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Sleep Medicine Reviews Jun 2024Insomnia and nightmares are both prevalent and debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia and...
Insomnia and nightmares are both prevalent and debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia and nightmares in individuals without a concomitant psychopathology. The relationships between insomnia and dreams are also addressed. PsycINFO and Medline were searched for papers published in English or French from 1970 to March 2023. Sixty-seven articles were included for review. Most results support positive relationships between insomnia variables and nightmare variables in individuals with insomnia, individuals with nightmares, the general population, students, children and older adults, and military personnel and veterans. These positive relationships were also apparent in the context of the COVID-19 pandemic. Some psychological interventions, such as Imagery Rehearsal Therapy, might be effective in alleviating both nightmares and insomnia symptoms. Regarding the relationships between insomnia and dreams, compared with controls, the dreams of individuals with insomnia are characterized by more negative contents and affects. The results show that insomnia and nightmares are connected and may be mutually aggravating. A model is proposed to explain how insomnia might increase the likelihood of experiencing nightmares, and how nightmares can in turn lead to sleep loss and nonrestorative sleep.
Topics: Humans; COVID-19; Dreams; Sleep Initiation and Maintenance Disorders
PubMed: 38733767
DOI: 10.1016/j.smrv.2024.101931 -
Journal of Cancer Research and Clinical... May 2024In 2023 FIGO revised the endometrial cancer staging system after 13 years. There is a lacuna of data regarding the performance and practicality of the revised 2023 FIGO...
BACKGROUND
In 2023 FIGO revised the endometrial cancer staging system after 13 years. There is a lacuna of data regarding the performance and practicality of the revised 2023 FIGO staging schema for endometrial cancer from Low Middle-Income Countries (LMIC).
OBJECTIVE
To estimate the shift of stage and adjuvant management of endometrial cancer based on the FIGO 2023 system compared to the FIGO 2009 system and assess the predictive potential of the FIGO 2023 system.
MATERIAL AND METHODS
A retrospective study was conducted from 1st January 2017 to 31st December 2022. All patients with endometrial cancer were staged according to the FIGO 2023 and FIGO 2009 staging system. Follow-up of patients was done to determine recurrence.
RESULTS
A total of 152 patients were included. Aggressive histology was seen in 66 (45%) patients. Eighteen (11%) had subserosal involvement. Substantial LVSI was noted in 23 (15%) of patients. Twenty-four (47%) patients of FIGO 2009 Stage IA and 26 patients (63%) of FIGO 2009 Stage IB were upstaged. Eleven (50%) patients of FIGO 2009 Stage IIIA were down staged to IA3. Overall 23 patients (15%) had a shift of stage. Fifteen out of 152 patients (15%) would have had a possible risk stratification change which would imply 23 patients (15%) would have needed a more radical treatment. Molecular classification was done in 32 patients; however, only 2 patients could afford POLE testing. Kaplan-Meier curves showed significant PFS differences in FIGO 2009 Stage IB and Stage IIIA when restaged according to the FIGO 2023 system.
CONCLUSION
The FIGO 2023 endometrial staging is a more robust prognosticator; however, the practicality of molecular classification in LMICs is still a distant dream.
Topics: Humans; Female; Endometrial Neoplasms; Neoplasm Staging; Retrospective Studies; Middle Aged; Prognosis; Aged; Adult
PubMed: 38733417
DOI: 10.1007/s00432-024-05739-w -
Nature Communications May 2024Sleepwalking and related parasomnias result from incomplete awakenings out of non-rapid eye movement sleep. Behavioral episodes can occur without consciousness or...
Sleepwalking and related parasomnias result from incomplete awakenings out of non-rapid eye movement sleep. Behavioral episodes can occur without consciousness or recollection, or in relation to dream-like experiences. To understand what accounts for these differences in consciousness and recall, here we recorded parasomnia episodes with high-density electroencephalography (EEG) and interviewed participants immediately afterward about their experiences. Compared to reports of no experience (19%), reports of conscious experience (56%) were preceded by high-amplitude EEG slow waves in anterior cortical regions and activation of posterior cortical regions, similar to previously described EEG correlates of dreaming. Recall of the content of the experience (56%), compared to no recall (25%), was associated with higher EEG activation in the right medial temporal region before movement onset. Our work suggests that the EEG correlates of parasomnia experiences are similar to those reported for dreams and may thus reflect core physiological processes involved in sleep consciousness.
Topics: Humans; Dreams; Electroencephalography; Male; Female; Adult; Parasomnias; Young Adult; Consciousness; Mental Recall; Sleep, REM; Middle Aged; Sleep
PubMed: 38724511
DOI: 10.1038/s41467-024-48337-7 -
PNAS Nexus May 2024Regulatory focus theory (RFT) describes two cognitive-motivational systems for goal pursuit-the promotion and prevention systems-important for self-regulation and...
Regulatory focus theory (RFT) describes two cognitive-motivational systems for goal pursuit-the promotion and prevention systems-important for self-regulation and previously implicated in vulnerability to psychopathology. According to RFT, the promotion system is engaged in attaining ideal goals (e.g. hopes and dreams), whereas the prevention system is associated with accomplishing ought goals (e.g. duties and obligations). Prior task-based functional magnetic resonance imaging (fMRI) studies have mostly explored the mapping of these two systems onto the activity of a priori brain regions supporting motivation and executive control in both healthy and depressed adults. However, complex behavioral processes such as those guided by individual differences in regulatory focus are likely supported by widely distributed patterns of intrinsic functional connectivity. We used data-driven connectome-based predictive modeling to identify patterns of distributed whole-brain intrinsic network connectivity associated with individual differences in promotion and prevention system orientation in 1,307 young university volunteers. Our analyses produced a network model predictive of prevention but not promotion orientation, specifically the subjective experience of successful goal pursuit using prevention strategies. The predictive model of prevention success was highlighted by decreased intrinsic functional connectivity of both heteromodal association cortices in the parietal and limbic networks and the primary motor cortex. We discuss these findings in the context of strategic inaction, which drives individuals with a strong dispositional prevention orientation to inhibit their behavioral tendencies in order to shield the self from potential losses, thus maintaining the safety of the status quo but also leading to trade-offs in goal pursuit success.
PubMed: 38711811
DOI: 10.1093/pnasnexus/pgae167 -
Nature Neuroscience Jun 2024Cortical malformations such as focal cortical dysplasia type II (FCDII) are associated with pediatric drug-resistant epilepsy that necessitates neurosurgery. FCDII...
Cortical malformations such as focal cortical dysplasia type II (FCDII) are associated with pediatric drug-resistant epilepsy that necessitates neurosurgery. FCDII results from somatic mosaicism due to post-zygotic mutations in genes of the PI3K-AKT-mTOR pathway, which produce a subset of dysmorphic cells clustered within healthy brain tissue. Here we show a correlation between epileptiform activity in acute cortical slices obtained from human surgical FCDII brain tissues and the density of dysmorphic neurons. We uncovered multiple signatures of cellular senescence in these pathological cells, including p53/p16 expression, SASP expression and senescence-associated β-galactosidase activity. We also show that administration of senolytic drugs (dasatinib/quercetin) decreases the load of senescent cells and reduces seizure frequency in an Mtor FCDII preclinical mouse model, providing proof of concept that senotherapy may be a useful approach to control seizures. These findings pave the way for therapeutic strategies selectively targeting mutated senescent cells in FCDII brain tissue.
Topics: Animals; TOR Serine-Threonine Kinases; Mice; Humans; Seizures; Senotherapeutics; Cellular Senescence; Dasatinib; Epilepsy; Male; Malformations of Cortical Development; Neurons; Female
PubMed: 38710875
DOI: 10.1038/s41593-024-01634-2 -
Scientific Reports May 2024Emotions experienced within sleep mentation (dreaming) affect mental functioning in waking life. There have been attempts at enhancing dream emotions using olfactory...
Emotions experienced within sleep mentation (dreaming) affect mental functioning in waking life. There have been attempts at enhancing dream emotions using olfactory stimulation. Odors readily acquire affective value, but to profoundly influence emotional processing, they should bear personal significance for the perceiver rather than be generally pleasant. The main objective of the present sleep laboratory study was to examine whether prolonged nocturnal exposure to self-selected, preferred ambient room odor while asleep influences emotional aspects of sleep mentation and valence of post-sleep core affect. We asked twenty healthy participants (12 males, mean age 25 ± 4 years) to pick a commercially available scented room diffuser cartridge that most readily evoked positively valenced mental associations. In weekly intervals, the participants attended three sessions. After the adaptation visit, they were administered the odor exposure and odorless control condition in a balanced order. Participants were awakened five minutes into the first rapid eye movement (REM) stage that took place after 2:30 a.m. and, if they had been dreaming, they were asked to rate their mental sleep experience for pleasantness, emotional charge, and magnitude of positive and negative emotions and also to evaluate their post-sleep core affect valence. With rs < 0.20, no practically or statistically significant differences existed between exposure and control in any outcome measures. We conclude that in young, healthy participants, the practical value of olfactory stimulation with self-selected preferred scents for enhancement of dream emotions and post-sleep core affect valence is very limited.
Topics: Humans; Male; Adult; Female; Dreams; Odorants; Young Adult; Emotions; Sleep; Smell; Sleep, REM; Wakefulness
PubMed: 38710748
DOI: 10.1038/s41598-024-60226-z -
Anaesthesia, Critical Care & Pain... May 2024Preventive anesthetic impact on the high rates of postoperative neurocognitive disorders in elderly patients is debated. The Prevention of postOperative Cognitive...
Preoperative ketamine administration for prevention of postoperative neurocognitive disorders after major orthopedic surgery in elderly patients: A multicenter randomized blinded placebo-controlled trial.
BACKGROUND
Preventive anesthetic impact on the high rates of postoperative neurocognitive disorders in elderly patients is debated. The Prevention of postOperative Cognitive dysfunction by Ketamine (POCK) study aimed to assess the effect of ketamine on this condition.
METHODS
This is a multicenter, randomized, double-blind, interventional study. Patients ≥60 years undergoing major orthopedic surgery were randomly assigned in a 1:1 ratio to receive preoperative ketamine 0.5 mg/kg as an intravenous bolus (n = 152) or placebo (n = 149) in random blocks stratified according to the study site, preoperative cognitive status and age. The primary outcome was the proportion of objective delayed neurocognitive recovery (dNR) defined as a decline of one or more neuropsychological assessment standard deviations on postoperative day 7. Secondary outcomes included a three-month incidence of objective postoperative neurocognitive disorder (POND), as well as delirium, anxiety, and symptoms of depression seven days and three months after surgery.
RESULTS
Among 301 patients included, 292 (97%) completed the trial. Objective dNR occurred in 50 (38.8%) patients in the ketamine group and 54 (40.9%) patients in the placebo group (OR [95% CI] 0.92 [0.56;1.51], p = 0.73) on postoperative day 7. Incidence of objective POND three months after surgery did not differ significantly between the two groups nor did incidence of delirium, anxiety, apathy, and fatigue. Symptoms of depression were less frequent in the ketamine group three months after surgery (OR [95%CI] 0.34 [0.13-0.86]).
CONCLUSIONS
A single preoperative bolus of intravenous ketamine does not prevent the occurrence of dNR or POND in elderly patients scheduled for major orthopedic surgery. (Clinicaltrials.gov NCT02892916.).
PubMed: 38710325
DOI: 10.1016/j.accpm.2024.101387 -
F1000Research 2024The majority of indie game development teams are driven by the desire to produce a blockbuster game. But there are many obstacles on the way to realizing this desire,...
The majority of indie game development teams are driven by the desire to produce a blockbuster game. But there are many obstacles on the way to realizing this desire, especially in the beginning. It is possible to create a game alone, but more often than not, something genuinely amazing involves a group of talented people working together toward a similar objective. Finding the correct stakeholders is one of the biggest problems with starting an independent game development team. People with the required technical talents, such as programmers and artists, as well as those with business acumen, like marketing and finance experts, are included in this. Success depends on being able to locate these people and manage them. But after the correct individuals have been identified, it is crucial to develop open lines of communication and a common comprehension of the project's objectives and expectations. Finding the perfect people to join their team is a problem that independent game development teams frequently encounter. Attracting talented individuals to a brand-new, unproven initiative might be difficult. The attention of skilled people interested in working on cutting-edge and intriguing initiatives might be attracted through networking. There are other things to consider as well since forming a team comes with the type of game one is making, finding skilled teammates, team chemistry, conflict resolution, communication, long-term relation maintenance and leadership aspects. In general, creating and leading an independent game team is a difficult process. There is no specific method for doing this, but with a little help from others' expertise, it is possible to assemble a team of creative people who can collaborate to produce a game that is genuinely enjoyable.
Topics: Humans; Cooperative Behavior; Communication
PubMed: 38708288
DOI: 10.12688/f1000research.139274.1 -
ACS Omega Apr 2024Recent studies show that nanofillers greatly contribute to the increase in the mechanical and abrasive behaviors of the polymer composite. In the current study, epoxy...
Recent studies show that nanofillers greatly contribute to the increase in the mechanical and abrasive behaviors of the polymer composite. In the current study, epoxy composites were made by hand lay-up with the reinforcement of carbon fabric and titanium dioxide (TiO) nanoparticles as secondary reinforcement in weight percentages of 0.5, 1.0, and 2.0. Hardness, tensile, and abrasive wear tests have been carried out for the fabricated composites. The obtained results confirm that as the percentage of filler addition increases, hardness of the carbon epoxy (CE) composite increases, and significant enhancement of 10.25% hardness is confirmed in 2 wt % nano TiO-added CE composite. The CE composite filled with 2 wt % of TiO nanofiller shows 15.77 and 9.15% improvement of tensile strength and modulus, respectively, compared to unfilled CE composites. The abrasive wear volume exhibits a nearly linear increasing trend as the abrading distance increases. In addition, it is discovered that the abrasive wear volume is greater for higher applied loads. The inclusion of nano TiO reduced the wear loss in the CE composite for all abrading distances, regardless of the load, low or high. The scanning electron microscopy analysis of worn surfaces was carried out to analyze the contribution of the filler to improve the wear resistance.
PubMed: 38708248
DOI: 10.1021/acsomega.3c07830 -
Heliyon May 2024To explore the effects of propofol and ciprofol on patient euphoric reactions during sedation in patients undergoing gastroscopy and to investigate potential factors...
OBJECTIVE
To explore the effects of propofol and ciprofol on patient euphoric reactions during sedation in patients undergoing gastroscopy and to investigate potential factors that may influence euphoric reactions in patients.
METHODS
A total of 217 patients were randomly divided into two groups: the propofol group (P group, n = 109) and the ciprofol group (C group, n = 108). The patients in the P group were given 2 mg/kg propofol, and those in the C group were given 0.5 mg/kg ciprofol. The patients were assessed using the Addiction Research Center Inventory-Chinese Version (ARCI-CV) to measure euphoric reactions at three time points: preexamination, 30 min after awakening, and 1 week after examination. Anxiety, depression, and sleep status were evaluated using appropriate scales at admission and 1 week after the examination. The dream rate, sedative effects, vital sign dynamics, and adverse reactions were documented during the sedation process.
RESULTS
After 30 min of awakening, the P group and C group showed no statistically significant differences in the mean morphine-benzedrine group (MBG) score (8.84 vs. 9.09, > 0.05), dream rate (42.2 % vs. 40.7 %, > 0.05), or MBG score one week after the examination (7.04 vs. 7.05, > 0.05). The regression analysis revealed that sex, dream status, Alcohol Use Disorders Identification Test (AUDIT) score, and examination time had notable impacts on the MBG-30 min score. No statistically significant differences were observed in sedative effects, anxiety, depression, or sleep status between the two groups ( > 0.05). The incidence of injection pain and severe hypotension was significantly lower in the C group ( < 0.05), and hemodynamics and SpO were more stable during sedation ( < 0.05).
CONCLUSION
There was no significant difference between propofol and ciprofol in terms of euphoria experienced by patients after sedation in patients undergoing gastroscopy. Ciprofol has demonstrated addictive potential similar to that of propofol, warranting careful attention to its addictive potential during clinical application.
PubMed: 38707441
DOI: 10.1016/j.heliyon.2024.e30378