The function of dreams is a longstanding scientific research question. Simulation theories of dream function, which are based on the premise that dreams represent evolutionary past selective ...pressures and fitness improvement through modified states of consciousness, have yet to be tested in cross-cultural populations that include small-scale forager societies. Here, we analyze dream content with cross-cultural comparisons between the BaYaka (Rep. of Congo) and Hadza (Tanzania) foraging groups and Global North populations, to test the hypothesis that dreams in forager groups serve a more effective emotion regulation function due to their strong social norms and high interpersonal support. Using a linear mixed effects model we analyzed 896 dreams from 234 individuals across these populations, recorded using dream diaries. Dream texts were processed into four psychosocial constructs using the Linguistic Inquiry and Word Count (LIWC-22) dictionary. The BaYaka displayed greater community-oriented dream content. Both the BaYaka and Hadza exhibited heightened threat dream content, while, at the same time, the Hadza demonstrated low negative emotions in their dreams. The Global North Nightmare Disorder group had increased negative emotion content, and the Canadian student sample during the COVID-19 pandemic displayed the highest anxiety dream content. In conclusion, this study supports the notion that dreams in non-clinical populations can effectively regulate emotions by linking potential threats with non-fearful contexts, reducing anxiety and negative emotions through emotional release or catharsis. Overall, this work contributes to our understanding of the evolutionary significance of this altered state of consciousness.
Social anxiety disorder (SAD) is characterized by a significant amount of fear when confronted to social situations. Exposure therapy, which is based on fear extinction, does not often lead to full ...remission. Here, based on evidence showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR) during REM sleep to enhance extinction learning in SAD.
Forty-eight subjects with SAD were randomly assigned to two groups: control or TMR group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk in front of a virtual jury. At the end of each session, and only in the TMR group (
= 24), a sound was paired to the positive feedback phase of therapy (i.e., approval of their performance), which represented the memory to be strengthened during REM sleep. All participants slept at home with a wearable headband device which automatically identified sleep stages and administered the sound during REM sleep. Participants' anxiety level was assessed using measures of parasympathetic (root mean square of successive differences between normal heartbeats, RMSSD) and sympathetic (non-specific skin conductance responses, ns-SCRs) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation phase of their talks before (T1) and after (T2) one full-night's sleep and after 1 week at home (T3). Participants also filled in a dream diary.
We observed an effect of time on subjective measures of anxiety (SUDS). We did not find any difference in the anxiety levels of the two groups after 1 week of TMR at home. Importantly, the longer the total duration of REM sleep and the more stimulations the TMR group had at home, the less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with ns-SCRs and SUDS at T3 in the TMR group.
TMR during REM sleep did not significantly modulate the beneficial effect of therapy on subjective anxiety. Yet, our results support that REM sleep can contribute to extinction processes and substantiate strong links between emotions in dreams and waking stress levels in these patients.
•Dual-task is more sensitive than single-task to detect subtle gait impairments.•Mobile app and insoles to study ecological walking during single- and dual-task.•Transparent and automatic labeling of ...gait data if the user is on the phone.•Ability to discriminate dual-task effect on gait parameters in seniors.•Excellent usability reported from long-term use on senior users.
Early detection of gait impairments in older adults allows the early uncovering of fall risk and/or cognitive deficits, resulting in timely interventions. Dual-task paradigms have been shown to be more sensitive than single-task conditions for the detection of subtle yet relevant gait impairments.
Can a system - encompassing a pair of instrumented insoles and a customized mobile app - transparently and accurately study ecological walking activities in single- and dual-task conditions, with the aim of detecting early and subtle age-related alterations of gait?
The system was tested on 19 older adults during outdoor walking (two identical single-task trials and two motor-cognitive dual-task trials with the user engaged in a simple phone call and in a cognitive-demanding phone call). A single-task cognitive trial was included. Relative reliability of the gait parameters provided by the insoles during single-task walking was investigated (Intraclass Correlation Coefficient). The effect of dual tasking on both motor (Friedman test) and cognitive (Wilcoxon signed-rank test) domains was studied.
To study usability, the system was tested on 5 older adults in real-life environment over 3 months.
Most of the parameters showed excellent reliability. Independently from the cognitive demand, walking while talking resulted in increased gait cycle and step time, with a prolonged stance phase due to an augmented double-support. Variability of gait cycle and stance phase increased only during the most demanding dual-task. Dual tasking resulted in a reduced cognitive score.
Usability feedback were excellent, with users reporting to understand the usefulness of the devised system and to feel at ease when using the system and the insoles.
This work paves the way toward fruitful applications of the devised system to achieve accurate and ecological monitoring of daily-life walking activities, with the final aim of detecting early and subtle alterations of gait.
The integration of Ambient Assisted Living (AAL) frameworks with Socially Assistive Robots (SARs) has proven useful for monitoring and assisting older adults in their own home. However, the ...difficulties associated with long-term deployments in real-world complex environments are still highly under-explored. In this work, we first present the MoveCare system, an unobtrusive platform that, through the integration of a SAR into an AAL framework, aimed to monitor, assist and provide social, cognitive, and physical stimulation in the own houses of elders living alone and at risk of falling into frailty. We then focus on the evaluation and analysis of a long-term pilot campaign of more than 300 weeks of usages. We evaluated the system’s acceptability and feasibility through various questionnaires and empirically assessed the impact of the presence of an assistive robot by deploying the system
with
and
without
it. Our results provide strong empirical evidence that Socially Assistive Robots integrated with monitoring and stimulation platforms can be successfully used for long-term support to older adults. We describe how the robot’s presence significantly incentivised the use of the system, but slightly lowered the system’s overall acceptability. Finally, we emphasise that real-world long-term deployment of SARs introduces a significant technical, organisational, and logistical overhead that should not be neglected nor underestimated in the pursuit of long-term robust systems. We hope that the findings and lessons learned from our work can bring value towards future long-term real-world and widespread use of SARs.
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•R. capsulatus generates extracellular tellurium nanoparticles (TeNPs) with lawsone.•TeNPs are composed of crystalline metallic tellurium and organic coating material.•The coating ...organic material contains proteins also present in the outer membrane.•Tellurite and lawsone interact oxidoreductively leading to formation of metallic Te.
Cells of the facultative photosynthetic bacterium Rhodobacter capsulatus exploit the simultaneous presence in the cultural medium of the toxic oxyanion tellurite (TeO32−) and the redox mediator lawsone (2-hydroxy-1,4-naphthoquinone) by reducing tellurite to metal Te0 nanoprecipitates (TeNPs) outside the cells. Here we have studied the mechanism by which lawsone interacts with metabolically active cells and analysed both structure and composition of the TeNPs collected from the growth medium of phototrophycally grown R. capsulatus. High Resolution Transmission Electron Microscopy (HR-TEM) images and Energy-Dispersive X-ray (EDX) microanalysis of TeNPs showed a central core of polycrystalline tellurium interspersed in an organic matrix with a predominant protein-based composition. The main proteins from Te0 nanostructures were identified by Liquid Chromatography tandem-Mass Spectrometry and were all correlated with the cell outer membrane composition. The interaction of reduced lawsone with tellurite and with the bacterial cells was probed by Cyclic Voltammetry and Scanning ElectroChemical Microscopy (SECM). We concluded that lawsone is required for the reduction of tellurite to metal Te0 in a reaction mechanism dependent on reducing equivalents deriving from the cell photosynthetic metabolism. SECM experiments demonstrate that lawsone, by diffusing inside the bacterial cells, is effectively available at the membrane site of the photosynthetic electron transport chain.
Telemonitoring is one of the most expedient answers to the strong need for preventive care imposed by the rapidly aging society. We propose an innovative solution to the detection of early signs of ...frailty by presenting a serious game controlled by a smart sensorized soft plastic ball, designed to achieve continuous home-based monitoring of muscle weakness in older adults. Design, development, and testing of the smart ball and of the game interface devised to guide the monitoring procedure are presented. Reliability and concurrent validity of the system in measuring maximal grip strength against the clinical standard Jamar® were evaluated. Serious game usability and acceptance were investigated on 26 elderlies. Smart ball and Jamar measurements were well correlated (0.76 and 0.80 for dominant and non-dominant hands) and test–retest reliability of pressure measurements was excellent (intraclass correlation coefficient >0.94). The serious game was well accepted by the 96.1 percent of participants, who provided a strongly positive usability score (87.7/100). The smart ball–driven serious game demonstrated excellent reliability and good validity in measuring grip strength. The proposed smart ball–driven serious game can be used for home self-monitoring of grip strength in elderlies.
Vulvar cancer (VC) is a rare disease of which recurrence poses management problems due to patients' advanced age and comorbidities, and to the localization of the disease. Palliative treatments, ...allowing local disease control in patients previously treated with multimodal therapies or with comorbidities, are lacking. In this study we tested electrochemotherapy (ECT) on recurrent VC refractory to standard therapies to assess the tumor response and to define the selection criteria for patient's candidate to ECT. This is a multicenter observational study carried out in five Italian centers. Data about patients and tumor characteristics, treatment, toxicity, and clinical response were recorded. In all procedures, intravenous bleomycin was administered according to European Standard Operative Procedure ECT (ESOPE) guidelines. Sixty-one patients, with a median age 79 years (range: 39-85) and mainly affected by squamous cellular carcinoma (91.8%), were treated with ECT. No serious adverse events were reported. Patients were discharged after three days (median, range: 0-8 days). Two months after ECT, the clinical response rate was 83.6% and was not related to age, body mass index, International Federation of Gynecology and Obstetrics (FIGO) stage, number of treated nodules, or previous treatments. ECT is a safe procedure with a favorable cost-effectiveness ratio and should be considered as a treatment option for local disease control in patients unsuitable for standard therapies.
We present the development of a novel smart ink pen instrumented with force and motion sensors designed for the quantitative and ecological assessment of daily-life handwriting. This work aims at ...testing the pen's sensors and algorithms and the use of the smartpen to detect age-related changes in writing and tremor parameters during daily-life handwriting. A comparison against reference instruments was carried out to validate the pen tip force during static and dynamic conditions, the pen's tilt angle, and the algorithm for the segmentation of the force signal into strokes. The smartpen was tested on 43 healthy adults divided into three age groups (young, middle-old, and old) during unconstrained handwriting on paper. The validation of the pen's sensors and algorithms reported excellent results. A solid test-retest reliability was found in the writing and tremor indicators extracted from both young and old adults. As for the age-related analysis, the older age groups were characterized by an increase of temporal writing measures, a more uniform writing pressure, and more repetitive and predictable tremor oscillation components. The greatest accomplishment of our smart ink pen is the ability to combine the advantages of the digitizing tablet technology with the natural "feel," the ease of use, and the ecological validity of the traditional pen-and-paper approach. The proposed solution represents an important step toward a simple, ecologically valid, reliable quantitative assessment of daily-life handwriting. Our smartpen is particularly suitable for daily-life telemonitoring applications in a number of important health-related fields.
Background
Difficulties in handwriting, such as dysgraphia, impact several aspects of a child’s everyday life. Current methodologies for the detection of such difficulties in children have the ...following three main weaknesses: (1) they are prone to subjective evaluation; (2) they can be administered only when handwriting is mastered, thus delaying the diagnosis and the possible adoption of countermeasures; and (3) they are not always easily accessible to the entire community.
Objective
This work aims at developing a solution able to: (1) quantitatively measure handwriting features whose alteration is typically seen in children with dysgraphia; (2) enable their study in a preliteracy population; and (3) leverage a standard consumer technology to increase the accessibility of both early screening and longitudinal monitoring of handwriting difficulties.
Methods
We designed and developed a novel tablet-based app Play Draw Write to assess potential markers of dysgraphia through the quantification of the following three key handwriting laws: isochrony, homothety, and speed-accuracy tradeoff. To extend such an approach to a preliteracy age, the app includes the study of the laws in terms of both word writing and symbol drawing. The app was tested among healthy children with mastered handwriting (third graders) and those at a preliterate age (kindergartners).
Results
App testing in 15 primary school children confirmed that the three laws hold on the tablet surface when both writing words and drawing symbols. We found significant speed modulation according to size (P<.001), no relevant changes to fraction time for 67 out of 70 comparisons, and significant regression between movement time and index of difficulty for 44 out of 45 comparisons (P<.05, R2>0.28, 12 degrees of freedom). Importantly, the three laws were verified on symbols among 19 kindergartners. Results from the speed-accuracy exercise showed a significant evolution with age of the global movement time (circle: P=.003, square: P<.001, word: P=.001), the goodness of fit of the regression between movement time and accuracy constraints (square: P<.001, circle: P=.02), and the index of performance (square: P<.001). Our findings show that homothety, isochrony, and speed-accuracy tradeoff principles are present in children even before handwriting acquisition; however, some handwriting-related skills are partially refined with age.
Conclusions
The designed app represents a promising solution for the screening of handwriting difficulties, since it allows (1) anticipation of the detection of alteration of handwriting principles at a preliteracy age and (2) provision of broader access to the monitoring of handwriting principles. Such a solution potentially enables the selective strengthening of lacking abilities before they exacerbate and affect the child’s whole life.
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