Search Results (88)

This essay examines how Shakespeare’s King Lear and Tarkovsky’s Nostalghia employ fool figures to articulate truths inaccessible through rational discourse. The Fool in King Lear speaks through riddles, songs, and prophecies, revealing uncomfortable realities about power and identity that direct statement cannot safely convey. His performed madness contrasts with Lear’s genuine descent into insanity, yet both states access knowledge unavailable to those maintaining social position and sanity. Tarkovsky’s Domenico embodies the Russian Orthodox tradition of yurodstvo (holy foolishness), performing sacred madness through impossible rituals and apocalyptic prophecy. His mathematical impossibility—“1 + 1 = 1”—expresses spiritual unity that logic cannot grasp. Both figures draw on Plato’s distinction in the Phaedrus between divine madness and human pathology, where four forms of god-sent mania provide superior insight into rational thought. Through Erasmus’s humanist satire and Foucault’s analysis of reason’s violent separation from unreason, the essay traces how Western culture moved from integrating fool-wisdom to confining it as pathology. The protective mechanisms enabling fool-speech—performance frames, liminal positioning, sacred authorization—reveal society’s ambivalent need for dangerous truths. As contemporary culture increasingly medicalizes cognitive deviation, these masterworks preserve essential epistemological functions, demonstrating why certain truths require the fool’s disruptive voice. Full article

The geometric content of chaos in nonlinear systems with multiple stabilities of high order is a challenge to computation. We introduce a single algorithmic framework to overcome this difficulty in the present study, where a parametrically forced oscillator with cubic–quintic nonlinearities is considered as an example. The framework starts with the Sparse Identification of Nonlinear Dynamics (SINDy) algorithm, which is a self-learned algorithm that extracts an interpretable and correct model by simply analyzing time-series data. The resulting parsimonious model is well-validated, and besides being highly predictive, it also offers a solid base on which one can conduct further investigations. Based on this tested paradigm, we propose a unified diagnostic pathway that includes bifurcation analysis, computation of the Lyapunov exponent, power spectral analysis, and recurrence mapping to formally describe the dynamical features of the system. The main characteristic of the framework is an effective algorithm of computational basin analysis, which is able to display attractor basins and expose the fine scale riddled structures and fractal structures that are the indicators of extreme sensitivity to initial conditions. The primary contribution of this work is a comprehensive dynamical analysis of the DM-CQDO, revealing the intricate structure of its stability landscape and multi-stability. This integrated workflow identifies the period-doubling cascade as the primary route to chaos and quantifies the stabilizing effects of key system parameters. This study demonstrates a systematic methodology for applying a combination of data-driven discovery and classical analysis to investigate the complex dynamics of parametrically forced, high-order nonlinear systems. Full article

Grounded in the theory of metacognitive prediction error minimization, this study is the first to propose and empirically validate the mechanism of implicit metacognitive predictive processing by which bodily interaction influences the Aha! experience. Three experimental groups were designed to manipulate the level of temporal synchrony in bodily interaction: Immediate Mirror Group, Delayed Mirror Group, and No-Interaction Control Group. A three-stage experimental paradigm—Prediction, Execution, and Feedback—was constructed to decompose the traditional holistic insight task into three sequential components: solution time prediction (prediction phase), riddle solving (execution phase), and self-evaluation of Aha! experience (feedback phase). Behavioral results indicated that bodily interaction significantly influenced the intensity of the Aha! experience, likely mediated by metacognitive predictive processing. Significant or marginally significant differences emerged across key measures among the three groups. Furthermore, fNIRS results revealed that low-frequency amplitude during the “solution time prediction” task was associated with the Somato-Cognitive Action Network (SCAN), suggesting its involvement in the early predictive stage. Functional connectivity analysis also identified Channel 16 within the reward network as potentially critical to the Aha! experience, warranting further investigation. Additionally, the high similarity in functional connectivity patterns between the Mirror Game and the three insight tasks implies that shared neural mechanisms of metacognitive predictive processing are engaged during both bodily interaction and insight. Brain network analyses further indicated that the Reward Network (RN), Dorsal Attention Network (DAN), and Ventral Attention Network (VAN) are key neural substrates supporting this mechanism, while the SCAN network was not consistently involved during the insight formation stage. In sum, this study makes three key contributions: (1) it proposes a novel theoretical mechanism—implicit metacognitive predictive processing; (2) it establishes a quantifiable, three-stage paradigm for insight research; and (3) it outlines a dynamic neural pathway from bodily interaction to insight experience. Most importantly, the findings offer an integrative model that bridges embodied cognition, enactive cognition, and metacognitive predictive processing, providing a unified account of the Aha! experience. Full article

The anatomical arrangement of the atrioventricular node has been likened to a riddle wrapped up in an enigma. There are several reasons for this alleged mystery, not least the marked variability in structure between different species. Lack of detailed knowledge of the location of the node relative to the atrial and ventricular septal structures has also contributed to previous misunderstandings. Recent studies comparing the findings of gross dissection with virtual dissection of living datasets, combined with access to a large number of serially sectioned human and animal hearts, have served to provide the evidence to solve the riddle. We summarise these findings in this review. We explain how the node is located within the atrial walls of the inferior pyramidal space. It becomes the non-branching component of the atrioventricular conduction axis as the axis extends through the plane of atrioventricular insulation to enter the infero-septal recess of the left ventricular outflow tract. The node itself is formed by contributions from the tricuspid and mitral vestibules, with extensive additional inputs from the base of the atrial septum. We show how knowledge of development enhances the appreciation of the arrangements and offers an explanation as to why, on occasion, there can be persisting nodoventricular connections. We discuss the findings relative to the circuits producing atrioventricular re-entry tachycardia. We conclude by emphasising the significance of the variation of the anatomical arrangements within different mammalian species. Full article

Engaging patients in medication safety is essential but remains under-addressed in hospital settings. This pilot study aimed to assess the impact of an educational intervention—the Medication Safety Adventure Trail—on medication safety knowledge and satisfaction among hospital visitors. A quasi-experimental pre-post intervention using this educational tool was conducted over five days. A booth was set up in a hospital lobby inviting all passers-by to follow a six-step trail involving riddles to solve. The experiment comprised three phases: 1. Briefing plus pre-test; 2. The trail; 3. Debriefing plus post-test. A logistic mixed-effects model was employed to assess changes in the odds of correct responses to eight items between the pre-test and post-test. A five-point scale assessed participants’ degrees of certainty (DC) in their answers, and a comparison pre- and post-test was performed with a linear mixed-effects model. Satisfaction was based on Kirkpatrick’s levels 1 and 2 (reaction and learning) and was assessed using categorical scales and open-ended questions. A total of 93 participants completed the trail (60% non-healthcare professionals, 36% healthcare professionals, and 4% unspecified). The odds of a correct answer were higher at post-test than at pre-test (72% vs. 51%, p < 0.001), and the odds of providing a correct answer were nearly five times higher following the activity compared to before (OR = 4.8 [95%CI 3.5 to 6.4], p < 0.001). The mean DC was also improved from pre-test to post-test (4.43, 95%CI [4.36–4.49] vs. 4.83, 95%CI [4.80–4.86]; p < 0.001). All 93 participants reported being either very satisfied (89%) or satisfied (11%) with the educational tool. The tool significantly improved participants’ knowledge about medication safety issues and was appreciated. Full article

This paper proposes that William Cowper’s Olney Hymns (1779) instantiate a curious form of modern belief. Cowper’s hymns are riddled with personal confessions of doubt, unbelief, and a sense of exile from the broader Christian church. At the same time, the public nature of his hymns—an emergent genre in eighteenth-century England—placed such private misgivings in a communal context. As congregations collectively sang their individual doubts, those doubts were transformed into tentative affirmations of faith. To believe meant one first had to admit his or her unbelief, joining voices with those who likewise declared that they, too, lacked faith and did not belong in God’s church. This sense of exile was abiding for Cowper, and his hymns thereby suggest that a crucial aspect of faith and communal religious identity is Christians’ insistence that they can never quite believe what it is they are singing. Belief is, therefore, inextricably tied to a sense of belonging with those who do not belong. Full article

Histone modifications serve as molecular switches controlling critical cellular processes. The ubiquitination of histone H2A at lysines 13 and 15 (H2AK13/15ub) is a crucial epigenetic modification that coordinates DNA repair and genome stability during the DNA damage response (DDR). This epigenetic mark is dynamically regulated by three functional protein groups: “writer” enzymes (e.g., E3 ubiquitin ligase RNF168 that catalyzes H2AK13/15ub formation), “reader” proteins (including 53BP1 and BRCA1-BARD1 that recognize the mark to guide DNA repair), and “eraser” deubiquitinases (such as USP3 and USP16 that remove the modification). Dysregulation of the precisely coordinated network of H2AK13/15ub is strongly associated with various diseases, including RIDDLE syndrome, neurodegenerative disorders, immune deficiencies, and breast cancer. This review systematically analyzes the dynamic regulation of H2AK13/15ub in DDR and explores its therapeutic potential for disease intervention. Full article

The relationship between the cognitive and affective dimensions of understanding has remained unexplored due to the lack of reliable methods for measuring emotions and feelings during learning. Focusing on five phases of understanding—nascent understanding, misunderstanding, confusion, emergent understanding, and deep understanding—this study introduces an AI-driven solution to measure subjective understanding by analyzing physiological activity manifested in facial expressions. To investigate these phases, 103 participants remotely worked on 15 riddles while their facial expressions were video recorded. Action units (AUs) for each phase instance were measured using AFFDEX software. AU patterns associated with each phase were then identified through the application of six supervised machine learning algorithms. Distinct AU patterns were found for all five phases, with gradient boosting machine and random forest models achieving the highest predictive accuracy. These findings suggest that physiological activity can be leveraged to reliably measure understanding. Further, they advance a novel approach for measuring and fostering understanding in educational settings, as well as developing adaptive learning technologies and personalized educational interventions. Future studies should explore how physiological signatures of understanding phases both reflect and influence their associated cognitive processes, as well as the generalizability of this study’s findings across diverse populations and learning contexts (A suite of AI tools was employed in the development of this paper: (1) ChatGPT4o (for writing clarity and reference checking), (2) Grammarly (for grammar and editorial corrections), and (3) ResearchRabbit (reference management)). Full article

This study aimed to evaluate our center’s experience in diagnosing and managing placenta accreta spectrum (PAS) in a high-risk population, focusing on prenatal ultrasound features associated with PAS severity and maternal outcomes. We conducted a retrospective analysis of 102 high-risk patients with confirmed placenta previa who delivered at our center between 2018 and 2023. Patients underwent transabdominal and transvaginal ultrasound scans, assessing typical sonographic features. Binary and multivariate logistic regression analyses were performed to identify sonographic markers predictive of PAS and relative complications. Key ultrasound features—retroplacental myometrial thinning (<1 mm), vascular lacunae, and retroplacental vascularization—were significantly associated with PAS and a higher risk of surgical complications. An exceedingly rare sign, the “riddled cervix” sign, was observed in only three patients with extensive cervical or parametrial involvement. Those patients had the worst surgical outcomes. This study highlights the utility of specific ultrasound features in stratifying PAS risk and guiding clinical and surgical management in high-risk pregnancies. The findings support integrating these markers into prenatal diagnostic protocols to improve patient outcomes and inform surgical planning. Full article

Active learning techniques are taking the classroom by storm. Numerous research articles have highlighted the benefits of active learning techniques on student understanding, knowledge retention, problem solving, and teamwork. One avenue to introduce active learning into the classroom is the gamification of course learning content. Educational escape rooms are one such example in which students solve a series of puzzles related to course content to “escape” within a set time frame. Escape games play an interesting role in motivating students, building communication skills and allowing for multimodal learning, having been shown to increase students’ test results and enjoyment of the course content. In lieu of the traditional escape room format, a fully immersive room(s) with classical escape room puzzles (finding items, riddles, alternative locking mechanisms) is used alongside learning activities, and educators have begun to develop truncated activities for easier applications in larger classrooms. In this review, we explore several escape room activities: immersive, paper-based, Battle Boxes, condensed escape activities, and online/virtual, providing examples of the types of puzzles included therein. We similarly discuss the creation of escape room materials and recommendations for the interested educator, as well as the learning benefits of engaging in puzzle development. Finally, we provide an overview on methods to assess active learning through escape rooms, establishing an overview of empirical evidence towards their effectiveness as a learning tool. Full article

What is the riddle of Oedipus? This paper is an exploration of the philosophy involved in Sophocles’ famous play Oedipus Tyrannus. The play involves a riddler who becomes king, a man who is famously good at understanding what others find obscure, and yet is unable to see it when he is confronted by an obvious set of uncomfortable truths about himself. As well as for Oedipus, the play poses a number of different riddles for us: in particular it is a study of responsibility and shame, and of deliberation and choice. Like any work of art, the play does not tell us what conclusions we should reach; but it does show us some questions that need asking, and indeed some riddles that we face. Full article

Theoretical subjects, such as history, usually do not attract the interest of students and as a result educational games and serious games that use augmented reality (AR) are increasingly used as a means of supporting education. It is believed that these games can make the lesson more engaging and contribute to improving student performance. However, relevant research is limited. The present research presents the AR-enhanced serious game “Exploring Ancient Greece” that aims at supporting 10- to 14-year-old students in learning the history of Ancient Greece. It consists of three levels that include: a presentation of archaeological sites with AR that gives students the chance to explore places of historical interest; a trivia game that includes an AR presentation of a monument or piece of art somewhere in the physical surroundings of the students; and an escape room where the player is trapped in an archaeological site and tries to solve riddles to find the exit. To evaluate the game, an empirical study was conducted involving students between the ages of 10 and 14 who answered knowledge questions before and after playing the game, completed a questionnaire including questions based on the System Usability Scale (SUS), as well as questions for evaluating their experience, and answered oral questions. Based on the results of this study, students improved their knowledge of history, evaluated the game positively and stated that they prefer the use of serious games and AR in education. Full article

Escape room games are educational gamification technologies that consist of introducing a team of players into a physical or digital space in search of clues to answer puzzles, riddles or enigmas and solve a mystery or problem. This study aims to determine the effectiveness of escape room games on the training of nursing students in an international context. A systematic review was carried out in MEDLINE, WOS, SCOPUS, CINAHL and LILACS databases using the MeSH terms “Education, Nursing” and “Educational Technology”, and the free term “Escape room”, combined with Boolean operators AND/OR. Intervention studies in Spanish, English and Portuguese were included, without limitation for the year of publication. Selection and critical appraisal were conducted by two independent reviewers. A total of n = 13 interventional studies were included (n = 2 Randomized Clinical Trials and n = 11 quasi-experimental design). Escape rooms are a recent and growing educational methodology, increasingly used in academia and in the training of nurses and nursing students. However, it is necessary to expand their use and the quality of the studies in a greater number of contexts. Furthermore, it is necessary to homogenize and standardize validated instruments to evaluate the effectiveness of escape rooms in the nursing education area. Full article

A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double vision. The ophthalmic examination revealed paralysis of III (n. oculomotorius) and VI (n. abducens) cranial nerves with ptosis, deficit in elevation and abduction of the left eye. The patient underwent urgent MRI imaging of the brain/orbits and paranasal sinuses, and urgent neurological assessment. MRI revealed a volume-occupying process, starting from the posterior wall of the left maxillary sinus with perineural diffusion and involvement of the homolateral trigeminal nerve, intracranial spread in the medial cranial fossa and involvement of the cavernous, sphenoidal sinuses and the orbital apex on the left side. Biopsy was performed, and the histology resulted in sinonasal squamous cell carcinoma with intracranial spread. Full article

Background: Epidemiology supports a link between ultra-processed foods (UPFs) and health, mediated mainly through the clustering of foods with suboptimal nutrient profiles within UPFs. However, successful NOVA categorization requires access to a food’s ingredient list, which we hypothesized can impact both UPF identification and the link between processing and composition. Methods: Foods (n = 4851) in the HelTH branded food composition database were classified as NOVA1-4, with or without using the ingredient lists (generic and branded approach, respectively), to identify differences in NOVA classification (chi-square test) and the estimated average nutritional composition of each NOVA group (Kruskal–Willis U test). Results: Using the ingredients list increased UPF identification by 30%. More than 30% of foods commonly assumed to be minimally processed (NOVA1-plain dairy, frozen vegetables, etc.) were reclassified as UPFs when using ingredient lists. These reclassified foods, however, had nutritional compositions comparable to NOVA1 foods and better than UPFs for energy, fat, sugars, and sodium (p < 0.001). In fact, UPFs did not show a uniform nutritional composition covering foods from Nutri-Score A (~10%) to Nutri-Score E (~20%). Conclusions: The assumption that all UPFs have the same unfavorable nutritional composition is challenged when NOVA is applied using the appropriate branded food composition database. Full article