Search Results (787)

Background/Objectives: This study aimed to examine the effect of different forgetting strategies on intentional forgetting, specifically comparing the passive decay strategy (‘forgetting by keeping the mind blank’) and the active rehearsal strategy (‘forgetting by rehearsing other words’). Methods: An item-method directed forgetting paradigm was used in a between-subjects design while the electroencephalogram (EEG) was recorded. Results: Behavioral results showed that both strategies produced a robust directed forgetting (DF) effect, but participants in the active rehearsal group recognized more to-be-remembered (TBR) words. Event-related potential (ERP) results indicated that both groups exhibited a DF effect in the cue-induced P2–P3 complex. Compared to the passive decay group, the active rehearsal group did not show a DF effect in the cue-induced later positive component (LPC); instead, a significant DF effect appeared in the P600 during the test phase. Time–frequency results showed that the passive decay group exhibited a significant DF effect in the 9–25 Hz frequency band during the late stage of cue processing, while the active rehearsal group showed a reversed DF effect in the 8–16 Hz frequency band during the mid-stage of cue processing. Conclusions: These findings indicate that forgetting strategies do not affect the recognition performance of to-be-forgotten (TBF) words. The active rehearsal strategy led participants to shift attention from TBF to TBR words, resulting in better TBR recognition performance in this group. Full article

Background: Radiotherapy (RT) combined with immune checkpoint inhibitors (ICIs) has shown therapeutic benefits, and the potential for enhanced immune activation has raised concerns about increased immune-related adverse events (irAEs). The immunological implications of mediastinal RT combined with ICI therapy remain unclear. Methods: We conducted an exploratory retrospective review of 58 patients with esophageal oresophagogastric junction cancer who received ICIs between 2021 and 2024. Patients were categorized into RT (+) and RT (-) groups based on whether they underwent mediastinal RT. The incidence and severity of irAEs were compared using chi-square testing. Subgroup analyses included treatment sequence (RT before vs. after ICI), interval between RT and ICI (<90 vs. ≥90 days), and ICI regimen (nivolumab [N], pembrolizumab [P], or nivolumab plus ipilimumab [NI]). Results: irAEs occurred in 28.6% of RT (+) and 39.1% of RT (-) (p = 0.42). Severe irAEs were uncommon in both groups. Treatment sequence and RT-ICI interval did not significantly influence irAE incidence. irAEs were more frequent in the NI group (85.7%) than in N (22.9%) or P (31.2%) (p = 0.01). Mediastinal RT itself did not increase irAE risk. Conclusions: Although RT combined with ICIs has been hypothesized to elevate irAEs through enhanced immune activation, mediastinal RT did not increase irAEs in this cohort. However, given the exploratory and small patient cohort, these findings suggest, with caution, that mediastinal irradiation may attenuate systemic immune activation through lymphocyte depletion, potentially balancing ICI-induced immune responses. Full article

Background/Objectives: Uremic middle molecules contribute to chronic inflammation and symptom burden in hemodialysis patients. The Theranova 500 medium-cutoff (MCO) dialyzer enhances clearance of larger uremic toxins and may offer clinical advantages. We hypothesized that Theranova 500 would improve dialysis adequacy (spKt/V), attenuate inflammation (CRP), and provide targeted improvement in symptom burden compared with the high-flux Revaclear 500. Methods: We conducted an open-label, prospective, quasi-randomized controlled trial including forty prevalent adult hemodialysis patients from two centers in Israel (Barzilai and Sheba Medical Centers). Patients were sequentially allocated 1:1 to Theranova 500 or Revaclear 500. Demographic, laboratory, and patient-reported outcomes (KDQOL-SF, Dialysis Symptom Index) were assessed at baseline and week 24. Within-group changes were analyzed using paired tests, and between-group differences using ANCOVA adjusted for baseline values. Safety monitoring included adverse events, dialyzer reactions, hospitalizations, and mortality. Results: Theranova 500 significantly increased mean spKt/V (1.24 ± 0.33 to 1.40 ± 0.36; p = 0.025), while Revaclear showed no significant change. CRP remained stable in the Theranova group but rose nearly threefold in the Revaclear group by week 24 (p < 0.001). Albumin, dry weight, anemia and mineral bone parameters remained stable in both groups. Total cholesterol increased modestly in the Theranova arm without nutritional compromise. Symptom-level analysis showed improvement in irritability, restless leg, dry skin, chest pain, and diarrhea with Theranova, whereas global KDQOL-SF domain scores improved similarly in both groups. No non-serious adverse events, hypersensitivity reactions, or dialyzer-related intolerance was observed. Hospitalizations (n = 8 per group) and mortality (two per group) were identical. Conclusions: Over 24 weeks, Theranova 500 MCO dialyzer improved dialysis adequacy and prevented the rise in inflammatory markers seen with Revaclear without compromising nutrition or safety. Targeted improvement in specific uremic symptoms suggests potential clinical benefit beyond small-molecule clearance. These findings support the safety and clinical utility of expanded hemodialysis and highlight the need for larger, fully randomized trials to validate these results. Full article

Background/Objectives: Vaginitis is a prevalent inflammatory disorder of the vaginal mucosa, frequently arising from its anatomical proximity to the anorectal region and a microenvironment conducive to pathogen colonization and dysbiosis. This prospective, multicenter, randomized, third-party-blinded study assessed the efficacy and safety of a plasma vaginal cleanser (WOMEN CARE^®) employing plasma-activated water (PAW) as a non-pharmacological alternative to conventional antimicrobials for restoring vaginal homeostasis. Methods: Women aged ≥19 years with clinically suspected vaginitis were assigned to either the experimental group (WOMEN CARE^®) or the control group (standard pharmacotherapy). The primary endpoint was the proportion of participants exhibiting decreased Nugent scores between baseline and Visit 4. Results: Of 144 participants in the experimental group, 125 completed the study. The experimental group showed comparable outcomes to standard pharmacotherapy group across Nugent scores, vaginal pH, and symptoms severity, with pathogen suppression confirmed as non-inferior. Additionally, PAW exerted anti-HPV activity through a potential effect against new genotypic HPV infection. While the control group experienced antibiotic-associated adverse effects (e.g., headache, abdominal discomfort, nausea), no treatment-related adverse events occurred in the WOMEN CARE^® group. Conclusions: These results indicate that PAW vaginal cleansing provides an effective, safe, non-antibiotic approach for managing vaginitis and maintaining vaginal ecological balance. Full article

Alzheimer’s disease (AD) is a pervasive neurodegenerative disorder characterized by chronic neuroinflammation; current interventions primarily offer symptomatic relief. Cannabidiol (CBD), a non-psychoactive phytocannabinoid, exhibits multi-target therapeutic potential due to its established anti-inflammatory and neuroprotective properties. While growing interest exists, the evidence regarding CBD’s effects on AD-related neuroinflammation has not been robustly consolidated in a quantitative meta-analysis. Therefore, this article reviews the current literature around CBD related to its potential in alleviating neuroinflammation, followed by a meta-analysis of preclinical and clinical studies using random-effects modeling to assess CBD efficacy on neuroinflammation and clinical outcomes in AD. In preclinical AD models, the meta-analysis demonstrated that CBD significantly and consistently reduced key markers of neuroinflammation and reactive gliosis, specifically glial fibrillary acidic protein (GFAP) (p < 0.0001), Interleukin-6 (IL-6), and inducible nitric oxide synthase (iNOS). Effects on other markers, such as tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), were non-significant and heterogeneous. Clinical evidence, though limited by small sample size and heterogeneity, showed a borderline significant benefit favoring CBD for overall behavioral symptoms (p = 0.05), agitation, and caregiver distress. Adverse events were typically mild. We conclude that CBD demonstrates biologically consistent anti-inflammatory efficacy in preclinical AD models. While current clinical data remains insufficient to substantiate efficacy, they suggest promising signals for behavioral control. Determining CBD’s full therapeutic potential in AD necessitates future rigorous, mechanism-driven trials with standardized preparations and biomarker-anchored endpoints. Full article

Differences in risk perception between frontline construction workers and managers can create communication barriers and lower the efficiency of safety management. In this study, we focused on frontline construction workers and managers and used event-related potentials (ERPs) to examine discrepancies in risk perception across two processes: hazard identification and risk judgment. During hazard identification, workers identified fewer hazards correctly than managers (p = 0.009 < 0.05). Managers also showed larger N200 amplitudes than workers (p = 0.040 < 0.05), which suggests that managers engaged conflict monitoring and inhibitory control more strongly. During risk judgment, workers responded more slowly than managers (p = 0.012 < 0.05). They also showed lower P100 (p = 0.026 < 0.05) and LPP amplitudes (p = 0.024 < 0.05), indicating weaker early visual–attentional gating and less sustained evaluative engagement with hazardous scenes. These patterns indicate that workers rely more on irrelevant information, whereas managers respond more sensitively to potential hazards. By revealing when and how role-based differences emerge, our findings offer a neurocognitive explanation for the persistent gap in risk perception and highlight specific targets for training. These insights can guide risk communication between managers and workers, extend research on risk-perception differences beyond self-report measures, and illustrate the value of ERP as a time-resolved tool for studying risk perception. Full article

Background: Neurological immune related adverse events (N-irAEs) following immune checkpoint inhibitor (ICI) therapy are associated with significant morbidity and mortality. The early involvement of neurological services is therefore recommended to assist diagnosis and guide management. However, the practical experience of specialist neurology involvement is poorly understood. Methods: A multi-centre, retrospective case note review was performed in a unified healthcare setting in the United Kingdom via predetermined proforma to investigate the involvement and impact of neurology services in this setting. Results: One hundred and nine patients with N-irAE were identified with a median time from ICI treatment to symptom onset of 52 days. Neurology service models, reasons for referral and referral rates varied by centre. Overall, eighty-seven (79.8%) patients (range 52.9–100% by centre) had neurology involvement. Neurology input was associated with younger age (median 67.2 vs. 72.8 years), anatomical location (Central > Peripheral) and severity of neurotoxicity (p < 0.001, q < 0.004). Patients with neurology involvement were more likely to undergo specialist investigations: MR imaging (p = 0.041, q = 0.043), lumbar puncture (p < 0.001, q < 0.004), and neurophysiology (p = 0.005, q = 0.007) resulting in a broader range of specific N-irAE diagnoses. Steroids were appropriately prescribed, with second line treatment (Intravenous immunoglobulins/Plasma exchange) associated with neurology involvement. At lower grades (CTCAE ≤ 2), resolution rates were similar in those with or without neurology involvement. At grades 3–4, one-third of patients with neurology involvement had resolution. In a centre with a model of early neurology involvement for all possible N-irAEs the aetiology of the neurological presentation was changed in 63.7%. Conclusions: This study highlights the potential to improve diagnosis and treatment algorithms and therefore patient outcomes through development of uniform N-irAE models of care to support this area of growing clinical need. Full article

Background: This study aimed to investigate how myopia affects early event-related potential (ERP) components and neural oscillatory activity during a face inversion task in adolescents, in order to clarify the potential mechanisms by which degraded visual input influences facial structural encoding and neural dynamic regulation. Methods: Forty-eight adolescents aged 13–17 years participated, including 24 with myopia and 24 with normal vision. EEG signals were recorded while participants performed a classic upright–inverted face recognition task. A mixed-design ANOVA was applied to compare group differences in the amplitude and latency of the P1 and N1 components. Time–frequency analyses were conducted to assess task-related oscillatory power in the θ (4–7 Hz) and α (8–13 Hz) bands. Results: No significant group differences were found in P1 amplitude or latency, whereas the N1 latency was significantly longer in the myopia group (p = 0.049). Time–frequency analysis revealed significantly greater θ synchronization (p = 0.034) and greater α desynchronization (p = 0.018) within the early post-stimulus window corresponding to the P1 latency range in the myopia group, with a similar but nonsignificant trend observed within the window corresponding to the N1 range. The main effect of task confirmed a typical face inversion effect (FIE), characterized by smaller N1 amplitudes and longer latencies for inverted than upright faces (p < 0.05). Conclusions: Myopia in adolescents is associated with delayed neural processing during facial structural encoding and enhanced θ–α oscillatory activity within early post-stimulus periods, which may reflect altered early neural engagement in response to degraded visual input. These findings indicate that the effects of myopia extend beyond optical defocus to involve perceptual–cognitive integration, providing novel evidence for the neurodevelopmental characteristics and regulatory mechanisms of adolescent myopia. Full article

Background: Opioid use disorder (OUD) and associated overdose deaths have reached epidemic proportions worldwide over the past two decades, with death rates for men consistently reported at twice the rate for women. We have recently reported sex-specific differences in electrocortical activity in persons with OUD in a visual object recognition task. The mesolimbic dopamine (DA) system is implicated in OUD but also plays a critical role in some disorders of visual attention and a modulatory role in the processing of visual stimuli in the blue cone pathway of the retina. We hypothesized that electrocortical responses to color stimuli would be affected differentially in men and women with OUD. Methods: Using a controlled, cross-sectional, age-matched (18–56 years) design, we evaluated color processing in male and female subjects recruited from a community-based, high-intensity residential substance abuse and detoxification treatment program. We evaluated electroencephalogram (EEG) event-related potentials (ERPs) and reaction time (RT), in male and female participants with OUD (n = 38) vs. sex- and age-matched non-OUD control participants (n = 37) in a simple color recognition Go/No-Go task, as well as perceptual and behavioral responses in physiological and neuropsychological tests. Results: N200, P300, and late potential (LP) Relevant stimulus-induced ERPs were evoked by the task and were well-differentiated from Irrelevant distractor stimuli. P300 amplitudes were significantly greater and N200 and LP latencies were significantly shorter in male vs. female non-OUD controls in this task. There were significant sex differences in N200, P300, and LP amplitudes and latencies between male vs. female non-OUD subjects and OUD differences with blue color as the Relevant stimulus. In the Binocular Rivalry Test, there were shorter dwell times for perceiving a blue stimulus in male OUD subjects and there were significant sex and OUD differences in neuropsychological tests including Finger Tapping, Trails A/B, and Symbol Digit Modalities Test. Conclusions: These findings suggest that there are significant sex-related physiological, perceptual, and cognitive differences in color processing that may result from deficits in DA production in the retina that mirror deficits in mesolimbic DA transmission correlating with OUD, suggesting that blue color processing has the potential to be an effective biomarker for brain DA and for diagnosis and monitoring of treatment efficacy in substance use disorders. Full article

Alzheimer’s disease (AD) is an age-related neurodegenerative disorder, characterised by the build-up of amyloid beta (Aβ) plaques and neurofibrillary tangles comprising hyper-phosphorylated tau. Increasing evidence indicates that in the early stages of AD, elevated levels of oligomeric forms of Aβ and phosphorylated tau (p-tau) gives rise to impaired synaptic function which ultimately drives AD-associated cognitive abnormalities. Thus, developing drugs that can limit the synaptic impairments that occur early in AD may have therapeutic benefits. Clinical evidence increasingly supports a link between lifestyle choices and AD risk. Indeed, there is an association between the circulating levels of the metabolic hormone leptin, mid-life obesity and disease risk, which has in turn stimulated interest in targeting the leptin system to treat AD. It is well-established that leptin readily accesses the brain, with the hippocampus, a key region that degenerates in AD, identified as a prime target for this hormone. Within the hippocampus, leptin has cognitive enhancing properties as it markedly influences the cellular events underlying hippocampal-dependent learning and memory, with significant impact on synaptic plasticity and trafficking of glutamate receptors at hippocampal excitatory CA1 synapses. Moreover, studies using a range of cell-based systems and animal models of disease indicate not only that leptin has powerful pro-cognitive effects, but also that leptin protects against the unwanted synapto-toxic effects of Aβ and tau, as well as enhancing neuronal cell viability. Moreover, recent studies have demonstrated that smaller leptin-based molecules replicate the full repertoire of protective features of whole leptin. Here we review the evidence that the leptin system is a potential novel avenue for drug discovery in AD. Full article

Background/Objectives: Accurate prediction of severe adverse events (SAEs) is crucial for optimizing supportive care while maintaining treatment intensity in diffuse large B-cell lymphoma (DLBCL). We evaluated the predictive value of the Geriatric Nutritional Risk Index (GNRI) for SAEs in de novo DLBCL and examined potential interactions with treatment regimen and age. Methods: This multicenter retrospective study included 555 adults treated with standard immunochemotherapies. SAEs, defined as grade ≥ 3 non-hematological adverse events or febrile neutropenia, were independently assessed by board-certified hematologists. Results: Multivariable logistic regression identified GNRI as an independent predictor of SAEs (odds ratio 0.982, 95% confidence interval 0.967–0.997). Restricted cubic spline modeling revealed a significant non-linear association between GNRI and SAE risk (p = 0.045). No significant interaction was observed between GNRI and regimen or age (p = 0.894 and 0.217, respectively), a finding consistent across subgroups in forest plot analyses. Conclusions: This study showed that lower diagnostic GNRI was independently associated with higher SAE risk regardless of treatment regimen or age. These findings highlight the potential utility of GNRI as a simple clinical indicator for identifying patients at higher risk of treatment-related toxicity, although they are derived from a retrospective, tertiary-care cohort and require confirmation in external prospective studies. Full article

Background: Examining the influence of phonological neighborhoods on the early stages of visual word recognition provides insights into the architecture and dynamics of lexical representation and processing. Methods: Using event-related potentials (ERPs), this investigation explored how phonological neighborhood density (PND; large vs. small) and type (PNT; tone-edit vs. constituent-edit neighbors) influence the recognition of monosyllabic words in Mandarin Chinese. Participants engaged in a priming paradigm combined with a visual lexical decision task. Results: Behavioral data demonstrated the main effect of PNT: words with tone-edit neighbors produced greater processing inhibition compared to those with constituent-edit neighbors. ERP results revealed that large PND enhanced the P200 amplitude, a frontal-mediated effect that was particularly pronounced for tone-edit neighbors. This early differentiation subsequently propelled a stronger N400 response to tone-edit neighbors, culminating in a significant interaction between PND and PNT during the N400 window. Conclusions: These findings support a cascaded competition model: early PND assessment (P200), enhanced for tone neighbors, amplifies their later N400 conflict. This neural mechanism elucidates the hierarchical organization of phonological processing in Chinese monosyllabic words, thereby clarifying a core component which underpins the recognition of more complex words in Mandarin. Full article

This study aimed to investigate the effects of acute exhaustion exercise on cognitive control in young men, a key higher cognitive function for goal-directed behavior. Although long-term regular exercise benefits cognition, the effects of acute exhaustion exercise on cognitive control and its neural mechanisms are not fully understood. 35 male college students completed a Stroop task before and after exhaustion exercise on a cycle ergometer with incremental load. Electroencephalogram data were collected synchronously during the task. Behavioral measures (accuracy, reaction time), Event-Related Potential components (N2, P3 amplitudes and latencies), and Event-Related Spectral Perturbation (energy changes in theta, alpha, beta frequency bands) were analyzed. Results: Behavioral results showed that task accuracy only significantly decreased under the conflict condition (incongruent trials) following exhaustive exercise. ERP analysis revealed that the P3 amplitude at the anterior site (Fz) was significantly reduced post-exercise, but specifically for the incongruent condition, while the N2 amplitude demonstrated a more widespread enhancement. Time–frequency analysis found a significant decrease in alpha-band power over the parietal region after exercise. Theta and beta band activities were not significantly affected by exercise-induced fatigue. Conclusions: Acute exhaustive exercise did not impair early conflict monitoring functions (as indicated by stable N2 component and theta oscillations), but it compromised later higher-order cognitive processes related to attentional resource allocation and conflict resolution (manifested as reduced anterior P3 amplitude), accompanied by decreased efficiency in neural oscillatory activity associated with inhibitory control (reduced alpha power). This suggests that fatigue primarily affects the neural mechanisms of the “implementation” stage rather than the “monitoring” stage in the cognitive control cascade. Full article

Background and Clinical Significance: Mastocytosis and mast cell activation syndrome (MCAS) include conditions in which patients manifest signs, symptoms, and laboratory findings consistent with mast cell activation and can only be diagnosed in the presence of specific criteria. Mutations of ZRSR2, a gene involved in RNA splicing, are not closely associated with mast cell disorders, but rather with myelodysplastic syndromes development. Case Presentation: We report a case of a 37-year-old man who was referred to our institution for anaphylaxis after a bee sting and elevated serum tryptase levels (17.8 ng/mL in the first sample and 19.2 ng/mL in the second sample). Complete blood count was unremarkable. Bone marrow biopsy showed signs of dysplasia and some CD25+ mast cells. ASO-qPCR and targeted myeloid NGS analysis did not detect the KIT p.D816V mutation, but rather showed the presence of a pathogenetic variant of the ZRSR2 gene (p.S447_R448del) with a variant allele frequency of 7.4%. Mastocytosis could not be diagnosed based on the established diagnostic criteria. The patient’s symptoms were not recurrent and tryptase release was not event-related; therefore, a diagnosis of MCAS could not be made either. Taken together, these findings led to the diagnosis of clonal hematopoiesis of indeterminate potential (CHIP). A watch and wait strategy consisting of clinical evaluations, blood tests, and cardiovascular risk assessment was initiated. Conclusions: This case report highlights the importance of combining clinical and laboratory findings, hematopathology, and molecular analyses to establish the most probable diagnosis in challenging cases. It also underscores the possible relevance of identifying predisposing conditions, such as CHIP, in order to guide counseling and follow-up strategy. Full article

This review systematically examines electroencephalography (EEG) studies on gifted children, focusing on the signal processing pipelines across acquisition, preprocessing, feature extraction, and analysis, and identifying opportunities for methodological standardisation relevant to educational research. Following PRISMA 2020 guidelines, a comprehensive search was carried out in PubMed, Scopus, Web of Science, IEEE Xplore, and PsycINFO. From 197 records, 14 studies met the inclusion criteria and were analysed for EEG setup, preprocessing strategies, and analytical approaches, including event-related potentials, spectral and connectivity measures, and applications of machine learning. Substantial heterogeneity was observed in device configurations, preprocessing practices, and analytical choices, limiting cross-study comparability and the transfer of findings to educational contexts. Nevertheless, recurring neurophysiological markers were identified, such as P300, frontoparietal $\gamma$ synchronisation, and $\theta$–$\alpha$ modulations during cognitive tasks. Only a minority of studies implemented supervised classification methods, suggesting an underexplored potential for advanced data-driven approaches in paediatric EEG. Transparent and standardised EEG pipelines, with explicit reporting of filters, artefact thresholds, and rejection rates, are essential to enhance reproducibility and translational value. By framing EEG signal processing within an educational perspective, this review provides methodological guidance to support early identification, inform classroom practice, and strengthen the bridge between neuroscience and education. Full article