Search Results (35,178)

Background: Postoperative delirium (POD) is a common complication in geriatric patients. This prospective cohort study evaluated a possible influence of intraoperative positioning on the occurrence of POD, as intraoperative prone positioning could affect cerebral perfusion. Methods: We included 760 patients of ³60 years scheduled for elective surgery in prone or supine positions. The primary outcome was POD incidence on the first five days after surgery, assessed via 3D-Confusion Assessment Method (3-D CAM) or Confusion Assessment Method for Intensive Care Units (CAM-ICU). Preoperative assessments included the American Society of Anesthesiologists (ASA) and New York Heart Association (NYHA) classifications as well as short screenings for the cognitive (modified Montreal Cognitive Assessment (MoCA)) and self-care status of the patient. Secondary outcomes were length of hospital stay (LOS) and mortality rates. Results: Postoperative delirium rates were similar in prone and supine patients (7.6% vs. 5.5%; p = 0.31), and logistic regression analysis revealed no association of intraoperative prone positioning with POD (odds ratio 1.42 (95% CI 0.68–2.92; p = 0.342)). The overall incidence of POD was 6.1% and was associated with older age (81.5 (CI 76.2–84.8) vs. 72.0 (CI 67.0–79.0) years; p < 0.01), higher ASA and NHYA classifications, lower preoperative modified MoCA, reduced independence in self-care (p < 0.001, respectively), and longer incision-to-suture times (107.0 (CI 73.0–173.0) vs. 85.0 (CI 60.0–130.0) minutes; p < 0.01). Postoperative delirium resulted in longer LOS (14.5 (CI 9.0–27.0) vs. 7.0 (CI 4.0–9.0) days; p < 0.001), and increased mortality (13.0% vs. 1.7%; p < 0.001). Conclusions: Intraoperative prone positioning was not associated with POD in patients aged 60 years or older (OR 1.42; CI 0.68–2.92; p < 0.340), and LOS and mortality as secondary outcome parameters were also similar in patients after prone and supine surgery. Future studies assessing additional and possible confounding factors and intraoperative systemic and regional hemodynamics and oxygenation are needed to verify this result and to evaluate cerebral hypoperfusion as a possible mechanism of POD. Full article

Background: Connexins (Cx) are a family of transmembrane proteins that form gap junctions and connexin hemichannels (HCs), enabling direct intercellular communication within the nervous system. Connexin 43 (Cx43), the principal astrocytic connexin, exhibits a context-dependent dual role: under physiological conditions it maintains tissue homeostasis and metabolic support, whereas under pathological conditions excessive activation of Cx43 hemichannels promotes neuroinflammation, excitotoxicity, blood–brain barrier disruption, and secondary neural tissue damage. Other connexin isoforms also contribute to the pathogenesis of neurological and psychiatric disorders through alterations in neuronal synchronization, glial signaling, and myelin integrity. Objective: To systematize current evidence on the role of key connexin isoforms in acute nervous system injuries—including stroke, traumatic brain injury, spinal cord injury, and peripheral nerve injury—as well as chronic disorders such as neurodegenerative diseases, epilepsy, and psychiatric disorders, with particular emphasis on the functional duality of connexin channels and the therapeutic potential of their selective modulation. Methods: A systematic literature search was conducted in the PubMed, Scopus, and Web of Science databases in accordance with the PRISMA framework and the PRISMA Extension for Scoping Reviews guidelines. The review included data from experimental models, postmortem brain studies, genetic association analyses, and pharmacological intervention studies. The retrieved studies were screened, assessed for eligibility, and integrated using a qualitative narrative synthesis approach. Results: In acute neural injuries, hyperactivation of Cx43 hemichannels amplifies inflammatory signaling, edema formation, and neuronal death, whereas selective HCs inhibitors reduce lesion volume and improve functional outcomes in experimental models. Connexin 36 (Cx36) contributes to cortical spreading depolarization and seizure propagation, while Connexin 32 (Cx32) and Connexin 47 (Cx47) are critically involved in oligodendrocyte function and white-matter demyelination. In PNI, Cx43 upregulation contributes to neuropathic pain, whereas mutations in Cx32 cause hereditary demyelinating neuropathies. In neurodegenerative diseases—including Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis—Cx43 hemichannel activity promotes neuroinflammation and pathological protein accumulation, while reduced Cx32/Cx47 expression disrupts metabolic support of axons. In psychiatric disorders such as major depressive disorder, bipolar disorder, and schizophrenia, decreased astrocytic connexin expression (Cx43 and Cx30) has been associated with impaired glial–neuronal communication and cognitive–emotional dysfunction. In epilepsy, increased Cx43/Cx30 expression contributes to neuronal hypersynchronization and blood–brain barrier dysfunction, whereas selective hemichannel blockade suppresses seizure activity. Conclusions: Cx—particularly Cx43—occupies a central position in the molecular mechanisms of secondary neural injury and network dysfunction. The dual functional properties of gap junctions and hemichannels determine their context-dependent effects across neurological and psychiatric diseases. Selective inhibition of pathological HCs activity shows significant neuroprotective and anticonvulsant potential and represents a promising direction for the development of targeted therapeutic strategies. Further studies are required to determine optimal therapeutic time windows, tissue-specific effects, and the long-term safety of Cx modulation. Full article

Challenges remain in developing a comprehensive understanding of spatial cognition, including gender and developmental differences, partly due to limitations of well-established spatial measures. Many traditional tasks face accessibility constraints and are not well suited for use across broad age ranges, populations, or ability levels. The present study introduced two game-based tasks, Q-bitz^® and Spot it!^®, designed to assess mental rotation and object location memory, respectively. We examined whether these game-based measures meaningfully complement established spatial tests, the Mental Rotation Test (MRT) and the Object Location Memory (OLM) task, across a wide age range (7–79 years, N = 114). Results indicated that MRT scores were strongly related to Q-bitz performance, whereas OLM scores were strongly related to Spot it! performance, supporting the convergent validity of the game-based tasks. Notably, gender-specific patterns emerged in the relationships among spatial measures, suggesting differences in spatial function. Age was associated with performance on speeded tasks (Q-bitz and Spot it!) but not with accuracy-based MRT or OLM performance. Together, these findings demonstrate that game-based assessments capture meaningful spatial constructs and reveal gender-specific patterns across the lifespan, providing a practical and ecologically valid approach for advancing research on spatial cognition. Full article

This paper investigates the cooperative formation control problem in unmanned surface vehicles (USVs) with prescribed performance constraints under complex marine conditions including external disturbances, model uncertainties, actuator faults, and input saturation. A novel fault-tolerant control (FTC) algorithm is developed by integrating cooperative learning neural networks (NNs), distributed disturbance observers, and the backstepping technique. Specifically, the learning NNs adaptively approximate system uncertainties, and the learned weight information is shared among vehicles to enhance cooperative cognition. Additionally, an auxiliary dynamic system and an actuator configuration matrix are designed to compensate for input saturation and propeller failures. Theoretical analysis based on the Lyapunov method proves that all signals in the closed-loop system are bounded, and the formation tracking errors strictly remain within the predefined transient and steady-state performance bounds. Finally, simulation experiments involving a group of four USVs validate the proposed algorithm. The results demonstrate that the USVs can rapidly converge to and maintain the desired quadrilateral formation shape despite time-varying disturbances and actuator efficiency loss. Furthermore, comparative simulation results indicate that the proposed cooperative learning FTC scheme significantly reduces velocity tracking error oscillations compared to traditional non-learning methods, explicitly verifying its superior robustness and fault-tolerant capabilities. Full article

This study explored how smart governance can foster city demographic sustainability by shaping youth retention intention in developed cities. In the case of Busan, South Korea, a structural model was constructed and tested to link the dimensions of perceived value of smart governance (PV)—including Accessibility and Efficiency of Public Services (PV-A), Transparency and Information Accessibility of Governance (PV-T), Participation and Responsiveness (PV-P), Career Development and Innovation Support (PV-C), and Contribution to Urban Quality of Life (PV-Q)—with perceived demographic sustainability (PDS) and youth retention intention (YRI). On the basis of 939 valid questionnaires, confirmatory factor analysis and a structural equation model were used to test the measurement validity, model fitting, and mediating effects. Consequently, all the dimensions of smart governance had a positive effect on youth retention intention (YRI), with all path coefficients statistically significant at p < 0.001, and perceived demographic sustainability (PDS) partially mediated the effects of each dimension on youth retention intention (YRI), with indirect effects significant at p < 0.05. Among the dimensions, PV-T had the strongest effect, with a standardized coefficient of β = 0.283 at p < 0.001, followed by PV-P (β = 0.185, p < 0.001) and PV-Q (β = 0.167, p < 0.001), while PV-A and PV-C showed comparatively weaker but still statistically significant effects. In view of governance orientation and cognitive mechanism, this study provides empirical support for demographic sustainability design in smart cities. Full article

The recycling of pesticide packaging waste is crucial for the sustainable development of agriculture and the advancement of ecological civilization. However, the current recycling management still faces challenges. This study adopts a dynamic analytical framework of “ex-ante behavioral cognition and post-event outcome perception” to investigate the impact of digitalization on farmers’ recycling behavior of pesticide packaging waste. The analysis draws on data from the 2020 China Rural Revitalization Survey and examines two dimensions of digitalization: digital technology access and digital technology usage. The findings indicate that integrating digital technologies into farming practices significantly increases the likelihood of farmers participating in pesticide packaging waste recycling programs. These results remain robust after conducting robustness checks and addressing potential endogeneity issues. A heterogeneity analysis reveals that the promotional effect of digitalization varies significantly across different categories of rural elite status, cooperative membership, education level, pesticide spraying methods, and income structure. Mechanism testing further indicates that hazard cognition regarding pesticide packaging serves as a mediating factor in the impact of both digital technology access and usage on farmers’ recycling behavior. In contrast, farmers’ satisfaction with their living environment mediates only the effect of digital technology usage on recycling behavior. Overall, these findings provide both theoretical and empirical support for the hypothesis that digitalization can facilitate the recycling of pesticide packaging waste and enhance the ecological effectiveness of agricultural policy governance. Full article

Promoting farmers’ adoption of low-carbon technologies constitutes a vital pathway for achieving agricultural sustainability and a key measure for implementing the national dual-carbon strategy. Drawing upon field survey data from 602 wheat farmers in Heze City, Shandong Province, this study employs an ordered probit model to empirically examine the influence mechanism of data capital on farmers’ low-carbon technology adoption behaviour. The results show that (1) data capital significantly promotes farmers’ adoption of low-carbon technologies; (2) ecological cognition plays a significant mediating role, while economic incentives and human capital serve as positive moderators; (3) heterogeneity analysis indicates that the promoting effect of data capital is more pronounced among large-scale farmers. Based on these findings, recommendations are proposed to consolidate rural digital infrastructure, establish agricultural data service platforms, and enhance farmers’ ecological cognition, thereby fully unleashing the potential of data capital in driving agricultural sustainability. Full article

Background: Malnutrition is a known outcome of dysphagia. Objectives: To estimate the association between the timing of the Clinical Swallow Evaluation (CSE) at admission and nutrition status at hospital discharge. Methods: In this single-center prospective study, the electronic medical records of patients discharged from the neurogeriatric rehabilitation department at the participating hospital, who had undergone CSE by a speech pathologist per hospital bed-side evaluation protocol, were reviewed. The participants were divided into two groups: those who underwent CSE within 48 h of hospitalization per Israel Ministry of Health guidelines (early CSE, N = 31); and those who underwent CSE later than 48 h from admission (late CSE, N = 47). Nutrition status was evaluated by a registered dietitian using the Mini Nutritional Assessment Tool Short Form (MNA-SF). Nutrition status at discharge was categorized and compared between the groups. Results: Seventy-eight patients were included (mean age 80.7 ± 8.1 years); 85.9% were malnourished at admission, with no difference between groups. At discharge, malnutrition was less prevalent in the early vs. late CSE group (61.3% vs. 78.7%; p = 0.012). In multivariable logistic regression, late CSE increased odds of malnutrition at discharge by more than six-fold. Each additional year of age increased the odds of malnutrition by 13%; each additional point in baseline MNA SF score reduced the odds by 48%; and greater cognitive decline increased the odds of discharge malnutrition risk by more than 2.6-fold. Sex and the number of dietitian consultations were not associated with malnutrition at discharge. Conclusions: Early CSE in elderly patients hospitalized for neurogeriatric rehabilitation is associated with less malnutrition at discharge. Full article

The Mediterranean Diet (MD) is recognized for promoting longevity and reducing the risk of chronic disease, yet the mechanisms underlying these benefits remain uncharacterized. This review highlights the diverse nutritional and phytoactive constituents of the MD and research exploring its complex network of polyphenols. It discusses data evaluating MD-derived constituents formulated into a dietary supplement capsule developed using a systems and network biology framework. Component selection was based on their actions on enzyme systems involved in senescence-related pathways and health preservation. This review highlights how MD components synergistically modulate pathways central to antioxidant activity, cognitive health, and aging. Liquid chromatography–mass spectrometry identified phytochemically diverse constituents in capsules (supplied by DailyColors™, Warwickshire, UK and Sebastopol, CA, USA) derived from primary color groups in sixteen Mediterranean plants. These constituents were mapped to bioactive networks targeting enzymes linked to inflammation, metabolic regulation, and cellular senescence. Preclinical studies demonstrated the modulation of mitochondrial and metabolic health markers, with complementary effects on cytokine inhibition and glucose sensitivity. Two clinical studies confirmed broad proteomic and epigenetic effects on pathways governing immunity, skeletal muscle, cognition, and inflammation. Therefore, this review advances a novel perspective that MD polyphenols act through synergistic, multi-pathway interactions that link dietary patterns to coordinated regulation of longevity and healthy aging. Full article

Background/Objectives: Maternal valaciclovir therapy is increasingly used to reduce fetal viral replication in cases of primary cytomegalovirus (CMV) infection during pregnancy. However, data on its impact on early neurodevelopmental outcomes remain limited. This study aimed to evaluate the association between prenatal valaciclovir exposure and early neurodevelopment in infants with confirmed congenital CMV infection (cCMV). Methods: In this retrospective monocentric cohort study, 30 infants with PCR-confirmed cCMV infection were assessed at 4–8 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Infants were stratified according to prenatal exposure to maternal valaciclovir. Univariate analyses and multivariable linear regression models were performed to evaluate the association between prenatal antiviral exposure and cognitive outcome, adjusting for brain MRI findings and selected clinical variables. Results: Fifteen infants (50%) were exposed to prenatal valaciclovir. Exposed infants demonstrated higher cognitive composite scores compared with unexposed infants (median 105 [IQR 100–110] vs. 90 [85–110]; p = 0.030). In multivariable analysis, prenatal valaciclovir exposure remained significantly associated with higher cognitive scores (β = 11.89, 95% CI 2.86–20.92; p = 0.012), while neonatal MRI abnormalities were not independently associated with outcome. No significant differences were observed in language or motor domains. The final model explained 30% of the variance in cognitive scores (R² = 0.30). Conclusions: Prenatal valaciclovir exposure was associated with higher cognitive composite scores after adjustment for selected covariates. Although causality cannot be inferred, these findings suggest a potential association with early neurodevelopmental outcomes and support the inclusion of functional neurodevelopmental endpoints in future prospective studies. These results should be considered exploratory and hypothesis-generating Full article

Extended Reality (XR) and Artificial Intelligence (AI) are increasingly converging within cyber–physical infrastructures, including digital twins, the Spatial Web, and smart-city systems. These environments require new frameworks for understanding how human performance emerges through sustained interaction with immersive interfaces and adaptive computational agents. This paper introduces the TAXI–XI-CAP framework, a two-layer model that links psychobiological mechanisms of XR–AI interaction to higher-level, experimentally testable capability constructs. The TAXI layer defines 42 mechanisms spanning perception, cognition, physiology, sensorimotor control, and social coordination, while XI-CAP organizes these into capability patterns such as remote dexterity, distributed cognition, and adaptive workload regulation. Derived through a theory-guided synthesis across XR, neuroscience, and human–automation interaction, the framework models performance as emerging from interacting mechanisms under real-world constraints. A validation-oriented research agenda is proposed, emphasizing mechanism-level measurement, capability-level evaluation, and longitudinal testing. The TAXI–XI-CAP framework provides a structured basis for hypothesis generation, comparative analysis, and empirical validation of XR–AI systems, supporting the development of reliable, scalable, and human-centered Extended Intelligence infrastructures. Full article

Multi-objective optimization problems (MOPs) are ubiquitous in scientific research and engineering applications, where multiple conflicting objectives must be optimized simultaneously. Unlike traditional multi-objective evolutionary algorithms, which aim to approximate the entire Pareto front, preference-based multi-objective evolutionary algorithms (PBMOEAs) incorporate decision maker preferences to guide the search toward a region of interest (ROI). This paper presents a focused survey of PBMOEAs using a three-dimensional analytical framework consisting of preference articulation mode, preference modeling approach, and preference incorporation mechanism. Under this framework, the survey reviews major preference modeling approaches and preference incorporation mechanisms, and further discusses three practical issues critical to PBMOEA design: the effectiveness of preference incorporation, the practical limits of interactive methods, and the role of visualization in ROI-oriented decision support. Findings indicate that while PBMOEAs enhance decision-making efficiency, their performance hinges on preference quality, problem characteristics, cognitive load, and method suitability. Future directions include unified modeling, comprehensive evaluation, human-centered design, and integrating surrogate models, explainable learning, and LLM-assisted interfaces. Full article

Glucagon-like peptide-1 (GLP-1) and dual GIP/GLP-1 receptor agonists, originally introduced for the management of type 2 diabetes mellitus and obesity, are increasingly recognized for their broader actions within the central nervous system, with emerging implications in neuropsychiatry and neurodegeneration. This review integrates current preclinical and clinical evidence, emphasizing their pharmacodynamic profile, central receptor distribution, and the molecular pathways linking metabolic signaling to neural function. Evidence suggests that GLP-1 receptor activation across key brain regions involved in energy balance and reward modulates multiple neurotransmitter systems, including dopamine and serotonin, as well as glutamatergic and GABAergic transmission, thereby influencing behavior, affective processes, and cognitive function. In parallel, these agents exhibit neuroprotective properties through improved neuronal insulin sensitivity, attenuation of neuroinflammatory pathways, and support of neuroplasticity, alongside effects on limiting pathological protein aggregation. Dual GIP/GLP-1 agonism may further potentiate these central actions through complementary metabolic and synaptic mechanisms. Although pharmacovigilance data have identified isolated neuropsychiatric adverse events, current clinical evidence does not support a consistent causal association. Collectively, incretin-based therapies represent a promising translational approach at the interface of metabolic and neuropsychiatric disorders, warranting further investigation into their long-term central safety, therapeutic efficacy, and clinical relevance. Full article

Generative artificial intelligence (AI) has demonstrated significant potential in education, yet empirical research on its application in “hardware-driven” interdisciplinary design courses remains scarce. This study employed a randomized crossover experimental design in an IoT Hardware and Design Innovation course at Hunan University. Twelve industrial design undergraduates with no prior IoT background alternated between AI-assisted (ChatGPT-4o) and traditional learning resource conditions across six short-cycle tasks. The crossover design enabled each participant to serve as both experimental and control subjects, yielding 72 observation-level data points. Grounded in Cognitive Load Theory, the study examined three dimensions: process efficacy, difficulty structure, and switching adaptation costs. Results indicated that AI significantly improved perceived task completion efficiency, self-reported goal attainment, and learning experience, yet self-assessed knowledge transfer did not differ significantly between conditions. AI reduced the total number of reported difficulties but altered the difficulty-type distribution: resource-retrieval difficulties decreased while information-verification difficulties increased—a phenomenon we term “difficulty restructuring”. Furthermore, switching from AI back to traditional resources incurred significantly higher adaptation costs than the reverse transition, revealing emerging dependency risks. These findings suggest that generative AI may function more as a “difficulty restructurer” than a “difficulty eliminator” in hardware-driven design education, providing exploratory empirical evidence for incorporating verification literacy into future course design and calling for calibrated scaffold fading that may help mitigate emerging dependency risks. Full article

Ischemic stroke (IS) remains a major cause of global disability and mortality. While exogenous H₂S has demonstrated neuroprotective potential, the role of endogenous H₂S generated by cystathionine β-synthase (CBS) in cerebral ischemia–reperfusion injury (CIRI) remains incompletely elucidated. L-Cysteine (L-Cys), as a substrate for CBS, serves as a key precursor for endogenous H₂S. Using the established pre-clinical model of CIRI—middle cerebral artery occlusion/reperfusion (MCAO/R) in rats—we investigated the neuroprotective effects of brain-derived CBS-generated H₂S through neurological function scoring, 2,3,5-triphenylchlorotetrazole (TTC) staining, enzyme-linked immunosorbent assay (ELISA), and histopathological examination. Immunofluorescence, Western blot, and laser speckle contrast imaging were utilized to analyze the protein expression of ZO-1, claudin-5, CBS, vascular endothelial growth factor receptor-2 (VEGFR₂) and CD31, as well as cerebral blood flux changes. L-Cys treatment ameliorated neurological deficits, reduced cerebral infarct volume, decreased serum lactate dehydrogenase (LDH) and neuron-specific enolase (NSE) levels, attenuated histopathological damage, alleviated cerebral edema, and restored blood–brain barrier integrity via upregulation of tight junction proteins ZO-1 and claudin-5. Additionally, L-Cys improved MCAO/R-induced cognitive impairment and behavioral deficits. Furthermore, L-Cys upregulated CBS and VEGFR₂ expression, enhanced endogenous H₂S production, promoted post-ischemic cerebral angiogenesis, and improved cerebral blood flux recovery. CBS-derived H₂S promoted post-ischemic angiogenesis mediated by VEGFR₂, enhances cerebral reperfusion flux, and consequently ameliorated MCAO/R-induced CIRI in rats, providing experimental evidence for clinical translation. Full article