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Free parking in Lisbon is becoming increasingly difficult
But we've discovered some places where you can still leave your car without paying a penny before going to work
Lisbon is a city known for its heavy traffic
 but we can’t even say that there are so few places to park… for a fee
because there are fewer and fewer free ones
the city does offer some free parking options
both in specific areas and in dedicated parks
At Lisboa Secreta we know that the places where you usually park are either always full or are about to become yet another paid parking lot
when we can’t park for free in Lisbon
we’ve discovered some secret spots where you can still park for free before going to work
But if you live in areas closer to Lisbon and don’t need four wheels to get to work
because you even have to take the kids to nursery or school
you can also use these tips to park for free in the city
From what we’ve consulted on the planning maps of the company that manages parking in Lisbon
some of these places can become outdated from one day to the next
 To give you a better idea of the free parking spots we’ve found in Lisbon
we’ ve divided the city into five zones:
namely their proximity to Lisbon’s most used public transport: metro
some of these areas may require you to walk for a few minutes to find a metro station or bus stop
But this can also be solved by opting for one of the mobility solutions scattered throughout the city, from scooters, <a href="https://lisboasecreta.co/bicicletas-gira-gratuitas-passe-navegante/" rel="noopener noreferrer" target="_self" class="shortcode-outbound-link" data-has-ga="true" data-ga-type="click" data-label="https://lisboasecreta.co/bicicletas-gira-gratuitas-passe-navegante/" data-action="text_cta_6" data-category="click_internal">bicycles</a> or car and motorcycle sharing services
the main parking lot manager in Lisbon already occupies a large part of the central area of the city
leaving a few free parking spaces for areas further away from the center 
But let&#8217;s leave these discussions for other pages and get down to business
 Let&#8217;s start with the easternmost part of Lisbon and one of the city&#8217;s newest areas
Although it &#8216;s very difficult to find free parking in the center of Parque das  <a href="https://lisboasecreta.co/en/what-to-see-and-do-in-parque-das-nacoes/" rel="noopener noreferrer" target="_self" class="shortcode-outbound-link" data-has-ga="true" data-ga-type="click" data-label="https://lisboasecreta.co/en/what-to-see-and-do-in-parque-das-nacoes/" data-action="text_cta_8" data-category="click_internal">Nações</a>
there are some very interesting alternatives very close to public transport
in this case the Sacavém train station and bus stops
Near Sacavém train station there are a few parking lots where you can leave your car and then take the train or bus to the city center
Here you can leave your car near the Parque do Rio urbanization
The park is at the end of Via do Oriente and Passeio dos Heróis do Mar
📍<a href="https://maps.app.goo.gl/xYdTFo5NHY92jUC87" rel="nofollow noopener noreferrer" target="_blank" class="shortcode-outbound-link" data-has-ga="true" data-ga-type="click" data-label="https://maps.app.goo.gl/xYdTFo5NHY92jUC87" data-action="text_cta_9" data-category="click_non_sales">Coordinates</a>
 On your way to Parque das Nações from the south to the north
if you go along the waterfront you&#8217;ll come across the Santa Apolóniatrain station and
finding a parking space can be a challenge
If you&#8217;re not one of the first to arrive
So our suggestion is that you arrive at one of these places between 07h45 and 08h15
you&#8217;ll probably be scrambling around until you find a seat
📍<a href="https://maps.app.goo.gl/Hnmtgxujteb8U31X9" rel="nofollow noopener noreferrer" target="_blank" class="shortcode-outbound-link" data-has-ga="true" data-ga-type="click" data-label="https://maps.app.goo.gl/Hnmtgxujteb8U31X9" data-action="text_cta_12" data-category="click_non_sales">Coordinates</a>
Rua Luís de Camões is one of the few streets where you can still see cars parked on the sidewalk
In the parallel streets you&#8217;ll be able to find free parking without too much trouble
If you can&#8217;t find a space as soon as you arrive in this well-known neighborhood
we guarantee that you&#8217;ll have a parking space within 5-10 minutes
But for that you&#8217;ll have to be in the area between 8.45 and 9.15am
when the locals also drive to work in their cars and leave the spaces vacant
📍<a href="https://maps.app.goo.gl/rNpQNHAicPdt6wtH6" rel="nofollow noopener noreferrer" target="_blank" class="shortcode-outbound-link" data-has-ga="true" data-ga-type="click" data-label="https://maps.app.goo.gl/rNpQNHAicPdt6wtH6" data-action="text_cta_15" data-category="click_non_sales">Coordinates</a>
you&#8217;re sure to find your parking space in the sun
The area is very well served by public transport
with trains and buses to almost every part of Lisbon
you may have to park a little away from these stops
otherwise take the opportunity to rent a scooter or bicycle along the way
📍<a href="https://maps.app.goo.gl/ByVuKUkFjHiiAdgt6" rel="nofollow noopener noreferrer" target="_blank" class="shortcode-outbound-link" data-has-ga="true" data-ga-type="click" data-label="https://maps.app.goo.gl/ByVuKUkFjHiiAdgt6" data-action="text_cta_18" data-category="click_non_sales">Coordinates</a>
 The Benfica area is the furthest away from the city center
But that doesn&#8217;t mean you can&#8217;t find your free parking space in Lisbon
there&#8217;s plenty of public transport you can take from here
You&#8217;ll find free parking in all areas of Benfica
but with the train station right next door
it&#8217;s very difficult to get a parking space
📍<a href="https://maps.app.goo.gl/yoscoSWopud5SA7b9" rel="nofollow noopener noreferrer" target="_blank" class="shortcode-outbound-link" data-has-ga="true" data-ga-type="click" data-label="https://maps.app.goo.gl/yoscoSWopud5SA7b9" data-action="text_cta_19" data-category="click_non_sales">Coordinates</a>
But the truth is that public transport is still not the ideal solution for those who want to get from place A to place B as comfortably and quickly as possible
Lisbon can be a more pleasant place for people to move around
We always believe that the solution will be better without cars
but we also know that until these conditions are met
finding free parking in Lisbon will always be a problem for those who want to move around the city
At the general conference leadership session on Thursday
61 new Area Seventies from 28 countries were announced and presented for a sustaining vote
Another 50 Area Seventies will be released on or before August 1
See the lists below of the <a href="#new">new Area Seventies</a> and those who will be <a href="#released">released this year</a>
Africa Central Area; currently serving as stake Young Men counselor of the Nairobi Kenya West Stake; former bishop
and stake president; wife: Josephine; four children
Nigeria; currently serving as president of the Nigeria Port Harcourt Mission; former bishop
branch president and stake president; wife: Nicoline; two children
Democratic Republic of the Congo; coordinator
Seminaries and Institutes of Religion; currently serving as stake president of the Ruashi Democratic Republic of the Congo Stake; former bishop
and stake presidency counselor; wife: Mufuka Lyliane; five children
Seminaries and Institutes of Religion; currently serving as high councilor of the Roodepoort South Africa Stake; former bishop
stake president and mission president; wife: Andronica; four children
Shepstone &amp; Wylie Attorneys; currently serving as a branch presidency counselor and as counselor of the South Africa Durban Mission; former bishopric counselor
branch president and stake presidency counselor; wife: Tumeka; three children
Self-Reliance Services; currently serving as stake president of the Freetown Sierra Leone Stake; former bishopric counselor
high councilor and stake presidency counselor; wife: Susan; five children
Town and Country Planning; currently serving as president of the Kumasi Ghana Suame Stake; former bishop
stake presidency counselor and stake president; wife: Linda; seven children
MyVitalz Telehealth; currently serving as elders quorum president of the New Haven Ward; former bishopric counselor
high councilor and stake president; wife: Stella Ebele; four children
real estate; currently serving as stake president of the Phnom Penh Cambodia North Stake; former branch president
district president and mission presidency counselor; wife: Dany; five children
Japan; currently serving as president of the Japan Kobe Mission; former branch presidency counselor
high councilor and stake presidency counselor; wife: Tomomi; six children
Valcom IT Services Private Ltd.; currently serving as president of the Bengaluru India Stake; former branch president and district president; wife: Stella Christina; three children
Seminaries and Institutes of Religion; currently serving as counselor of the Brazil Fortaleza Mission; former bishop
stake presidency counselor and stake president; wife: Ana Rosa; three children
Brazil; currently serving as president of the Brazil Maceio Mission; former bishop
stake presidency counselor and stake president; wife: Daniela; three children
doTerra Brazil; currently serving as Sunday School teacher of the Aldeia da Serra branch; former bishop
high councilor and mission president; wife: Lilian; four children
Dominican Republic; administrative director
Orlando Industries; currently serving as Young Men ward adviser of the Herrera 1st ward; former bishop
stake presidency counselor and stake president; wife: Dareidi; three children
Mexico; currently serving as president of the México Tijuana Mission; former bishopric counselor
high councilor and stake presidency counselor; wife: Julia; two children
Cartonera Hued SAS; currently serving as president of the Santo Domingo Dominican Republic Las Americas Stake; former bishop
branch presidency counselor and high councilor; wife: Niurka Atavelis; one child
Mexico; construction manager; currently serving as a temple ordinance worker of the Monterrey México Temple; former bishop
high councilor and stake president; wife: Myriam Elizabeth; four children
Comisión Nacional de Áreas Naturales Protegidas; currently serving as elders quorum president of the Belenes Ward; former bishop
stake presidency counselor and stake president; wife: Holly; two children
Seminaries and Institutes of Religion; former president of the Nicaragua Managua South Mission
high councilor and stake presidency counselor; wife: Zeidy; three children
Argentina; currently serving as president of the Argentina Salta Mission; former bishopric counselor
stake presidency counselor and stake president; wife: Gabriela; four children
Central America Area; currently serving as president of the San Salvador El Salvador Stake; former bishop
stake presidency counselor and stake president; wife: Claudia; three children
KADRI Servicios S.a de C.V.; currently serving as elders quorum president of the Contry Ward; former bishop
high councilor and mission president; wife: Elisa; five children
Infonavit; currently serving as president of the México City Ermita Stake; former bishopric counselor
high councilor and stake presidency counselor; wife: Nadia; four children
Europe East and Middle East/Africa North Areas)
Baringa Partners; currently serving as a Sunday School teacher in the Watford Ward; former bishop
high councilor and stake president; wife: Jennifer L.; four children
Finland; currently serving as president of the Bulgaria/Central Eurasian Mission; former stake president; wife: Anna-Maria; three children
Europe Central Area; currently serving as emergency preparedness specialist of the Frankfurt 2nd Ward; former bishop and high councilor; wife: Elodie; three children
self-employed; currently serving as president of the Prague Czech Republic Stake; former branch president
district president and mission presidency counselor; wife: Alena; four children
Pestana Tennis Academy; currently serving as an institute teacher of the Oeiras Stake; former bishop
stake presidency counselor and stake president; wife: Zélia Lina Valente; four children
England; managing director UK; Tyrus Capital Alternatives LLP; currently serving as president of the Ipswich England Stake; former bishop
bishopric counselor and high councilor; wife: Amy; four children
Eighth Quorum (Pacific and Philippines Areas)
Philippines Area; currently serving as Sunday School president of the Cainta 2nd Ward; former mission presidency counselor
stake presidency counselor and mission president; wife: Angie; three children
Australia; recently released as president of the Philippines Missionary Training Center; former bishopric counselor
stake presidency counselor and mission president; wife: Tracy; four children
self-employed; currently serving as stake young single adult adviser of the Christchurch New Zealand Stake; former high councilor
mission presidency counselor and stake president; wife: Stephanie; three children
self-employed; currently serving as president of the Paco Roman Branch; former bishopric counselor
stake president and mission president; wife: Marivic; five children
Ninth Quorum (South America Northwest and South America South Areas)
self-employed; currently serving as president of the Oruro Bolivia Stake; former bishopric counselor and high councilor; wife: Pamela Anabel; three children
FamilySearch; recently released as stake president of the Santa Fe Argentina North Stake; former bishop
branch president and high councilor; wife: Romina; five children
Peru; recently released as president of the Perú Cusco Mission; former bishop
mission presidency counselor and stake president; wife: Carol G.; three children
Seminaries and Institutes of Religion; currently serving as Assistant Area Auditor of the Arequipa Hunter Stake; former bishop
stake president and mission president; wife: Alicia; two children
Peru; Welfare and Self-Reliance manager; currently serving as an area temple and family history advisor of the Peru Lima East Area; former bishop
stake president and mission president; wife: Betsy; two children
Ecuador; ICS Technical Support Representative
The Church of Jesus Christ of Latter-day Saints; currently serving as counselor in the mission presidency of the Ecuador Quito Mission; former bishop
stake presidency counselor and stake president; wife: Sandra; three children
North America Northeast and North America Southeast Areas)
currently serving as president of the Louisiana Baton Rouge Mission; former bishop
bishopric counselor and stake presidency counselor; wife: Michelle; three children
United Bilt Homes; recently released as stake president of the Springdale Arkansas Stake; former bishop
high councilor and stake presidency counselor; wife: Deri Lyn; five children
Grow Rasmussen LLP; currently serving as ward Young Men advisor; former bishop
stake presidency counselor and mission president; wife: Becky; four children
Canada; currently serving as president of the Edmonton Alberta Temple; former bishop
high councilor and stake president; wife: Dixie; five children
Pickett Ranch; currently serving as Sunday School teacher of the Oakley 3rd Ward; former bishop
stake president and mission president; wife: Kristin; five children
Missoula Bone &amp; Joint; recently released as stake president of the Missoula Montana stake; former bishopric counselor
stake presidency counselor and stake president; wife: Shalayne; five children
White &amp; Case LLP; currently serving as Sunday School teacher of the Palm Springs Ward; former bishop
and stake president; wife: LaTeshia; two children
Brock &amp; Scott; currently serving as president of the Winston-Salem North Carolina Stake; former bishop
high councilor and stake presidency counselor; wife: Ginger; seven children
Canada; director of planning and forecasting
Hydro-Québec; currently serving as president of the Montréal Québec stake; former bishop
bishopric counselor and high councilor; wife: Marie-Lyne; five children
University of Michigan; currently serving as president of the Ann Arbor Michigan Stake; former bishop
stake presidency counselor and stake president; wife: Jana Lynn; six children
Eleventh Quorum (North America Southwest and North America West Areas)
Demolition/Deconstruction - EZ Services; currently serving as high councilor of the Vista California Stake; former bishop
high councilor and mission president; wife: Linda; five children
Alaska Dental Care; currently serving as stake president of the Eagle River Alaska Stake; former bishop
bishopric counselor and high councilor; wife: Tiffany; four children
Thomas and Mack Company; currently serving as president of the Las Vegas Nevada Redrock Stake; former bishop
and stake president; wife: Leslie; five children
Sunwarrior; currently serving as stake president of the Washington Utah Stake; former bishop; wife: Jennae; three children
Burdsal &amp; Fale; currently serving as president of the Provo Utah Wasatch Stake (Tongan); former bishop and high councilor; wife: Gaylene; five children
Missionary Department; currently serving as stake presidency counselor of the Huntsville Utah stake; former bishop
high councilor and mission president; wife: Kim; four children
Space Dynamics Laboratory; currently serving as president of the Wellsville Utah Stake; former bishop and high councilor; wife: Natalie; six children
Intermountain Healthcare; recently released as stake president of the Orem Utah Hillcrest Stake; former bishop
stake presidency counselor and stake president; wife: Mary; five children
Zions Bank; currently serving as an Area Seventy Executive Secretary; former bishop
high councilor and stake president; wife: Debra; five children
the Stirling Foundation; currently serving as bishop of the North Field 2nd Ward; former bishopric counselor
stake president and mission president; wife: Brooke; five children
University of Utah; currently serving as stake missionary preparation instructor of the Centerville Utah North Stake; former bishop
stake president and mission president; wife: Cristin; six children
Area Seventies to Be Released on or before August 1
Third Quorum of the Seventy (Africa Central
Fourth Quorum of the Seventy (Asia and Asia North Areas)
Seventh Quorum of the Seventy (Europe Central
Eighth Quorum of the Seventy (Pacific and Philippines Areas)
Ninth Quorum of the Seventy (South America Northwest and South America South Areas)
Tenth Quorum of the Seventy (North America Central
Eleventh Quorum of the Seventy (North America Southwest and North America West Areas)
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Detecting invalid cognitive performance is an important clinical challenge in neuropsychological assessment. The aim of this study was to explore behavior and eye-fixations responses during the performance of a computerized version of the Test of Memory Malingering (TOMM-C) under standard vs. feigning conditions.
TOMM-C with eye-tracking recording was performed by 60 healthy individuals (31 with standard instruction – SI; and 29 were instructed to feign memory impairment: 21 Naïve Simulators – NS and 8 Coached Simulators – CS) and 14 patients with Multiple Sclerosis (MS) and memory complaints performed. Number of correct responses, response time, number of fixations, and fixation time in old vs. new stimuli were recorded. Nonparametric tests were applied for group comparison.
Healthy simulators have a distinct behavioral and eye-fixation response pattern, reflecting a novelty preference. Oculomotor measures may be useful to detect exaggeration or fabrication of cognitive dysfunction. Though, its application in clinical populations may be limited.
Volume 15 - 2024 | <a class="ArticleLayoutHeader__info__doi" href="https://doi.org/10.3389/fpsyg.2024.1395434">https://doi.org/10.3389/fpsyg.2024.1395434</a>
This article is part of the Research TopicNeuropsychological Testing: From Psychometrics to Clinical Neuropsychology<a class="Link Link--linkType Link--maincolor Link--medium Link--icon Link--chevronRight Link--right" aria-label="View all 12 articles" href="https://www.frontiersin.org/research-topics/56234/neuropsychological-testing-from-psychometrics-to-clinical-neuropsychology/magazine" target="_self" data-event="customLink-linkType-a_viewAll12Articles">View all 12 articles</a>
Background: Detecting invalid cognitive performance is an important clinical challenge in neuropsychological assessment
The aim of this study was to explore behavior and eye-fixations responses during the performance of a computerized version of the Test of Memory Malingering (TOMM-C) under standard vs
Participants and methods: TOMM-C with eye-tracking recording was performed by 60 healthy individuals (31 with standard instruction &#x2013; SI; and 29 were instructed to feign memory impairment: 21 Na&#x000EF;ve Simulators &#x2013; NS and 8 Coached Simulators &#x2013; CS) and 14 patients with Multiple Sclerosis (MS) and memory complaints performed
Nonparametric tests were applied for group comparison
Results: NS produced fewer correct responses and had longer response times in comparison to SI on all three trials
SI showed more fixations and longer fixation time on previously presented stimuli (i.e.
familiarity preference) specially on Trial 1
whereas NS had more fixations and longer fixation time on new stimuli (i.e.
novelty preference) specially in the Retention trial
MS patients produced longer response time and had a different fixation pattern than SI subjects
No behavioral or oculomotor difference was observed between NS and CS
Conclusion: Healthy simulators have a distinct behavioral and eye-fixation response pattern
Oculomotor measures may be useful to detect exaggeration or fabrication of cognitive dysfunction
its application in clinical populations may be limited
whereas less than one tenth of low-functioning Child Protection claimants who are motivated to do well failed on PVTs
patients referred for routine clinical neuropsychological evaluation utilize the results of the examination for Social Security documentation
PVTs are objective tests designed to detect invalid cognitive performance, i.e., feigned and/or exaggerated diminished capability (<a href="#ref32">Sweet et al., 2021</a>). PVTs usually require little effort or ability, as they typically are normally performed by a wide range of patients who have bona fide neurologic, psychiatric, or developmental problems (<a href="#ref9">Heilbronner et al., 2009</a>)
The Test of Memory Malingering (TOMM; <a href="#ref34">Tombaugh, 1996</a>) is one of the most widely used PVTs in research and clinical practice. TOMM is a forced-choice visual memory recognition test and the number of correct responses is the standard measure to discriminate between true memory impairment from noncredible performance. Response times are also able to detect feigned memory impairment on TOMM (<a href="#ref2">Bolan et al., 2002</a>; <a href="#ref14">Kanser et al., 2019</a>)
The oculomotor behavior during the performance of TOMM has yet to be investigated
This study aimed to quantify the potential information gains provided by eye fixation data in addition to behavioral response (i.e.
in the performance of a computerized version of TOMM (TOMM-C)
to distinguish simulators from non-simulators
The clinical applicability of these measures was also explored in a sample of patients with multiple sclerosis and memory complaints
could be an informative complement to behavioral responses on TOMM-C and that oculomotor measures are less vulnerable to coaching than behavioral responses
Flowchart of the study participants and of the TOMM experiment
Two areas of interest were identified: the &#x201C;old&#x201D; (i.e.
drawing previously seen on the learning phase) and the &#x201C;new&#x201D; (i.e.
Three behavioural measures were recorded: Number of Correct Responses
and Median Response Time on Correct Responses
Three oculomotor measures were considered: % of Total Number of Fixation on &#x201C;new&#x201D; items
% of Total Fixation Time on &#x201C;new&#x201D; items
and % of Fixation Time on &#x201C;new&#x201D; items for correct responses
(A) TOMM encoding phase at Trials 1 and 2; (B) TOMM two choice recognition phase at Trial 1
Eye-fixation data on Trial 2 and Retention Trial from two NS participants were discarded due to recording problems that resulted in extensive missing data
however their behavioral responses on those trials were analyzed
One NS participant did not produce correct responses on Trial 2
therefore the Median Response Time on Correct Responses and the % of Fixation Time on &#x201C;New&#x201D; for Correct Responses could not be calculated
SI and MS participants were asked to perform the TOMM-C to the best of their ability. The MS group were also asked to perform the Nine Hole Peg Test, the Symbol Digit Modalities Test &#x2013; SDMT and the Auditory Verbal Learning Test - AVLT. The SDMT (<a href="#ref31">Sousa et al., 2021</a>) and AVLT (<a href="#ref4">Cavaco et al., 2015</a>) were adjusted to the demographic characteristics of the subjects according to the available norms
the CS participants additionally received a series of suggestions to produce the most severe memory problems without making it too obvious to the examiner
Multiple logistic regression analyses were used to explore the association between abnormal TOMM score performance and group
while taking into consideration demographic characteristics
TOMM score (recoded according to the cut-off) was the dependent variable
and years of education were the independent variables
No variable selection was applied and basic assumptions were verified
Simple logistic regression analyses were used to explore in MS group the association between performance on the SDMT and AVLT and some TOMM-C measures
As presented in <a href="#tab1">Table 1</a>
the SI group (n =&#x2009;31) and the NS group (n =&#x2009;21) had similar demographic characteristics
SI group was younger than the MS group (n =&#x2009;14; p =&#x2009;0.018) and had fewer years of education than the CS group (n =&#x2009;8; p =&#x2009;0.031)
NS individuals were younger (p &#x0003C;&#x2009;0.001) and had more years of education (p =&#x2009;0.011) than MS patients; and were younger than CS (p =&#x2009;0.029) participants
No group differences were recorded regarding sex
75th percentiles) on the SDMT was 44.1 (31.0
75th percentiles) of the AVLT-Delayed Recall was &#x02212;1.0 (&#x02212;1.7
These adjusted scores correspond to the number of standard deviations below/above the mean of the participant&#x2019;s normal peers with the same sex
Three MS patients (21.4%) scored below the estimated 18th percentile on AVLT-Delayed Recognition for the demographic characteristics of each individual
the NS group produced fewer correct responses (large effect sizes)
had longer total response time and median response time on correct responses (small effect sizes)
higher % of total number of fixations on &#x201C;new&#x201D; and % of total fixation time on &#x201C;new&#x201D; stimuli (medium effect sizes for Trials 1 and Retention
and % of fixation time on &#x201C;new&#x201D; stimuli for correct responses (small effect sizes on all trials) in comparison to the SI group on all TOMM-C trials
MS participants were slower to respond (i.e.
total response time and median response time for correct responses) on all trials (p &#x0003C;&#x2009;0.001)
but had similar number of correct responses
The effect sizes for the response time measures were relatively small
On both Trial 1 (p &#x0003C;&#x2009;0.06) and Retention Trial (p &#x0003C;&#x2009;0.01)
the % of total fixation time on &#x201C;new,&#x201D; and the % of fixation time on &#x201C;new&#x201D; for correct responses was higher for the MS group than the SI group
The MS group only differed from the NS group on the number of correct responses (all p &#x0003C;&#x2009;0.001 and with large effect sizes)
Neither response time nor oculomotor measures differed between MS and NS participants
NS and CS groups did not differ on any of TOMM-C behavioral and oculomotor measures. As shown in <a href="#tab1">Table 1</a>
the comparison between SI group and CS group revealed significant differences on all measures
a medium effect size was observed for Trial 1 and large effect sizes were recorded for Trials 2 and Retention
For both Total Response Time and Median Response Time for Correct Responses
Medium effect sizes were observed for Trial 1 on the % of Total Number of Fixation on &#x201C;New&#x201D; and % of Total Fixation Time on &#x201C;New.&#x201D; Small effect sizes were also recorded on these measures at Retention Trial
<a href="#tab2">Table 2</a> shows the best cut-off scores to differentiate SI and NS participants
while setting the specificity at &#x0003E;90%
These cut-off scores were then used to identify the frequency of abnormal scores in the MS group and CS group
Multiple logistic regression analyses revealed that
MS patients had higher odds of abnormal score than SI participants on Total Response Time and Median Response Time for Correct Responses at Trial 1 (respectively adjusted odds&#x2009;=&#x2009;6.441
p =&#x2009;0.076 and adjusted odds&#x2009;=&#x2009;25.027
p =&#x2009;0.016) and Trial 2 (respectively adjusted odds&#x2009;=&#x2009;11.001
p =&#x2009;0.008 and adjusted odds&#x2009;=&#x2009;4.476
MS patients also had higher odds of abnormal score at Trial 1 on the following oculomotor measures: % of Total Number of Fixation on &#x201C;New&#x201D; (adjusted odds&#x2009;=&#x2009;44.085
% of Total Fixation Time on &#x201C;New&#x201D; (adjusted odds&#x2009;=&#x2009;34.961
and % of Fixation Time on &#x201C;New&#x201D; for Correct Responses (adjusted odds&#x2009;=&#x2009;40.412
No statistically significant difference (p &#x0003E;&#x2009;0.05) on oculomotor measures was found between SI and MS participants on Trial 2 and Retention trial
when demographic characteristics were considered
Simple logistic regressions were used to explore in MS patients the association between standard neuropsychological measures (i.e.
SDMT and AVLT) and the following TOMM-C measures: Total Response Time
Median Response Time for Correct Responses
and % of Total Fixation Time on &#x201C;New.&#x201D; No significant association was found (p &#x0003E;&#x2009;0.05)
Study results revealed that both behavioral responses (i.e.
response accuracy and response time) and eye-fixation data can distinguish simulators from non-simulators in a computerized version of TOMM
Healthy simulators were asked to imagine experiencing &#x201C;real&#x201D; memory problems and needing to exaggerate their cognitive difficulties to obtain disability benefits
gaze aversion could not be documented in the present study
because only two areas of interest - AOI (i.e.
the screen was divided in two - &#x201C;old&#x201D;/ &#x201C;new&#x201D; drawings) were considered
fixations in non-relevant spaces within each AOI were considered on target
and fixations outside the two AOI were discarded
Future studies ought to explore in greater detail the viewing pattern during the performance of TOMM
Future studies ought to explore the preference for familiarity / novelty in bona fide MS patients and in other clinical populations and to investigate their associations with standard measures of memory (both visual and verbal)
The number of Correct Responses was similar between MS patients and SI healthy individuals on all trials
only the number of Correct Responses clearly differentiated MS patients from NS participants
These results provide support to its use in clinical practice
in the present study no clear association was found between response time on TOMM-C and a standard measure of visual working memory and psychomotor speed (i.e.
No effect of coaching how to avoid detection of invalid performance was observed on any of the behavioural and eye-fixation measures of TOMM-C. In other words, the performance of NS and CS participants did not differ, which may reflect lack of statistical power or resistance of the test to coaching (<a href="#ref11">Jelicic et al., 2011</a>)
Larger samples are necessary to confirm these negative findings
the characteristics of the clinical group were not ideal
because none of the MS participants with cognitive complaints had a diagnosis of dementia and not all had memory impairment
Future studies ought to study other clinical aetiologies and suspected clinical malingers
Recent studies with pupillometry have reported that pupil dilation can detect feigned cognitive impairment on TOMM (<a href="#ref8">Heaver and Hutton, 2011</a>; <a href="#ref20">Patrick et al., 2021a</a>,<a href="#ref21">b</a>)
the present study focused only on eye-fixations
Future studies should explore the possibility of combining pupil reactivity with eye-fixation pattern in the detection of deception
The standardization of the viewing period (3&#x2009;s) prior to the behavioral response facilitated the comparison between participants
though it also limited the informative value of the response time
healthy individuals feigning memory impairment showed a distinct behavioral (i.e.
fewer correct responses and longer response times) and oculomotor (i.e.
longer fixation time on &#x201C;new&#x201D; stimuli) response pattern on a computerized version of TOMM
which may reflect an increased effort to inhibit a natural response
Further investigation is necessary to understand the potential application of response time and eye-fixation measures in real-life clinical situations
The raw data supporting the conclusions of this article will be made available by the authors
The studies involving humans were approved by Comiss&#x000E3;o de &#x000C9;tica do Centro Hospitalar Universit&#x000E1;rio de Santo Ant&#x000F3;nio
The studies were conducted in accordance with the local legislation and institutional requirements
The participants provided their written informed consent to participate in this study
The author(s) declare that financial support was received for the research
This work was supported by Bial Foundation Grant 430/14 UIDB/00215/2020; UIDP/00215/2020; LA/P/0064/2020
We would like to express our gratitude for Ana Filipa Ger&#x000F3;s and Paulo de Castro Aguiar contribution to data processing
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article
or claim that may be made by its manufacturer
is not guaranteed or endorsed by the publisher
The Supplementary material for this article can be found online at: <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1395434/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1395434/full#supplementary-material</a>
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Martins da Silva A and Cavaco S (2024) Using behavior and eye-fixations to detect feigned memory impairment
Received: 03 March 2024; Accepted: 25 July 2024; Published: 20 September 2024
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A garda investigation is ongoing in Wexford after an incident which saw two men hospitalised after being struck by separate vehicles at a rural Wexford GAA club
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Oxytocin has recently received remarkable attention for its role as a modulator of human behaviour
we aimed to expand our knowledge of the neural circuits engaged by oxytocin by investigating the effects of intranasal and intravenous oxytocin on the functional connectome at rest in 16 healthy men
Oxytocin modulates the functional connectome within discrete neural systems
but does not affect the global capacity for information transfer
These local effects encompass key hubs of the oxytocin system (e.g
amygdala) but also regions overlooked in previous hypothesis-driven research (i.e
Increases in levels of oxytocin in systemic circulation induce broad effects on the functional connectome
yet we provide indirect evidence supporting the involvement of nose-to-brain pathways in at least some of the observed changes after intranasal oxytocin
our results suggest that oxytocin effects on human behaviour entail modulation of multiple levels of brain processing distributed across different systems
our knowledge about the neural mechanisms through which oxytocin affects human behaviour is still insufficient
investigating the effects of oxytocin on the functional brain substrates engaged at rest may provide insights that help us understand its pharmacodynamics and its potential as an adjunctive treatment for several neuropsychiatric disorders
the application of graph theory to the study of the pharmacodynamics of oxytocin in the human brain has the potential to unravel new mechanisms through which oxytocin might modulate human cognition and behaviour
we are not aware of any study investigating the effects of exogenous oxytocin on the human functional connectome at rest through the lens of graph theory
The inclusion of this second method of intranasal administration allowed us to inspect whether we can maximize the effects of intranasal oxytocin on brain connectivity by increasing its deposition in putative areas of transport to the brain
in this study we sought to expand our previous perfusion findings and apply connectomic analyses to investigate how exogenous oxytocin
when administered using different routes and methods for intranasal administration
we conducted exploratory connectomic analyses at the whole-brain
as an attempt to unravel new aspects of the effects of oxytocin on the brain that previous studies might have missed by simply focusing on key hubs of the brain oxytocin system
we demonstrate that oxytocin modulates the local topography of the human functional connectome at rest within discrete neural systems
but does not affect the global capacity for information transfer among nodes of the functional connectome
We show that in addition to brain systems previously identified as key hubs of the brain oxytocin system (e.g
oxytocin also modulates several brain systems that have not been thoroughly investigated in the field
We also demonstrate that the presence of oxytocin in systemic circulation has broad effects on human brain regional connectivity
Yet we also provide indirect evidence supporting the involvement of nose-to-brain pathways in at least some of changes in brain function observed after intranasal oxytocin
</a>We tested the effects of the four treatment conditions on global efficiency using repeated measures one-way analysis of variance
we present box and violin plots depicting the distribution of the global efficiency measure for each treatment condition; middle horizontal lines represent the median; boxes indicate the 25th and 75th percentiles
we present the descriptive statistics for each condition (n = 16 per treatment condition)
The green and red colours depict increases and decreases in betweenness-centrality
The size of each nodal sphere is proportional to the T-statistic of each comparison
Cereb Cerebellum; PostCG Postcentral gyrus
toMTG temporo-occipital area of the middle temporal gyrus
The green and red colours depict increases and decreases in local efficiency
The green and red colours depict increases and decreases in node degree
We did not find any individual edge where the four treatment conditions differed in connectivity after applying the stringent FDR correction for the number of edges
Repeating this analysis with NBS also did not identify any subnetwork where the four treatment conditions differed on connectivity after correcting for multiple testing
irrespective of the primary threshold used
The functional decoding of the pathways for which we identified significant modulatory effects of oxytocin revealed terms mostly associated with early visual processing, mentalizing and theory-of-mind, social and audiovisual processing, facial processing, expectancy, aversion, somatosensation (pressure and nociception) and heart physiology (Fig. <a data-track="click" data-track-label="link" data-track-action="figure anchor" href="/articles/s42003-020-01610-z#Fig5">5</a>).
</a>The word cloud presents the top terms derived from the NeuroSynth decoder for the neural pathways engaged by oxytocin using reverse inference
after excluding terms for brain regions or imaging methods
Font size is coded by the correlation strength between the pathway and term
Overlap was quantified using the Dice coefficient
which measures the percentage of voxels of each resting-state network overlapping with our treatment effect mask
we provide an overview of all regions where we found treatment effects
irrespective of route/method of administration
we provide a heatmap summarizing the percentage of overlap (Dice coefficient) between the regions in A and each of the seven networks (each network rendered in a 3D surface model)
</a>We conducted a linear mixed model on plasmatic oxytocin concentrations measured in a blood sample collected immediately before the beginning of the resting-state acquisition
Treatment and Time × Treatment as fixed factors and a random intercept for subject
We followed up the significant interaction with further post-hoc tests to examine differences between each pair of treatment conditions between baseline and post-administration and between treatment conditions within each time level
using Tukey’s correction for multiple testing
we present box and violin plots depicting the distribution of plasmatic concentrations of oxytocin for each treatment condition and time point; middle horizontal lines represent the mean; boxes indicate the 25th and 75th percentiles (n = 16 per treatment condition and time point)
we present the descriptive statistics for each level of the two factors
*Intravenous condition compared to the other three (p &lt; 0.01) at post-administration; # Spray and Nebuliser conditions compared to placebo (&lt;0.001) at post-administration
Motivated by the current lack of clarity regarding the central targets of exogenous oxytocin
we conducted an exploratory data-driven examination of the effects of exogenous oxytocin on the human brain functional connectome at rest using different routes of administration
By identifying the functional substrates that oxytocin engages at rest we expected to provide insights that help understand its effects on human brain and behaviour
We discuss each of our main findings below
while our data is broadly compatible with these two studies
We show that most likely the effects of oxytocin on brain processing involve several brain networks and can hardly be attributed to a single neural pathway
oxytocin most likely operates at multiple levels
spanning basic sensory processing to salience detection and attention orientation
emotional processing and high-order mental representations of the self and others
Considering that our data was acquired about 17 min later
it is conceivable that the effects of oxytocin on the functional connectivity of the basal ganglia happened at a post-dosing window that we did not sample
the ability of intravenous oxytocin to target these areas
but also show that the effects of oxytocin when administered intravenously may be broader and encompass other cortical areas
We can therefore infer that the presence of oxytocin in systemic circulation can influence brain function in a wide range of circuits potentially related to the behavioural effects associated with intranasal oxytocin
our data showed increases in the betweenness-centrality of the right occipital pole and increases in local efficiency in the right superior frontal gyrus
both for the intranasal (by spray) and the intravenous administration of oxytocin
when compared to placebo; direct comparisons between spray and intravenous administrations for these nodes did not yield any significant differences
our findings call for caution in attributing all of the neural/behavioural effects of intranasal oxytocin to direct nose-to-brain pathways
While we show that systemic oxytocin produces widespread changes in the functional connectome at rest and that at least some of these effects mirror the changes observed after the intranasal administration of exogenous oxytocin
we also show that the presence of oxytocin in systemic circulation does not fully account for all the changes we identified following the intranasal administration of oxytocin
increases in betweenness-centrality in the left lateral occipital cortex or the right posterior medial temporal gyrus observed after the administration by spray were not observed after intravenous administration compared to placebo
the direct comparison of these two methods confirmed that these effects were specific for the intranasal spray route
Other examples include the increases in betweenness-centrality in the left temporo-occipital middle temporal gyrus and in node degree in the left superior temporal gyrus after the administration of oxytocin with the nebuliser compared to placebo
These effects were not observed after the intravenous oxytocin administration (compared to placebo) and remained significant when we directly compared these two methods of administration
There were many other effects induced by the intranasal (either by spray or nebuliser) administration of oxytocin
which were not seen following intravenous oxytocin administration
in these cases the direct comparisons between the intranasal and intravenous routes yielded no differences
for these effects we cannot be certain about the exact route they originated from
resulting in increased amounts of oxytocin reaching the brain (compared to the standard nasal spray)
Our hypothesis invites for future dose-response studies using the nebuliser to inspect whether lowering the dose administered with the nebuliser may approximate the effects on the functional connectome achieved after the administration of a high dose of oxytocin with the standard spray
using an exploratory connectomics approach
oxytocin modulation involves several brain systems that have not been thoroughly investigated in the field
but might contribute to the broad modulatory role of oxytocin on social-emotional behaviour in humans
We demonstrate that the presence of oxytocin in systemic circulation has broad effects on human brain regional connectivity and may account for at least some of the effects on brain function and behaviour typically ascribed to direct nose-to-brain transport after intranasal oxytocin
we also provide indirect evidence supporting the involvement of nose-to-brain pathways in at least some of changes in brain function observed after intranasal oxytocin
our results suggest that an overarching model for the role of oxytocin in human behaviour should consider modulation of multiple levels of the brain processing hierarchy relevant for socio-affective related behaviours
from basic sensory processing to high-level theory-of-mind inference
which could have affected our neuroimaging metrics in unpredictable ways
Only three participants were regular smokers (2–3 cigarettes/day) and one participant used to smoke occasionally (around 5 cigarettes/month) at the time of the study
Our sample size would allow us to detect a medium effect size f = 0.25 with 80% of statistical power in a repeated measures one-way ANOVA testing for differences across our four treatment conditions in this study
Intranasal administrations lasted for about 6 min
while the intravenous administration occurred at the highest rate of 1IU/min for 10 min
We collected plasma samples at baseline and at five timepoints post-dosing to measure changes in the concentration of oxytocin
The resting-state BOLD-fMRI scan used in this study was acquired between 57–65 min post last drug administration offset (the end of our second intranasal administration was considered time = 0)
*Duration of treatment administration in minutes
we used specially manufactured placebo that contained the same excipients as Syntocinon except for oxytocin
Participants self-administered intranasal oxytocin or placebo with the nasal spray or nebuliser following under the supervision of the lead experimenter who ensured the correct application of the devices
all participants had been trained during the screening visit in the correct administration procedures
each containing 0.1 ml Syntocinon (4IU) or placebo
alternating between nostrils (hence 40 IU OT in total)
Participants blocked opposite nostril while administering each puff
and each puff was followed by an immediate
The resting state fMRI scan lasted 8 min 10 s
with collection of a total of 192 volumes for each echo
Magnetisation Prepared Rapid Acquisition (3D MPRAGE) T1-weighted scan was acquired (TR/TE/TI = 7328/3024/400 ms
each participant’s cleaned datasets were co-registered to their corresponding structural scan
normalized to the study-specific template before warping to standard MNI152 space
The final normalised images were visually inspected to ensure the quality of the preprocessing and the absence of artefacts
we normalized our correlation measures to z-scores using the Fisher’s r-z transform per subject/session
All of our statistical analyses on graph metrics were therefore run on AUC parameters rather than the raw values
the terms related to brain regions or imaging methods were excluded
We present these decoding results as a word cloud
where font size codes correlation strengths
This atlas includes a coarse parcellation of seven canonical resting-state networks
which estimates the percentage of voxels of each resting-state network that overlap with our treatment effect mask
We did so by examining treatment-related changes in mean connectivity and global efficiency of the whole-brain network (macroscale)
graph properties of regional connectivity at the node level (mesoscale) and individual connections between pairs of nodes (microscale)
These analyses were performed using repeated measures one-way analysis of variance
we followed up with post-hoc paired t-tests between each pair of the four treatment conditions
Mean functional connectivity was calculated as the average of the elements in the lower triangular connectivity matrix for each participant and treatment condition
we retrieved the global efficiency of the brain network for each participant and treatment condition
we compared treatment groups using repeated measures one-way analysis of variance
betweenness-centrality and local efficiency of each node of the connectome for each subject and treatment condition
We first compared the four treatment conditions using repeated measures one-way analysis of variance
controlling false positives with FDR correction for the number of nodes examined
we tested a range of arbitrary primary thresholds varying from 1.5 to 4
We then used a two-tailed secondary threshold of 0.025 (0.05/2)
Further information on research design is available in the <a data-track="click" data-track-label="link" data-track-action="supplementary material anchor" href="/articles/s42003-020-01610-z#MOESM6">Nature Research Reporting Summary</a> linked to this article
Data can be accessed from the corresponding author upon reasonable request
A reporting summary for this Article is available as a Supplementary Information file
and Supplementary Figures 1 and 3 are provided as a Source data file (Supplementary Data 2)
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We would like to thank all participants that volunteered for this study
We would also like to thank Sofia Vasilakopoulou
Jack Loveridge and Ndaba Mazibuko for their assistance in data collection and Dr Fernando Zelaya for his comments on the first draft of the manuscript
This study was part-funded by: an Economic and Social Research Council Grant (ES/K009400/1) to Y.P.; scanning time support by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London to Y.P.; an unrestricted research grant by PARI GmbH to Y.P
is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London
wrote the first draft of the paper and all co-authors provided critical revisions
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Volume 7 - 2013 | <a class="ArticleLayoutHeader__info__doi" href="https://doi.org/10.3389/fnbeh.2013.00126">https://doi.org/10.3389/fnbeh.2013.00126</a>
This article is part of the Research TopicProgress in Episodic Memory Research<a class="Link Link--linkType Link--maincolor Link--medium Link--icon Link--chevronRight Link--right" aria-label="View all 45 articles" href="https://www.frontiersin.org/research-topics/894/progress-in-episodic-memory-research/magazine" target="_self" data-event="customLink-linkType-a_viewAll45Articles">View all 45 articles</a>
Episodic memory refers to the capacity to bind multimodal memories to constitute a unique personal event
Most developmental studies on episodic memory focused on one specific component
The present study examines the relevance of a novel episodic paradigm to assess its developmental trajectories in a more comprehensive way according to the type of association (item-feature
and item-sequence associations) with measures of both objective and subjective recollection
We conducted a behavioral study aimed at testing the effects of age in a large sample of 160 children
We confronted the behavioral data to the neural correlates in a subgroup of 30 children using voxel-based morphometry
Behavioral data outlined differential developmental trajectories according to the type of association
with a continuous increase of factual associative memory efficiency until 10 years
a linear increase of performance in spatial associative memory that pursues until early adulthood and an abrupt increase in temporal associative memory efficiency between 9 and 10
measures showed a more pronounced enhancement from 9 to 10 years
behavioral data highlight a peculiar period in late childhood (8&#x02013;10 years old) crucial for the developmental time course of episodic memory
we found that the improvement of associative memory efficiency was related to a decrease in gray matter volume in a large cerebral network including the dorsolateral and ventrolateral prefrontal cortex (and superior and anterior temporal regions)
These data suggest that multimodal integration would probably be related to the maturation of temporal regions and modulated by a fronto-parietal network
our findings emphasize the relevance of the present paradigm to assess episodic memory especially in the clinical setting
when assessed with an ordered repeated word list paradigm
It is noteworthy that comparisons across developmental studies are challenging due to methodological issues with multiple paradigms and variables that may impact pediatrics behavioral data such as motivational
are related to increasing memory efficiency in this developmental period
Developmental trends of the hippocampus and their relations with associative memory still need to be clarified
Because associative memory is a defining feature of episodic memory
the understanding of associative memory development needs to take into consideration the type of associations in order to better describe children&#x02019;s capacity to form and retrieve episodic memories
no behavioral studies have explored the three associative domains (i.e.
and temporal &#x02013; WHEN) with a single protocol in the same sample
the first goal of the present study is to describe the development of within-domain and inter-domain associative memory in a large sample of 160 healthy participants
We further examined our protocol&#x02019;s reliance by confronting these behavioral results to structural imaging data collected in a subgroup of 30 children and adolescents to identify the regions that subserve episodic memory efficiency from childhood to young adulthood
to consider the possible influence of verbalization and retrieval processes on associative memory efficiency during development
we conducted additional correlational analyses between the 30 participants&#x02019; performance in verbal fluency and (1) behavioral data (the WHAT-WHERE-WHEN paradigm) and (2) volume of cerebral regions related to associative memory
One hundred children from 6 to 10 years (from childhood to adolescence; Mean &#x0003D; 100.7 &#x000B1; 17.04 months
51 females) and 60 adolescents and young adults from 12 to 23 years (from adolescence to adulthood; Mean &#x0003D; 194.30 &#x000B1; 49.90 months
29 females) were involved in the behavioral study
The children sample had been equally divided among five age groups (each group n &#x0003D; 20): 6 years old group (Mean &#x0003D; 77.1 &#x000B1; 4 months
7 years old group (Mean &#x0003D; 88.7 &#x000B1; 3.54 months
8 years old group (Mean &#x0003D; 109.5 &#x000B1; 3.65 months
9 years old group (Mean &#x0003D; 113.2 &#x000B1; 3.05 months
and 10 years old group (Mean &#x0003D; 123.55 &#x000B1; 3.27 months
the adolescent and adult sample had been equally divided among three age groups: 11&#x02013;12 years old group (Mean &#x0003D; 142.55 &#x000B1; 6.14 months
14&#x02013;15 years old group (Mean &#x0003D; 180.58 &#x000B1; 6.77 months
and 20&#x02013;23 years old group (Mean &#x0003D; 259.5 &#x000B1; 12.86 months
30 right-handed children and adolescents underwent a morphological MRI [age range: 79&#x02013;180 months (6.6&#x02013;15 years)
Mean &#x0003D; 135.77 &#x000B1; 28.19 months (11.31 &#x000B1; 2.35 years)
They additionally participated in various standard neuropsychological tests among which a verbal fluency test (i.e.
this French task requires the participants to generate as many words as possible
firstly in a letter fluency condition and secondly
in a category fluency condition &#x02013; 60 s are provided for each condition)
All 30 children and adolescents accurately performed both the behavioral and the morphological MRI investigations on the same day
objective recollection was assessed by asking the children to retrieve the corresponding source
in the shape of the person who performed the match (matched by the experimenter; matched by the child or matched prior to the presentation)
The WHERE task relied on between-domain spatial associations and is similar to the sub-test &#x0201C;Memory for designs&#x0201D; from the standardized battery NEPSY II (<a href="#B34">Korkman et al., 2007</a>)
Children were tested on their encoding of the exact location of each animal in an array (3 &#x000D7; 4 grid for children aged 6&#x02013;10 years; 4 &#x000D7; 4 grid for children aged 11&#x02013;18 years)
They encoded the animal-location association by matching the colored frame surrounding the photograph of the animal to a colored marker in the center of each box of the grid
Animals were presented one at a time and the child was asked to place each animal into the correct location
The order of animals presentation was randomized across participants
Animals remained in view as the child proceeded through the task
children were given 1 min to review the animal-location associations
children were again provided with the animals one at a time and were asked to place them in the array
In this condition there were no color cues
The WHEN task investigated between-domain sequential associative memory
Children were asked to encode the animal-sequence association by placing the animals into slots in a wooden wheel
the animal-sequence association was determined by color cues that appeared in each slot
Each color corresponded to a specific animal
children were provided with the full set of animals and required to place them into the slots following the sequence determined by the color showing in the slot at each turn of the wheel
the children were given one opportunity to review the overall sequence for a maximum of 1 min
children were again provided with the complete set of animals and required to retrieve the exact encoded sequence
there were no color cues in this condition
The measures derived from the WHAT-WHERE-WHEN test were then as follows:
(i) For the WHAT task: (1) total number of correct animal-feature associations (WHAT); (2) total number of sources that were correctly provided (Objective Recollection); (3) ratio of Remember judgments provided for every accurate association (Subjective Recollection, with Recollection &#x0003D; Remember responses/total number of associations); (4) familiarity is calculated in absence of recollection (as defined by <a href="#B76">Yonelinas and Jacoby, 1995</a>) with Familiarity &#x0003D; K/1-R
where K &#x0003D; Know responses/total number of associations
This formula allows us to analyze separately Know from Recollection judgments
(ii) For the WHERE task: total number of correct animal-location associations (WHERE)
(iii) For the WHEN task, we have taken into account both the correct placement of the animals individually and pairs of animals in the correct temporal order (see <a href="#B59">Riggins et al., 2009</a> for a similar approach)
Thus one point was credited for each animal that was assigned to its rightful place in the sequence and 1/2 point was credited for each animals that accurately followed the original order but were inaccurately placed in the sequence [example A: animal one in first position
animal three in third position &#x0003D; (1 &#43; 1 &#43; 1) &#x0003D; 4 points; example B: animal seven in first position
and animal nine in third position &#x0003D; (2 &#x000D7; 1/2) &#x0003D; 1 point]
The WHEN hits thus corresponds to the sum of placement and order in the sequence
We normalized all associative memory scores and Objective Recollection scores
This transformation of these possible heterogeneous raw scores into a common domain is needed prior to combining them into an episodic score (see below) and conducting parametric statistical analysis on normal distributions
In order to assess overall episodic memory development
we computed a composite score obtained as follow: first
so it has been finally divided by the square root of the sum of the variance of the three subtests (which equals 3 &#x000D7; 1 since we used z-score) plus twice the sum of the covariance of the three subtests
their covariances equal their correlation coefficients
see &#x0201C;Combining different scores from tests&#x0201D; in &#x0201C;Advanced Topics&#x0201D; section of the Psych Assessment website
This score assesses more specifically episodic memory since it encompasses three primary components of associative memory
in the Service Hospitalier Fr&#x000E9;d&#x000E9;ric Joliot (CEA-I2BM
with the following parameters: TR &#x0003D; 9.9 ms; TE &#x0003D; 2 ms; IR-Prep-time &#x0003D; 600 ms; flip angle &#x0003D; 10&#x000B0;; voxel size:0.9 mm &#x000D7; 9 mm &#x000D7; 1.2 mm
MRI data were segmented, normalized to a pediatric sample of the NIH (N &#x0003D; 324, age range &#x0003D; 4.5&#x02013;18.5 years, <a href="#B17">Fonov et al., 2011</a>), and modulated using the VBM5.1 toolbox (<a href="#B3">Ashburner and Friston, 2005</a>) implemented in the Statistical Parametric Mapping 5 (SPM) software (Wellcome Trust Centre for Neuroimaging
UK) to obtain maps of local gray matter volume corrected for brain size
each image was smoothed with a Gaussian kernel (FWHM &#x0003D; 12 mm)
we used a gray matter explicit mask in the voxelwise analyses so as to restrain the analyses to the gray matter
This mask was obtained by first averaging all segmented gray matter and white matter images
then thresholding the gray matter average to include voxels with a probability higher than 0.4 and the white matter average to include voxels with a probability higher than 0.2
the final GM mask used in the analyses was obtained by subtracting the WM mask from the GM mask
We analyzed age-related changes on brain morphometry using two statistical models entering either age (linear) or age and age2 (quadratic) as predictors using this fitting model: volume &#x0003D; a0 &#43; a1score &#43; a2score2 &#43; &#x003F5; where a0, a1, and a2 are polynomial parameters to be found, and error represents the residual error of the model (<a href="#B9">B&#x000FC;chel et al., 1998</a>; <a href="#B29">Hu et al., 2013</a>)
we included sex as a regressor of non-interest
and WHEN) and the composite score referring to episodic memory were related to brain morphometry
These analyses were conducted first on the whole brain and second within the hippocampus only using a hippocampus delineated on a template
We performed the same regression analyses as before replacing age by the episodic score
Note that the predictor variables were first orthogonalized before being entered together in the quadratic models: age and age2 for age-related analyses
episodic and episodic score2 for brain-behavior relationships analyses
Because any relationship between brain volumes and memory could be driven by the common effect of age or sex
regression analyses with episodic memory were conducted with two regressors of non-interest (age and sex)
we conducted a last set of correlations between fluency z-score (which combines both letter and category fluency) and: (1) each z-score (WHAT
and WHEN) and the composite score referring to episodic memory
(2) mean of gray matter volumes in clusters previously identified in brain-memory relationships analyses
We performed one-way ANOVA for each task with age groups as between factor and Tukey&#x02019;s adjustment for multiple comparisons (HSD). Those revealed three different developmental patterns (Figure <a href="#F2">2</a>)
Behavioral performances on the associative memory tasks
(A) Mean performance of associative cued recall (hits) for each memory task as a function of age
(D) Mean subjective recollection and familiarity index
Tuckey post hoc tests revealed a slight increase from the age of 6 to 9 followed by a marked increase between 9- and 10-year-olds (6 &#x0003C; 7
9; 10 &#x02013; 7 &#x0003C; 10 &#x02013; 8 &#x0003C; 10 &#x02013; 9 &#x0003C; 10)
The one-way ANOVAs conducted on each of the associative score revealed a significant group effect only for WHERE&#x02019;s performance [F(2
57) &#x0003D; 4.74; p &#x0003D; 0.01; 11 &#x02013; 12 &#x0003C; 21&#x02013;24 age group]
No significant developmental difference was evident for neither the two other associative memory tasks nor the episodic score
Analysis conducted on the oldest age groups revealed that only the familiarity index decreased significantly from 11&#x02013;12- to 21&#x02013;23-year-olds [F(2
57) &#x0003D; 3.56; p &#x0003D; 0.03; 11 &#x02013; 12 &#x0003E; 21&#x02013;24 age group]
The regression analysis focused on the hippocampus
with the volume as the dependent variable and age as the predictor variable while controlling for the effect of sex
indicate a significant reduction in the volume of the hippocampal body bilaterally extending
(A) Age-related changes concern fronto-temporal and posterior parietal regions bilaterally (uncorrected p &#x0003C; 0.001
(B) A significant reduction was found in the hippocampus bilaterally
with a more extended region in the left hippocampus (uncorrected p &#x0003C; 0.01
including the posterior part of the medial frontal gyrus
(ii) the superior temporal cortex encroaching both the transverse temporal gyrus around the lateral sulcus and the inferior parietal lobule
(iv) the ventrolateral prefrontal cortex (VLPFC) and
Analyses performed on the hippocampus gray matter volume revealed significant relationships between memory efficiency and the body of the hippocampus on the right side and the anterior part of the hippocampus on the left side
Scatterplots of these effects showed that the enhancement of episodic performances was mainly associated with a decrease in mean volumes except for three participants with the highest scores
(A) Significant positive correlation (quadratic
U-shaped) with episodic score was found with the volume of gray matter in dorsolateral frontal regions bilaterally
and the ventrolateral prefrontal cortex (upper figure
(B) Scatterplots of episodic effects are shown for regions identified in whole brain analyses
(C) Significant positive correlation (quadratic
U-shaped) was observed between memory and right hippocampal body and the anterior part of the left hippocampus (uncorrected p &#x0003C; 0.01
Brain &#x02013; associative memory relationships
Correlational behavioral analyses revealed significant positive correlation between fluency z-score and each associative memory task (p &#x0003D; 0.004 WHAT; p &#x0003D; 0.026 WHERE; p &#x0003D; 0.003 WHEN) and the episodic composite score (p &#x0003D; 0.003)
indicating that better efficiency in verbal fluency was associated with better performances in associative memory
we observed a significant negative correlation between the fluency z-score and two clusters previously detected
dorsolateral frontal regions bilaterally and the superior temporal cortex
a decrease in volume in these three cortical regions was associated with increased efficiency in verbal fluency
These analyses did not detect any statistical correlation with the hippocampus
The first aim of the present study was to describe the developmental trajectories of associative memory distinguishing within-domain (factual) and between-domain (spatial and temporal) associations by means of an original single paradigm
Results showed that these three types of associative memory follow distinct developmental trajectories: a slight but continuous increase of within-domain factual associative memory (WHAT)
a linear increase of between-domain spatial associative memory (WHERE)
and noticeable changes in between-domain temporal associative memory from 9 to 10 years (WHEN)
the composite score that combines the three associative components of episodic memory (the &#x0201C;episodic score&#x0201D;) showed a slight but significant increase up to 9 years followed by a marked increase from 9 to 10
source memory) and subjective recollection improved with age with the most important effects from 8 to 10 years
these findings highlight major changes from 8&#x02013;9 to 10 years
adolescence is characterized by slight changes
including enhancement of spatial associative memory and noticeable decrease in familiarity
Voxel-based morphometry suggests that episodic memory performance
is related to gray matter volume changes (i.e.
following an inverted U-curve) in temporal regions including medial structures
Although these cortical regions and medial temporal structures have been previously described in functional studies
no such morphological data have been reported in developmental studies in relation with participants&#x02019; overall associative memory efficiency
our results point out the relevance of using a single paradigm to assess associative memory
and recollection in order to get a more comprehensive picture of episodic memory development
All these cognitive functions develop through childhood and adolescence and may contribute to the age-related effect on spatial processes observed in the present study from six to early adulthood
though not significant increase of performance during adolescence
Debriefing of the participants after the test allows us to hypothesize that this results from the particular design of the task itself
many adolescents explained that they intentionally created a script on the bases of the animal orders (i.e.
&#x0201C;when the urodel runs after the almiqui &#x02026;&#x0201D;)
the use of verbal strategies to encode the sequence in a chronological and meaningful order at this age may impact subsequent retrieval
this is in accordance with our additional analyses showing a significant correlation between verbal fluency efficiency and the WHEN
the above mentioned data suggest that associative episodic memory maturation depends on the type of information to be bound and that the overall processes may differentially contribute to episodic memory enhancement
the evolution of the combining episodic score through childhood tends to be non-linear prompted by the time course of temporal memory
the period of late childhood (9&#x02013;10 years of age) is crucial in the developmental time course of episodic memory
Objective and subjective recollection have been distinguished in functional (<a href="#B67">Spaniol et al., 2009</a> for review) and clinical studies (<a href="#B15">Duarte et al., 2008</a>) in adults and have more recently encounter an increasing interest in the developmental literature (<a href="#B20">Ghetti and Angelini, 2008</a>; <a href="#B53">Picard et al., 2009</a>; <a href="#B18">Friedman et al., 2010</a>)
The authors notably pointed out the relationship between familiarity and mid-frontal regions recruitment restricted to adolescents
these data argue for a comprehensive approach based on both neuroimaging and behavioral studies to understand age-related effects on episodic memory maturation
The present study pointed out the relationship between an increase in associative memory efficiency and a decrease in gray matter volume in a large cerebral network (including the dorsolateral and VLPFC, superior and anterior temporal regions) and the hippocampus bilaterally. In our sample, only three participants displayed a different pattern. As <a href="#B64">Shaw et al. (2006)</a> argued in their study on global intellectual efficiency and cortical thickness
in which they reported different developmental trajectories of cortical thickness according to participants&#x02019; IQs
the variability in our sample may reflect different trajectories depending on the individual level of memory performance
increased performances were related with volume reduction in the dorsolateral and the VLPFC
the reduction of DLPFC was also correlated with increased performances in verbal fluency in our sample
thus suggesting a possible contribution of executive functions to memory efficiency as measured by the WHAT-WHERE-WHEN paradigm
further investigations are needed to understand the contribution of the hippocampus along its longitudinal axis to the development of episodic memory
we observed that the reduced volume in the superior temporal cortex extending to the inferior parietal lobule was related to episodic enhancement in children and adolescents
This region was not reported in previous structural studies but could support the generation of verbal strategies in our three associative tasks
The negative correlation between the volume reduction in the superior temporal cortex and the increase in verbal fluency performance would be consistent with this hypothesis
is this cortical region involved in a larger fronto-parietal network including dorsolateral PFC that would implement cognitive control functions on memory functioning
and would support the progressive development of top-down attention modulation
Our findings bring interesting perspectives to assess episodic memory from childhood to adolescence in a more comprehensive way
the present study is the first to address episodic memory maturational trajectories by investigating its main components within the same paradigm
It thus provides a more accurate picture of how episodic memory processes (i.e.
binding of within/between-domain information
By confronting behavioral results to structural data
we also describe the cortical regions that subserve episodic memory efficiency as a whole
the present study failed to detect finer relationships between each component (factual
Knowing the large inter-individual variability in both memory efficiency and cerebral maturation in children and adolescents
we assume that the lack of sensitivity in morphometric analyses could be overcome in a larger cohort
the behavioral and structural analyses questioned the implication of maturing executive processes that may explain
the differential trajectories that we report according to the type of information to be encoded and recollected
This hypothesis needs to be directly addressed in a future study by using more dedicated executive tasks
Besides its relevance to provide additional data to the research literature, the present paradigm is considered to be a sensitive and valid tool to assess episodic memory in the clinical setting. The WHAT-WHERE-WHEN paradigm has been administered to children and adolescents suffering from temporal lobe epilepsy and has successfully detected differential profiles of deficits according to epilepsy lateralization (<a href="#B27">Guillery-Girard et al., 2010</a>)
It thus can be helpful to reveal possible memory dissociations in young patients
Episodic memory refers to the capacity to bind different components into a single representation that will promote a vivid sense of re-experiencing at retrieval
our findings show the differential developmental trajectories of episodic memory processes in relationship with both cortical changes and neuropsychological factors such as verbal strategies and executive functions
the present study suggests that the multimodal integration would be related to the maturation of temporal regions and may be modulated by a fronto-parietal network
Despite a limited sample for structural analyses
this study confirms the need to combine neuroimaging and behavioral data in order to better understand the developmental trajectory of episodic memory in a research setting
and to use a single paradigm to assess episodic memory as a whole in a clinical setting
We would like to thank Valerie Gyselinck and Maud Markus for their contribution to the WHAT-WHERE-WHEN paradigm development
and Lionel Allirol for their assistance with data collection
We are grateful to Jane Holmes-Bernstein for her helpful comments on the manuscript
We are also indebted to the participants and institutions that took part in our research
Assessment and development of executive function (EF) during childhood
Associations between performance on the Rey-Osterrieth Complex Figure and regional brain volumes in children with and without velocardiofacial syndrome
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Introduction: 7,8-dihydroxyflavone (7,8-DHF) is a low molecular weight compound that can cross the blood brain barrier and has been implicated in numerous functions and behaviours. It is thought to have neuroprotective capability and has been shown to alleviate symptoms in a wide range of diseases.
Methods: 7,8-DHF was administered systemically to wildtype mice during Morris water maze training. Long-term spatial memory was assessed 28 days later. Ex-vivo T2-weighted (T2w) imaging was undertaken on a subset of these mice to assess brain-wide changes in volume.
Results: We found that systemic 7,8-DHF administration during the training period enhanced spatial memory 28 days later. Volumetric changes were observed in numerous brain regions associated with a broad range of functions including cognition, sensory, and motor processing.
Discussion: Our findings give the first whole brain overview of long-term anatomical changes following 7,8-DHF administration providing valuable information for assessing and understanding the widespread effects this drug has been shown to have in behaviour and disease.
Volume 17 - 2023 | <a class="ArticleLayoutHeader__info__doi" href="https://doi.org/10.3389/fnsys.2023.1134594">https://doi.org/10.3389/fnsys.2023.1134594</a>
Introduction: 7,8-dihydroxyflavone (7,8-DHF) is a low molecular weight compound that can cross the blood brain barrier and has been implicated in numerous functions and behaviours
It is thought to have neuroprotective capability and has been shown to alleviate symptoms in a wide range of diseases
Methods: 7,8-DHF was administered systemically to wildtype mice during Morris water maze training
Long-term spatial memory was assessed 28 days later
Ex-vivo T2-weighted (T2w) imaging was undertaken on a subset of these mice to assess brain-wide changes in volume
Results: We found that systemic 7,8-DHF administration during the training period enhanced spatial memory 28 days later
Volumetric changes were observed in numerous brain regions associated with a broad range of functions including cognition
Discussion: Our findings give the first whole brain overview of long-term anatomical changes following 7,8-DHF administration providing valuable information for assessing and understanding the widespread effects this drug has been shown to have in behaviour and disease
there has not yet been investigation of the effect of 7,8-DHF on brain-wide changes in volume
In the current study we assessed the effect of 7,8-DHF administration on long-term spatial memory in mice and evaluated effects on brain volume using post-mortem whole-brain anatomical T2-weighted (T2w) imaging. Superior resolution and contrast can be gained by using ex-vivo MRI (<a style="color:red;" href="#B36">Lerch et al., 2012</a>)
although arguably less stress is caused compared to alternative tests that use prolonged dietary restriction
Steps taken to limit stress in this study included using low level lighting and limiting the number of trials to three on the first day of exposure to the water
Stress caused by the experimenter was also limited as outlined in the section above
was filled with water to a depth of &#x0007E;0.29 m
the mice were required to find a hidden platform (diameter 21 cm) with fixed location and submerged approximately 1 cm below the water surface
The swim paths of the mice were recorded and tracked using Watermaze software (Actimetrics
During the training period the mice received four trials per day for a total of 7 days
In each trial they were placed into the pool at one of eight different starting points in a randomly selected order
The mice had a maximum of 90 s to find the platform and once found remained on the platform for 15 s
the mice were guided gently to the platform&#x02019;s location
Twenty-eight days later the mice underwent a probe test
During the probe test the platform was removed and the mice swam freely for 45 s
The percentage of time they spent in the four quadrants of the maze
along with their average speed were recorded
Following the MWM probe test, 24 randomly selected mice (DHF n = 12; f = 9/m = 3, vehicle n = 12; f = 7/m = 5) were anaesthetized using pentobarbital and perfused with 30 ml of PBS containing Gadovist (2 mM, Bayer, Berlin, Germany), followed by 30 ml of 4% paraformaldehyde containing Gadovist (2 mM, Bayer) and Heparin (1 &#x003BC;l/ml, Wockhardt, Wrexham, UK) at a flow rate of 1 ml/min (<a style="color:red;" href="#B590">Cahill et al., 2012</a>)
The skulls containing the brains were removed and postfixed in 4% PFA with 2 mM Gadovist for 36 h at 4&#x000B0;C
They were then transferred into PBS with 0.02% sodium azide and Gadovist and stored at 4&#x000B0;C
the skulls were transferred into a 15 ml falcon tube containing fluorinert (3M) and placed in a vacuum pump to remove any potential bubbles
The MRI data was collected on a BioSpec 70/20 (7T field strength
20 cm bore diameter) small animal MR system with a Paravision 360 console (Bruker BioSpin MRI
T2w anatomical MRI was acquired using TurboRARE 3D with the following parameters: TR = 350 ms
field of view (FOV) 24 &#x000D7; 9.6 &#x000D7; 12 mm
matrix size 400 &#x000D7; 160 &#x000D7; 200
resolution = 60 &#x000D7; 60 &#x000D7; 60 &#x003BC;m
MWM behavioural data were assessed for normal distribution using the Shapiro-Wilk test and for homogeneity of variances using Levene&#x02019;s test
If the data was found to have normal distribution and homogeneity of variances then two-way mixed ANOVA
independent student&#x02019;s t-test or Pearson&#x02019;s r test were used
If the assumptions for parametric tests were not met then a Wilcoxon rank sum test was used
Data were analysed with R studio (version 2021.09.2)
Data are presented as mean &#x000B1; standard deviation (SD) or standard error of the mean (SEM); graphs were generated in GraphPad Prism (version 9.3.0)
A linear mixed effect model was then fit either at each voxel or at each ROI
Two mice were excluded from the T2w analysis due to incomplete Jacobian outputs
Voxelwise clusters showing significant drug-related effects were then used to extract average Jacobian values across voxels within the cluster for each mouse
These Jacobian values were then correlated with the respective behavioural performance of each mouse (as measured by the percentage of time spent in the target quadrant) through a Pearson&#x02019;s r two-tailed test
Long-term memory performance in the Morris water maze
(A) Both the mice that received 7,8-DHF and vehicle following each training session successfully learnt the location of the platform during the training period
(B) The 7,8-DHF group spent a greater percentage of time in the target quadrant during the 28-day probe test
(C,D) The 7,8-DHF group found the platform quicker and crossed it more often than the controls
(E) Swim speed was equivalent between groups 
A voxelwise analysis tested for whole-brain volumetric bidirectional changes using Jacobian determinant images in mice that had received 7,8-DHF (n = 10; f = 8/m = 2) during the MWM training period compared with those that received vehicle (n = 12; f = 7/m = 5)
Widespread volumetric changes were observed (tpeak = 4.21
the average Jacobian values across all significant voxelwise clusters for each subject in the 7,8-DHF group were not found to correlate with the percentage of time spent in the target quadrant of the MWM during the 1-month probe test (Pearson&#x02019;s r = &#x02212;0.1 p > 0.05)
Other ROIs showed a smaller volume in the 7,8-DHF group
including the right (q = 0.05) and left (q = 0.05) ventral tenia tecta and the left stratum lucidum hippocampus (SLu q = 0.05) and the cornu ammonis 1 (CA1) pyramidal layer (q = 0.05)
Brain regions showing volume expansion and contraction following 7,8-DHF administration
Brain structures showing an increase in volume following 7,8-DHF administration
Brain structures showing a decrease in volume following 7,8-DHF administration
We found that administering 7,8-DHF resulted in changes to brain volume in a wide range of brain areas including area 24 of the cingulate cortex
and deep cerebellar nuclei including the fastigial nucleus
7,8-DHF was also found to decrease volume in other regions including the ventral tenia tecta and regions of the hippocampus
find any significant correlation with the percentage of time spent in the target quadrant
time to reach the target platform or number of platform crosses during the MWM probe test
Given the broad range of diseases and behaviours that 7,8-DHF has been associated with
it is perhaps not surprising that numerous brain areas were found to be altered by its administration
Further research will be needed to determine the behaviours these brain volumes changes are associated with
We have outlined below previous literature indicating potential roles of these brain regions in behaviour and disease to inspire future work using 7,8-DHF
we found that 7,8-DHF when administered during MWM training enhances long-term spatial memory
Changes in brain volume in a wide range of brain areas was observed but were not found to correlate with spatial memory enhancement
Gaining an overview of the brain regions affected by 7,8-DHF administration is critical when assessing it for therapeutic use
All animal experiments were approved under the UK Animals (Scientific Procedures) Act 1986
and JL contributed to the data analysis and revised the manuscript
HJ-B contributed to interpretation of the data and revised the manuscript
All authors gave final approval of the version to be published and agree to be accountable for all aspects of the work
All authors contributed to the article and approved the submitted version
This work was funded by a senior Wellcome Trust grant HMR01180 to HJ-B
We thank Claire Bratley for initial MRI acquisition training
Flavonoid derivative 7,8-DHF attenuates TBI pathology via TrkB activation
Muscle-generated BDNF (brain derived neurotrophic factor) maintains mitochondrial quality control in female mice
7,8-Dihydroxyflavone improves cognitive functions in ICV-STZ rat model of sporadic Alzheimer&#x02019;s disease by reversing oxidative stress
mitochondrial dysfunction and insulin resistance
Optimized integration of fluoxetine and 7,8-dihydroxyflavone as an efficient therapy for reversing depressive-like behavior in mice during the perimenopausal period
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Received: 30 December 2022; Accepted: 21 February 2023; Published: 15 March 2023
Copyright &#x000A9; 2023 Rawlings-Mortimer, Lazari, Tisca, Tachrount, Martins-Bach, Miller, Lerch and Johansen-Berg. This is an open-access article distributed under the terms of the <a rel="license" href="http://creativecommons.org/licenses/by/4.0/" target="_blank">Creative Commons Attribution License (CC BY)</a>
*Correspondence: Florence Rawlings-Mortimer, <a id="encmail">ZmxvcmVuY2VyYXdsaW5nc21vcnRpbWVyQGdtYWlsLmNvbQ==</a>
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Preventing childhood obesity is a public health challenge of the twenty-first century and it must be a priority
Governments play a major role in creating and supporting a healthy school environment and should prioritise actions to improve children’s health
Sintra Grows Healthy aims to promote healthy lifestyles to prevent childhood obesity and improve children’s health-related quality of life and social and emotional skills
through the development of a school evidence-based and sustainable model
This protocol describes a quasi-experimental design and community-based participatory research
The participants included in the study are the school community of Portuguese public primary schools from the municipality of Sintra
Data will be collected on demographic and socio-economic characterization
There is evidence to support interventions in school settings as strategies for obesity prevention
Up-to-date homogeneous and community-based interventions for preventing childhood obesity are lacking
therefore Sintra Grows Healthy intends to fill this gap
Sintra Grows Healthy aims to contribute with relevant scientific findings that will allow the development of better strategies for policymakers and society to manage this major public health problem
this study protocol aimed to describe the design and methodology of the Sintra Grows Healthy
This protocol reports a community intervention with a quasi-experimental design and community-based participatory research
The study was developed by the municipality of Sintra (the project owner) with a partnership between health and academic entities as stakeholders: Sintra Health Centres Group
College of Communication and Media Studies (Polytechnic Institute of Lisbon)
Lisbon School of Health Technology (Polytechnic Institute of Lisbon)
Nutrition Laboratory of Faculty of Medicine (University of Lisbon)
Faculty of Human Kinetics (University of Lisbon)
SGH has the institutional support of organisations such as Ministry of Health
Portuguese National Programme for the Promotion of Healthy Eating
Portuguese National Programme for the Promotion of Physical Activity
Food and Agriculture Organisation of the United Nations (FAO) – Portugal
NOVA National School of Public Health (NOVA University Lisbon) and Food
Farming &amp; Forestry College (F3) (University of Lisbon)
Sintra’s School Network includes 20 public school clusters with a total of 96 kindergartens and primary schools
The study includes the respective subgroup of 83 primary schools from the municipality of Sintra (approximately 13,100 children)
we are recruiting 16 schools and our goal is to reach within 5 years the entire population - the 83 primary schools from the municipality of Sintra
The sample is selected by the schools’ convenience and split into an intervention group and a control group
guaranteeing the sample size required to reach the minimum difference of proportions between groups of 3–5% with at least 80% statistical power
Any children who meet the inclusion criteria (attend the primary schools belonging to the project and give written freely given
informed consent for participation with children’s legal guardian approval and signature) and do not meet the exclusion criteria (to have a motor and/or intellectual disabilities and/or not present a valid consent for participation) are eligible (census procedure)
As mentioned in the informed consent this study does not represent any risk
SGH aims to develop a sustainable model of intervention to promote healthy lifestyles in a school environment and to evaluate its impact
SGH community-based intervention focuses on community actors and prioritises three axes: 1) food and nutrition curricula named Health at the Table
2) school food environment and 3) physical activity
a specialised team will design a set of communication tools to inform
engage and motivate all the stakeholders involved in the process
teachers and other actors who play an important role in the school environment
The intervention follow-up will occur during each school year from the first to fourth grade
SGH researchers will assure continuous monitoring and disclosure of a quarterly report for all intervention axes to the schools
to communicate and verify the school community engagement
This axis will be monitored through a weekly submission in an SGH platform for each food and nutrition education sessions applied by the teachers
teachers will fill in a form regarding the application of each session and will answer several questions
children’s competencies achieved and activity adequacy)
The municipality of Sintra has already developed several policies to provide children with a healthier school food environment such as assuring the quality of school meals
being all menus established by registered nutritionists/dietitians
a salt control policy has been implemented at school lunches
Sintra assures professional ongoing training of cooks
and monthly healthy culinary workshops for families
Snacks Diagnosis – Qualitative and quantitative evaluation of foods consumed by children in both morning and afternoon snacks
Snacks Assembly – Within the scope of health at the table
children will organise an assembly to discuss the quality of theirs snacks: what is a healthy snack
which causes lead to the consumption of unhealthy snacks by the class
and what they could implement to improve their snacks
with the main conclusions of their debate to be discussed in an assembly with the school community
the school community will afterwards construct a healthy snacks policy
After construction and approval of the healthy snacks policy
it will be incorporated into the school regulation
</a>Sintra Grows Healthy framework of action
Questionnaires are important to assess physical activity because they help to understand the context in which it occurs
the questionnaires do not allow to determine the intensity of the activity practised regularly
children also have difficulty reporting the intensity of activities accurately
accelerometers are important to understand the levels of intensity of physical activity practised
To determine the physical activity intensity
children will wear an accelerometer for at least two weekdays and one weekend
SGH study data will be centralized by the project executive responsible who will hold the participant individuals’ coded key
All individuals involved in the study will be assigned a single anonymised code that will be used to link the respective data across all the existing databases/tables
Each of the performed surveys will have its own database/table with the participant individuals anonymised code
Regular reporting will be performed using RStudio Notebooks that collect information from the several available databases/tables
The iterative process of automatic generation of data reporting identifies errors
originated by OCR transposition of paper questionnaires to digital databases/tables
The SGH protocol promotes extensive data collection with baseline data points and follow-up points
and with individuals entering and exiting the study during its expected implementation
this represents a great challenge for the study data management and analysis
statistical characterisation will be performed using descriptive statistics (absolute and relative frequencies for qualitative variables and mean and standard-deviations or median and IQRs for quantitative variables according to verification normality distribution assumption using the Shapiro-Wilk test)
Bivariate relations with the main socioeconomic characteristics will be tested using chi-square tests or Fisher exact test (when both variables will be qualitative); Pearson or Spearman’s correlation coefficients (when both variables will be quantitative); and t-
ANOVA or Mann-Whitney and Kruskal-Wallis tests (when one variable will be quantitative and the other qualitative
whether parametric test use will be met or not and according to the discrepancy of sample size between groups)
For the comparison of two moments of the same quantitative variable
the paired-samples t-test or the Wilcoxon signed-rank test will be used
the Generalized Linear Models family will be used (it includes Multiple Linear Regression
and Negative Binomial regression among other models)
SGH aims to contribute with relevant research to obtain evidence-based practices
providing significant knowledge for policymakers and health and education professionals’ actions
the sustainability and future reproduction of good practices
through the empowerment of the school community
preventing the increase of childhood obesity prevalence
and improving children’s social and emotional skills and health-related quality of life
SGH will innovate by its consistent monitoring and scientific evaluation to establish a sustainable and effective intervention model to prevent childhood obesity
Quality control and assurance of procedures through training of researchers
processes of internal data quality verification will be taken
an annual report addressed to policymakers will be developed
there will be strategic thinking about all the issues concerning the institutional communication of the intervention
as well as social behaviour change communication
SGH scientific dissemination of findings will be assured through a shared publication policy with SGH consortium
It is crucial to reinforce public investment in health
namely through the presence of more health professionals in local governments and schools
prioritsing the measurement of the impact of their interventions
through partnerships with academic researchers
In addition to having evidence-based practices
it is also essential to obtain more evidence based on practices
Implementing this study protocol will bring relevant scientific findings regarding different factors related to childhood obesity
allowing the development of better strategies to manage this major health problem
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This research is funded by the Municipality of Sintra and co-funded by Gulbenkian Academies for Knowledge
The Sintra Grows Healthy is promoted by the Municipality of Sintra
supports the Municipality of Sintra assigning a subsidy in order to promote social and emotional skills but played no role in the study design
The Municipality of Sintra provides financial support to Faculty of Medicine
for this institution to undertake the technical and scientific leadership
development and dissemination of Sintra Grows Healthy
Ferreira and Telma Nogueira contributed equally to this work
Escola Superior de Tecnologia da Saúde de Lisboa
Paulo Jorge Nogueira &amp; Adilson Marques
Laboratório de Biomatemática Faculdade de Medicina
Instituto de Medicina Preventiva e Saúde Pública
Faculdade de Motricidade Humana &amp; UIDEF
AQ and AP contributed to the initial study design protocol and the final research protocol
RJF and TN coordinate the study implementation
data collection and methodological and operational adjustments
PN and AMP coordinate statistical analyses plan and database management
AR coordinates the institutional communication
TN coordinates the impact evaluation of the study
VDS and MP drafted and critically revised the manuscript
All authors contributed to further discussion and critically revised the manuscript
All authors read and approved the final manuscript
This study is conducted according to the guidelines laid down in the Declaration of Helsinki and it is obtained written informed consent from the children’s legal guardian
Lisbon Academic Medical Centre ethics committee (401/17)
the National Data Protection Commission (11468/2017) and the Ethics Boards of each participating school approved the study
Permission from the relevant rights holders of each questionnaire applied was obtained
The authors declare that they have no competing interests
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
unless otherwise stated in a credit line to the data
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DOI: https://doi.org/10.1186/s12889-020-09715-0
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Chairman of the Board Ryan Cohen is an audacious young capitalist who promises to reinvent the video game retailer
Armed with bold plans and an activist mindset
the Chairman is seen as one key piece in the company&#x2019;s turnaround efforts
Wall Street Memes discusses the importance of Chairman Cohen to GME stock investors
(Read more from WS Memes:&#xA0;<a href="https://www.thestreet.com/memestocks/clov/2-reasons-why-buying-clov-could-be-a-good-idea">2 Reasons Why Buying CLOV Could Be A Good Idea</a>)
36-year-old Ryan Cohen was the CEO of Chewy, the pet e-commerce company that he founded when he was only 25 years old. In 2017, he <a href="https://www.wsj.com/articles/how-petsmart-swallowed-chewyand-proved-the-doubters-wrong-11569858310" rel="noopener" onclick="return phoenixTrackClickEvent(this, event);" target="_blank">sold</a> Chewy to PetSmart in a $3.3 billion deal for the purpose of pursuing other personal goals
Then, the investor side of Ryan Cohen&#x2019;s began to gain notoriety. After the sale of Chewy, he <a href="https://www.marketwatch.com/story/how-the-coronvavirus-stock-market-rout-left-chewys-founder-down-150-million-on-his-apple-bet-2020-03-23" rel="noopener" onclick="return phoenixTrackClickEvent(this, event);" target="_blank">invested</a> a large sum in Apple and became the company&apos;s largest individual investor
holding around 6 million split-adjusted shares
By the end of 2020, Cohen had also become the largest single shareholder in GameStop, having <a href="https://www.bloomberg.com/news/articles/2020-09-21/top-gamestop-investor-wants-to-turn-retailer-into-amazon-rival" rel="noopener" onclick="return phoenixTrackClickEvent(this, event);" target="_blank">acquired</a> 10% of GME&apos;s shares and subsequently increasing the ownership percentage to about 13%
These investments were made before the short squeeze of GameStop stock
the investor was appointed as Charmain of the Board
Cohen&#x2019;s revolutionUpon taking over as chairman in early 2021, Cohen had already seen his initial investment in GME rise by more than 2,500%. With a bold and defiant speech, he <a href="https://www.wsj.com/articles/gamestop-ryan-cohen-chewy-meme-stock-11628776861?mod=article_inline" rel="noopener" onclick="return phoenixTrackClickEvent(this, event);" target="_blank">opposed</a> the board members&apos; idea to issue $100 million in equity due to concerns over the value of GME stock
Mr. Cohen <a href="https://www.wsj.com/articles/gamestop-ryan-cohen-chewy-meme-stock-11628776861?mod=article_inline" rel="noopener" onclick="return phoenixTrackClickEvent(this, event);" target="_blank">proposed</a> a series of changes to the company&apos;s strategy
He encouraged investments beyond brick-and-mortar stores
and aiming for a high-quality customer service model
the chairman helped to change the company&apos;s team of executives
cutting a few loose and hiring former Chewy and Amazon employees for senior managerial positions
(Read more from WS Memes:&#xA0;<a href="https://www.thestreet.com/memestocks/amc/amc-stock-3-reasons-the-short-squeeze-could-be-on-its-way">AMC Stock: 3 Reasons The Short Squeeze Could Be On Its Way</a>)
GameStop has been reporting annual losses for the last three consecutive years (see chart below)
the company began to suffer from the secular trends that favor the digital channel over brick-and-mortar stores
The COVID-19 crisis only served to worsen GameStop&#x2019;s competitive position
<a></a>Figure 2: GameStop&#x2019;s net income chart in the last 5 years.
Ryan Cohen was one of the few billionaire investors who understood how Reddit forums worked even before the meme stock boom of January 2021. He saw in GME an investment opportunity that combined potential for future financial performance with the stock&apos;s popularity among individual investors.
It did not take long for prominent and vocal retail investors to see &#x201C;Papa Cohen&#x201D; as one of their representatives and allies inside the company.
One of the appeals of GameStop stock to retail investors is Ryan Cohen&#x2019;s influence and unconventional vision as a chairman. In addition, Mr. Cohen has a proven track record in what GameStop probably needs the most right now: e.g. growth in e-commerce and startup-like momentum.
GameStop&#x2019;s fundamentals and growth prospects are far from being pristine at this moment. Yet, Ryan Cohen may very well be a bullish factor that keeps GME investors hopeful about another leg higher in the company&#x2019;s share price.
Twitter speaksGameStop&#x2019;s Chairman Ryan Cohen is seen as one key piece in the company&#x2019;s turnaround efforts. How do you believe that &#x201C;the Ryan Cohen factor&#x201D; will be reflected on the stock?
(Disclaimers: this is not investment advice. The author may be long one or more stocks mentioned in this report. Also, the article may contain affiliate links. These partnerships do not influence editorial content. Thanks for supporting Wall Street Memes)
</a>By <a href="https://www.thestreet.com/memestocks/author/bernard-zambonin" onclick="return phoenixTrackClickEvent(this, event);" phx-track-id="Author Name" rel="author">Bernard Zambonin</a>Bernard is the co-producer of The Street's financial channels and holds the researcher and operations manager position at DM Martins Research. Additionally, he contributes articles to Seeking Alpha.
</a><a href="https://www.thestreet.com/memestocks/author/daniel-martins" onclick="return phoenixTrackClickEvent(this, event);" phx-track-id="Author Image" title="Daniel Martins"></a>By <a href="https://www.thestreet.com/memestocks/author/daniel-martins" onclick="return phoenixTrackClickEvent(this, event);" phx-track-id="Author Name" rel="author">Daniel Martins</a>Head researcher and portfolio strategist of independent firm DM Martins Research
WEST PALM BEACH — About 9 a.m. on May 8, two maintenance workers at an apartment complex west of Boca Raton heard a sound <a href=https://www.palmbeachpost.com/news/20190709/mental-health-exam-sought-for-mom-who-put-baby-in-boca-area-dumpster>coming from a dumpster</a>
That's how we found out," one of them told a 911 dispatcher
Sergio Vega and Yusdani Gonzalez-Delgado had found
the Palm Beach County Sheriff's Office presented the two men with its Samaritan Award
as part of the agency's annual awards ceremony
“She was dirty and bloody but she was alive and well," Vega said at the event
with two felonies after they say she confessed to placing the baby in the trash bin
"You cannot understand how someone can do something like that
Both the father and daughter were at Thursday's ceremony
pointed a loaded handgun at him and his son Khaled and would not let them leave their West Palm Beach-area business
And also in July, <a href=https://www.palmbeachpost.com/news/20190910/by-bookrsquo-pbso-detective-recalled-for-love-of-family-music-movies>deputy David German</a>
commented that he'd love to sit by his pool on his birthday
A colleague contacted her pool service technician
was able to spend his birthday and his last days enjoying his pool
Life-saving medals were presented in three separate incidents
and two others pulled a woman out of a burning car following a crash
Responding to a report that a woman had shot her husband in their driveway
roused its eight occupants and led them to safety as a large explosion rocked the garage
Others recognized were agent Charles Booth
named Investigator of the Year for helping bring down two gang members; Luis Pacheco was honored as Deputy of the Year for his work in catching a major drug operator; and Kimberly Wright was named Corrections Deputy of the Year for busting a homemade liquor operation inside the county satellite jail in Belle Glade
PBSO also commended its communications training unit, jail emergency response team, District 3 North and District 5 West community policing, Greenacres district detective bureau, narcotics interdiction unit, airport drone unit and emergency field force. It also honored the<a href=https://www.palmbeachpost.com/news/20190402/dozens-arrested-in-patient-brokering-scheme-connected-to-lake-park-lab> Palm Beach County Sober Homes Task Force</a>
Staff photographer Lannis Waters contributed to this story
MEO Kalorama Festival added another splash of colour to the landscape&#8217;s canvas
It’s a big departure from the muddied fields and rowdy lads we’ve come accustomed to back in the UK
but art and sustainability taking centre stage
with its amphitheatre-like shape provided unobstructed views of the main stage – a welcome sight for anyone blocked by 6ft+ giants at previous festivals this summer
The wide open space allowed for a crisp listening experience
mustering up an energy that delighted both eyes and ears
earth shattering bass could be felt in your chest throughout the festival grounds
 Karen O left it all on the stage as she ran through a cascade of hits including ‘Spitting off the Edge of the World’ and ‘Heads Will Roll’
Metronomy anthem ‘The Look,’ sent the crowd into a giddy frenzy
the legendary Blur offered a welcome hit of nostalgia
performing timeless classics like &#8216;Country House&#8217;
There’s something about Britpop abroad that feels like it shouldn’t work
Saturday night was an emotional but uplifting experience with Florence + The Machine
the star implored fans to savour the moment by putting away their phones as she serenaded with ‘You&#8217;ve Got the Love’ – making everyone there feel like she was singing to them alone
with Pongo’s contagious energy almost hypnotising the crowd into replicating her dance moves (it’s safe to say all our dancing shoes must’ve been left back at home)
anticipation filled the air for Pabllo Vittar&#8217;s performance – and she didn’t disappoint
closing out the weekend with her infectious confidence
But it wasn&#8217;t just about the music: the festival embraced the spirit of art, partnering with Lisbon-based arts and culture platform <a href="http://www.under-dogs.net/">Underdogs</a>
While wandering through the festival grounds
vibrant murals brought Lisbon&#8217;s rich artistic heritage to life
crafted by local artists working with Underdogs
transformed the venue into a contemporary art gallery
a collective of artists from the Mem Martins region in Sintra
The group draw inspiration from their life experiences of communities on the outskirts of Lisbon
where social inequalities are still rife and their artwork pulsates with the raw essence of these often-overlooked suburbs
a visionary Portuguese graphic artist and designer
brought the Samsung stage to life with a display of his psychedelic designs
featuring beloved characters and heroes from his childhood
graced the main stage with artwork that paid homage to The Prodigy
a band that held a special place in her heart during her formative years
there was a chance for the general public to get their hands dirty
festival attendees are too smashed to partake in anything other than terribly screaming lyrics needlessly close to your ear
activities like stencil workshops added a wholesome and communal element
with festival-goers coming together to contribute to a mural
highlighting the sense of togetherness felt throughout the event’s duration
MEO Kalorama stands as a love letter to Lisbon&#8217;s art and music scene
and moment of unity resonates on a deep level
rising talent and sense of community make for a uniquely pure festival experience
We’d be lying if I said the sun didn’t help
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The Cash &amp; Carry chain of <a href="https://www.poupanca.pt/" target="_blank">Amaral e Filhos</a> will open the new Poupança de Leiria in May.&nbsp;
this will be the chain's largest store and the first to open its doors outside the Greater Lisbon area
further expanding the offer to the central part of the country
 The new store will open in the Zicofa Industrial Zone (warehouse 3) and
in addition to being the largest in the area
the store will have a more diversified offer of products
with emphasis on the new bakery and fresh vegetables sections provided by suppliers from the Western Region
This space will have more than 12 thousand products available on the shelves
In 2023, <a href="https://grupobel.pt/" target="_blank">Grupo BEL</a> acquired Amaral &amp; Filhos
reinforcing its presence in the Distribution and Logistics sector
The entry of the BEL Group into the capital of the distribution and wholesale trade company allowed the opening of the Famões store in June last year and
it is preparing to open another commercial space in the Central area
 For the opening of the new store in Leiria
Amaral &amp; Filhos Distribuição operates exclusively in Portugal and currently has a total of 11 stores in Almeirim
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