency were predictors of amyloid PET status. When submitting to ROC analysis, P200 standard latency exhibited the highest specificity and sensitivity in predicting amyloid PET positivity, correctly classifying the amyloid PET status for 86% of patients. Conclusions: ERP-P200 measures are strong indicators of amyloid-ß presence in patients from a memory disorder clinic. Increased P200 amplitude and decreased P200 latency in patients with a positive amyloid PET scan may be attributed to hyperactivation of perceptual bottom-up processes compensating for AD-related synaptic loss in the fronto-parietal networks.

Management and Rehabilitative Treatment in Osteoarthritis with a Novel Physical Therapy Approach: A Randomized Control Study.

Knee osteoarthritis (KOA) is a chronic degenerative disease characterized by progressive joint damage leading to significant disability. Although rehabilitative treatment methods for KOA have been widely implemented, the optimal integrated instrumental physical therapy approach remains unclear. Therefore, this study aimed to analyze the effect of Quantum Molecular Resonance (QMR) on pain reduction as the primary outcome and the functional improvement in activity daily living (ADL) as a secondary outcome. The study was designed as a double-blind, randomized, controlled trial in an outpatient setting. Fifty-four (N = 54) patients were enrolled and then randomized into three groups according to a simple randomization list: Group 1 (intensive protocol, N = 22), Group 2 (extensive protocol, N = 21), and a Sham group (N = 11). Patients were evaluated over time with scales assessing pain and function. Treatment was performed with the QMR model electro-medical device, which generates alternating electric currents characterized by high frequency (4-64 MHz). The results showed that QMR had a positive effect with respect to the Sham group in terms of pain and function (p < 0.01), and intensive treatment was more effective than the extensive treatment in terms of "speed of response" to the treatment (p < 0.05). In conclusion, QMR in KOA could be effective in slowing the progression of clinical symptoms and improving patients' pain and functionality and thus quality of life. Future studies will be necessary to investigate further treatment algorithms and therapeutic associations with rehabilitative exercise.

Search in the Periphery for Potential Inflammatory Biomarkers of Dementia with Lewy Bodies and Alzheimer's Disease.

Background: Neuroinflammation, with altered peripheral proinflammatory cytokine production, plays a major role in the pathogenesis of neurodegenerative diseases, such as Alzheimer's disease (AD), while the role of inflammation in dementia with Lewy bodies (DLB) is less known and the results of different studies are often in disagreement. Objective: The present study aimed to investigate the levels of TNFα and IL-6 in serum and supernatants, and the related DNA methylation in patients affected by DLB and AD compared to healthy controls (HCs), to clarify the role of epigenetic mechanisms of DNA promoter methylation on of pro-inflammatory cytokines overproduction. Methods: Twenty-one patients with DLB and fourteen with AD were frequency-matched for age and sex with eleven HCs. Clinical evaluation, TNFα and IL-6 gene methylation status, cytokine gene expression levels and production in serum and peripheral blood mononuclear cell (PBMC) supernatants were performed. Results: In AD and DLB patients, higher serum levels of IL-6 and TNFα were detected than in HCs. Differences in LPS-stimulated versus spontaneous PBMCs were observed between DLB, AD, and HC in the levels of TNFα (p = 0.027) and IL-6 (p < 0.001). Higher levels were also revealed for sIL-6R in DLB (p < 0.001) and AD (p < 0.001) in comparison with HC.DNA hypomethylation in IL-6 and TNFα CpG promoter sites was detected for DLB and AD patients compared to the corresponding site in HCs. Conclusions: Our preliminary study documented increased levels of IL-6 and TNFα in DLB and AD patients to HCs. This overproduction can be due to epigenetic mechanisms regarding the hypomethylation of DNA promoters.

The effects of prefrontal tDCS and hf-tRNS on the processing of positive and negative emotions evoked by video clips in first- and third-person.

The causal role of the cerebral hemispheres in positive and negative emotion processing remains uncertain. The Right Hemisphere Hypothesis proposes right hemispheric superiority for all emotions, while the Valence Hypothesis suggests the left/right hemisphere's primary involvement in positive/negative emotions, respectively. To address this, emotional video clips were presented during dorsolateral prefrontal cortex (DLPFC) electrical stimulation, incorporating a comparison of tDCS and high frequency tRNS stimulation techniques and manipulating perspective-taking (first-person vs third-person Point of View, POV). Four stimulation conditions were applied while participants were asked to rate emotional video valence: anodal/cathodal tDCS to the left/right DLPFC, reverse configuration (anodal/cathodal on the right/left DLPFC), bilateral hf-tRNS, and sham (control condition). Results revealed significant interactions between stimulation setup, emotional valence, and POV, implicating the DLPFC in emotions and perspective-taking. The right hemisphere played a crucial role in both positive and negative valence, supporting the Right Hemisphere Hypothesis. However, the complex interactions between the brain hemispheres and valence also supported the Valence Hypothesis. Both stimulation techniques (tDCS and tRNS) significantly modulated results. These findings support both hypotheses regarding hemispheric involvement in emotions, underscore the utility of video stimuli, and emphasize the importance of perspective-taking in this field, which is often overlooked.

Age-related differences on temporal source memory by using dynamic stimuli: the effects of POV and emotional valence.

Previous studies have highlighted that temporal source memory can be influenced by factors such as the individual's age and the emotional valence of the event to be remembered. In this study, we investigated how the different points of view (POVs) from which an event is presented could interact with the relationship between age-related differences and emotional valence on temporal source memory. One hundred and forty-one younger adults (aged 18-30) and 90 older adults (aged 65-74) were presented with a series of emotional videos shot from different POVs (first vs. third-person) in three sessions. In the fourth session, participants were asked to indicate in which session (1, 2, or 3) they viewed each video. The results indicated that the first-person POV amplified the effects of the emotional valence on temporal source memory. Only in this experimental condition, older adults "pushed away" negative stimuli by perceiving them as more distant in time, and "kept closer" positive stimuli by perceiving them as more recent. In comparison, younger adults "kept closer" positive stimuli. These findings add to the existing literature on the positivity effect on temporal source memory and highlighted the importance of considering the POV in relation to the emotional valence.

Detecting implicit and explicit facial emotions at different ages.

Emotions are processed in the brain through a cortical route, responsible for detailed-conscious recognition and mainly based on image High Spatial Frequencies (HSF), and a subcortical route, responsible for coarse-unconscious processing and based on Low SF (LSF). However, little is known about possible changes in the functioning of the two routes in ageing. In the present go/no-go online task, 112 younger adults and 111 older adults were asked to press a button when a happy or angry face appeared (go) and to inhibit responses for neutral faces (no-go). Facial stimuli were presented unfiltered (broadband image), filtered at HSF and LSF, and hybrids (LSF of an emotional expression superimposed to the HSF of the same face with a neutral expression). All stimuli were also presented rotated on the vertical axis (upside-down) to investigate the global analysis of faces in ageing. Results showed an overall better performance of younger compared to older participants for all conditions except for hybrid stimuli. The expected face-inversion effect was confirmed in both age groups. We conclude that, besides an overall worsening of the perceptual skill with ageing, no specific impairment in the functioning of both the cortical and the subcortical route emerged.

Influence of stimuli emotional features and typicality on memory performance: insights from a virtual reality context.

The present study tested the influence of stimuli emotional valence, emotional arousal, and typicality on memory recollection in three groups of participants exposed to the same environment through different modalities: in vivo exposure (i.e., real-life), 3D virtual reality (i.e., VR), and 2D pictures. Context-related free-recall, recognition accuracy, and recognition confidence were analyzed. The results showed that memory performance was best in the real-life modality, and participants in the VR and 2D pictures modalities performed comparably. Interesting effects of stimuli emotional valence and typicality emerged: in the VR and 2D pictures modalities, positive items were better recalled than negative items; typicality was relevant only in the real-life modality, with less common objects within the explored setting (i.e., an office) recalled more often. Furthermore, recognition accuracy and confidence were significantly higher in the real-life modality than in the VR and 2D pictures modalities. Further research is needed to support the creation of VR environments that are sufficiently comparable to real-life contexts in order to obtain higher ecological validity in studies of cognitive performance. In particular, the impact of stimuli typicality and emotional valence in VR contexts should be investigated to gain insight into how these features might improve memory recall in virtual scenarios.

Virtual reality and cognitive rehabilitation for older adults with mild cognitive impairment: A systematic review.

Virtual Reality (VR) has been gaining increasing attention as a potential ecological and effective intervention system for treating Mild Cognitive Impairment (MCI). However, it remains unclear the efficacy and effectiveness of VR-based cognitive rehabilitation therapy (VR-CRT) in comparison with cognitive rehabilitation therapy (CRT). Consequently, a systematic review on Pubmed, Scopus, PsycInfo, and Web Of Science was conducted to assess the state of the art of the literature published between 2003 and April 2023. Only articles that adopted CRT as control group and that included some measure of at least one domain among overall cognitive function, executive function and functional status were included. Participants needed to be older adults aged 65 or over with a diagnosis of MCI. The risk of bias and the quality of evidence were assessed using the Version 2 of the Cochrane risk-of-bias tool for randomized trials. Initially, 6503 records were considered and screened after removing duplicates (n = 1321). Subsequently, 81 full texts were assessed for eligibility. Four articles met the inclusion criteria but 2 of them were merged as they were describing different outcomes of the same research project. Consequently, 3 overall studies with a total of 130 participants were included in the final analysis. Due to the high heterogeneity in the methodology and outcome measures employed, it was not possible to conduct a meta-analysis. Included studies used semi-immersive (k = 2) and full-immersive (k = 1) VR systems in their research. Two articles evaluated overall cognitive function through the MoCA together with specific tests for executive functions (n = 69), while one study adopted a comprehensive neuropsychological battery to evaluate both cognitive function and executive function (n = 61). Finally, one study evaluated functional status through instrumental activities of daily living (n = 34). A However, the limited number of studies, the small sample size, and the potential issues with the quality and methodology of these studies that emerged from the risk of bias assessment may raise doubts about the reliability of their results. Nevertheless, although scarce, results of the present review suggest that VR-CRT may be paramount in treating MCI for its additional ecological and adaptive advantages, as all of the studies highlighted that it was at least as effective as conventional CRT for all the outcome measures. Therefore, more rigorous research that compares VR-CRT and CRT is needed to understand the degree to which VR-CRT is effective with older adults with MCI and the potential role of immersion to influence its efficacy. Indeed, these preliminary findings highlight the need for the development of standardized VR protocols, as the integration of such technology into clinical practice may help improve the quality of life and cognitive outcomes for this growing demographic.

Pleasure before business: emotions and age effects on daily activity scheduling.

Activity scheduling represents a key process in daily life, involving the evaluation of the costs and benefits of the resources to be invested, but also a preference for when to engage in pleasant or unpleasant activities. Aging affects the evaluation processes and individual preferences due to changes in cognitive functioning and life perspectives. The present study investigated the differences between younger adults (age range 19-33) and older adults (age range 65-87) in a task assessing preferential scheduling of activities. Participants were asked to schedule thirty emotional activities (positive, negative, or neutral) within a 30-day time window, assigning one activity for each day. Results indicated that older adults, but not younger adults, planned positive activities closer in time, supporting the "positivity effect". Also, both younger and older adults tended to postpone negative activities, scheduling them in the last days. Finally, for older adults only, negative affect was associated with the tendency to put positive activities closer in time. Present findings showed age-specific effects of emotional content on daily activity scheduling.

Bored with boredom? Trait boredom predicts internet addiction through the mediating role of attentional bias toward social networks.

Internet addiction is an emerging issue, impacting people's psychosocial functioning and well-being. However, the prevalence and the mechanisms underlying internet misuse are largely unknown. As with other behavioral addiction disorders, the increase and persistence of internet addiction may be favored by negative affect such as boredom. In this study, we examined the role of boredom susceptibility, as a personality trait, in predicting the risk of internet addiction. Furthermore, we analyzed the attentional mechanisms that may exacerbate dysfunctional internet behaviors. Specifically, we assessed the mediating role of attentional bias toward social media cues on the relation between boredom susceptibility and internet addiction. Sixty-nine young adults were administered a dot-probe task assessing internet-related attentional bias (AB) and questionnaires measuring internet addiction (IAT) and boredom susceptibility (BS-BSSS). Correlation and t-test analyses confirmed that the tendency to experience boredom and selective attention toward social network information was related to internet addiction. Furthermore, the mediation model indicated that AB fully explains the link between BS-BSSS and IAT. The study highlighted the crucial role of selective attentional processing behind internet addiction. The current results are useful for both researchers and clinicians as they suggest that intervention programs for internet addiction should include strategies to cope with dysfunctional cognitive processes.

Changing Decisions: The Interaction between Framing and Decoy Effects.

BACKGROUND: Cognitive biases are popular topics in psychology and marketing, as they refer to systematic cognitive tendencies in human thinking that deviate from logical and rational reasoning. The framing effect (FE) and the decoy effect (DE) are examples of cognitive biases that can influence decision making and consumer preferences. The FE involves how options are presented, while the DE involves the addition of a third option that influences the choice between the other two options. METHODS: We investigated the interaction between the FE and the DE in the case of both incongruent (ID) and congruent (CD) decoys in a sample of undergraduates (n = 471). The study had a two (positive vs. negative valence) × three (original, congruent decoy, incongruent decoy) within-subject design. RESULTS: The ID option reduces the FE in both positive- and negative-framed conditions compared to the controls, while adding the CD option increases the FE only in the positive-framed condition. Additionally, the inclusion of the CD option enhances the level of decision confidence, whereas no significant differences were found in the ID condition. CONCLUSIONS: Our findings gave new insights into the interplay between two of the most frequent cognitive biases.

Exploring physician engagement in health care organizations: a scoping review.

RATIONALE: Enhancing health system effectiveness, efficiency, and appropriateness is a management priority in most world countries. Scholars and practitioners have focused on physician engagement to facilitate such outcomes. OBJECTIVES: Our research was intended to: 1) unravel the definition of physician engagement; 2) understand the factors that promote or impede it; 3) shed light on the implications of physician engagement on organizational performance, quality, and safety; and 4) discuss the tools to measure physician engagement. METHOD: A scoping review was undertaken. Items were collected through electronic databases search and snowball technique. The PRISMA extension for Scoping Reviews (PRISMA-ScR) statement and checklist was followed to enhance the study replicability. RESULTS: The search yielded 16,062 records. After an initial screening, 300 were selected for potential inclusion in this literature review. After removing duplicates and records not meeting the inclusion criteria, full-text analysis of 261 records was performed, yielding a total of 174 records. DISCUSSION: Agreement on the conceptualization of physician engagement is thin; furthermore, scholars disagree on the techniques and approaches used to assess its implementation and implications. Proposals have been made to overcome the barriers to its adoption, but empirical evidence about implementing physician engagement is still scarce. CONCLUSIONS: Our scoping review highlights the limitations of the extant literature about physician engagement. Physician engagement is a relatively ill-defined concept: developing an evidence base for its actual implementation is necessitated to provide reliable guidance on how the governance of health care organizations could be improved. Although we did not assess the quality or the robustness of current empirical research, our findings call for further research to: 1) identify potential drivers of physician engagement, 2) develop dependable assessment tools providing health care organizations with guidance on how to foster physician engagement, and 3) evaluate engagement's actual impact on health care organizations' performance.

The effect of aging and emotions on time processing.

BACKGROUND: Time perception is an automatic process that can be influenced by intrinsic and extrinsic factors. AIMS: This study aimed to investigate the effect of age and emotions on the ability to keep track of short suprasecond intervals. METHODS: Younger adults (N = 108, age range: 18-35) and older adults (N = 51, age range: 65-87) were asked to reproduce, bisect, or double the duration of facial stimuli randomly presented for 1500, 3000, and 4500 ms. The experiment included facial stimuli with positive, negative, or neutral expressions. RESULTS: The participants across age correctly reproduced intervals but overestimated and underestimated them when asked to bisect and double the intervals, respectively. Overall, when faces were presented with a positive or negative expression, an overestimation of time intervals emerged compared to faces with neutral expressions. Emotions had a greater effect on older adults, who showed a greater overestimation of positive facial expressions and an underestimation of sad, but not angry, facial expressions. DISCUSSION: The results provide evidence that time perception is influenced by age and emotions, with older adults showing a greater effect of emotions on time processing. CONCLUSION: The study suggests an interaction among time processing, age, and emotions, highlighting an automatic relationship among these domains, often considered independent.

With or without the Mask: Age Differences in Perceived Trustworthiness and Health during the COVID-19 Pandemic.

The COVID-19 pandemic and the obligation to wear surgical face masks have affected social interactions. Wearing a mask can cause impairments in face identification, emotion recognition, and trait impressions. The present study investigated, during the COVID-19 period, age-related differences in perceived trustworthiness (Study 1) and health (Study 2) when viewing faces with or without masks. Younger (YAs, 18-35 years) and older (OAs, over 65 years) adults' ratings were compared. Through a web-based platform, a series of neutral younger and older faces (YFs vs. OFs) were presented, on a computer screen, with or without a mask (Mask vs. No-Mask), and participants were asked to rate them on a 7-point scale. Furthermore, data collected during the pandemic (Mask and No-Mask conditions) were compared with ratings obtained before it (Pre-COVID condition). Perceived trustworthiness was lower in the No-Mask condition for both age groups compared to Mask and Pre-COVID conditions, which did not differ. For health ratings, no differences emerged for OAs between the conditions, whereas YAs' ratings were lower in both the Mask and No-Mask conditions compared to the Pre-COVID condition. The fear of contracting COVID-19 affected both trustworthiness and health ratings. Wearing a surgical face mask affects trait impressions for YAs and OAs, partly due to the fear of COVID-19. Trait impressions are also influenced by the age of the face to be evaluated.

Aging and Mixed Emotions: A Word-Suffix Approach in Free Recall.

The current study investigated mixed-emotional memories in groups of young, young-old, and old-old participants. We used a "word-suffix approach" to simulate the co-occurrence of positive and negative emotions. The participants engaged in a free-recall task for valenced words and mixed-emotional words (valenced words coupled with pejorative or endearment suffixes). Our results showed that the groups of older adults recalled higher numbers of suffixed words compared to their younger counterparts. Our findings highlighted older adults' tendency to perceive and remember emotionally ambivalent words to a greater extent than younger adults and showed that the young-old participants were particularly good at solving ambivalence by focusing on positive-dominant ambivalent words.

How emotions induced by reading influence sleep quality in young and older adults.

OBJECTIVES: This study examined whether emotions induced by reading before sleep influence sleep quality in young and older adults. METHOD: Sixty older adults (64-75 years) and 60 young adults (18-35 years) were randomly assigned to three conditions: positive reading, neutral reading, and control. The reading groups read a short story at bedtime, whereas the control group kept its routine. Participants completed measures of affective states, subjective sleep parameters, and self-reported sleep quality related to emotions over 7 consecutive days. RESULTS: Older adults reported much longer sleep latency and lower sleep efficiency than young adults. In both reading conditions, older adults reported reduced sleep latencies compared to the control group. In the positive reading condition, older adults reported an increased sleep duration compared to younger adults and the other conditions. Young and older adults in the positive condition showed better self-reported sleep quality than those in the neutral conditions, regardless of age. CONCLUSIONS: Reading at bedtime appears to reduce older adults' time to fall asleep and increase their sleep duration. Positive emotions induced by reading short stories at bedtime seem to be a sleep-promoting factor that improves bedtime and wake time in young and older adults.

Time reproduction, bisection and doubling: a novel paradigm to investigate the effect of the internal clock on time estimation.

Time perception is not always veridical, but it can be modulated by changes in internal and external context. The most-acknowledged theory in this regard hypothesises the existence of an internal clock allowing us to subjectively estimate time intervals. The aim of the present study is to investigate the possible effect of such an internal clock, measured as the ability to reproduce a target duration, in the mental manipulation of time: 63 healthy participants were asked to Bisect and to Double reference time intervals, besides Reproducing them. Moreover, to investigate whether time processing might be predicted by individual differences, handedness, anxiety, and personality traits were also assessed by means of standardized questionnaires. Results show that participants correctly Reproduce time intervals (internal clock), but they overestimate time intervals during Bisection and underestimate them during Doubling. We explain this unexpected pattern of results as a kind of aftereffect, due to the short-term retention (adaptation) to the subjective representation of shorter (Bisection) vs longer (Doubling) intervals, respectively. Moreover, hierarchic regression models reveal that some personality traits can predict Bisection accuracy, but they clearly show that the best predictor for both Bisection and Doubling is the accuracy in Reproducing time intervals, confirming the fundamental role of the internal clock in time estimation. We conclude that time estimation is a unique skill, mostly independent from inter-individual differences, and the new paradigms introduced here (bisection vs doubling) reveal that the correct functioning of the internal clock also explains the ability to mentally manipulate the time.

Public opinion in vaccine allocation priority: who comes first?

OBJECTIVE: We investigated people's preferences in COVID-19 vaccine allocation priority, comparing different social categories based on age and occupation. Vaccine allocation preferences were related to perceived health vulnerability and economic backlash (economic negative consequences) endured by the different social groups during the pandemic. In-group favoritism in vaccine allocation preferences was analyzed. DESIGN: Data were collected through an online survey in Italy (n = 506) before the start of the vaccination campaign. MAIN OUTCOME MEASURES: Vaccine allocation preferences, health vulnerability, and economic backlash due to COVID-19, measured through ranking tasks. RESULTS: The healthcare workers category was placed at the top of the ranking in vaccine allocation priority by 65% of the respondents. Vaccine allocation priority was related to perceived health vulnerability and not economic difficulties. Limited self-preference effects emerged. People who did not consider healthcare workers a priority (1/5 of the sample) had a lower education level, were more worried about COVID-19 infection risk, and did not trust vaccines. CONCLUSIONS: A consensus emerged on who should be vaccinated first. Governments and policymakers should be aware of these preferences when designing and communicating vaccine allocation plans to predict and foster the public's acceptance of the COVID-19 vaccination programs created by experts.