Search Results (516)

Background/Objectives: Although people with schizophrenia appear to experience emotions like healthy individuals, previous studies suggest that their ability to engage in empathic emotional responses might be impaired. As per our knowledge, no studies in the Arab world have investigated empathy in patients with schizophrenia, which is likely due to the lack of valid and reliable measures to assess the empathy construct among Arabic-speaking people. The aim of this research is to validate the Arabic version of the Pictorial Empathy Test (PET) in patients with schizophrenia from Lebanon. Methods: A two-month cross-sectional study was carried out at the Psychiatric Hospital of the Cross during January and February of 2024. The average age of the 113 participants in this study was 57.52 ± 10.35 years and 63.5% of them were men. Data were collected through in-person interviews. A confirmatory factor analysis (CFA) was conducted using SPSS AMOS version 29. Parameter estimation utilized the maximum likelihood approach. In order to examine sex invariance in PET scores, a multi-group CFA was conducted. Measurement invariance was assessed across configural, metric, and scalar levels. Evidence of invariance was determined based on the criteria: ΔCFI ≤ 0.010, ΔRMSEA ≤ 0.015, or ΔSRMR ≤ 0.010. Results: CFA revealed that the Arabic PET exhibited a unidimensional factor structure. The PET demonstrated solid internal consistency (ω = 0.93, α = 0.93). Measurement invariance testing confirmed that the scale performed equally well across sexes. A linear regression analysis found that female sex and higher levels of alexithymia were significantly correlated with lower levels of affective empathy. Conclusions: The findings indicate that the Arabic version of the PET is a reliable and valid tool for measuring affective empathy in Arabic-speaking patients with schizophrenia. The culturally adapted and validated Arabic PET would help detect affective empathy deficits, design and implement context-tailored interventions, and encourage future research in this area in the Arab region. Future research should aim to validate the PET against behavioral tasks like the Empathic Accuracy Task to improve its ecological validity. Full article

The menstrual cycle affects the autonomic nervous system (ANS), cognition, and emotional valence in all biological women. There exists a complex relationship between hormonal fluctuations, ANS, cognition, and emotional valence during the different phases of the menstrual cycle, which includes menstruation, the follicular phase, ovulation, and the luteal phase. Hence, this narrative review is an attempt to comprehensively understand the effects of the menstrual cycle on the structural and functional integrity of the ANS. In order to provide a comprehensive understanding of the complex relationship between the menstrual cycle, hormonal fluctuations, and ANS function in biological women, this review examines key parameters, including heart rate variability (HRV), baroreflex sensitivity (BRS), muscle sympathetic nerve activity (MSNA), and pupillary light reflex (PLR), to investigate how these physiological systems are dynamically influenced by the cyclical changes in hormone levels and how these fluctuations impact various physiological and psychological outcomes, such as mood, cognition, and emotional regulation. There have been several studies previously performed to assess these parameters during different phases of the menstrual cycle. However, the results have been contradictory; therefore, this review explores possible reasons behind these inconsistent results, with likely reasons including irregularity in the menstrual cycles and differences in hormonal fluctuations between different women during similar phases of the menstrual cycle. Overall, there appears to be evidence to suggest that the menstrual cycle has both direct and indirect effects on ANS, cognition, and emotional valence, whilst measures of ANS may provide a means for assessing the effect of the menstrual cycle. Full article

This opinion article aims to highlight the potential mechanisms behind a specific stage of Yoga Nidra (YN) practice, i.e., the formulation and repetition of Sankalpa, encouraging scholars to further study it and providing athletes with suggestions on how to use it for their sport and health. YN can be defined as a meditation practice encompassing a sequence of breathing, guided body awareness, visualization and cognitive restructuring process exercises. According to preliminary results, YN stimulates a hypnagogic state generally associated with improvements in sleep parameters, thus enhancing recovery and health in different populations including athletes. Cognitive restructuring processes can be stimulated by the formulation of Sankalpa, a YN element comparable to positive self-instructions used to counteract dysfunctional cognitions. From a practical standpoint, the formulation of Sankalpa involves expressing an intention that could positively influence body, mind and emotions. For example, Sankalpa might stop or reverse unhealthy thought patterns, resulting in greater mental health. It might also foster intrinsic motivation and enhance emotional intelligence by strengthening mental resilience. In particular, athletes could use Sankalpa as an affirmation to awaken any strength they may feel is necessary to provide them with stress–recovery balance and mental health. However, additional research on this topic is needed to better elucidate Sankalpa’s mechanisms/effects and better integrate its formulation into sport programs. Full article

Despite the extensive evidence supporting the effectiveness of cognitive stimulation, differences in results may be due to the influence of cognitive and non-cognitive aspects in people with dementia. The aim of this systematic review is to identify the most reliable variables in forecasting the effectiveness of cognitive stimulation in people with mild to moderate dementia. According to PRISMA guidelines, the research was conducted using five databases (PubMed, Scopus, Cochrane, Web of Science, APA PsycInfo), considering randomized controlled trials. A total of six studies were included. Different aspects moderating the gain resulting from cognitive intervention were collected and assessed in terms of demographic, cognitive, emotional, social, and quality of life parameters. People with dementia benefit more from cognitive intervention if they are female, if they have a low formal education level, a low baseline level of cognitive function, and lower depressive symptoms, and if caregivers actively participate in sessions. Quality of life, if low at baseline, also seems to improve following CST intervention. A deeper understanding of the cognitive and non-cognitive aspects ensuring improvement after cognitive stimulation may guide future research to develop more personalized interventions. Full article

Recent advancements in generative artificial intelligence have significantly progressed the field of text-to-music generation, enabling users to create music from natural language descriptions. Despite the success of various models, such as MusicLM, MusicGen, and AudioLDM, the current approaches struggle to capture fine-grained genre-specific characteristics, precisely control musical attributes, and handle underrepresented cultural data. This paper introduces a novel, lightweight fine-tuning method for the AudioLDM framework using low-rank adaptation (LoRA). By updating only selected attention and projection layers, the proposed method enables efficient adaptation to musical genres with limited data and computational cost. The proposed method enhances controllability over key musical parameters such as rhythm, emotion, and timbre. At the same time, it maintains the overall quality of music generation. This paper represents the first application of LoRA in AudioLDM, offering a scalable solution for fine-grained, genre-aware music generation and customization. The experimental results demonstrate that the proposed method improves the semantic alignment and statistical similarity compared with the baseline. The contrastive language–audio pretraining score increased by 0.0498, indicating enhanced text-music consistency. The kernel audio distance score decreased by 0.8349, reflecting improved similarity to real music distributions. The mean opinion score ranged from 3.5 to 3.8, confirming the perceptual quality of the generated music. Full article

Mental stress is a psychological or emotional strain that typically occurs because of threatening, challenging, and overwhelming conditions and affects human behavior. Various factors, such as professional, environmental, and personal pressures, often trigger it. In recent years, various deep learning (DL)-based schemes using electroencephalograms (EEGs) have been proposed. However, the effectiveness of DL-based schemes is challenging because of the intricate DL structure, class imbalance problems, poor feature representation, low-frequency resolution problems, and complexity of multi-channel signal processing. This paper presents a novel hybrid DL framework, BDDNet, which combines a deep convolutional neural network (DCNN), bidirectional long short-term memory (BiLSTM), and deep belief network (DBN). BDDNet provides superior spectral–temporal feature depiction and better long-term dependency on the local and global features of EEGs. BDDNet accepts multiple EEG features (MEFs) that provide the spectral and time-domain features of EEGs. A novel improved crow search algorithm (ICSA) was presented for channel selection to minimize the computational complexity of multichannel stress detection. Further, the novel employee optimization algorithm (EOA) is utilized for the hyper-parameter optimization of hybrid BDDNet to enhance the training performance. The outcomes of the novel BDDNet were assessed using a public DEAP dataset. The BDDNet-ICSA offers improved recall of 97.6%, precision of 97.6%, F1-score of 97.6%, selectivity of 96.9%, negative predictive value NPV of 96.9%, and accuracy of 97.3% to traditional techniques. Full article

Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. Methods: This narrative review analyzed peer-reviewed literature from 2020–2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. Results: The review confirms rehabilitation as essential in addressing Intensive Care Unit–acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0–7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Discussion: Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Conclusions: Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally. Full article

Despite being highly prevalent among women of reproductive age, the psychological dimensions of iron deficiency anemia (IDA) often go unrecognized. While the hematological consequences of IDA are well established, emerging evidence suggests that it may also adversely affect emotional processing, mental health, and overall quality of life. This study aimed to systematically assess levels of alexithymia, anxiety, depressive symptoms, and quality of life in women diagnosed with IDA compared to age-matched healthy controls. A total of 151 women with confirmed IDA and 150 healthy controls were recruited. Participants underwent laboratory testing and completed validated questionnaires, including the Beck Depression Scale (BDS), State-Trait Anxiety Inventory (STAI), WHOQOL-BREF-TR, and the Toronto Alexithymia Scale (TAS-20). Women with IDA demonstrated significantly higher alexithymia and anxiety scores and lower quality of life compared to controls. Within the IDA group, probable alexithymia was associated with more severe anemia parameters and poorer psychological outcomes. These findings indicate that IDA is not only a hematological disorder but also one with a substantial psychological burden. Recognizing and addressing these psychological dimensions in clinical practice is critical. A multidisciplinary management approach that integrates both hematological treatment and mental health interventions may be essential to improve overall patient outcomes among women with IDA. Full article

Acoustic quality is one of the aspects that contribute to the heritage of cultural and religious spaces. It is increasingly common to find scientific literature detailing the sound characteristics of places of worship, especially those with cultural and historical significance. This article presents a comprehensive acoustic characterization of three colonial heritage churches in Quito. It examines the relationship between objective and subjective parameters that influence the valuation of a space or sound environment. To analyze this relationship, we employed structural equation modeling (SEM) to evaluate three latent variables using perceptual acoustic indicators. The SEM results highlighted significant associations between physical acoustic parameters, emotional responses, and evaluative judgments, underscoring that traditional intelligibility metrics alone may not fully capture acoustic quality in these contexts. These findings provide a robust interdisciplinary framework that spans objective measures and human perception, offering valuable guidance for future heritage conservation efforts. Full article

Children living with chronic diseases represent a great challenge for the health care system, their families, and communities. These young patients face continuous medical needs that affect not only their health but also their daily routines, emotional well-being, and family dynamics. In response, clinical practice is increasingly integrating psychosocial indicators alongside traditional medical parameters. Consequently, there is a growing consensus that the evaluation of pediatric chronic diseases should address not only clinical dimensions but also the disease’s impact on socialization, emotional health, and daily functioning. This narrative review explores the role of psychosocial variables in the management of pediatric chronic illnesses, including the experiences of parents and siblings, with a focus on effective strategies to improve everyday life. The integration of quality of life and well-being within a multidimensional care model could be instrumental in both symptom management and psychosocial support. Recognizing that children with chronic conditions are at increased risk for long-term adverse outcomes, it is critical to develop interventions that go beyond clinical care, encompassing education, coping reinforcement, and family-centered approaches. Full article

Objectives: The aim of the present study was to investigate the impact of postoperative morbidity on mid-term quality of life and patient-related outcome (PRO) parameters after colorectal surgery for colorectal carcinoma. Methods: Quality of life and perioperative data were prospectively collected from 99 adult patients treated for colorectal carcinoma—56 patients with colonic carcinoma and 43 with rectal carcinoma, all of whom underwent R0 colorectal resection, at the University Hospital Erlangen between 2018 and 2021. Quality of life data (EQL C29 and C30) were assessed before the start of treatment and one year after. Patients were grouped based on the presence or absence of postoperative morbidity, and their quality of life was compared between the two groups. Results: In the colonic carcinoma cohort, global quality of life and emotional functioning showed significant improvement from pre-treatment to the one-year follow-up (63 vs. 72, p = 0.012 and 63 vs. 76, p = 0.009, respectively). Among the symptom scales, five items improved, while two worsened. Patients who experienced postoperative morbidity (32% in the colonic carcinoma group) did not exhibit worse outcomes in functioning or symptom scales compared to those without morbidity (4 items improved and 1 worsened in the morbidity group vs. 3 improved and 1 worsened in the no-morbidity group). The rectal carcinoma cohort demonstrated a decline in quality of life from pre-treatment to the one-year follow-up. Two functioning scales worsened significantly (physical function: 89 vs. 83, p < 0.001; role function: 81 vs. 68, p = 0.009), and twelve symptom scales showed deterioration, with only two symptom scales improving. Postoperative morbidity (33% in the rectal carcinoma group) did not result in more pronounced impairments compared to those without morbidity. The morbidity group experienced 2 worsened and 0 improved items, while the no-morbidity group had 10 worsened and 1 improved item. Conclusions: Postoperative morbidity was not significantly associated with a worse quality of life at one-year follow-up after treatment of colorectal carcinomas, including colorectal resections, compared to patients who did not develop postoperative morbidity. Full article

Background and Objectives: Polycystic ovary syndrome (PCOS) is associated with an elevated risk of impaired mental health and psychiatric disorders, such as depression and anxiety. Physical factors like weight and hirsutism, as well as psychological factors, such as self-esteem and coping strategies, are all known to have an influence on mental health status. Aim: To assess psychological symptoms in women with and without PCOS, by use of the well-established, validated self-report questionnaire: Symptom Checklist-90-Revised (SCL-90); to determine the reliability of the SCL-90 for assessment of PCOS patients. Design: Prospective case-control study. Methods: Psychological symptoms were assessed using the German version of the SCL-90 in 31 PCOS women and 31 healthy controls. To test the impact of various parameters on numerical outcome parameters, correlation analyses were conducted. Results: PCOS women revealed significantly increased SCL-90 scores in seven out of the nine subscales (hostility subscale, anxiety subscale, depression subscale, paranoid ideation subscale, psychoticism subscale, somatization subscale, interpersonal sensitivity subscale, obsessive compulsive subscale), as well as in all three global indices (p < 0.05). SCL-90 scores were significantly positively correlated with perceived total stress and perceived helplessness and significantly negatively correlated with perceived self-efficacy (p < 0.05). Conclusions: PCOS women experienced higher levels of psychological symptoms including depressive and anxiety symptoms. Higher perceived stress, higher perceived helplessness and lower self-efficacy were associated with more psychological symptoms. Hence, there is a need to support PCOS women with their emotional regulation and coping strategies. Full article

Biophilic design has emerged as a multidimensional response to growing concerns about health, well-being, and ecological balance in the built environment. Despite its rising prominence, research on the topic remains fragmented across building typologies, user groups, and geographic contexts. This study presents a comprehensive review of the biophilic design literature, employing a hybrid methodology combining structured content analysis and bibliometric mapping. All peer-reviewed studies indexed in the Web of Science and Scopus were manually screened for architectural relevance and systematically coded. A total of 435 studies were analysed to identify key trends, thematic patterns, and research gaps in the biophilic design discipline. This review categorises the literature by methodological strategies, building typologies, spatial scales, population groups, and specific biophilic design parameters. It also examines geographic and cultural dimensions, including climate responsiveness, heritage buildings, policy frameworks, theory development, pedagogy, and COVID-19-related research. The findings show a strong emphasis on institutional contexts, particularly workplaces, schools, and healthcare, and a reliance on perception-based methods such as surveys and experiments. In contrast, advanced tools like artificial intelligence, simulation, and VR are notably underused. Few studies engage with neuroarchitecture or neuroscience-informed approaches, despite growing recognition of how spatial design can influence cognitive and emotional responses. Experimental and biometric methods remain scarce among the few relevant contributions, revealing a missed opportunity to connect biophilic strategies with empirical evidence. Regarding biophilic parameters, greenery, daylight, and sensory experience are the most studied parameters, while psychological parameters remain underexplored. Cultural and climate-specific considerations appear in relatively few studies, and many fail to define a user group or building typology. This review highlights the need for more inclusive, context-responsive, and methodologically diverse research. By bridging macro-scale bibliometric patterns with fine-grained thematic insights, this study provides a replicable review model and valuable reference for advancing biophilic design as an evidence-based, adaptable, and human-centred approach to sustainable architecture. Full article

Background: Patients with Down syndrome (DS) commonly experience psychological and mental problems. Studying the quality of life (QoL) of children with DS is important because it increases knowledge related to understanding the challenges that this group may face. This study aims to examine the QoL of children with DS from a parental perspective in terms of physical, emotional, social, and school domains, depending on several factors, and identify demographic characteristics of their parents that may affect their QoL. Methods: This online survey study was conducted in Saudi Arabia between November 2024 and March 2025. The inclusion criteria targeted parents of children with confirmed DS diagnoses aged between 8 and 18 years. Results: The findings of this study showed that children with DS aged between 0 and 2 years had significantly lower QoL scores (10.18 ± 3.83) compared to other age groups (p = 0.02). In addition, gender differences were significant in the emotional (p = 0.03), social (p = 0.01), and school (p = 0.01) domains, with females scoring lower QoL scores in all areas compared to males. Moreover, educational level showed significant results across all domains, particularly for children with no education, who had the lowest QoL scores in the physical domain (22.34 ± 7.53, p = 0.004), emotional domain (10.41 ± 3.79, p = 0.003), social domain (11.22 ± 4.06, p = 0.001), and school domain (8.75 ± 5.09, p = 0.001). The findings of this study showed that children with DS who are in primary school (odds ratio (OR) = 5.90, 95% confidence interval (CI): 1.85–18.78, p = 0.003) and middle school (OR = 5.27, 95% CI: 1.44–19.31, p = 0.012) had significantly higher odds of better QoL compared to children with no formal education. Additionally, children cared for by their fathers had significantly lower odds compared to those cared for by their mothers (OR = 0.07, 95% CI: 0.01–0.90, p = 0.041). None of the demographic characteristics of caregivers reached a statistical significance level to have influence on caregivers QoL (p > 0.05). Conclusions: The findings of this study demonstrated a low level of QoL, affecting the emotional, social, and school domains, especially among female children with DS aged between 0 and 2 years with no formal education and cared for by their fathers. Governments should develop a comprehensive plan to care for these children and families in order to enhance their rights and quality of life, thereby placing emphasis on those who exhibit parameters related to a lower QoL. Full article

Background: Autistic children experience social communication challenges that are often linked to reduced social motivation and attention. However, there is currently no effective intervention to improve social attention in autistic children. Objective: This study compared the effects of rope therapy (RT), a novel intervention, with traditional sensory integration therapy (SIT) on social attention and temperament traits in autistic children. Methods: A two-arm randomized controlled trial was conducted in which participants were randomly assigned to RT (n = 14) and SIT (n = 12) groups. Social attention was assessed using eye-tracking parameters, and temperament trait changes were measured using the Taylor–Johnson Temperament Analysis (T-JTA) scale. Results: Both groups showed significant improvements in social attention over time (p < 0.05). Although the RT group demonstrated numerically greater improvements in social attention compared to the transitional SIT group, most of the between-group differences were not statistically significant. Additionally, the RT group showed significant reductions in anxiety and emotional repression temperament traits (p < 0.05). Conclusions: RT exhibits promise as an effective intervention for improving social attention and temperament trait patterns in autistic children. Further research is required to confirm the findings of this study and explore the long-term effects of RT. Full article