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21 pages, 2139 KB  
Article
Structural Symmetry Modeling and Network Optimization for Evaluating Industrial Chain Integration and Firm Performance: Evidence from Xinjiang’s Characteristic Food Processing Industry Under the Big Food Concept
by Ting Wang and Reziyan Wakasi
Symmetry 2026, 18(5), 735; https://doi.org/10.3390/sym18050735 (registering DOI) - 25 Apr 2026
Abstract
Industrial chains in agriculture are currently fragmented and do not support developing resource-based competitive advantages. This is true under the Big Food Framework’s strategic orientation. This research seeks to develop a new analytical framework for evaluating pathways to the integration of agricultural industrial [...] Read more.
Industrial chains in agriculture are currently fragmented and do not support developing resource-based competitive advantages. This is true under the Big Food Framework’s strategic orientation. This research seeks to develop a new analytical framework for evaluating pathways to the integration of agricultural industrial chains and their impact on the performance of companies engaged in food processing in Xinjiang. A mixed-method approach, employing both an exploratory and sequential design, will be used to do this. The primary method of data collection for this study is the case study method, along with the questionnaire method involving 145 agricultural enterprises. From these data, structural equation modeling (SEM) will be used to test the paths of causation among cognitive managers of firms who have implemented the BFF. Evidence will be presented to demonstrate the relationship among three types of integration (vertical, horizontal, and lateral) in the agricultural industrial chain, dynamic capabilities, and company performance. Additionally, network topology and optimization simulations will be conducted to determine how effectively structures are organized in training the respective companies. Important findings revealed in this research include the following: The managerial cognition constructs offered by BFFs play a key role in enhancing the depth and structural balance of industry chain integration. There were complementary performance effects found, and they are related to vertical integration achieving operational efficiency and financial efficiency; horizontal integration improving market competitiveness and brand competitiveness; and lateral integration facilitating innovative growth. Dynamic capabilities are a significant mediating mechanism linking institutional support and digital capability with the depth of integration across different modes of integration. The findings from network optimization suggest that there is a positive effect of balanced connectivity across the different dimensions of integration on overall system efficiency and reduced structural inefficiencies. Based on these findings, the authors recommend that organizations establish governance mechanisms that facilitate coordinated connectivity; strengthen adaptive capabilities within the firm; and promote balanced integration across industrial networks. Future researchers should consider applying these findings to conducting longitudinal studies on network evolution; integrating sustainability measures as part of their analysis; and conducting comparative validation studies across regions or industry systems. Full article
(This article belongs to the Section Chemistry: Symmetry/Asymmetry)
16 pages, 1382 KB  
Article
The Effects of Mental Fatigue on Psychophysiological Responses, Mood States, and Archery Shooting Performance Under a Simulated Archery Competition: A Randomized Cross-Over Study
by Sevval Soylu, Ersan Arslan, Bulent Kilit and Yusuf Soylu
Brain Sci. 2026, 16(5), 459; https://doi.org/10.3390/brainsci16050459 (registering DOI) - 24 Apr 2026
Abstract
Background/Objective: Mental fatigue (MF) significantly impairs psychomotor performance in dynamic sports; however, its specific impact on closed-skill precision-demanding tasks remains underexplored. This study investigated the acute effects of experimentally induced MF exposure on psychophysiological responses, mood states, and archery shooting performance. Methods: Fifteen [...] Read more.
Background/Objective: Mental fatigue (MF) significantly impairs psychomotor performance in dynamic sports; however, its specific impact on closed-skill precision-demanding tasks remains underexplored. This study investigated the acute effects of experimentally induced MF exposure on psychophysiological responses, mood states, and archery shooting performance. Methods: Fifteen well-trained male compound-bow archers participated in a randomized crossover study. Participants completed an MF condition (30 min modified Stroop task) and a control condition (CON; passive viewing of a neutral documentary), separated by a 72 h washout period. Continuous heart rate (HR), archery shooting accuracy, ratings of perceived exertion (RPE), rating scale of mental effort (RSME), state anxiety (VAS-A), mood states, and exercise enjoyment scale (EES) were assessed. Results: The Stroop task successfully induced subjective MF. Consequently, shooting accuracy significantly deteriorated in the MF condition compared to that in the CON condition (p < 0.001; g = 0.731). While HR and VAS-A remained consistent across conditions, the MF condition elicited a significant increase in RPE (p = 0.007; g = 0.836) and RSME (p = 0.010; g = 0.794). Furthermore, MF significantly increased feelings of anger and fatigue while drastically reducing PACES (p < 0.001; g = 1.530). Conclusions: Acute MF significantly degrades fine motor accuracy in precision sports. The pronounced dissociation between elevated RPE and stable peripheral physiological strain suggests that performance decline is driven by top-down cognitive burden rather than physiological limitations. Therefore, systematic monitoring of cognitive load is crucial for optimizing performance in precision sports. Full article
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13 pages, 555 KB  
Case Report
Augmentative and Alternative Communication as an Ecological Window on Neglect-Related Spatial Asymmetry After Hemorrhagic Stroke: A Longitudinal Case Report
by Carmela Rifici, Rosaria De Luca, Francesco Corallo, Sabrina Miceli, Santina Caliri, Andrea Calderone, Rosalia Calapai, Alessio Mirabile, Maria Pagano, Angelo Quartarone and Rocco Salvatore Calabrò
Brain Sci. 2026, 16(5), 456; https://doi.org/10.3390/brainsci16050456 (registering DOI) - 24 Apr 2026
Abstract
Background/Objectives: Spatial neglect after stroke may be difficult to characterize in patients with severe motor, cognitive, and communication impairment. Augmentative and alternative communication interfaces require visual scanning and intentional selection and may therefore provide an ecological context in which lateralized visuospatial behavior becomes [...] Read more.
Background/Objectives: Spatial neglect after stroke may be difficult to characterize in patients with severe motor, cognitive, and communication impairment. Augmentative and alternative communication interfaces require visual scanning and intentional selection and may therefore provide an ecological context in which lateralized visuospatial behavior becomes clinically observable. Methods: A 58-year-old man with a unilateral right-hemisphere hemorrhagic stroke underwent serial assessment at baseline before training, at the end of 24 AAC sessions delivered over 2 months in addition to standard neurorehabilitation, and at 1-month follow-up. Measures included cognitive functioning, behavioral responsiveness, global disability, bedside communication status, and P300 latency. The AAC/eye-tracking intervention also generated process data across 21 analyzable sessions, including calibration quality, free-exploration heatmaps, and performance in the Stars and Bow-Target tasks. Results: Global measures showed modest early improvement followed by stabilization. Cognitive functioning improved from 2 to 3 and remained stable, behavioral responsiveness increased from 7 to 10 and then to 11, bedside communication increased from 7 to 9 and remained stable, and P300 latency decreased from 393 to 350 and then to 351 ms, whereas global disability remained unchanged at 25 throughout. Calibration was at least good in all quadrants and never scored 0. Performance was lower and more unstable in Stars than in Bow-Target. Heatmaps showed rightward clustering, reduced left-sided exploration, and limited whole-screen scanning. Conclusions: AAC/eye-tracking did not provide formal diagnostic proof of neglect, but it supported ecological recognition of a neglect-like lateralized exploratory pattern under less guided conditions. Full article
(This article belongs to the Topic Advances in Neurorehabilitation)
32 pages, 4458 KB  
Article
Developing a Protocol-Based Expressive Therapies Continuum Assessment Profile (ETC-AP): Current Achievements and Future Perspectives
by Elza Strazdiņa, Viktorija Perepjolkina, Anda Upmale-Puķīte, Elīna Akmane, Jana Duhovska and Kristīne Mārtinsone
Behav. Sci. 2026, 16(5), 640; https://doi.org/10.3390/bs16050640 - 24 Apr 2026
Abstract
Art therapy assessment benefits from analytical clarity while preserving non-directive, process-sensitive practice. Although the Expressive Therapies Continuum (ETC) is widely used to conceptualize sensory, affective, cognitive, and symbolic processes in art-making, ETC-informed assessment often relies on implicit clinical reasoning, limiting transparency and interdisciplinary [...] Read more.
Art therapy assessment benefits from analytical clarity while preserving non-directive, process-sensitive practice. Although the Expressive Therapies Continuum (ETC) is widely used to conceptualize sensory, affective, cognitive, and symbolic processes in art-making, ETC-informed assessment often relies on implicit clinical reasoning, limiting transparency and interdisciplinary communication. This article presents the developmental stage of a protocol-based Expressive Therapies Continuum Assessment Profile (ETC-AP) developed at Rīga Stradiņš University. The ETC-AP differentiates activation and inhibition patterns around integration midpoints and organizes observation in a defined five-step interpretive sequence without positioning the method as a psychometrically validated test. It combines (i) a uniform three-task, non-directive administration with a brief post-task inquiry; (ii) criteria-guided coding of observable features across three artworks and process notes; and (iii) 0–100 descriptive profile indicators to support within-case pattern description and professional dialogue. An illustrative case vignette shows how the ETC-AP can generate trauma-informed, regulation-oriented hypotheses about channel accessibility and cautious regulation-oriented sequencing, while remaining subordinate to clinical judgment and context. Key boundaries include incomplete operational coverage in some inhibition ranges, limits of static documentation for process-dependent markers, and the need for structured training materials and programmatic studies of reliability, feasibility, and sensitivity to change. Full article
19 pages, 1262 KB  
Article
Cognitive Improvement in Methamphetamine-Dependent Males: A Randomized Trial Comparing Different Exercise Interventions with Behavioral and fNIRS Evidence
by Xuejie Zhang, Jisheng Xu, Xulin Zhou, Yan Yang, Guosi Ying and Xue Li
Brain Sci. 2026, 16(5), 451; https://doi.org/10.3390/brainsci16050451 (registering DOI) - 24 Apr 2026
Abstract
Background: Long-term methamphetamine use disrupts brain function and impairs cognition. Currently, there is a lack of effective treatments for cognitive dysfunction in this population. This study aimed to investigate the effects of different exercise interventions on cognitive function and brain activation in [...] Read more.
Background: Long-term methamphetamine use disrupts brain function and impairs cognition. Currently, there is a lack of effective treatments for cognitive dysfunction in this population. This study aimed to investigate the effects of different exercise interventions on cognitive function and brain activation in methamphetamine-dependent individuals and to explore the potential neural mechanisms underlying cognitive improvement. Methods: In this randomized, assessor-blind, controlled study, 162 male methamphetamine-dependent individuals in compulsory isolation were randomly assigned to one of four groups: traditional regimen training (TR, n = 41), aerobic exercise (AE, n = 40), multimodal cognitive exercise training (MC, n = 40), and a control group (MA, n = 41). All participants completed an 8-week intervention. Cognitive function was assessed before and after the intervention using the Stroop task, while fNIRS was used to measure task-related hemodynamic responses. In addition, the Memory and Executive Screening (MES) and choice reaction time tests were used to evaluate cognitive and psychomotor performance. Results: After 8 weeks, traditional regimen training (p = 0.006), aerobic exercise (p = 0.024), and multimodal cognitive exercise training (p < 0.001) all significantly improved Stroop task accuracy. Aerobic exercise significantly increased activation in L-DLPFC (p = 0.044), R-DLPFC (p = 0.036), and L-FPA (p = 0.038), improved MES-T scores (p < 0.001) and shortened choice reaction time (p < 0.001). Traditional regimen training increased L-DLPFC activation (p = 0.026), improved MES-T scores (p < 0.001), and shortened choice reaction time (p < 0.001). Multimodal cognitive exercise training increased activation in L-DLPFC (p = 0.006), R-DLPFC (p = 0.014), and L-FPA (p = 0.002), improved MES-T scores (p < 0.001) and shortened choice reaction time (p < 0.001). Conclusions: Cognitive impairment in methamphetamine-dependent individuals may be associated with reduced prefrontal functional activity. Different exercise modalities produced different patterns of cognitive improvement and brain activation, with multimodal cognitive exercise training showing the largest overall benefit. Full article
(This article belongs to the Section Cognitive, Social and Affective Neuroscience)
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29 pages, 4143 KB  
Article
Effects of Cognitive Style and Evaluation Context on Hedonic and Sensory Perception of Café Latte: A Comparison of Sensory Booth, Real-Life, and Mixed Reality Environments
by Dongju Lee, Sangoh Kim, Seongju Woo and Youngseung Lee
Foods 2026, 15(9), 1487; https://doi.org/10.3390/foods15091487 - 24 Apr 2026
Abstract
This study examined cognitive style-related differences (analytic vs. holistic) in consumer liking, sensory perception, and ideal sensory profiles across three evaluation contexts (real café, sensory booth, and mixed reality). A total of 77 participants were divided into an analytic group (N = 34) [...] Read more.
This study examined cognitive style-related differences (analytic vs. holistic) in consumer liking, sensory perception, and ideal sensory profiles across three evaluation contexts (real café, sensory booth, and mixed reality). A total of 77 participants were divided into an analytic group (N = 34) and a holistic group (N = 43) based on the Analysis–Holism Scale. They evaluated six café latte samples varying in sugar concentration (0, 2.5, 5%) and espresso-to-milk ratio (1:2 and 1:3) for three environments using a within-subject design. Consumer evaluation comprised overall liking and sensory perception assessed using CATA (25 attributes) and Ideal CATA, with descriptive analysis (DA) conducted in parallel by eight trained panelists. The results showed no significant differences between cognitive styles in overall liking, but differences appeared in sensory perception and ideal product mapping between the booth and real café. The analytic group focused on dominant attributes with little variation for environments, whereas the holistic group integrated contextual cues, showing more context-dependent patterns. Compared with the other two environments, the MR environment showed high similarity to the DA results in terms of attribute profiles (RV = 0.88). This study indicates that cognitive style is a key factor in consumer sensory evaluation and should be considered to improve sensory evaluation methodology. Full article
(This article belongs to the Section Sensory and Consumer Sciences)
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10 pages, 421 KB  
Article
Association Between Neuropsychiatric Symptoms of Dementia and Caregiver Outcomes: A Cross-Sectional Study in Primary Care
by Constança Paúl, Marta Vieira e Silva, Susana Sousa and Laetitia Teixeira
J. Gerontol. Geriatr. 2026, 74(2), 13; https://doi.org/10.3390/jgg74020013 - 24 Apr 2026
Viewed by 66
Abstract
Neuropsychiatric symptoms in dementia impact diagnosis and caregiver burden. Informal caregivers effectively identify cognitive changes and confirm the care receiver’s symptoms. This study aims to examine the association between neuropsychiatric symptoms in primary care users with probable dementia and caregiver burden and depression, [...] Read more.
Neuropsychiatric symptoms in dementia impact diagnosis and caregiver burden. Informal caregivers effectively identify cognitive changes and confirm the care receiver’s symptoms. This study aims to examine the association between neuropsychiatric symptoms in primary care users with probable dementia and caregiver burden and depression, as reported by informal caregivers, and describe the most frequent neuropsychiatric symptoms in this population. This cross-sectional study included 101 primary care users aged 65+ with mental health concerns identified by their General Practitioner and informal caregivers, excluding those in institutional care, without memory concerns and an informal caregiver, or without Neuropsychiatric Inventory Questionnaire (NPI-Q) data. The sample (79.4 ± 7.7 years) was 53.5% female, 33.7% had no formal education, and 60.4% presented probable dementia per Global Deterioration Scale. The NPI-Q total score and the distress dimension score were 10.1 (sd = 5.6) and 11.9 (sd = 9.1), respectively. The most reported symptoms were agitation/aggression (69.3%) and apathy/indifference (65.3%). We found a significant positive association between NPI-Q total and Distress scores and Caregiver Burden Scale, 0.296 (p = 0.023) and 0.417 (p < 0.001), and between NPI-Q total and Distress scores and AB Clinician Depression Screen, 0.227 (p = 0.023) and 0.416 (p < 0.001). Probable dementia was linked to more neuropsychiatric symptoms and greater caregiver burden and depression. Training for caregivers can improve the quality of care and, as a result, may reduce burnout and depression. Full article
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16 pages, 576 KB  
Article
An Integrated Student Well-Being and Resilience Model for Health Professions Education in South Africa
by Xolani Lawrence Mhlongo
J. Mind Med. Sci. 2026, 13(2), 11; https://doi.org/10.3390/jmms13020011 - 23 Apr 2026
Viewed by 98
Abstract
Background: South African university students face escalating levels of psychological distress driven by academic overload, financial precarity, and social challenges. Health professions students are particularly vulnerable due to the demanding nature of clinical training and repeated exposure to human suffering. Aim: This study [...] Read more.
Background: South African university students face escalating levels of psychological distress driven by academic overload, financial precarity, and social challenges. Health professions students are particularly vulnerable due to the demanding nature of clinical training and repeated exposure to human suffering. Aim: This study aims to propose an Integrated Student Well-being and Resilience Model tailored to the South African health professions education context. Methods: This conceptual paper draws on empirical evidence from South African studies on student mental health, global campus well-being frameworks, and socio-ecological theory. Bronfenbrenner’s Socio-Ecological Systems Theory and a tiered public health approach were synthesized to develop a multi-level model aimed at addressing the academic, financial, and social determinants of student mental health. Conceptual synthesis: The study unequivocally identified a syndemic of interconnected factors predisposing students to depression, which included the interplay of academic rigour and cognitive burnout, financial vulnerability as a determinant of mental health, the crisis of social connection and psychological safety, and institutional failure and the resilience fallacy. Conclusions: The Integrated Student Well-being and Resilience (ISWR) Model is a systemic architecture designed to coordinate institutional governance with the complex psychosocial needs of health professions students. The model provides a holistic, scalable framework for strengthening student well-being within health professions education. By shifting from reactive counselling to proactive, system-level interventions, the model offers a strategic blueprint for creating resilient, supportive learning environments capable of improving student mental health and fostering a healthier future healthcare workforce. Full article
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13 pages, 708 KB  
Systematic Review
Neurofeedback in Football: A Systematic Review of Cognitive, Technical, Physical and Psychological Outcomes
by Sílvio A. Carvalho, Pedro Bezerra, José E. Teixeira, Pedro Forte, Rui M. Silva and José M. Cancela-Carral
NeuroSci 2026, 7(3), 50; https://doi.org/10.3390/neurosci7030050 - 23 Apr 2026
Viewed by 157
Abstract
This systematic review synthesized the existing evidence on neurofeedback interventions applied to football players, aiming to clarify their effects on cognitive, technical–tactical, physical and psychological performance. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four databases (PubMed, Web of Science, [...] Read more.
This systematic review synthesized the existing evidence on neurofeedback interventions applied to football players, aiming to clarify their effects on cognitive, technical–tactical, physical and psychological performance. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four databases (PubMed, Web of Science, SCOPUS and SportsDiscus) were searched up to November 2025. Seven studies met the inclusion criteria, involving 133 players across youth, amateur, national and elite levels. Neurofeedback protocols primarily targeted alpha or sensorimotor rhythm (SMR) activity, and some were combined with heart rate variability (HRV) biofeedback. Across studies, neurofeedback may be associated with improvements in several cognitive outcomes, including improvements in working memory, visuospatial memory, task switching, mental rotation and decision-making. Limited evidence suggests potential improvements in technical skills (particularly shooting accuracy) and tactical decision-making. Some studies reported changes in physiological markers and stress-recovery capacity, although their interpretation remains uncertain. However, the evidence base remains constrained by small samples, heterogeneous protocols and limited use of randomized controlled designs. Overall, neurofeedback appears to be a potentially promising but still experimental tool to support cognitive and psychophysiological readiness in football, warranting more rigorous and standardized research to establish efficacy and optimal training parameters. Full article
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33 pages, 24046 KB  
Article
CoDA: A Cognitive-Inspired Approach for Domain Adaptation
by Cavide Balkı Gemirter, Emin Erkan Korkmaz and Dionysis Goularas
Appl. Sci. 2026, 16(9), 4115; https://doi.org/10.3390/app16094115 - 23 Apr 2026
Viewed by 229
Abstract
Modern neural networks have achieved remarkable success in visual recognition; however, due to their sensitivity to domain shifts, Unsupervised Domain Adaptation (UDA) remains an open research problem. A key reason for this limitation is that source-trained models rely primarily on texture, lacking the [...] Read more.
Modern neural networks have achieved remarkable success in visual recognition; however, due to their sensitivity to domain shifts, Unsupervised Domain Adaptation (UDA) remains an open research problem. A key reason for this limitation is that source-trained models rely primarily on texture, lacking the explicit geometric information required for object recognition. To overcome this problem, we introduce CoDA, an object-centric learning framework inspired by infant cognitive development, specifically the process of object individuation. By introducing a geometric prior, our approach employs a physically grounded generation pipeline that uses a textureless “Sculpture Mode” and object isolation to complement textural information with 3D geometric features, capturing shape information that is often ignored during training. To enable robust training from scratch, we further integrate two control mechanisms: a Network Stability Scheduler to orchestrate training progression based on convergence stability, and a Dynamic Top-K Pseudo-Labeling strategy that adapts confidence thresholds for each individual class. Extensive evaluations on three real-world target datasets (VegFru, Fruits-262, and Open Images v7) demonstrate that CoDA, trained on a source dataset of just 12,000 synthetic images, achieves comparable results to (and in specific domains surpasses) ImageNet-pretrained models (leveraging 1.2 million images), significantly outperforming state-of-the-art adversarial and semi-supervised domain adaptation methods. Full article
(This article belongs to the Special Issue Advanced Signal and Image Processing for Applied Engineering)
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32 pages, 16741 KB  
Article
Quadrato Motor Training in Parkinson’s Disease: Resting-State fMRI Changes and Exploratory Whole-Brain Radiomics
by Carlo Cosimo Quattrocchi, Claudia Piervincenzi, Raffaella Di Giacopo, Donatella Ottaviani, Maria Chiara Malaguti, Chiara Longo, Francesca Cattoi, Nikolaos Petsas, Loredana Verdone, Micaela Caserta, Sabrina Venditti, Bruno Giometto, Rossana Franciosi, Federica Vaccarino, Marco Parillo and Tal Dotan Ben-Soussan
Bioengineering 2026, 13(5), 486; https://doi.org/10.3390/bioengineering13050486 - 22 Apr 2026
Viewed by 365
Abstract
Parkinson’s disease (PD) may benefit from non-pharmacological motor–cognitive rehabilitation, but sensitive neuroimaging markers of training-related brain changes remain limited. This study investigated whether 4 weeks of daily Quadrato Motor Training (QMT) modulate resting-state functional connectivity (FC) in PD and secondarily explored whether whole-brain [...] Read more.
Parkinson’s disease (PD) may benefit from non-pharmacological motor–cognitive rehabilitation, but sensitive neuroimaging markers of training-related brain changes remain limited. This study investigated whether 4 weeks of daily Quadrato Motor Training (QMT) modulate resting-state functional connectivity (FC) in PD and secondarily explored whether whole-brain radiomic features derived from T1-weighted and fractional anisotropy (FA) images could detect pre–post differences over this short intervention interval. Fifty patients with idiopathic PD were randomized to QMT or a SHAM repetitive stepping condition, and 48 completed the protocol (25 SHAM, 23 QMT). MRI was acquired at baseline and after 4 weeks and included resting-state fMRI, 3D T1-weighted imaging, and diffusion-derived FA maps. Resting-state fMRI was analyzed using independent component analysis and dual regression, whereas an IBSI-compliant radiomics workflow and machine-learning models were used for exploratory scan-level classification. Compared with baseline, the SHAM group showed reduced synchronization across several resting-state networks, whereas the QMT group showed increased synchronization in the right sensorimotor and frontoparietal networks and no significant reductions. Between-group analyses showed lower delta-FC in SHAM than QMT in the cerebellar and sensorimotor networks. In contrast, radiomics showed limited discrimination between pre- and post-QMT scans; the best model achieved a ROC-AUC of 0.65 with near-chance accuracy, and no selected predictor remained significant after multiple-comparison correction. These findings suggest that QMT may support short-term functional network stability or task-relevant reorganization in PD relative to the SHAM condition, whereas whole-brain structural radiomics appears less sensitive for detecting early training-related effects in this setting. Full article
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22 pages, 5386 KB  
Review
Augmented Reality in Maritime Navigation: Future Solutions for Young Navigators
by Artem Holovan, Vytautas Dubra and Andrii Holovan
Future Transp. 2026, 6(3), 93; https://doi.org/10.3390/futuretransp6030093 - 22 Apr 2026
Viewed by 116
Abstract
This study addresses the question of how augmented reality (AR) technologies can be designed and integrated into maritime navigation systems to meet the needs of young navigators within contemporary socio-technical bridge environments. The article is based on a qualitative, literature-based research methodology involving [...] Read more.
This study addresses the question of how augmented reality (AR) technologies can be designed and integrated into maritime navigation systems to meet the needs of young navigators within contemporary socio-technical bridge environments. The article is based on a qualitative, literature-based research methodology involving a structured analysis and synthesis of peer-reviewed journal articles and conference proceedings related to AR interfaces, human performance, decision support, and maritime training. The reviewed studies indicate that AR can enhance perceptual and situational awareness by overlaying navigational information directly into the navigator’s field of view, thereby reducing head-down time, improving spatial alignment of information, and supporting performance in low-visibility and high-traffic conditions. The literature also shows that AR-enabled visualizations and shared displays can support individual and team-based decision-making by facilitating real-time, context-aware information exchange on the ship’s bridge. Safety-related benefits are identified as indirect outcomes of improved perception and cognitive support rather than as isolated technological effects. Simultaneously, the findings highlight that these benefits depend strongly on human-centered interface design and appropriate training. The study concludes that AR has significant potential to enhance maritime navigation for young navigators when integrated as part of a balanced socio-technical system combining technology, human factors, and structured education. Full article
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22 pages, 1043 KB  
Systematic Review
Update on Repetitive Transcranial Magnetic Stimulation in Post-Stroke Cognitive Rehabilitation: A Systematic Review of Randomized Clinical Trials
by Davide N. Tringali, Rosario Ferlito, Rita Bella, Mariagiovanna Cantone, Rita Chiaramonte, Raffaele Ferri, Francesco Fisicaro, Michele Iacona, Maria P. Mogavero, Manuela Pennisi, Michele Vecchio and Giuseppe Lanza
Life 2026, 16(4), 700; https://doi.org/10.3390/life16040700 - 21 Apr 2026
Viewed by 134
Abstract
Background: We synthesized evidence from randomized clinical trials (RCTs) published between 2019 and 2025 on repetitive transcranial magnetic stimulation (rTMS) in post-stroke cognitive impairment (PSCI) and compared different stimulation parameters, cortical targets, and combinations with rehabilitation interventions. Methods: A systematic review according to [...] Read more.
Background: We synthesized evidence from randomized clinical trials (RCTs) published between 2019 and 2025 on repetitive transcranial magnetic stimulation (rTMS) in post-stroke cognitive impairment (PSCI) and compared different stimulation parameters, cortical targets, and combinations with rehabilitation interventions. Methods: A systematic review according to PRISMA guidelines examined the RCTs applying rTMS in adults with PSCI compared with control or sham groups. The primary outcome was improvement in cognitive function and functional outcomes measured with standardized scales. Results: Fifteen studies, involving a total of 732 patients, were included. The most frequently investigated were high-frequency (≥10 Hz) stimulation protocols of the left dorsolateral prefrontal cortex, with treatment cycles ranging from 2 to 6 weeks. Overall, rTMS was generally safe and well tolerated, with rare and mild adverse events. Several studies reported improvements in cognitive performance following rTMS, although effects were variable across trials and need caution in light of heterogeneity in stimulation protocols, sample sizes, outcome measures, and methodological quality. In most cases, rTMS or intermittent theta burst stimulation combined with structured cognitive training yielded greater cognitive and functional gains than stimulation or rehabilitation alone. This suggests a positive interaction between rTMS and cognitive training, although current evidence does not yet allow definitive conclusions. Conclusions: rTMS appears to be a promising strategy for post-stroke cognitive rehabilitation, particularly for attention and executive functioning. However, heterogeneity in stimulation protocols and outcome measures, along with limited sample sizes and short follow-up, reduces the certainty and comparability of current evidence. The widespread reliance on global screening tools may further underestimate domain-specific effects. Future multicentre trials with standardized protocols and more sensitive cognitive assessments are needed to clarify efficacy and guide further clinical application of rTMS in PSCI. Full article
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18 pages, 307 KB  
Review
Music-Based Interventions in Childhood Hearing Loss: A Comprehensive Narrative Review
by Mirko Aldè, Letizia Casella, Umberto Ambrosetti, Stefania Barozzi, Eleonora Gandolfo, Federica Di Berardino and Diego Zanetti
Children 2026, 13(4), 574; https://doi.org/10.3390/children13040574 - 21 Apr 2026
Viewed by 245
Abstract
Background/Objectives: Childhood hearing loss (HL) affects auditory, linguistic, and social development. Alongside conventional rehabilitation, music-based interventions have gained increasing attention for their potential to support both auditory and non-auditory domains. This narrative review aims to summarize current evidence on the use of music-based [...] Read more.
Background/Objectives: Childhood hearing loss (HL) affects auditory, linguistic, and social development. Alongside conventional rehabilitation, music-based interventions have gained increasing attention for their potential to support both auditory and non-auditory domains. This narrative review aims to summarize current evidence on the use of music-based interventions in children with HL. Methods: A narrative review of the literature was conducted, examining studies involving pediatric cochlear implant or hearing aid users. Publications were categorized into three main areas: musical auditory perception, musical training, and music therapy. Results: Studies on musical auditory perception demonstrate persistent limitations in pitch and timbre perception in children with HL, while rhythmic abilities appear relatively preserved. Musical training interventions, particularly those targeting rhythm, have been associated with improvements in auditory perception, linguistic processing, and selected cognitive skills, although parental involvement and long-term designs remain limited. Existing literature on music therapy is scarce but suggests potential benefits extending beyond auditory skills to emotional regulation, social interaction, and quality of life. Conclusions: Music-based interventions represent a promising complementary approach in pediatric hearing rehabilitation. While musical training is more widely studied, music therapy is still underrepresented despite its holistic focus. Further structured studies are needed to define standardized protocols and outcome measures for music therapy in children with HL. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Ear and Vestibular Disorders)
18 pages, 926 KB  
Article
Research on Threshold Optimization and Variability-Based Digital Biomarker Approaches Through MMSE-Lifelog Multimodal Integrated Analysis from a Clinical Screening Perspective
by Yeeun Park and Jin-hyoung Jeong
Healthcare 2026, 14(8), 1094; https://doi.org/10.3390/healthcare14081094 - 20 Apr 2026
Viewed by 201
Abstract
Background: Early screening of cognitive impairment is essential for timely clinical intervention; however, conventional cognitive tests such as the Mini-Mental State Examination (MMSE) rely on fixed thresholds that may not be optimal in real-world screening settings. Methods: This study developed a [...] Read more.
Background: Early screening of cognitive impairment is essential for timely clinical intervention; however, conventional cognitive tests such as the Mini-Mental State Examination (MMSE) rely on fixed thresholds that may not be optimal in real-world screening settings. Methods: This study developed a threshold-aware multimodal screening framework integrating MMSE item-level scores with wearable-derived sleep and physical activity lifelog data. A dataset of 174 adults was analyzed and categorized into cognitively normal (CN), mild cognitive impairment (MCI), and dementia, with MCI and dementia combined as an impaired group. A CatBoost-based binary classification model was trained using five-fold cross-validation. The optimal decision threshold was determined by maximizing balanced accuracy using out-of-fold predictions. Results: The optimized threshold (0.49) achieved an accuracy of 0.818 and a balanced accuracy of 0.728 on the validation set. The recall values were 0.885 for CN and 0.571 for the impaired group, with an area under the ROC curve of 0.676. Feature importance and stability analyses showed that variability-related sleep and activity features were consistently selected across folds. Conclusions: These findings suggest that threshold optimization combined with multimodal lifelog integration may improve the interpretability of screening decisions. Variability-based lifelog features may provide complementary information alongside MMSE, although their role remains exploratory and requires further validation in larger and longitudinal cohorts. Full article
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