Search Results (4,958)

Indigenous cultures in Taiwan embody rich ecological knowledge and strong environmental conservation values. However, elementary and secondary education often provides limited exposure to these cultures due to geographic constraints and insufficient instructional resources, relying primarily on textbooks and teacher-centered teaching methods. Such approaches restrict experiential learning, which may diminish students’ motivation and depth of understanding. However, 360-degree virtual reality (VR360) enables immersive simulations of authentic environments, increasing the accessibility of cultural and ecological education through smartphones and low-cost Google Cardboard. In addition, drone technology enhances learning by offering multiple perspectives for environmental exploration and data collection. This study examines the effectiveness of integrating a VR360 and virtual drone system into instruction focused on the ecological context of Sun Moon Lake and Thao Indigenous culture. Learning outcomes for Indigenous and non-Indigenous students were compared in terms of learning effectiveness, motivation, cognitive load, and technology acceptance. Ecological and cultural materials were collected through field investigations and drone photography, enabling students to explore landscapes from a first-person perspective and engage with Thao cultural practices and their relationship with local ecology. The findings indicate that the proposed VR-based system significantly enhances learning experiences and demonstrates strong potential for cultural and ecological education, offering valuable guidance for the design of future immersive instructional strategies and learning materials related to Indigenous cultures. Full article

Background: Eye-tracking (ET) devices are gaining attention in technology-based paediatric rehabilitation through their intrinsic ability to assess patients’ engagement and visual attention within motivating, technology-based environments. We conducted a systematic review of available evidence from 2004 to 2025 on the implementation of ET in rehabilitative trainings targeting paediatric populations with neurological and neurodevelopmental disorders. This paper aims to outline the rehabilitative outcomes pursued in the clinical populations considered. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were consulted to summarise the state of the art of the last 20 years. Selected articles were categorised according to the type of treated disorder and the rehabilitated function. Results: ET devices have been increasingly integrated into paediatric rehabilitation with promising results across multiple neurodevelopmental conditions (e.g., ASD, ADHD, cerebral palsy). These systems have proven effective not only in training gaze control, but also in enhancing executive functions, social cognition, communication, and participation. Furthermore, they promote personalised and data-driven solutions and support high levels of engagement, feasibility, and user satisfaction. Conclusions: ET represents a promising frontier for paediatric rehabilitation, addressing various neurodevelopmental disorders. The gaze-contingent protocols employed have demonstrated potential effects in promoting adaptive behaviour across multiple developmental areas. Further research is warranted to provide shared guidance and to strengthen practice recommendations. Full article

Background/Objectives: The global incidence of diabetes in childhood is increasing, raising concern about its long-term effects on the developing brain. Although paediatric diabetes research has traditionally focused on microvascular and macrovascular complications, accumulating evidence indicates that the brain is also a vulnerable target. Methods: This narrative review synthesizes current knowledge on the impact of diabetes on brain health in children and adolescents, with emphasis on epidemiology, neuroimaging and cognitive outcomes, underlying mechanisms, risk and protective factors, and clinical implications. Results: In type 1 diabetes (T1D), studies consistently demonstrate subtle but measurable alterations in brain structure, including reduced growth of total, grey, and white matter volumes, alongside functional and microstructural changes. These neurobiological differences are associated with mild deficits in cognition, particularly in attention, executive function, memory, and processing speed. While clinically significant impairment affects a minority, subclinical alterations are common and may accumulate over time. Key risk factors include chronic hyperglycaemia, glycaemic variability, severe hypoglycaemia, diabetic ketoacidosis, and younger age at onset, whereas good glycaemic stability, diabetes technologies, supportive psychosocial environments, and adequate sleep appear protective. Proposed mechanisms involve oxidative stress, neuroinflammation, disrupted insulin signalling, altered cerebral metabolism, and vulnerability of the immature brain during critical developmental windows. Type 2 diabetes (T2D), increasingly diagnosed in youth, is also associated with adverse brain outcomes. Emerging data link early-onset T2D to alterations in brain structure and connectivity, poorer cognitive performance, and increased mental health burden, mediated by hyperglycaemia, insulin resistance, inflammation, and psychosocial stressors. Conclusions: Overall, childhood diabetes—both T1D and T2D—is associated with meaningful effects on brain development and function. Longitudinal and interventional studies are needed to establish causality and determine whether optimizing glycaemic control and psychosocial support can mitigate neurocognitive risk. Recognizing brain health as a potential complication of paediatric diabetes has important implications for monitoring, prevention, and clinical care. Full article

The rapid proliferation of large language models has created significant opportunities for personalized education, yet existing systems rarely account for user competency as a determinant of interaction quality. This study introduces Persona in The Loop (PITL), a dual-mode adaptive framework that recommends AI personas for blockchain and smart contract education applications. PITL employs 100 AI personas organized across two domains, ten sub-specialties, and five Dreyfus competency levels, recommending personas via either similarity-based mode grounded in Cognitive Load Theory or complementary mode grounded in the Zone of Proximal Development, with an adaptive switching mechanism driven by NASA-TLX cognitive load feedback. A mixed-method study with 150 participants using a 2 × 5 factorial design showed that the complementary mode produced higher learning gains, while the similarity-based mode yielded lower cognitive load and higher code quality. The adaptive mechanism outperformed both fixed-mode conditions on learning gain and code quality. The Mode × Dreyfus interaction was significant for cognitive load and task duration but not for learning gains, suggesting mode effects on learning outcomes are consistent across competency levels. Qualitative interviews with 20 participants corroborated quantitative findings. PITL offers a theoretically grounded and empirically validated approach to competency-based AI persona recommendation in educational contexts. Full article

Background/Objective: Breast cancer is one of the leading diseases affecting the Brazilian population and is often diagnosed at advanced stages. Due to its heterogeneity, treatment involves multiple therapeutic modalities, such as chemotherapy, hormone therapy, immunotherapy, and radiotherapy. The aim of this study was to characterize the profile of patients undergoing treatment for breast cancer in a private hospital in southern Brazil, and to assess the physical and psychological effects associated with different therapeutic modalities. Methods: An ambidirectional longitudinal cohort study was conducted from September 2018 to December 2024, incorporating retrospective data since 2013. Clinical and therapeutic data were collected, and Patient-Reported Outcome Measures (PROMs) using the QLQ-C30 Summary Score (QLQ-BR23, FACT-ES, BREAST-Q, LMC21) and Symptom Global Score questionnaires were analyzed using mixed-effects models to evaluate physical, emotional, cognitive, social, and overall quality-of-life domains, as well as body image. The temporal trend of time-to-treatment was assessed via linear regression. Results: Among 871 individuals evaluated, 98.4% were female, and invasive ductal carcinoma was the predominant histological type (75.1%). Radiotherapy was one of the most frequently used treatment modalities (39.2%), while immunotherapy had the lowest usage rate (2.7%). A significant reduction in the time between diagnosis and initiation of treatment was observed from 2013 to 2024 (from 21.0 to 10.9 days; p < 0.01), reflecting improvements in healthcare services. Mixed-effects models for PROMs indicated significant improvements across all assessed domains (p < 0.01) over the 48-month follow-up, despite a median follow-up of 22 months. Conclusions: High-quality and timely oncological care provided to breast cancer patients in a private hospital in southern Brazil demonstrates the implementation of a dynamic, agile, and human-centered care model, contributing to improved clinical and patient-reported outcomes validated by robust longitudinal analysis. Full article

This meta-analysis investigates the outcomes associated with ChatGPT-integrated English instruction on non-linguistic outcomes in South Korea. Following the PRISMA 2020 guidelines, 22 experimental studies (k = 26, N = 1303) were synthesized using a random-effects model, which revealed a significant medium overall effect size (g = 0.55). Subgroup analyses showed medium-to-large effects in Affective (g = 0.67) and AI Literacy (g = 0.59) domains, but a small effect on Cognitive/Metacognitive outcomes (g = 0.17). Moderator analyses (e.g., educational level, duration) yielded no significant differences, suggesting a meaningful overall trend across contexts. However, the descriptive disparity between affective gains and cognitive growth indicates an ‘Affective–Cognitive Gap.’ Findings suggest that while ChatGPT is associated with a reduction in psychological barriers—partly by reducing mental effort—it may lead to ‘cognitive offloading’ without intentional pedagogical scaffolding. The study concludes that mere tool adoption is insufficient. To prevent a ‘plateau effect’ after the initial novelty wears off, instruction must evolve from passive use to ‘agentic engagement’ through structured metacognitive routines. These results emphasize the necessity of teacher-mediated integration to repurpose AI-afforded efficiency toward higher-order evaluative and critical thinking tasks. Full article

The physical and mental health of adolescents is a cornerstone of national future. However, traditional “one-size-fits-all” school health interventions often fail to address the diverse needs of students. To overcome this limitation, this research introduces an evidence-based, tiered intervention model designed to provide personalized health support. This study constructs and validates a dynamic ‘Dynamic Weighting-based Asset-Condition-Resource Allocation-Evaluation-Feedback’ (DWA-CRISPR) tiered intervention model, moving from a “triage-driven” to a “needs-driven” service delivery framework. The model is built upon a Response to Intervention (RTI)/Multi-Tiered System of Support (MTSS) three-tier structure and integrates ecological systems theory, social cognitive theory, and the health belief model. Using a quasi-experimental design with propensity score matching (PSM), the intervention’s effectiveness was evaluated on a final matched cohort of 470 students. Difference-in-differences (DID) analysis was then employed to assess the outcomes. The results demonstrate that the tiered intervention significantly reduced the BMI Z-scores of at-risk students compared to the control group. Furthermore, by employing XGBoost and SHAP, the study identified key risk factors, such as cardiorespiratory fitness and baseline BMI, enabling precise and early risk identification. Hierarchical linear models (HLMs) further clarified the multi-level factors influencing intervention outcomes. In conclusion, the DWA-CRISPR tiered model proves to be more effective than traditional approaches, providing a scientific, efficient, and personalized pathway for improving the physical health of primary and secondary school students. Full article

Cognitive impairments are a core feature of psychotic disorders and are strongly associated with long-term functional disability. Although Cognitive Remediation Therapy (CRT) is an evidence-based intervention for improving cognition in psychosis, its feasibility and preliminary effects in acute inpatient settings—particularly using web-based platforms—remain underexplored. This single-arm, pre–post pilot study evaluated the feasibility of delivering a web-based CRT program and examined preliminary cognitive outcomes in a secure psychiatric inpatient facility. Thirteen inpatients with psychotic and non-psychotic diagnoses completed a 15-week intervention comprising twice-weekly sessions that included adaptive computerized CRT exercises (Happy Neuron Pro) and therapist-led bridging discussions focused on metacognitive reflection and functional application. Cognitive performance was assessed pre- and post-intervention using the MATRICS Consensus Cognitive Battery. All participants completed the study with no withdrawals or adverse events, attending a mean of 27.77 of 30 sessions (93.0%). Pre–post improvements were observed in processing speed, verbal learning, and overall composite cognition, with large within-sample effect sizes that remained robust in sensitivity analyses. Exploratory analyses suggested potential associations between sex, history of self-harm, and cognitive change, though these findings require cautious interpretation. Findings support the feasibility of inpatient web-based CRT and provide preliminary cognitive effect-size estimates. Given the single-arm design and absence of systematic medication monitoring, results should be interpreted as exploratory signals warranting controlled validation. Overall, findings support the feasibility of inpatient web-based CRT and provide preliminary signals of cognitive benefit, warranting evaluation in larger controlled studies. Full article

Background: Positive and existential psychiatry are approaches to mental health that emphasize the promotion of well-being, resilience, and optimal functioning alongside the conventional management of mental illness. Research suggests that the development of self-regulatory metacompetencies is associated with positive mental health and well-being outcomes. Artificial intelligence (AI) technologies are increasingly being used as assistive tools in psychiatry. However, the integration of AI in therapeutic interventions remains underexplored. Objectives: Thus, this systematic review aimed to synthesize evidence from randomized controlled trials evaluating whether AI-based positive and existential psychiatry interventions contribute to improvements in mental and emotional health. A second objective was to examine whether the therapeutic components and psychological processes implemented in these interventions conceptually relate to self-regulatory metacompetencies that underpin sustainable mental health and human flourishing. Methods: The review was conducted according to PRISMA 2020 guidelines. Only experimental studies including randomized controlled trials (RCTs) published from 2015 to 2025 were included. Twenty-four studies met the inclusion criteria. Results: Across interventions using conversational AI chatbots, generative AI and AI-augmented reflective systems, embodied conversational agents, social and humanoid AI robots, consistent improvements were observed in depression, anxiety, negative affect, and loneliness. The interventions enhanced various metacompetencies such as emotional regulation, emotional awareness, self-reflection, and cognitive reappraisal. Conclusions: The findings suggest that AI-based positive and existential psychiatry interventions can support mental and emotional health, especially when fostering key metacompetencies. Although promising, further high-quality trials are needed to clarify long-term effects. The findings of this study can contribute to the discussion about the ways AI-supported interventions may promote sustainable mental health. Full article

Traditional craft education relies heavily on hands-on practice; however, novice learners often struggle with procedural complexity, material behavior, and the tacit knowledge typically transmitted through prolonged apprenticeship. This paper presents an integrated framework that combines semantic Knowledge Graphs (KGs), real-time Finite Element Method (FEM) simulation, and high-fidelity physically based rendering (PBR) to support the teaching, understanding, and preservation of traditional crafts. Craft processes are modelled as ontologically grounded KGs that capture tools, materials, actions, decision points, and common procedural errors through an extensible representation aligned with CIDOC-CRM. These semantic structures drive an interactive FEM-based simulation that enables learners to enact craft actions in a virtual environment while receiving predictive feedback and corrective guidance derived from expert-defined execution parameters. The resulting workpiece states are visualized using PBR techniques, providing perceptually accurate cues essential for assessing surface changes, deformation patterns, and material conditions. The methodology is embedded within an eLearning ecosystem that supports the generation of structured courses, multimodal exemplars, and instructional design informed by Cognitive Load Theory. A use case involving wood and aluminum carving demonstrates the system’s ability to simulate realistic tool–material interactions and produce visually interpretable outcomes. The results indicate that coupling executable semantic knowledge modelling with physically grounded simulation offers a viable pathway toward scalable, safe, and contextually rich craft training while supporting the long-term preservation of domain expertise. Full article

This study examines how architectural acoustic environments of university buildings influence student learning outcomes from a sustainability perspective. In the context of sustainable campus development and indoor environmental quality (IEQ), acoustic conditions represent a critical yet often overlooked factor affecting cognitive performance and well-being. Through subjective questionnaires and objective assessments, we analyzed the acoustic experiences of 180 undergraduates, investigating the effects of varying noise levels (45 dBA, 60 dBA, and 75 dBA) and noise types (traffic and conversation) on learning outcomes during study sessions. This study aims to quantify acoustic sustainability in buildings of higher education and provides preliminary evidence that may inform sustainable campus planning and building design. Findings indicate that, within the experimental conditions of this study, regardless of the type of noise, higher noise levels are correlated with reduced subjective satisfaction and diminished learning outcomes. Specifically, traffic noise was found to have a stronger negative impact on memory, while conversational noise significantly impaired attention and reading ability. Additionally, an interaction effect was observed between noise type, noise level, as well as student gender, with male participants showing greater susceptibility to variations in noise level and type. These findings provide preliminary evidence for further improving sustainable campus planning and building design. Full article

Background/Objectives: Young adulthood is a critical developmental period during which lifestyle behaviors may shape intrinsic brain network dynamics that support cognition. This pilot longitudinal intervention study examined whether variability in physical activity and sedentary behavior during an 8-week exercise and/or cognitive intervention protocol was associated with changes in intrinsic brain dynamics and cognitive and mood outcomes in undergraduate young adults. Methods: Participants (n = 32) completed resting-state functional magnetic resonance imaging (rs-fMRI) at baseline (T1) and post-intervention (T2). Dynamic functional network connectivity (dFNC) was estimated from 53 intrinsic connectivity networks derived using spatially constrained independent component analysis (ICA). Ten recurring dynamic connectivity states were identified and individualized using constrained dynamic double functional independent primitives (c-ddFIPs). State occupancy and dynamic convergence and divergence metrics were computed to characterize network flexibility. Results: Greater moderate-to-vigorous physical activity was modestly but consistently associated with increased occupancy of integrative higher-order states, particularly States 6 and 7, and reduced occupancy of more segregated configurations. More physically active individuals also demonstrated greater divergence between integrative and low-engagement states, whereas greater sedentary time corresponded to increased similarity among segregated configurations. Working memory performance showed parallel associations with more integrative and better-differentiated dynamic patterns. Conclusions: These findings suggest that dynamic functional network reconfiguration may represent a neurobiological mechanism linking lifestyle behaviors and cognitive health in young adulthood. Furthermore, they highlight the translational promise of engagement-driven, low-burden programs for college-aged young adults, showing that even modest variability in habitual physical activity corresponds to greater engagement and differentiation of integrative connectivity states linked to executive and broader cognitive functions. Full article

Background/Objectives: Mild cognitive impairment (MCI) is common in Parkinson’s disease (PD) and significantly impacts quality of life. Non-invasive brain stimulation (NIBS) techniques have emerged as potential therapeutic interventions. This systematic review analyzes the current evidence regarding the efficacy of Transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES) on cognitive domains in patients with PD-MCI. Methods: A systematic search was conducted across the PubMed, Scopus, Web of Science, and Medline Ultimate databases up to 20 November 2025. We included studies investigating the effects of NIBS compared to sham stimulation on neuropsychological outcomes in diagnosed PD-MCI patients. Results: Eight studies involving different stimulation protocols were included. Interventions primarily used TMS or tES targeting the left dorsolateral prefrontal cortex (DLPFC). Episodic memory and global cognition were the most responsive domains, assessed with specific neuropsychological scales. Findings for executive functions and attention were heterogeneous, while visuospatial abilities generally showed limited immediate response. Conclusions: NIBS represents a promising but low-certainty-evidence adjunctive therapy for PD-MCI, with improvements found in memory and global cognition. Future research should prioritize larger sample sizes, combined interventions (NIBS plus cognitive rehabilitation), and extended follow-ups to evaluate long-term neuroplasticity. Full article

Background: Video gaming is a highly prevalent leisure activity globally, with complex associations across multiple health domains. Methods: This narrative review critically appraised the existing literature identified through targeted searches of PubMed and Google Scholar to synthesise evidence on associations between video gaming and psychosocial stress, physical activity, sleep quality, eating behaviour, and diet quality. Theoretical, biological, and psychosocial mechanisms underlying these relationships were examined, and methodological limitations and research gaps were identified. Results: The relationships between video gaming and health outcomes appear bidirectional and context dependent. While video gaming may provide short-term stress relief and social connection, frequent or prolonged gaming may be associated with sedentary behaviour, physical inactivity, impaired sleep quality, disrupted eating patterns, and poorer diet quality. These associations may vary by age, sex, gaming duration, timing, content, and motivational drivers. Gaming-related cognitive absorption and physiological arousal may influence appetite regulation, sleep onset, and stress responses, while temporal displacement and environmental factors, such as food availability and marketing exposure, also contribute. Conclusions: An integrated biopsychosocial framework is proposed to describe the interconnected pathways through which video gaming may influence health, incorporating biological arousal, psychological immersion, and social and environmental contexts. Significant gaps remain, including the scarcity of longitudinal studies, limited consideration of moderating factors, and inconsistent measurement of gaming behaviours. Addressing these gaps is essential for refining public health surveillance and supporting the development of evidence-based strategies that promote healthy gaming behaviours while preserving potential psychosocial benefits. Full article

Objectives: This randomized, double-blind, placebo-controlled 12-week clinical trial evaluated the efficacy and safety of a standardized ethanol extract of purple perilla leaves (Perilla frutescens Britton var. acuta Kudo; PE) in adults with cognitive impairment. Methods: Subjects who met the inclusion criteria were randomly assigned in a 1:1 ratio to one of two groups and received PE (n = 50, 500 mg/day) or placebo (n = 50) for 12 weeks. The primary efficacy outcomes included cognitive function, which was assessed by the Korean mini-mental status examination–2 (K–MMSE–2) and the Alzheimer’s disease assessment scale–cognitive subscale (ADAS–Cog), and plasma amyloid β (Aβ) and brain-derived neurotrophic factor (BDNF) levels, which were measured as secondary biochemical markers. The safety biomarkers were also assessed before and after the intervention. Results: After 12 weeks of intervention, the K–MMSE–2 total score, the K–MMSE–2 subdomain scores (attention and calculation and language), the ADAS–Cog total score, and the ADAS–Cog subscale scores (word recall, commands, delayed word recall, naming, word recognition, and recall instructions) showed statistically significant between-group improvements compared with the placebo group. Improvements were observed in both groups, whereas the magnitude of cognitive enhancement was greater in the PE group, indicating an effect beyond placebo-related responses. No statistically significant between-group differences were observed in plasma Aβ or BDNF levels. The safety evaluation found no clinically significant changes. Conclusions: Twelve-week administration of PE significantly improved cognitive outcomes without safety concerns, suggesting its potential as a standardized botanical ingredient for supporting cognitive function in individuals with early cognitive impairment. Full article