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.

Transport and fate of 137Cs in the Mediterranean and Black Seas system during 1945-2020 period: A modelling study

The compartment model POSEIDON-R with an embedded dynamic food web model was used to assess ¹³⁷Cs distributions in the Mediterranean and Black Seas during 1945-2020 due to the weapon testing and accident at the Chernobyl nuclear power plant. Three maximums of contamination of surface waters can be identified from 1950 in the Mediterranean Sea system. Two of them (in 1959 and 1963) were caused by atmospheric deposition due to the nuclear weapon testing. Third maximum in 1986 was related with the Chernobyl accident. Maximum of inventory of ¹³⁷Cs in the Mediterranean Sea (11461 TBq) was achieved in 1968, whereas secondary maximum caused by Chernobyl accident in 1986 was almost the same (11460 TBq). The corresponding maximum in the Black Sea (3703 TBq) was reached in 1986. It is approximately two times larger than nuclear weapon tests maximum. The results of simulations conducted with generic parameters agreed well with measurements of ¹³⁷Cs concentrations in the water, bottom sediments, and in marine organisms. The inventory in the Mediterranean Sea is most sensitive to the global deposition, whereas water exchange with Atlantic Ocean and the Black Sea plays minor role. The cumulative individual dose for the period 1945-2020 from consumption of marine products contaminated by ¹³⁷Cs was in the range 41-130 μSv in the Mediterranean Sea and 213-274 μSv in the Black Sea. The dose increased up to 40% due to Chernobyl accident in the Mediterranean countries and 66-103% in the Black Sea countries comparatively with dose from the global deposition. A useful application of the modelling for monitoring purposes was selection of representative regions in the Mediterranean Sea (5 regions) and in the Black Sea (4 regions) using "etalon" method for classification.

Potential Hazards Associated with Raw Donkey Milk Consumption: A Review

Donkey milk can be used as a substitute for infants and children who suffer from cow milk proteins intolerance and multiple food hypersensitivity. Up to date, this is one of the main reasons why donkey milk has become a substantial area for reasearch, with an increase over the the last fifteen years. In donkey milk chain, risk analysis should be the object of particular attention because children are the main consumers of this food. In fact, this process is one of the main tool to achieve a high level of protection of human health and life; thus, the most important safety hazards should be monitored in order to attain this goal. This review focuses on the main hazards possibly present in raw donkey milk, including bacteria, fungal toxins, parasites, and chemical pollutants. Literature data have been considered, including some information that is not provided in the international literature. In the authors' opinion, the current scientific knowledge should be improved, with the aim of allowing a suitable risk assessment along the whole donkey milk chain. However, in the meantime, the competent authorithies must carry out more stringent official controls, with particular attention given to the level of primary production. The issue of a traceability system in donkey milk chain should be considered of paramount importance.

Four days of simulated shift work reduces insulin sensitivity in humans

AIM

The aim of this study was to investigate the effects of 4 consecutive simulated night shifts on glucose homeostasis, mitochondrial function and central and peripheral rhythmicities compared with a simulated day shift schedule.

METHODS

Seventeen healthy adults (8M:9F) matched for sleep, physical activity and dietary/fat intake participated in this study (night shift work n = 9; day shift work n = 8). Glucose tolerance and insulin sensitivity before and after 4 nights of shift work were measured by an intravenous glucose tolerance test and a hyperinsulinaemic euglycaemic clamp respectively. Muscles biopsies were obtained to determine insulin signalling and mitochondrial function. Central and peripheral rhythmicities were assessed by measuring salivary melatonin and expression of circadian genes from hair samples respectively.

RESULTS

Fasting plasma glucose increased (4.4 ± 0.1 vs. 4.6 ± 0.1 mmol L^-1 ; P = .001) and insulin sensitivity decreased (25 ± 7%, P < .05) following the night shift, with no changes following the day shift. Night shift work had no effect on skeletal muscle protein expression (PGC1α, UCP3, TFAM and mitochondria Complex II-V) or insulin-stimulated pAkt Ser473, pTBC1D4Ser318 and pTBC1D4Thr642. Importantly, the metabolic changes after simulated night shifts occurred despite no changes in the timing of melatonin rhythmicity or hair follicle cell clock gene expression across the wake period (Per3, Per1, Nr1d1 and Nr1d2).

CONCLUSION

Only 4 days of simulated night shift work in healthy adults is sufficient to reduce insulin sensitivity which would be expected to increase the risk of T2D.

Monitoring of a Long Survival Myeloma Patient

Monitoring with anti-idiotypic sera has been applied to identify tumoral cells in a myeloma patient still alive in complete remission 9 years after diagnosis. Monoclonal plasma cells displayed a labeling index that decreased in complete remission below 1 %. The great majority of B lymphocytes belonged to the tumoral clone even in complete remission and were therefore not affected by conventional chemothrapy. Some aspects of this myeloma patient are discussed in the light of these immunologic and kinetic findings. In addition, it is suggested that the therapeutic management of the complete remission should be re-examined, by considering a lymphocytolytic therapy.

Cost-effectiveness of kidney transplantation from DCD in Italy

INTRODUCTION

Kidney transplantation represents the best therapeutic option for patients with end-stage renal disease (ESRD), providing the best outcomes for survival, quality of life, and cost-effectiveness. To increase kidney donations, in 2007, the Italian IRCCS Policlinico San Matteo Foundation in Pavia designed and conducted Programma Alba, a protocol for organ donation after cardiac death (DCD). This study evaluated the costs and health outcomes of DCD transplantation and in all types of transplants compared with current clinical practice.

PATIENTS AND METHODS

A Markov-based model was used to assess costs and health outcomes for new ESRD patients for 2008 to 2013. A health care founder perspective was used. Data sources were the Italian National Institute of Statistics and the Lombardy Registry of Dialysis and Transplantation. A microcosting analysis was performed to calculate costs related to clinical pathways for DCD. We assessed costs, survival, quality-adjusted survival, and cost-effectiveness.

FINDINGS

Changing the actual practice pattern for new patients with ESRD and increasing the availability of kidneys from DCD to 10 extra transplants per year will induce an incremental cost per quality-adjusted life-year of €4255. Increases in transplantation to reach an extra 10% by transplant type would result in reduced costs and increased patient survival and quality of life compared with the current scenario.

INTERPRETATION

Our data show that increasing DCD transplants would result in a cost-effective policy to expand the kidney donor pool compared with current ESRD treatment patterns. Italian policies should make an effort to increase transplant rates to optimize cost-effectiveness in ESRD service supply.

The role of BOLD-fMRI in elucidating migraine pathophysiology

Migraine is a neurologic disorder characterized by disabling attacks of throbbing headache with specific features and associated symptoms. Despite the recent discoveries in basic neurosciences, migraine pathophysiology is not completely understood. Nevertheless, in the last decades, advances in functional magnetic resonance imaging (fMRI) have significantly provided new insights into migraine mechanisms. Blood oxygen level dependent (BOLD) fMRI technique is the most commonly used method to explore brain function and connectivity due to high temporal and spatial resolution. The purpose of this review is to present a synthesis of recent BOLD-fMRI studies which have allowed us to elucidate the complex process involved in migraine pathophysiology.

Environmental radioactivity analyses in Italy following the Fukushima Dai-ichi nuclear accident

Following the Fukushima power plants accident on the 11th March 2011, the radioactivity monitoring programme at the Italian ENEA research centres was activated in order to detect the possible new input of radionuclides through atmospheric transport and precipitation. Measurements of (131)I and (134,137)Cs were carried out on atmospheric particulate, atmospheric deposition, seawater and mussels and sheep milk. In the daily samples of air particulate, (131)I was detectable between March 28 and April 12, with extremely low concentrations (<1 mBq m(-3); the detection limit for (131)I was ~0.2 mBq m(-3)) while Cs isotopes were always below the detection limit (<0.2 mBq m(-3)). The two main episodes of (131)I atmospheric deposition were registered in La Spezia research centre, around March 28 and April 15, reaching values of 17.8 ± 1.1 and 8.0 ± 2.5 Bq m(-2) respectively; maximum values of (134)Cs and (137)Cs were 0.11 ± 0.03 and 0.17 ± 0.02 Bq m(-2), respectively, detected in Brasimone research centre in April (reference date April 15). Mussels and seawater were collected in the Gulf of La Spezia: only mussels after the main (131)I deposition, on March 28, contained a measurable, although very small, amount of (131)I (0.18 ± 0.05 Bq kg(-1), detection limit (131)I = 0.03 Bq kg(-1) wet weight - soft parts). The (131)I was also detected in sheep milk in Rome (Casaccia research centre) until May 5, showing a maximum concentration of 4.9 ± 0.4 Bq L(-1). As for other European Countries for which data are available, activity levels remain of no concern for public health.

Effect of 5alpha-androst-16-en-3-one on oxytocin release in oestrous sows

The effect of an aerosol containing 5alpha-androst-16-en-3-one on oxytocin release in the sow was studied. The snouts of six estrous sows were sprayed with the aerosol for 2 sec. Blood samples were collected through indwelling vena cava canulas. The aerosol released oxytocin in all the sows tested. Maximum values, ranging from 24 to 101 pg oxytocin/ml plasma were recorded within 8 min of the treatment. A possible positive effect of the pheromonal stimulation on pigs' fertility is hypothesized.

The effects of pre-sleep learning on sleep continuity, stability, and organization in elderly individuals

Several studies have consistently shown that pre-sleep learning is associated to changes of sleep structure. Whereas previous research has mainly focused on sleep states, namely REM and NREM amount, very little attention has been paid to the hypothesis that pre-sleep learning might improve sleep continuity, stability, and cyclic organization, which are often impaired in aging. Thus, aim of this research was to assess, in a sample of 18 healthy elderly subjects, whether a memory task administered at bedtime would determine changes in any sleep parameter, with special regard to sleep continuity, stability, and organization. To this purpose, a baseline sleep (BL), i.e., a normal sleep with 9-h time in bed (TIB), was compared to a post-training sleep (TR), with the same TIB but preceded by an intensive training session. For the latter, a verbal declarative task was used, consisting in learning paired-word lists, rehearsed, and recalled for three times in a row. To control for individual learning abilities, subjects were administered several sets of lists with increasing difficulty, until they reached an error rate ≥20% at third recall. Relative to BL, TR shows a significant reduction in the frequency of brief awakenings, arousals, state transitions, "functional uncertainty" (FU) periods, and in the percentage of time in FU over total sleep time (TST). A significant increase in the number of complete cycles, total cycle time (TCT), and TCT/TST proportion was also found. All these changes are evenly distributed over the sleep episode. No sleep stage measure display significant changes, apart from a slight reduction in the percentage of Stage 1. Scores at retest are negatively correlated with both the frequency of arousals and of state transitions. Our data suggest that pre-sleep learning can yield a beneficial re-organizing effect on elderlies' sleep quality. The inverse correlation between recall scores and the measures of sleep continuity and stability provides further support to the role of these features in memory processes.

Effect of dietary vitamin E on cortisol and glucose responses to handling stress in juvenile beluga Huso huso

An 8-week feeding experiment was conducted to investigate the effect of dietary vitamin E on the physiological response to handling stress in juvenile beluga Huso huso. Fish were fed six experimental diets supplemented with 0, 25, 50,100, 200, or 400 mg Dl-all-rac-alpha-tocopherol acetate/kg diet. At the end of the experiment, the fish in each tank were subjected to acute handling and air exposure stress. Cortisol and glucose were measured as the primary hormonal and secondary metabolic responses to the stressors, both before and 3 h after application of the stressors. The growth parameters and feed utilization rates were significantly lower in fish fed the diet not supplemented with vitamin E than in fish fed diets supplemented with vitamin E. Cortisol concentration was not affected by dietary treatment but glucose concentration was. Fish fed vitamin E at 0, 25, 100, and 400 mg/kg diet had higher concentrations of glucose than those fed vitamin E at 50 and 200 mg/kg. However, fish fed diets with 50 and 200 mg/kg exhibited higher growth rates. These results indicate that dietary vitamin E has some effect on plasma glucose but no effect on plasma cortisol. In general, when the stressors were applied to belugas, the glucose and cortisol responses were relatively low. This may be due to higher resistance and lower physiological responses to these types of stressors by this species or by chondrosteans in general.

Interictal cortical reorganization in episodic migraine without aura: an event-related fMRI study during parametric trigeminal nociceptive stimulation

The aim of our study was to explore the pain processing network in patients with migraine during trigeminal nociceptive stimulation. Sixteen patients with episodic migraine without aura and 16 healthy controls performed functional magnetic resonance imaging during thermal stimuli (at 41, 51 and 53°C). Patients with migraine showed a greater activation in the perigenual part of anterior cingulate cortex at 51°C and less activation in the bilateral somatosensory cortex at 53°C compared to healthy controls. There were no differences in experimental pain perception between groups. Our findings demonstrate a functional reorganization of cerebral areas known to be involved in pain processing in patients with migraine.

Comparison of surgical methods in catastrophic antiphospholipid syndrome (CAPS)

Antiphospholipid syndrome (APS) is an autoimmune condition characterized by vascular thromboses and/or pregnancy morbidity in the presence of antiphospholipid antibodies. The variant "catastrophic" (CAPS) is defined as a potential life-threatening disease, characterized by multiple small vessel thromboses that can lead to multiple organ failure. Surgery is between precipitating factors in CAPS International Registry, but it's still unclear the relationship between surgery and syndrome. The present study reports two surgical procedures, performed on two patients with APS admitted with diagnosis of loss of substance of the lower limb needing of reconstructive treatment. We compared and analyzed aggressive and minimally invasive surgery.

Quality of life, body image, and psychiatric complications in patients with a burn trauma: preliminary study of the italian version of the burn specific health scale-brief

Burn patients may suffer both physical and psychopathological consequences and their quality of life and the presence of psychopathological symptoms should be evaluated. The Burn Specific Health Scale - Brief (BHSH-B) is a tried and tested instrument for assessing burn patients' quality of life. The aim of this study is to propose the Italian translation of BSHS-B and presents the preliminary results of an exploratory study. The Italian version of the BSHS-B was administered to a sample group of 50 burn victims. Reliability was verified by Cronbach's alpha, and construct validity was evaluated through correlation with the Short Form 36 Health Survey Questionnaire (SF-36) and the Self-report Symptom Inventory - Revised (SCL-90). The entire scale and two out of three domains showed Cronbach's alpha values higher than 0.8. Significant correlations were identified between BSHS-B subscales and the SF-36 subscales Physical Pain and Social Activities. Several psychopathological SCL-90 subscales correlated with BSHS-B subscales Heat Sensitivity and Body Image. It was concluded that our translation of BSHS-B was reliable and showed good construct validity. The drawbacks of this study are the limited size of the sample and the wide variety of types of burn injuries.

Methotrexate in paediatric ulcerative colitis: a retrospective survey at a single tertiary referral centre

BACKGROUND

Patients with ulcerative colitis often receive thiopurines as immunomodulators (IMs) to maintain remission and avoid corticosteroids. If unresponsive or intolerant to these agents, patients are treated with methotrexate, an antimetabolite never assessed in paediatric ulcerative colitis.

AIM

To describe the experience with methotrexate in children with ulcerative colitis.

METHODS

Thirty-two patients (median age 13.9 years) received methotrexate. Pediatric Ulcerative Colitis Activity Index (PUCAI) and use of corticosteroids were the main outcomes evaluated at baseline and at 3, 6 and 12 months.

RESULTS

Indications to methotrexate were azathioprine unresponsiveness in 18 patients, azathioprine intolerance/toxicity in 10 and spondyloarthropathy in four. Response or remission was achieved in 72%, 63% and 50% of patients at 3, 6 and 12 months respectively. Mean PUCAI were 49.5 ± 23.3 at baseline and 32.9 ± 21.9, 29.5 ± 21.8 and 29.4 ± 19.9 at 3, 6 and 12 months respectively (P: 0.03). At the beginning of methotrexate, 16 patients (50%) received corticosteroids that were discontinued in 13 of them (81%) by 6 months. At the end of the study, 11 patients (33%) needed short courses of corticosteroids for disease relapse.

CONCLUSIONS

Methotrexate may be useful in treating children with ulcerative colitis, although large, controlled trials are warranted to define better its effectiveness.

Optimizing Burn Treatment in Developing Low-and Middle-Income Countries with Limited Health Care Resources (Part 3)

The present review of the literature aims at analysing the challenges facing burn management in low- and middleincome countries and exploring probable modalities to optimize burn management in these countries. In Part I, epidemiology of burns injuries and the formidable challenges for proper management due to limited resources and inaccessibility to sophisticated skills and technologies in low- and middle income countries (LMICs) were presented. Part II discussed the actual state of burn injuries management in LMICs. In Part III of this review strategies for proper prevention and burn care in LMICs will be presented.

Skin dendritic cells in burn patients

The body's immunological response to burn injury has been a subject of great inquiry in recent years. Burn injury disturbs the immune system, resulting in a progressive suppression of the immune response that is thought to contribute to the development of sepsis. Dendritic cells (DCs) are potent antigen-presenting cells that possess the ability to stimulate naïve T cells.DCs are derived from bone marrow progenitors and circulate in the blood as immature precursors prior to migration into peripheral tissues. Within different tissues, DCs differentiate and become active in the taking up and processing of antigens, and their subsequent presentation on the cell surface is linked to major histocompatibility molecules. Upon appropriate stimulation, DCs undergo further maturation and migrate to secondary lymphoid tissues, where they present antigen to T cells and induce an immune response. The purpose of this study was to determine the effects of burn injury on skin DCs in terms of percentage, HLA-DR, and Toll-like receptor-4 (TLR-4) expression. The skin DCs were isolated from burned skin and non-burned skin in the same patient at 7 days post-injury, and skin DCs were isolated from unburned healthy individuals as control. DCs from burned skin notably express low levels of HLA-DR and TLR-4 soon after cell isolation. In the post-burn period the ability of skin DCs to respond to bacterial stimuli is impaired. These changes in DC behaviour might contribute to the impaired host defences against bacteria during burn sepsis.

The attack on psychosomatic integrity: a study of the psychological sequelae of burn trauma

Burns pathology is characterized not only by insidious damage to the patients' outward appearance but also by the equally painful emotional difficulties they encounter as they reorganize their identity and their personal history. This exploratory survey, combining research work with medical action, considers the cases of 41 outpatients who were hospitalized and subjected to skin grafting. The patients were recruited through the database of the Palermo Civic Hospital Plastic Surgery and Burns Therapy Operative Unit. The questionnaires were compiled 6 and 12 months post-burn (12 months' observation). The main objective of the research was to investigate the quality of life of burn patients in relation to the way they handled their condition on the emotional level, in order to cope with the stress caused by the burn.

Serum Levels of Cortisol, Immunoglobulin, and C-reactive Protein in Burn Patients

Thermal injury is known to induce alterations in the immune system, but the precise mechanisms have yet to be elucidated. It has been shown that thermal injury in more than 20% of the total body surface area (TBSA) leads to disturbances in the cortisol metabolism and the equilibrium of the hypothalamic-pituitary-adrenal axis. We investigated the temporal relationship between serum cortisol levels, C-reactive protein, and immunoglobulin levels in the post-burn period. Twenty-one adult burn patients (mean age, 52 ± 17 yrs) were included in the study (TBSA, 10-80%); nine developed sepsis and five died. The nonseptic group consisted of twelve patients. Thirty healthy blood donors served as controls. Our results suggest that increased cortisol and decreased immunoglobulin levels could be related to severe sepsis and clinical outcome.