Search Results (4,034)

Background/Objectives: Tinnitus often occurs alongside the emotional symptoms of anxiety and depression. The Ginkgo biloba extract EGb 761^® was shown to be effective in reducing neuropsychiatric symptoms in elderly patients with both dementia and tinnitus, exerting direct effects on tinnitus severity and indirect effects mediated by improvement of anxiety, depression, and cognition. Whether the extent of the effects is influenced by the patient’s sex has not yet been investigated. We performed a conditional process analysis to evaluate this question. Methods: We analyzed the moderating role of sex on the direct and indirect effects of EGb 761^® on tinnitus severity using a first- and second-stage conditional process model. Results: Indirect effects of EGb 761^® on tinnitus severity mediated by improved cognition, anxiety, and depression did not differ between women and men (p > 0.05; all 95% bootstrap confidence intervals overlapped with zero). Moreover, direct treatment effects of EGb 761^® on tinnitus severity were statistically significant for both sexes (women, p < 0.0001; men, p = 0.0279). Conclusions: Beneficial effects of Ginkgo biloba extract EGb 761^® in dementia patients with tinnitus are likely to be unaffected by the patient’s sex. Further research into the influence of patient characteristics on the outcome of tinnitus drug treatment is encouraged. Full article

Introduction: Myotonic dystrophies (DM) are progressive genetic disorders with multisystemic involvement, particularly affecting the muscular, respiratory, and neuropsychological systems. Myotonic dystrophy type 1 (DM1), or Steinert’s disease, may lead to severe respiratory complications, including sleep-disordered breathing and hypercapnia, often requiring noninvasive ventilation to manage respiratory failure. However, adherence to NIV remains a major challenge, often influenced by cognitive and psychological factors such as apathy and depression. This study aims to investigate the presence of depression and SDB in patients with DM1 initiating NIV, and to evaluate factors influencing adherence to ventilatory support. Materials and Methods: We selected 13 adult patients (≥18 years) with diagnosis of Steinert’s disease with respiratory impairment who needed to start respiratory support. Dysphagia was assessed in all patients at baseline by a videofluoroscopic swallow study. Beck’s Depression Inventory II was administered for measuring the severity of depression. The Montreal Cognitive Assessment was used as a screening tool to detect signs of neurocognitive disorders. We evaluated adherence to NIV. Results: The study population presented with sleep-disordered breathing, as indicated by a median apnea–hypopnea index (AHI) of 24 events per hour (IQR: 14.2–34.5) and an oxygen desaturation index (ODI) of 25 events per hour (IQR: 18–33). Adherence to NIV was obtained in seven patients. No difference in baseline lung function was observed. Adherent subjects had moderate hypercapnia at baseline; pCO2 was 52 vs. 49 mmHg. Non-adherent patients showed a higher prevalence of depression with a median BDI-II score of 18 vs. 6 in adherent patients. The findings highlight that psychological factors, especially depression, play a crucial role in adherence to NIV. Interestingly, depression was not linked to initial respiratory measurements but showed a significant association with nocturnal oxygen desaturation. This suggests that relying solely on clinical and respiratory assessments may not be adequate to predict or improve treatment adherence. Conclusions: Incorporating psychological evaluations and addressing mental health issues, such as depression, are essential steps to enhance NIV compliance and overall DM1 patient outcomes. A multidisciplinary approach combining respiratory and psycho-emotional interventions is crucial for effective disease management. Full article

Neurodegenerative disorders, including Alzheimer’s disease (AD), Parkinson’s disease (PD), and post-stroke cognitive impairment (PSCI), represent an escalating global health and economic challenge. In the quest for disease-modifying interventions, natural polyphenols—most notably curcumin, the principal bioactive compound of Curcuma longa—have attracted considerable interest due to their pleiotropic neuroprotective effects. This narrative review critically synthesizes findings from a selection of peer-reviewed articles published between 2000 and 2025, chosen for their relevance to curcumin’s molecular mechanisms and translational potential. Curcumin’s complex chemical structure confers antioxidant, anti-inflammatory, and epigenetic modulatory properties; however, its clinical application is limited by poor oral bioavailability. Mechanistically, curcumin attenuates oxidative stress and suppresses key inflammatory mediators, including nuclear factor kappa B (NF-κB), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS). Additionally, it modulates apoptosis, inhibits amyloid-beta aggregation, and enhances cellular quality control processes such as autophagy and mitophagy, while upregulating neurotrophic factors such as brain-derived neurotrophic factor (BDNF). Preclinical studies employing rodent models of AD, PD, and ischemic stroke have demonstrated curcumin’s dose-dependent neuroprotective efficacy, with improved outcomes observed using nanoparticle-based delivery systems. Early-phase clinical trials further support curcumin’s favorable safety profile and potential cognitive benefits, although challenges remain regarding pharmacokinetics, formulation standardization, and therapeutic reproducibility. Future directions include the development of advanced drug delivery platforms, combinatory therapeutic regimens, and personalized medicine approaches integrating curcumin within multifaceted neurotherapeutic strategies. Collectively, this narrative review highlights curcumin as a promising multi-targeted candidate for combating neurodegenerative diseases, while emphasizing the need for further translational and clinical validation. Full article

The integration of Artificial Intelligence (AI) technologies in students’ lives necessitates the systematic incorporation of foundational AI literacy into educational curricula. Students are challenged to develop conceptual understanding of computational frameworks such as Machine Learning (ML) algorithms and Decision Trees (DTs). In this context, unplugged (i.e., computer-free) pedagogical approaches have emerged as complementary to traditional coding-based instruction in AI education. This study examines the pedagogical effectiveness of an instructional intervention employing unplugged activities to facilitate conceptual understanding of DT algorithms among 47 9th-grade students within a Computer Science (CS) curriculum in Greece. The study employed a quasi-experimental design, utilizing the Structure of Observed Learning Outcomes (SOLO) taxonomy as the theoretical framework for assessing cognitive development and conceptual mastery of DT principles. Quantitative analysis of pre- and post-intervention assessments demonstrated statistically significant improvements in student performance across all evaluated SOLO taxonomy levels. The findings provide empirical support for the hypothesis that unplugged pedagogical interventions constitute an effective and efficient approach for introducing AI concepts to secondary education students. Based on these outcomes, the authors recommend the systematic implementation of developmentally appropriate unplugged instructional interventions for DTs and broader AI concepts across all educational levels, to optimize AI literacy acquisition. Full article

Background and Objectives: Music therapy has been used as a non-pharmacological treatment for neurological conditions, supporting cognitive, psychosocial, behavioural and motor functions. Although it is evidence-based, safe, and cost-effective, music therapy remains uncommon in neurorehabilitation services, largely due to a lack of quality research. This review aims to understand the effect of music therapy on psychological outcomes for neurological conditions using randomised clinical trials (RCTs). Materials and Methods: A systematic review of literature published in four databases (PsycINFO, CINAHL, PubMed, and Scopus which is inclusive of Medline and EMBASE) from 1 January 2015 to 31 January 2025 was performed. Results: Ten RCT’s comprising 469 participants were included in this review, with seven studies synthesised using a systematic review without meta-analysis approach. MT was found to improve cognitive function in individuals with Parkinson’s disease (PD) and Traumatic Brain Injury (TBI), but not in those with stroke or Huntington’s disease (HD). In HD, improvements in cognitive function were noted in the comparator group. MT led to significant improvements in emotional well-being in stroke survivors, though not in mood. Behavioural outcomes did not significantly improve in HD, while quality of life improved following MT for individuals with multiple sclerosis (MS) and stroke. Conclusions: Overall, MT was perceived as a positive intervention with potential psychological benefits. However, findings were mixed, and the heterogeneity of population, intervention, comparator, outcomes, and study design limited the ability to detect group differences and reduced confidence in the findings. Future research should focus on larger-scale RCTs that reduce bias, accommodate population diversity, and clearly define and distinguish MT from treatment-as-usual. Better standardisation of outcomes and improved reporting will be essential to evaluate the efficacy of music therapy in neurological conditions and strengthen the evidence base for its use in clinical practice. Full article

Social Communication Disorder (SCD) involves persistent verbal and non-verbal communication difficulties, significantly impacting children and adolescents’ social interactions. Traditional interventions, while valuable, face practical limitations, including difficulties replicating real-world social contexts and low engagement among some learners. This paper examines Virtual Reality (VR) as an innovative intervention tool for SCD through a comprehensive review of empirical studies (2010–2024). Analysis of 11 peer-reviewed studies, encompassing both autism spectrum disorder (ASD)-specific and broader SCD populations, revealed five key themes being discussed in the current literature: usability and acceptability, social skills training, gaze and attention tracking, measurement and assessment, and applications in inclusive education. Our findings demonstrate VR’s potential as a mediating tool between therapeutic interventions and real-world social interactions, offering controlled yet naturalistic environments that enable safe, structured practice while maintaining engagement. The alignment with cognitive science principles enhances learning processes through effective management of cognitive demands. Building on these findings, we propose implementation strategies for educational and therapeutic settings, addressing design considerations, delivery methods, and outcome evaluation. This synthesis advances the understanding of VR as an innovative, scalable approach to supporting social communication development in children and adolescents. Full article

Background/Objectives: Autism spectrum disorder (ASD) is frequently associated with self-injurious behaviors, posing significant risks to individuals and considerable challenges for families and professionals. While various interventions have been proposed, evidence regarding their relative effectiveness remains fragmented. The general aim of this study was to perform a narrative review to analyze effective non-pharmacological interventions targeting self-injurious behaviors (SIBs) in autistic children and adolescents, addressing the following research question: Which non-pharmacological interventions are effective in reducing self-injurious behaviors in autistic children and adolescents, and under what conditions? The review focused on identifying treatment types, contexts of implementation, and outcome efficacy. Methods: This review was conducted based on a search in WoS, SCOPUS and PubMed databases. According to the PICOS criteria, we included studies involving children and adolescents with ASD and interventions for self-injurious behaviors. We compared different types of interventions and evaluated outcomes in terms of reduction in SIBs. Eligible studies were those reporting quantitative or qualitative outcomes on SIB interventions, published within the past 10 years. Results: Thirteen studies met the inclusion criteria. The interventions included applied behavior analysis (ABA), cognitive behavioral therapy (CBT), sensory integration therapy, and pharmacology. The reported outcomes generally indicated reductions in the frequency and severity of self-injurious behaviors. However, many studies lacked long-term follow-up data, and few addressed the generalization of treatment effects. Methodological variability limited both the comparability across studies and the generalization of results. Conclusions: This review emphasized a multidisciplinary, individualized approach to treating self-injurious behaviors in autistic youth. ABA emerged as the most effective intervention, while CBT proved beneficial for higher-functioning adolescents, and sensory therapies addressed specific challenges. Combined treatments showed promise, and family involvement and long-term research remain essential. Full article

Background/Objectives: Vitamin D deficiency is a global epidemic. In certain populations, such as the United Arab Emirates (UAE), low nutritional intake of vitamin D, inadequate exposure to sunlight, and cultural dress codes can lead to deficiencies in blood vitamin D levels, predisposing them to musculoskeletal disorders, diabetes, and cardiovascular diseases. There are also notable associations between vitamin D deficiency, physical inactivity, and lower cognitive performance. The aim of this study was to determine how vitamin D status may affect physical inactivity and cognitive performance in a young UAE population. Methods: Primary data were obtained on vitamin D status, cardiorespiratory fitness, body composition, and blood profiles of students in the UAE. Following initial assessment, a cohort of vitamin D-deficient/insufficient individuals participated in a 10-week physical activity intervention (Group A), whilst another cohort was supplemented with 5000 IU vitamin D3 daily and an exercise intervention (Group B). Both groups underwent physiological and biochemical profiling, and the effects of vitamin D supplementation on cognitive function were assessed. Statistical analysis included paired samples t-tests between pre- and post-intervention values and the Wilcoxon signed rank test for within-group comparisons and the Mann–Whitney U test for between-group comparisons. Results: The findings suggest that physical exercise alone improves overall cardiorespiratory fitness, as shown by an increased VO₂ max (p < 0.05), while vitamin D supplementation combined with physical exercise did not significantly improve fitness over a 10-week period (p > 0.05). However, vitamin D combined with physical exercise significantly improved cognitive performance in Group B only, specifically in working memory, verbal memory, and cognitive flexibility (p < 0.05). Conclusions: This study highlights the need for targeted interventions such as physical exercise and vitamin D supplementation to be conducted at an early stage in order to improve physical and cognitive function and reduce the risk of disease. Full article

This study presents a novel and interpretable, deployment-ready framework for predicting cybersecurity incidents through item-level behavioral, cognitive, and dispositional indicators. Based on survey data from 453 professionals across countries and sectors, we developed 72 logistic regression models across twelve self-reported incident outcomes—from account lockouts to full device compromise—within six analytically stratified layers (Education, IT, Hungary, UK, USA, and full sample). Drawing on five theoretically grounded domains—cybersecurity behavior, digital literacy, personality traits, risk rationalization, and work–life boundary blurring—our models preserve the full granularity of individual responses rather than relying on aggregated scores, offering rare transparency and interpretability for real-world applications. This approach reveals how stratified models, despite smaller sample sizes, often outperform general ones by capturing behavioral and contextual specificity. Moderately prevalent outcomes (e.g., suspicious logins, multiple mild incidents) yielded the most robust predictions, while rare-event models, though occasionally high in “Area Under the Receiver Operating Characteristic Curve” (AUC), suffered from overfitting under cross-validation. Beyond model construction, we introduce threshold calibration and fairness-aware integration of demographic variables, enabling ethically grounded deployment in diverse organizational contexts. By unifying theoretical depth, item-level precision, multilayer stratification, and operational guidance, this study establishes a scalable blueprint for human-centric cybersecurity. It bridges the gap between behavioral science and risk analytics, offering the tools and insights needed to detect, predict, and mitigate user-level threats in increasingly blurred digital environments. Full article

Congenital heart disease (CHD) is associated with neurodevelopmental and cognitive impairments, but the underlying molecular mechanisms remain unclear. This study investigated cardiac neuronal genomics in CHD using single-nucleus RNA-sequencing data (GSE203274) from 157,273 cardiac nuclei of healthy donors and patients with hypoplastic left heart syndrome (HLHS), Tetralogy of Fallot (TOF), dilated (DCM), and hypertrophic (HCM) cardiomyopathies. The Uniform Manifold Approximation and Projection (UMAP) clustering identified major cardiac cell types, revealing neuron-specific transcriptional programmes. Neuronal populations showed enriched expression of neurodevelopmental disorder-linked genes (NRXN3, CADM2, ZNF536) and synaptic signalling pathways. CHD cardiac neurons exhibited upregulated markers of cognitive dysfunction (APP, SNCA, BDNF) and neurodevelopment regulators (DNMT1, HCFC1) across subtypes. Cardiomyocyte troponin elevation correlated with neuronal exosome receptor expression (TLR2, LRP1), suggesting intercellular communication. Gene ontology analysis highlighted overlaps between cardiovascular disease pathways and neurodevelopmental disorder signatures in CHD neurons. These findings provide the first neuro-genomic map of cardiac neurons in CHD, linking cardiac pathology to neural outcomes through transcriptional dysregulation. Further, the systemic analysis of clinical findings in CHD further supports the risk of neurodevelopmental impacts. In summary, this study identifies transcriptional dysregulation within cardiac neurons in CHD and, together with a systemic analysis of clinical data, provides molecular evidence linking cardiac pathology to neurodevelopmental and cognitive impairments. Full article

This study investigates the mediating role of self-awareness within the broader framework of business acumen, emphasizing its connection to entrepreneurial accounting proficiency and financial performance in community enterprises across Thailand. The purpose is to advance theoretical understanding by integrating metacognition theory and the resource-based view (RBV), and to provide practical insights for strengthening grassroots entrepreneurship. Using survey data from 210 enterprises, a hybrid Structural Equation Modeling–Artificial Neural Network (SEM–ANN) approach is applied to capture both linear and nonlinear relationships among cognitive, technical, and financial variables. The results confirm that accounting proficiency has a significant and positive effect on self-awareness with value of 0.125. However, self-awareness does not exert a direct influence on financial performance. These findings suggest that self-awareness may function as a cognitive enabler, facilitating the translation of entrepreneurial skills into effective decision-making, rather than serving as an independent predictor of financial outcomes. Empirical patterns further reveal that commercial enterprises report higher self-awareness than service firms, unregistered enterprises show greater awareness than registered ones, and financially stable firms display lower awareness, suggesting complacency or overconfidence. In contrast, regular participation in training significantly enhances awareness, underscoring the role of continuous learning. Full article

Artificial intelligence is transforming higher education, particularly in flipped classroom settings, in which students learn independently prior to class and collaborate during in-person sessions. This study examines the role of ChatGPT as a virtual peer in a veterinary anatomy course centered on cardiovascular and respiratory systems. Over two academic years (2023–2025), 297 first-year veterinary students worked in small groups to explore anatomy through structured prompts in English and Spanish using ChatGPT versions 3.5 and 4. Activities involved analyzing AI output, evaluating anatomical accuracy, and suggesting alternative names for vascular variations. Learning outcomes were assessed using Bloom’s Taxonomy-based questions, and student perceptions were captured via online surveys. Progressive performance improvement was noted across three instructional phases, particularly in higher-level cognitive tasks (Bloom level 4). Responses to English prompts were more accurate than those to Spanish prompts. While students appreciated ChatGPT’s role in reinforcing knowledge and sparking discussion, they also flagged inaccuracies and emphasized the need for critical evaluation. Peer collaboration was found to be more influential than chatbot input. Conclusions: ChatGPT can enrich flipped anatomy instruction when paired with structured guidance. It supports content review, fosters group learning and promotes reflective thinking. However, developing digital literacy and ensuring expert oversight are essential to maximizing the educational value of AI. Full article

Background/Objectives: This study presents Co.Ge. a Cognitive Generative digital platform for cognitive testing. We describe its architecture and report a pilot study. Methods: Co.Ge. is modular and web-based (Laravel-PHP, MySQL). It can be used to administer a variety of validated cognitive tests, facilitating administration and scoring while capturing Reaction Times (RTs), trial-level responses, audio, and other data. Co.Ge. includes a study-management dashboard, Application Programming Interfaces (APIs) for external integration, encryption, and customizable options. In this demonstrative pilot study, clinical and non-clinical participants completed an Auditory Verbal Learning Test (AVLT), which we analyzed using accuracy, number of recalled words, and reaction times as outcomes. We collected ratings of user experience with a standardized rating scale. Analyses included Frequentist and Bayesian Generalized Linear Mixed Models (GLMMs). Results: Mean ratings of user experience were all above 4/5, indicating high acceptability (n = 30). Pilot data from AVLT (n = 123, 60% clinical, 40% healthy) showed that Co.Ge. seamlessly provides standardized clinical ratings, accuracy, and RTs. Analyzing RTs with Bayesian GLMMs and Gamma distribution provided the best fit to data (Leave-One-Out Cross-Validation) and allowed to detect additional associations (e.g., education) otherwise unrecognized using simpler analyses. Conclusions: The prototype of Co.Ge. is technically robust and clinically precise, enabling the extraction of high-resolution behavioral data. Co.Ge. provides traditional clinical-oriented cognitive outcomes but also promotes complex generative models to explore individualized mechanisms of cognition. Thus, it will promote personalized profiling and digital phenotyping for precision psychiatry and rehabilitation. Full article

Cerebral amyloid angiopathy (CAA) is an increasingly recognized cause of cognitive decline and lobar intracerebral hemorrhage in older adults. Recent research highlights that neuropsychiatric symptoms (NPSs)—including depression, anxiety, apathy, and irritability—are highly prevalent in CAA, often emerging prior to overt cognitive impairment or major vascular events. Compared to other cerebrovascular diseases, CAA presents a distinctive and multifaceted NPS profile, with symptoms closely linked to disease severity and neuroimaging biomarkers such as white matter hyperintensities and microbleeds. Critically, NPSs in CAA can complicate cognitive assessment and predict worse functional outcomes, yet remain underappreciated in clinical and research contexts. Management is complicated by pharmacologic risks—including heightened bleeding risk associated with SSRIs and novel anti-amyloid therapies—underscoring the need for individualized and multidisciplinary approaches. We highlight the urgent need for standardized NPS assessment, targeted research into mechanisms and treatment, and greater integration of neuropsychiatric evaluation into CAA care. We suggest that recognizing NPSs as core clinical features—not secondary complications—of CAA is essential to improving both patient outcomes and scientific understanding. Future studies should focus on longitudinal analyses, the development of tailored interventions, and robust comparative research to clarify the pathophysiology, clinical trajectory, and optimal management of NPSs in CAA. Full article

Background: Immediately after discharge from hospital, COVID-19 patients have poor physical function and impaired performance in activities of daily living. Persisting symptoms and cognitive impairments have been reported, but the long-term impact on objectively measured physical activity (PA) in patients hospitalized for COVID-19 is not clear. Methods: A prospective cohort study was conducted to compare objectively measured PA and physical function 12 months post discharge in patients who were hospitalized for COVID-19 with age- and sex-matched healthy controls and to elucidate the impact of ICU admission on these outcomes. PA was objectively assessed using accelerometry in patients, healthy controls, and in a subset of partners of patients. Additionally, lung function, physical function (six-minute walk distance (6 MWD) and isometric quadriceps and handgrip force), symptom experience, and health-related quality of life (HRQoL) were evaluated in patients with and without ICU admission. Results: Included in the study were 101 patients (60 ± 10 years, 69% male), 36 healthy controls (60 ± 9 years, 58% male), and 14 partners (55 ± 8 years, 21% male). Daily step count and movement intensity (MI) during walking in patients were significantly lower compared with healthy controls (6726 ± 328 vs. 8155 ± 555 n.day⁻¹, p = 0.03 and 1.99 ± 0.04 vs. 2.21 ± 0.07 min/s².day⁻¹, p = 0.005). PA levels of patients and their partners were comparable. Physical function, symptom experience, HRQoL, and PA levels were comparable in patients with and without ICU admission (p > 0.05). Daily step count was weakly positively associated with 6 MWD (r = 0.30). Conclusions: One year post discharge, patients had lower PA levels than healthy controls. ICU admission did not affect physical function, symptoms, HRQoL or activity levels. Full article