Search Results (261)

Obstructive sleep apnea (OSA) is a prevalent disorder linked to metabolic complications such as diabetes and cardiovascular disease. By fragmenting normal sleep architecture, OSA perturbs the growth hormone/insulin-like growth factor (GH/IGF) axis and alters circulating levels of IGF-binding proteins (IGFBPs). A prior clinical observation of elevated IGFBP4 in OSA patients motivated the present investigation in a controlled animal model. Building on the previously reported protocol, OSA was induced in male C57BL/6 mice (9–12 weeks old) through intralingual injection of polytetrafluoroethylene (PTFE), producing tongue hypertrophy, intermittent airway obstruction, and hypoxemia. After 8–10 weeks, the study assessed (1) hypoxia biomarkers—including HIF-1α and VEGF expression—and (2) neurobehavioral outcomes in anxiety and cognition using the open-field and novel object recognition tests. PTFE-treated mice exhibited a significant increase in circulating IGFBP4 versus both baseline and control groups. Hepatic Igfbp4 mRNA was also upregulated. Behaviorally, PTFE mice displayed heightened anxiety-like behavior and impaired novel object recognition, paralleling cognitive deficits reported in human OSA. These findings validate the PTFE-induced model as a tool for studying OSA-related hypoxia and neurocognitive dysfunction, and they underscore IGFBP4 as a promising biomarker and potential mediator of OSA’s systemic effects. Full article

Temporal lobe epilepsy (TLE) is a common drug-resistant form of epilepsy, often accompanied by cognitive and emotional disturbances, highlighting the urgent need for novel therapies. Scorpion Venom Heat-Resistant Synthetic Peptide (SVHRSP), isolated and synthetically derived from scorpion venom, has shown anti-epileptic and neuroprotective potential. This study evaluated the anti-epileptic effects of SVHRSP in a kainic acid (KA)-induced TLE rat model. Our results demonstrated that SVHRSP (0.81 mg/kg/day) reduced the frequency and severity of spontaneous seizures. Behavioral tests showed improved cognitive performance in the novel object recognition, object location, and T-maze tasks, as well as reduced anxiety-like behavior in the open-field test. Moreover, SVHRSP mitigated hippocampal neuronal loss and glial activation. Transcriptomic analysis indicated that SVHRSP upregulates genes involved in adhesion molecule-triggered and axon guidance pathways. Western blotting and immunofluorescence further confirmed that SVHRSP restored dendritic (MAP2), axonal (NFL), and synaptic (PSD95) marker expression, elevated the functionally important L1CAM fragment (L1-70), and increased myelin basic protein-induced serine protease activity responsible for L1-70 generation. Blockade of L1CAM expression diminished the neuroprotective effects of SVHRSP, suggesting a critical role for L1CAM-mediated synapse functions. This study is the first to reveal the therapeutic potential of SVHRSP in TLE via L1CAM-associated mechanisms. Full article

Background: Post-concussion syndrome (PCS) and Functional Neurological Disorder (FND), including Functional Cognitive Disorder (FCD), are two frequently encountered but diagnostically complex conditions. While PCS is conceptualized as a sequela of mild traumatic brain injury (mTBI), FND/FCD encompasses symptoms incompatible with recognized neurological disease, often arising in the absence of structural brain damage. Yet, both conditions exhibit considerable clinical overlap—particularly in the domains of cognitive dysfunction, emotional dysregulation, and symptom persistence despite negative investigations. Objective: This review critically examines the shared and divergent features of PCS and FND/FCD. We explore their respective epidemiology, diagnostic criteria, and risk factors—including personality traits and trauma exposure—as well as emerging insights from neuroimaging and biomarkers. We propose the “Functional Overlay Model” as a clinical tool for navigating diagnostic ambiguity in patients with persistent post-injury symptoms. Results: PCS and FND/FCD frequently share features such as subjective cognitive complaints, fatigue, anxiety, and heightened somatic vigilance. High neuroticism, maladaptive coping, prior psychiatric history, and trauma exposure emerge as common risk factors. Neuroimaging studies show persistent network dysfunction in both PCS and FND, with overlapping disruption in fronto-limbic and default mode systems. The Functional Overlay Model helps to identify cases where functional symptomatology coexists with or replaces an initial organic insult—particularly in patients with incongruent symptoms and normal objective testing. Conclusions: PCS and FND/FCD should be conceptualized along a continuum of brain dysfunction, shaped by injury, psychology, and contextual factors. Early recognition of functional overlays and stratified psychological interventions may improve outcomes for patients with persistent, medically unexplained symptoms after head trauma. This review introduces the Functional Overlay Model as a novel framework to enhance diagnostic clarity and therapeutic planning in patients presenting with persistent post-injury symptoms. Full article

This study sought to clarify the role of after-death communication in resilience in grief. The primary research question guiding this study was: In what way do experiences of after-death communication inform the cultivation of gratitude and compassion as part of the grieving process? For Study 1, measures of grief, continuing bonds, compassion, and gratitude were administered to a diverse demographic pool (N = 329). Bivariate correlational analysis revealed strong correlations among the total scores of the four surveys. Of the 329 participants, 67.2% (n = 221) identified as having experienced after-death communication in some form, while 32.8% (n = 108) claimed that they did not. A series of one-way ANOVAs revealed that those identifying as having after-death communication and a spiritual practice showed significantly higher scores on all measures. Study 2 was a grounded theory study that conducted interviews with people claiming a significant after-death communication experience (N = 44). Results supported the survey data, suggesting that after-death communication was a catalyst and facilitator of grief that enhanced spirituality, shifted or enhanced belief structures, and reduced death anxiety. Conclusions support the recognition of after-death communication as a possible vehicle for enhanced grief resilience and spirituality. Full article

Foeniculum vulgare Mill. (Apiaceae) is an aromatic medicinal plant known for its anti-inflammatory, antispasmodic, antiseptic, carminative, diuretic, and analgesic properties. This study aimed to investigate the effects of F. vulgare essential oil (FVEO; 25, 150, and 300 μL/L) on the cognitive performance and brain oxidative stress in a scopolamine (SCOP; 100 μM)-induced zebrafish model of cognitive impairment. Additionally, the pharmacokinetic properties and bioactivity profiles of the main FVEO constituents were predicted to be used in silico tools, including SwissADME, pkCSM, PASS online, and ADMETlab 2.0. Behavioral assays, novel tank diving test (NTT), Y-maze, and novel object recognition (NOR) test, were used to evaluate anxiety-like behavior, spatial memory, and recognition memory, respectively. Biochemical assessments of acetylcholinesterase (AChE) activity and oxidative stress biomarkers were also conducted. The results demonstrated that FVEO significantly improved cognitive performance in SCOP-treated zebrafish, normalized AChE activity, and reduced oxidative stress in the brain. These findings suggest the therapeutic potential of FVEO in ameliorating memory impairment and oxidative damage associated with neurodegenerative disorders such as Alzheimer’s disease (AD). Full article

Background/Objectives: Major depressive disorder (MDD) is a debilitating illness, and chronic stress is a contributing factor for depressive symptoms. However, despite intense research, the mechanisms of MDD remain substantially unidentified. Quercetin is a powerful flavonoid and could be used as a possible therapeutic strategy for depression. Acknowledging the potential benefits of quercetin, this study investigated its effect alone or in association with the standard drug tranylcypromine (TCP) in a rodent model of chronic restraint stress (CRS). Methods: Adult male rats were subjected to a CRS model consisting of an immobilization session of 4 h daily during 14 consecutive days. Quercetin (50 mg/kg, gavage) was administered for 45 days. TCP (10 mg/kg, gavage) was administered for 14 days. Behavioral tasks were conducted to assess locomotor functions, memory, anhedonia, depression-like behaviors, and anxiety-like behaviors. The activity, gene expression, and protein density of acetylcholinesterase (AChE) were investigated. Results: Behavioral tasks showed that the CRS model effectively induced stable behavioral changes. CRS did not alter locomotor function assessed by the open field test (OFT) or anhedonia behavior assessed by the sucrose preference test (SPT). CRS increased total fecal count, which was prevented by quercetin administration in rats. TCP and the association of quercetin and TCP increased the recognition index in comparison with the CRS group in the novel object recognition (NOR) test and improved the swimming and immobility times in comparison to stressed animals in the forced swim test (FST). All treatments were able to decrease the anxiety index assessed by the elevated plus maze (EPM) test. The activity, gene expression, and protein density of AChE were increased in the CRS model compared to control males. Overall, quercetin and TCP proved to reverse CRS-induced alterations in these parameters. Conclusions: Quercetin mitigated cognitive deficits, behavioral impairments, and neurochemical alterations induced by the CRS model, especially in association with TCP, supporting its potential as a promising therapeutic agent for depression. Full article

Background/Objectives: Duchenne muscular dystrophy (DMD) is often discussed in the literature with regard to physical impairments. This narrative review aims to show that living with DMD involves psychological, psychosocial, and cognitive aspects in addition to the well-known physical complications. Methods: Firstly, this review examines the main cognitive functions affecting subjects with DMD and the possible role of dystrophin gene mutations on the central nervous system. Secondly, it analyzes the comorbidity between DMD, neurodevelopmental disorders (autism spectrum disorders, attention-deficit/hyperactivity disorder, obsessive–compulsive disorder) and psychopathological traits (anxiety and/or depressive symptoms). Finally, the review addresses the relatively sparse literature investigating the positive aspects associated with the experience of DMD, like psychosocial resources, resilience, subjective well-being, positive individual and social functioning, and social support. Results: DMD has a significant impact on cognitive areas, probably due to dystrophin deficiency in the brain. The prevalence of neurodevelopmental comorbidities and psychopathological symptoms is also higher in people with DMD than in the general population. Despite these challenges, emerging studies highlight the role of psychosocial and environmental resources, including resilience and supportive social relations, in promoting a good quality of life and successful adaptation to disease progression. Conclusions: Early recognition of the above difficulties and strengths could ensure better care and promote an overall better quality of life for people with DMD and their families, physically, psychologically, and socially. Preclinical and clinical research is moving in the direction of finding new therapies, treatments, and psychosocial interventions to pursue these goals. Full article

Cognitive problems are associated with impaired learning ability and memory dysfunction. Neuroinflammation has been identified as an important factor in the progression of anxiety and depressive disorders. Zingerone is a phenolic alkanone derived from ginger (Zingiber officinale Roscoe), which is known for its antioxidant and anti-inflammatory properties. A number of studies have investigated the effect of zingerone on neuroinflammation and cognitive impairment. However, this evidence has not been systematically reviewed. This study sought to systematically review the effect of zingerone on neuroinflammation and neurobehavioural changes associated with memory and learning impairment and anxiety-like and depressive-like behaviours. A systematic review was conducted using pre-defined search criteria on Google Scholar, Scopus and Web of Science. The records obtained were screened based on inclusion criteria, and data was extracted from the included studies. Out of the 482 studies that were identified, only 9 studies met the inclusion criteria. Neuroinflammatory markers such as interleukin 1β (IL-1β), interleukin 6 (IL-6), tumour necrosis factor-alpha (TNF-α) and ionized calcium binding adaptor molecule (IBA-1), as well as behavioural parameters including Morris water maze, Y-Maze, recognition test, passive avoidance test, elevated plus maze, sucrose preference test and forced swimming test were measured. Zingerone exhibited anti-neuroinflammatory effects by improving IL-1β, IL-6 and TNF-α levels. However, zingerone did not show any significant changes on activated microglia. The anti-neuroinflammatory mechanisms of zingerone were linked to the inhibition of nuclear factor kappa B (NF-kB) activation and the NOD-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome, as well as the reduction in neuronal nitric oxide synthase (nNOS). The anxiolytic and anti-depressive effects of zingerone were also associated with an improvement in cortical cholinergic transmission, the mitigation of oxidative stress and the upregulation of neurotransmitters such as serotonin and dopamine. This review provides scientific evidence on the cognitive enhancing and neuroprotective mechanisms of zingerone, which may be beneficial for future experimental investigations. Full article

Education-to-work transition among war-affected youth in post-conflict settings is fraught with challenges, not least compounded by the little attention placed on individual agency and mental health. This review examines the debate on war-affected youth skilling programmes in post-conflict settings, which neglect the roles of individual agency and mental health in the education-to-work transition. Building on Albert Bandura’s Self-Efficacy Theory (SET) and the Cumulative Stress Hypothesis (CSH), the review presents an integrated approach to skills development for improving education-to-work transition among war-affected youth. According to SET, the development of self-efficacy is anchored on enactive mastery, vicarious experience, verbal persuasion, and physiological arousal. Moreover, individual agency factors such as motivation, aspiration, goal orientation, active efforts, and alignment of intentions with skills are protective factors for effective education-to-work transition, but they are also eroded by the adverse consequences of violent conflicts. Similarly, the CSH also suggests that the effects of exposure to protracted violent conflicts are cumulative and may lead, in turn, to a plethora of mental health problems in the aftermath of violent conflicts. Mental health problems like depression, anxiety, and PTSD are linked to, inter alia, behaviours such as aggression, substance abuse, and apathy, all related to poor employment outcomes. To increase the employability of young people affected by war, skills training institutions and work settings need to prioritise the mental health and individual agency of the youth, as well as skills acquisition for specific trades. Consequently, we propose an integrated model of reintegrating war-affected and vulnerable youth anchored on professional technical and vocational skills training; recognition of individual agency; provision of mental and psychosocial support; and life skills training, all nested within the local economic realities. Full article

Introduction: Nonbinary individuals who do not identify as exclusively male or female often face unique emotional challenges due to societal cisheteronormativity and limited recognition of their identities. While existing research has primarily focused on anxiety, depression, and pathways to parenthood among nonbinary people, little attention has been paid to their comprehensive emotional experiences as parents. This study aims to explore the emotional universe of two nonbinary parents from Spain and the United States. Design: Hermeneutic study. Materials and Methods: We implemented purposive sampling, conducted semi-structured virtual interviews, and followed Ricoeur’s theory of interpretation for data analysis. We used the Universe of Emotions affective taxonomy as a starting category in this analysis. Our sample consisted of a 32-year-old white Spanish nurse (she/they/them), assigned female at birth and parent of two one-year-old toddlers, and a 34-year-old white North American physiotherapist (he/they/them) assigned female at birth and parent of a ten-year-old child. Results: Through its four themes (A story of misunderstanding: “What are you, a combat helicopter?”; Clearly, you don’t fit, so…; But (a new) family is there; No monster here: I’m, at the core, a human being), this study reveals the complex emotional journey experienced by two nonbinary parents. Conclusions: Central to this journey are three key emotions: strangeness, belonging, and acceptance. The participants describe an initial stage marked by body and social dysphoria, confusion, and rejection, followed by a transformative process in which parenthood becomes a catalyst for emotional and identity integration. This transition—from alienation to connection—reflects a broader movement from dehumanization to humanization, where the experience of parenting fosters emotional resilience, social recognition, and a renewed sense of self. Implications for the profession and/or patient care: Analyzing their emotions (both negative and positive ones), we obtained robust insights into these parents’ personal and social contexts. Therefore, we can facilitate understanding of the emotional complexity of nonbinary parents by the trans and cisgender communities. Through this understanding, nurses and the organizations they work for can improve their competence in their holistic care. Acceptance from nonbinary parents’ social contexts, of which nursing is a part, is a critical factor in their health and emotional wellbeing. Full article

Background/Objectives: The increased availability of naloxone underscores the urgent need for scalable, effective training interventions. While current training modalities show promise, critical challenges persist, particularly regarding the development of interactive, self-efficacious platforms that mitigate anxiety in real-world overdose response, especially among laypersons. Therefore, this study aimed to develop and evaluate the usability and acceptability of a novel, self-paced mixed reality-based training tool (ReviveXR). Methods: ReviveXR was designed using the Apple Vision Pro spatial computing headset and Unity platform, employing mixed reality technology to facilitate interaction with virtual overdose scenarios while maintaining awareness of the physical environment. The intervention included a simulated tutorial and interactive modules on overdose response, rescue breathing, and chest compressions. Field testing was conducted in two rounds across various settings with a heterogeneous sample (N = 25), including individuals who use drugs, bystanders, first responders, and technology specialists. Data collection involved pre- and post-intervention surveys and qualitative interviews. Results: Participants demonstrated significant improvements in knowledge related to overdose recognition, naloxone administration, rescue breathing, and chest compressions. ReviveXR increased participants’ confidence and intent to help overdose victims while reducing uncertainty during overdose reversal. Participants were predominantly from rural areas and primarily identified as White and male. Qualitative feedback emphasized the platform’s heightened engagement, realism, patient responsiveness, and capacity to enhance knowledge acquisition and behavioral preparedness compared with conventional training approaches. Conclusions: ReviveXR offers a scalable, cost-effective, engaging alternative to traditional naloxone training programs, demonstrating strong feasibility across diverse environments and participants. ReviveXR holds considerable promise for expanding and enhancing community overdose response capacities and training healthcare professionals and first responders. Full article

The widespread adoption of electric vehicles (EVs) necessitates advanced energy management strategies to alleviate range anxiety and improve overall energy efficiency. This study presents a novel framework for optimizing energy consumption in EVs by integrating driver behavior patterns, road conditions, and environmental factors. Utilizing a comprehensive dataset of 3395 high-resolution charging sessions from 85 EV drivers across 25 workplace locations, we developed a multi-modal prediction model that captures the complex interactions between driving behavior and environmental conditions. The proposed methodology employs a combination of driving scenario recognition and reinforcement learning techniques to optimize energy usage. Specifically, we utilize contrastive learning to extract meaningful representations of driving states by leveraging the symmetric relationships between positive pairs and the asymmetric nature of negative pairs and implement graph attention networks to model the intricate relationships between road environments and driving behaviors. Our experimental results demonstrate that the proposed framework achieves a significant reduction in energy consumption compared to baseline methods, with an average improvement of 17.3% in energy efficiency under various driving conditions. Furthermore, we introduce an adaptive real-time optimization strategy that dynamically adjusts vehicle parameters based on instantaneous driving patterns and environmental contexts. This research contributes to the advancement of intelligent energy management systems for EVs and provides insights into the development of more efficient and environmentally sustainable transportation solutions. Full article

In recent years, there has been a growing recognition within the medical community that idiopathic pulmonary fibrosis (IPF) cannot be effectively managed through a singular focus on the disease itself. Instead, a dual approach is essential, one that not only aims to prolong survival by targeting the underlying pathological mechanisms of IPF but also addresses the numerous comorbidities that frequently complicate the clinical picture for affected individuals. This narrative review seeks to provide a detailed and comprehensive exploration of the various comorbid conditions associated with IPF, which may include cardiovascular disease (CVD), lung cancer (LC), gastroesophageal reflux disease (GERD), obstructive sleep apnea (OSA), and anxiety/depression, among others. By understanding the interplay between these comorbidities and IPF, healthcare providers can better tailor treatment regimens to meet the holistic needs of patients. Furthermore, this review delves into both current management strategies and emerging therapeutic approaches for these comorbidities, emphasizing the importance of interdisciplinary collaboration in clinical practice. By synthesizing the latest research and clinical insights, this review aims to enhance awareness and understanding of the complexities surrounding IPF management, ultimately guiding clinicians in developing more effective, individualized care plans that address not only the fibrotic lung disease but also the broader spectrum of health challenges faced by patients. Through this comprehensive overview, we hope to contribute to the ongoing dialogue about improving quality of life and survival rates for individuals living with IPF. Full article

Background/Objectives: Chronic craniofacial inflammation is recognized as a factor in anxiety-like behaviors, yet effective therapeutic options remain limited. Agmatine, a dietary bioactive compound found in fermented foods such as sake lees, exhibits modulatory effects on neural functions, alleviating psychological distress like anxiety associated with local inflammation. Methods: We investigated both the therapeutic and preventive effects of agmatine on anxiety-like behaviors and the related neural basis in a mouse model of persistent craniofacial inflammation induced by complete Freund’s adjuvant (CFA). Results: Comprehensive behavioral assessments, including the elevated plus maze, open field, dark–light box, social interaction, and novel object recognition tests, revealed that therapeutic agmatine administration (1.0 and 30 mg/kg) significantly reduced CFA-induced anxiety-like behaviors, with the higher dose showing more robust and sustained effects across multiple time points. These behavioral improvements were paralleled by reductions in acetylated histone H3, FosB, and c-Fos expression in key anxiety-related brain regions, suggesting a reversal of craniofacial inflammation-associated neural changes. In contrast, preventive agmatine treatment exerted modest and time-dependent behavioral benefits with minimal molecular normalization. Notably, preventive agmatine did not affect general locomotor activity (indicated by total movement distance), indicating that its anxiolytic effects were not confounded by altered locomotor activity. Metabolomic analysis confirmed the presence of agmatine in sake lees (~0.37 mM), supporting the hypothesis that fermented food products might offer dietary routes to emotional resilience. Conclusions: These findings underscore agmatine’s promise as a context-specific epigenetic modulator capable of mitigating anxiety-like behaviors by normalizing inflammation-driven molecular dysregulation in the brain. Full article

Introduction: Hypoglossal nerve stimulation (HNS) “Inspire_© therapy” has garnered popularity among obstructive sleep apnea (OSA) patients seeking an alternative to continuous positive airway pressure (CPAP) therapy. The growth in HNS has been particularly high in older adults living with OSA. Consistent and proper use of HNS in the geriatric population faces unique age-associated barriers: a high rate of multiple chronic conditions (MCC) and polypharmacy (being on five or more drugs). Early recognition and patient-centered management of these barriers will allow older patients to obtain maximum benefits from HNS. HNS has distinct advantages in the geriatric population because it overcomes many concerns related to CPAP therapy adherence, such as mechanical limitations due to manual dexterity, maxillofacial anatomy, dental issues such as usage of dentures, allergy/otolaryngology-related disorders, and pre-existing post-traumatic stress disorder-related claustrophobia. This paper describes how we worked with older patients with OSA and their care partners to overcome these barriers so patients can continue to derive cardiovascular, neurologic, and quality of life benefits resulting from optimal OSA management. These benefits are especially important in the older population because of higher rates of comorbidities (dementia, coronary artery disease, and atrial fibrillation) exacerbated by sub-optimally treated OSA. In this article, we describe our clinical experience with elderly patients on Inspire_© therapy, with a focus on the everyday difficulties faced by these patients and the measures implemented to address and mitigate these barriers. Methods: A retrospective chart review was conducted to identify patients aged 65 and above who underwent hypoglossal nerve stimulator insertion. Experiences of older patients during and after the insertion procedure were documented and compared to a younger population of patients on HNS therapy. We specifically collected information on difficulties encountered during activation or follow-up visits and compared them between the different age groups. Using this information, we identified areas to improve treatment adherence from the patients’ perspectives. Results: We identified 43 geriatric (65 to 86 years old) patients who received the Inspire implant at a tertiary academic medical center and compared them to a younger population of 23 patients. Most common challenges noted—with a potential to impact adherence—included orofacial and lingual neuropraxia (ischemic or demyelination-induced neuropathy) at activation, cognitive dysfunction (memory problems), preexisting anxiety, and insomnia. Other difficulties that are less commonly reported but equally important to consistent and proper use of HNS included headaches, concerns of device malfunction, change in comfort levels after cardiac procedures, and general intolerance of the device. The older patient population had a statistically significant higher incidence of cognitive difficulties (30.2% vs. 4.4%) and a smaller social support system (62.8% vs. 91.3%) affecting device usage compared to the younger population. There were no statistically significant differences in the rates of other more commonly reported adverse effects such as headaches, dry mouth, and anxiety between the two age groups. Conclusion: Despite several challenges faced by geriatric patients, Inspire_© hypoglossal nerve stimulation remains a viable, alternative treatment option for OSA with improved tolerance and adherence compared to CPAP. After identifying less commonly reported barriers such as cognitive decline, sensory deficits, and decreased social support systems, minor adjustments and appropriate education on use allows older patients to correctly use and benefit from Inspire_© device therapy, with subsequent improvement in sleep and overall quality of life. Full article