Search Results (1,571)

This cross-sectional study included 112 community-dwelling older adults aged ≥ 60 years residing in Tha Sala District, Nakhon Si Thammarat Province, Thailand, recruited using a community-based quota sampling approach. Locomotive syndrome (LS) was assessed using the two-step test and classified according to the Japanese Orthopaedic Association criteria. Physical activity was evaluated using the Thai version of the Global Physical Activity Questionnaire across work-related, transportation-related, and recreational domains. Frailty and cognitive status were assessed using the Thai version of the FRAIL questionnaire and the Montreal Cognitive Assessment, respectively. Binary logistic regression analysis was used to examine associations. The prevalence of LS was 74.1%, with 37.5%, 33.0%, and 3.6% in participants classified as having LS stages 1, 2, and 3, respectively. Transportation-related physical activity was significantly associated with lower odds of LS. Frailty and mild cognitive impairment frequently coexisted with LS but were not independently associated with LS after adjustment for age and sex. Transportation-related physical activity emerged as a key protective factor, highlighting the importance of habitual mobility in daily life. Our findings suggest that LS overlaps with, but is not identical to, frailty and cognitive decline in relatively robust community settings. Early screening and mobility-related physical activity may be crucial in preventing functional decline in rapidly aging societies. Full article

Background: Mild traumatic brain injury (mTBI) is frequently associated with persistent cognitive and psychosocial symptoms, yet biological correlates of recovery remain poorly understood, particularly among Asian and Pacific Islander (API) populations. Pre-injury psychosocial adversity may further shape post-injury recovery trajectories. This pilot study examined associations between participation in a 2-week, home-based, dual-task cognitive–walking intervention (Daily Brain Exercise; DBE) and changes in cognitive, psychological, and salivary microRNA (miRNAs) measures among APIs with and without a self-reported history of mTBI. Methods: API participants completed remote cognitive testing (CNS Vital Signs), psychosocial assessments (Neuro-QoL), and saliva collection before and after DBE participation. Salivary RNA was purified, and miRNA expression was profiled using nCounter^® Human v3 miRNA Expression Panels (NanoString). Differential expression analyses were conducted using ROSALIND^® platform (OnRamp Bioinformatics, San Diego, CA, USA), a cloud-based bioinformatics analysis system, to calculate fold changes and p-values. Pre-injury psychosocial adversity was assessed via the Trauma History Screen and examined descriptively as a contextual modifier of functional outcomes. Results: Twenty-one APIs (mean age 22.9 years; 76.7% female) were enrolled, including 14 individuals with a self-reported history of mTBI (mean 4.64 years post-injury; 50% with multiple injuries). Following DBE participation, increases in cognitive flexibility and executive function scores were observed in both mTBI and control groups. Additional increases in psychomotor speed, processing speed, sleep disturbance, and depressive symptoms were observed descriptively within the mTBI group. Subgroup analyses suggested variability in pre–post patterns across combinations of mTBI history and pre-injury psychosocial adversity. Exploratory miRNA analyses identified seven miRNAs that were differentially expressed in the mTBI group following DBE (unadjusted p < 0.005), including hsa-miR-7-5p, previously reported in association with neurodevelopmental and neurological pathways. Conclusions: In this pilot, feasibility-focused study, participation in a brief, home-based, dual-task intervention was associated with descriptive changes in selected cognitive and psychosocial measures among APIs, particularly those with a history of mTBI and pre-injury adversity. The observed subgroup patterns warrant confirmation in adequately powered, controlled studies. Exploratory changes in salivary miRNAs co-occurred with functional improvements, thus generating a hypothesis for a future investigation. Full article

Background/Objective: Advances in intensive care medicine have substantially improved the survival of critically ill patients; however, they have also revealed the growing burden of neurological complications that affect both short-term outcomes and long-term functioning. Neurological complications in the intensive care unit (ICU) include a wide spectrum of disorders, ranging from acute brain dysfunction such as delirium, coma, and encephalopathy to persistent cognitive impairment after discharge, which represents a key component of Post-Intensive Care Syndrome (PICS). Delirium affects approximately one-third of ICU patients and is independently associated with increased mortality, prolonged hospitalization, and worse long-term neurocognitive outcomes. Due to the limited effectiveness of pharmacological therapies, current clinical approaches emphasize prevention, early diagnosis, and non-pharmacological strategies in line with PADIS guidelines. This narrative review aims to provide a clinically relevant synthesis of neurological complications in adult ICU patients, conceptualized as a continuum from acute brain dysfunction to long-term cognitive impairment. Methods: A narrative review of the literature was conducted, focusing on studies addressing epidemiology, pathophysiology, risk factors, diagnostic strategies, and prevention of neurological complications in critically ill adults. Attention was given to delirium, ICU-acquired cognitive impairment, and their association with PICS, as well as to current guideline-based and non-pharmacological interventions. Results: Available evidence indicates that neurological complications in the ICU are multifactorial and result from the interaction between patient vulnerability, severity of illness, systemic inflammation, sedative exposure, and environmental factors. Delirium remains the most common manifestation of acute brain dysfunction and is strongly associated with adverse outcomes. Increasing evidence supports the effectiveness of structured screening, early mobilization, sleep optimization, and multidisciplinary care bundles in reducing delirium incidence and duration. Moreover, growing attention is directed toward post-ICU follow-up and rehabilitation to reduce long-term cognitive decline. Conclusions: Neurological complications should be considered a central component of critical illness and a continuum extending beyond ICU discharge. Early identification of high-risk patients, implementation of preventive strategies, and integration of acute and post-ICU care are essential to improve survival and long-term cognitive outcomes. Further research should focus on personalized preventive and neuroprotective approaches in critically ill patients. Full article

Background and Objectives: The aim of this study is to evaluate impulsivity in childhood anxiety disorders and to examine its relationship with anxiety sensitivity and emotion regulation. Materials and Methods: The study group consisted of a total of 60 children aged 8–12 years diagnosed with generalized anxiety disorder (GAD, n = 30) and other anxiety disorders (n = 30). The control group consisted of 40 healthy children of similar age without a psychiatric diagnosis. Data collection forms included the Barratt Impulsiveness Scale Short Form (BIS-S), the Children’s Anxiety Sensitivity Index (ASI-3), the Emotion Regulation Checklist (ERC), and The Screen for Child Anxiety Related Emotional Disorders (SCARED). Results: Our study found no significant differences in BIS-S scores between GAD, other anxiety disorders, and the control group. The total/physical and ERC subscales of the ASI-3 were higher in the generalized anxiety disorder and other anxiety disorder group than in the control group. However, there were no significant differences in the social dimension and cognitive dimension scores of the ASI-3. It has been determined that anxiety sensitivity does not significantly mediate the relationship between emotion regulation and impulsivity, and that emotional variability/negativity is directly and completely related to impulsivity. Conclusions: Our study suggests that children with anxiety disorders experience greater difficulties in regulating their emotions compared to healthy children, and that emotional variability is directly related to impulsivity. In this context, enhancing emotion regulation skills in anxiety disorders may prove to be a pivotal factor in the efficacy of treatment and the maintenance of behavioral control. Full article

To address the limited accuracy of speech-based Alzheimer’s Disease (AD) screening and the shortage of paired multimodal data, this paper proposes a detection framework based on feature alignment and Rectified Flow-driven latent representation generation. The EEG dataset consists of 36 AD patients and 29 Healthy Controls (HC). The speech dataset contains 399 samples, which include 114 AD cases, 132 Mild Cognitive Impairment (MCI) cases, and 153 HC cases. We extracted multidimensional features of EEG signals, such as time-domain and frequency-domain characteristics, alongside behavioral representations of speech. A heterogeneous alignment network was used to map these features into a common semantic subspace, where an adaptive interpolation strategy reconstructed the missing pathological trajectories of MCI within the latent space. On this basis, a conditional Rectified Flow model was introduced to learn the optimal transport mapping from speech to EEG. This model generated physiological-information-rich latent representations to compensate for semantic gaps. Experimental results showed that the fused features from speech and latent representations achieved a three-class classification accuracy of 89.08%, a precision of 88.77%, and a recall of 88.71%. This performance represented an accuracy improvement of 9.28% compared with the speech-based baseline system. Our method combines the convenience of speech screening with the high reliability of neurophysiological signals, and it provides a new approach for low-cost early detection of AD. Full article

Background/Objectives: Mandarin orange peel (MOP) is rich in bioactive polymethoxyflavones, including hesperidin and nobiletin, which have shown neuroprotective effects in rodent models. However, comprehensive safety data in dogs are required to support its development as a therapeutic intervention for canine cognitive dysfunction syndrome. In this study, the safety profile of a standardized MOP formulation was evaluated in four healthy Beagle dogs. Methods: Initially, compositional analysis was performed, and 202 pesticide residues and psoralens were screened to ensure compliance with Japanese pet food safety standards. Subsequently, a dose-escalation study was conducted in which dogs received oral MOP at 2, 6, and 10 g/head/day for 3–4 weeks at each dose level. Clinical signs, hematology, and serum biochemistry were monitored throughout the study period. Results: The MOP powder composition and residue levels remained within regulatory safety limits. In the dose-escalation study, no significant dose-dependent abnormalities were observed in physical or clinicopathological parameters. One dog exhibited transient loose stools at higher doses and a temporary elevation in alkaline phosphatase levels at 2 g/head/day; however, these symptoms resolved spontaneously despite continued administration. Conclusions: MOP was safe and well tolerated in dogs even at 10 g/head/day (787–952 mg/kg/day), which is approximately five times the anticipated clinical dose. The observed fluctuations in active ingredient concentrations remained within the acceptable range for natural products and did not affect overall safety. Combined with comprehensive screening for residues, these results indicate that MOP is a high-quality and safe dietary intervention for older dogs. Full article

Background: Against the backdrop of global population aging, understanding the mechanisms of age-related cognitive decline has become crucial for improving the health and quality of life in older adults. Methods: This study employed a multimodal approach to investigate the neural modulations induced by a motor cognitive dual task and their relationship with age-related decline. By integrating behavioral assessments, electroencephalography (EEG), and body composition analysis, we comprehensively evaluated performance and neural correlates in 19 younger and 18 older adults. Specifically, EEG analyses focused on comparing pre-task and post-task resting-state recordings to investigate the immediate impact of a single acute cognitive-motor dual-task session on neural oscillations and brain network organization. Results: Key findings include: (1) older adults exhibited significantly inferior performance in task accuracy, reaction time, and composite performance score compared to younger adults (p < 0.001); (2) neural oscillatory analysis of resting-state data revealed a localized increase in gamma-band power at posterior-temporal sites (PO4/T6) in older adults following the dual-task, while younger adults exhibited widespread multi-band (delta to beta) power modulation across frontal, central, and temporal regions in younger adults; (3) brain network analysis demonstrated synergistic enhancement of multi-band (Theta, Alpha, Beta, Gamma) connectivity and optimized topological organization in younger adults post-task, contrasting with network rigidity and localized compensatory patterns in older adults; (4) correlation analyses indicated significant associations between dual-task performance and MoCA-B scores in older adults (r = 0.861, p < 0.001). Conclusions: This study innovatively elucidates the neurophysiological characteristics of brain aging. The motor-cognitive dual-task paradigm proves to be a sensitive tool for capturing early cognitive changes, holding significant promise for clinical screening. Full article

The growing complexity and interdependence of critical infrastructures (CIs), increasingly exposed to natural and technological hazards, call for educational approaches to enhance resilience and risk management. This study examines trends, patterns, and challenges in integrating digital and immersive technologies into education and training for stakeholders in critical infrastructure management. A systematic review of peer-reviewed literature was conducted using Scopus as the primary source, covering the last decade and analyzing the corpus across six dimensions: technological approach, pedagogical model, hazard typology, infrastructure domain, stakeholder category, and implementation phase. Following the PRISMA framework, 5635 records were identified and screened through a multistage process combining rule-based filtering and manual review, resulting in 105 papers meeting the inclusion criteria. The analysis reveals a shift from classroom instruction and physical drills toward immersive, simulation-based, and data-informed learning ecosystems that strengthen situational awareness, procedural accuracy, and decision-making under stress. However, the review identifies persistent gaps in evaluation metrics, cross-sector frameworks, and collaborative learning environments that limit adoption. The findings underscore that digital and immersive technologies can reconfigure education and training frameworks, enabling the formation of Resilient Operators endowed with adaptive cognition, continuous learning capacities, and responsiveness to natural hazard-induced technological risks. Full article

Background: Large Language Models (LLMs) are reshaping medical research workflows. Objective: This narrative review synthesizes evidence on LLM applications across systematic reviews, scientific writing, and clinical research. Methods: We reviewed literature from 2023–2025 examining LLM applications in medical research, identified through PubMed, Scopus, Web of Science, arXiv, medRxiv, and Google Scholar. Studies reporting empirical findings, methodological evaluations, or systematic analyses of LLM applications were included; editorials and commentaries without empirical data were excluded. Results: In systematic reviews, LLMs achieve 80–94% data extraction accuracy and 40% reduction in screening workload, but show only slight-to-moderate agreement (κ = 0.16–0.43) in risk-of-bias assessment. In scientific writing, hallucination rates of 47–55% for fabricated references and over 90% prevalence of demographic bias require rigorous verification. For clinical research, LLMs assist with statistical coding and protocol development but require human validation. Critically, excessive reliance on automated tools may cause cognitive offloading that compromises analytical capabilities. Conclusions: LLMs are powerful but unstable tools requiring constant verification. Success depends on maintaining human-in-the-loop approaches that preserve critical thinking while leveraging AI efficiency. Full article

Esports are a rapidly expanding form of competitive activity that demand high levels of cognitive alertness, motor precision, stress management, and resilience to mental and physical fatigue. At the same time, the sedentary lifestyle, extended screen exposure, and psychological pressures associated with competitive gaming raise concerns for both performance and long-term health. Growing evidence highlights the importance of nutrition and lifestyle behaviors in supporting cognitive performance and overall competitive demands. While balanced dietary patterns and adequate hydration are essential, dietary supplements may provide additional benefits when used appropriately and under professional guidance. However, the current research is limited by a predominance of cross-sectional and self-reported studies, short-term or acute interventions, small sample sizes, and insufficient emphasis on esports-specific and personalized strategies. This review examines existing evidence on individualized nutrition, supplementation, and lifestyle strategies in esports, identifies key methodological limitations, and outlines future directions to inform evidence-based practice for athletes, practitioners, and organizations seeking to optimize cognitive performance, well-being, and long-term sustainability in this emerging field. Full article

Background/Objectives: Alzheimer’s disease (AD) involves amyloid and tau pathology with neuroimmune dysregulation, and Yixin Yangshen Granules (YXYS) shows neuroprotective promise, though mechanisms remain unclear. This study aimed to elucidate the multi-target mechanisms of YXYS in AD. Methods: The study began by analyzing a public human AD hippocampal snRNA-seq dataset to identify cell-type-specific pathological pathways and profiled YXYS constituents by UPLC-QTOF-MS. In vitro, YXYS cytoprotection against mitochondrial dysfunction and oxidative stress was tested in Aβ_25–35-challenged HT22 cells; in vivo efficacy was assessed in Aβ_1–42-induced mice via behavioral and histopathological analyses. Integrated transcriptomic and proteomic profiling of brain tissue, with ELISA, qRT-PCR, and Western blot validation, confirmed pathway targets. Using the intersection of transcriptomic and proteomic targets as biological input, the DTIAM deep learning framework was employed to prioritize active YXYS constituents. Finally, molecular docking and 100-ns dynamics simulations demonstrated direct binding of Ganosporelactone A to HIF−1α. Results: AD snRNA-seq analysis highlighted HIF−1 and AGE-RAGE signaling as prominent pathways in the AD hippocampus, particularly enriched in brain microvascular endothelial cells, implicating neurovascular hypoxic and inflammatory stress. In Aβ-induced mice, YXYS improved cognition, reduced Aβ pathology, suppressed neuroinflammation, and promoted neuronal survival, consistent with in vitro evidence of restored mitochondrial function. Multi-omics confirmed convergence on HIF−1 and AGE-RAGE pathways, with YXYS rebalancing the neuroimmune microenvironment by reducing pro-inflammatory M0 macrophages. Screening against these consensus signaling hubs, deep learning analysis prioritized Ganosporelactone A as the top-ranked modulator, and molecular further demonstrated the stable binding of Ganosporelactone A to HIF−1α, linking YXYS to mitigation of hypoxic stress. Conclusions: Guided by multi-omics and deep learning, our findings suggest that YXYS may alleviate AD-related phenotypes through multi-target modulation of the HIF−1 and AGE-RAGE pathways, with associated improvements in neuro-immune homeostasis and reductions in oxidative stress, neuroinflammation, and hypoxia. Full article

The primary aim of this study is to develop a comprehensive theoretical model for creating digital content that enhances speech formation in toddlers aged 1–3, based on children’s folklore. This model seeks to integrate pedagogical, psychological, and cultural elements to offer a balanced and age-appropriate digital learning experience for young children. The study employed a systematic literature review using Creswell’s seven-step process, which involved identifying relevant research, reviewing and analyzing 22 peer-reviewed studies published between 2019 and 2023, and synthesizing their findings. VOSviewer version 1.6.18, a bibliometric visualization tool, was used to conduct a keyword co-occurrence analysis, identifying key concepts and trends in digital content creation for toddlers. The systematic review adhered to the PRISMA framework to ensure rigor in the selection and analysis of the included studies, which spanned fields such as education, psychology, and pediatric development. The study identified several key dimensions necessary for developing an effective theoretical model of digital content creation for toddlers: The content must be age-appropriate and consider the unique cognitive, linguistic, and developmental needs of toddlers. Children’s folklore plays a crucial role in language development, offering culturally rich and rhythmically engaging material for young learners. The model must address the balance between screen time and real-world interactions, ensuring that digital engagement does not replace essential real-life learning experiences. Ensuring the psychological and physiological safety of digital content is paramount, requiring the exclusion of inappropriate or harmful material and the inclusion of interactive, engaging content that supports speech development. The study concludes that a well-designed model for digital content creation, rooted in children’s folklore, can significantly enhance speech development in toddlers. Such a model must not only support language acquisition but also reflect cultural heritage, promote safe digital environments, and encourage a balance between digital and real-world interactions. By integrating the findings from various disciplines, this theoretical model provides a holistic framework that can guide the development of high-quality digital content aimed at supporting early childhood language development in the digital age. Full article

Background/Objectives: Age-related hearing loss (ARHL) is highly prevalent among older adults and has been linked to cognitive decline. However, the specific cognitive domains most vulnerable to ARHL and whether these associations exhibit lateralized effects remain unclear, which is critical for understanding and mitigating its broader impact on neurocognitive function. This study aimed to characterize the clinical profile of ARHL and examine associations between hearing thresholds and cognitive performance across domains, including the influence of educational attainment as a proxy for cognitive reserve. Methods: Audiometric assessments and cognitive screening using the Mini-Mental State Examination were conducted in older adults, including normal-hearing listeners (NHL, n = 31, mean age 71.4) and those with hearing loss (HL, n = 46, mean age 73.1). Associations between pure-tone averages, clinical complaints, and cognitive domains were analyzed while considering educational attainment. Results: HL participants exhibited a higher prevalence of tinnitus (NHL: 33.3% vs. HL: 65.2%) and slightly more frequent dizziness compared to their normal-hearing peers. Cognitive assessment revealed that decreased cognitive performance was strongly associated with hearing loss (p < 0.05), and this association was influenced by low educational level. Orientation was the most affected domain (p < 0.01), while recall and language were also significantly associated with low- and high-frequency pure-tone averages, respectively. Conclusions: These findings reinforce the relationship between ARHL and cognitive decline, suggesting an attentional basis whereby higher listening effort to decode the degraded auditory input may affect cognitive performance. The results also highlight the influence of educational attainment as a moderating factor. Full article

Background/Objectives: Patients after cardiac surgery admitted to the intensive care unit (ICU) are exposed to environmental, procedural, and psychological stressors that may affect comfort and recovery. This study aimed to assess perceived ICU stressors in postoperative cardiac surgery patients, identify the most and least distressing factors, and examine associations between stressor intensity and selected clinical and organizational variables. Methods: A single-center cross-sectional survey was conducted in an ICU in Poland (January 2024–February 2024). Adult patients after cardiac surgery who provided informed consent and had no cognitive impairment were included; cognitive status was screened using the Montreal Cognitive Assessment (MoCA). Perceived stressors were measured using the Intensive Care Unit Environmental Stressor Scale (ICUESS; 40 items; 4-point Likert scale). Results: The highest-rated stressors were sleep problems (M = 2.30; SD = 0.86) and hearing heart monitor alarms (M = 2.16; SD = 0.82). The lowest-rated stressors were not knowing what day it was (M = 1.46; SD = 0.54) and nurses not introducing themselves (M = 1.50; SD = 0.54). Longer respiratory support and higher pain intensity were associated with higher stressor ratings for multiple ICUESS items, whereas age showed no significant association. Higher room occupancy was linked to higher perceived stress related to environmental disturbances. ICU length of stay showed only limited item-level associations. Conclusions: Postoperative cardiac surgery patients experience a multifactorial burden of ICU stressors, with sleep disruption and alarm-related noise among the most distressing. Prioritizing modifiable environmental factors, symptom control (particularly pain), and patient-centered communication may help reduce perceived stress, especially in shared-room settings and among patients requiring longer respiratory support. Full article

Mental health disorders (MHDs) and acute coronary syndromes (ACSs) demonstrate reciprocal pathophysiological connections with substantial prognostic implications. Despite robust evidence linking MHDs to adverse cardiovascular outcomes, the bidirectional relationship remains inadequately characterized in clinical practice, with limited integration of mental health screening into routine cardiac care pathways. The present narrative review comprehensively presents contemporary data on epidemiology, shared biological mechanisms, clinical consequences, and integrated management strategies across the MHD–ACS continuum. A synthesis of peer-reviewed literature, meta-analyses, observational cohorts, randomized trials, and international guideline documents was performed, focusing on depression, anxiety, post-traumatic stress disorder, bipolar disorder, schizophrenia, and suicidality in relation to ACSs. MHDs are highly prevalent in ACS populations and independently predict increased mortality, major adverse cardiac events, and poorer functional recovery. Shared mechanisms include chronic low-grade inflammation, autonomic imbalance, hypothalamic–pituitary–adrenal axis hyperactivation, platelet hyperreactivity, and endothelial dysfunction. Selective serotonin reuptake inhibitors and cognitive behavioral therapy demonstrate the strongest evidence for treating depression in cardiac populations. Collaborative, stepped-care, and integrated cardiac rehabilitation models consistently improve psychological outcomes, with variable effects on cardiovascular endpoints. MHDs and ACSs form a self-reinforcing clinical continuum. Routine mental health screening and integrated cardio-psychiatric care represent essential components of secondary prevention and long-term outcome optimization. Full article