Search Results (231)

Cognitive impairment is a prevalent and disabling feature of multiple sclerosis (MS), significantly impacting patients’ quality of life (QoL) and psychological well-being. Despite its clinical relevance, there are currently no approved pharmacological treatments for cognitive deficits in MS, highlighting the need for effective non-pharmacological interventions. This narrative review explores evidence from studies evaluating the efficacy of cognitive re-education (CR) approaches (including traditional, group-based, computer-assisted, virtual reality, and innovative methods such as music therapy) on cognitive and QoL outcomes in people with MS. The findings demonstrate that while CR consistently influences cognitive domains such as memory, attention, and executive function, its effects on QoL are more variable and often depend on intervention type, duration, and individual patient characteristics. Notably, integrative approaches like virtual reality and music therapy show promising results in enhancing both cognitive performance and psychosocial well-being. Several studies report that cognitive gains are accompanied by improvements in mental health and functional QoL, particularly when interventions are tailored to individual needs and delivered within multidisciplinary frameworks. However, some interventions yield only limited or transient QoL benefits, underlining the importance of personalized, goal-oriented strategies that address both cognitive and psychosocial dimensions. Further research is needed to optimize intervention strategies and clarify the mechanisms linking cognitive and QoL outcomes. Full article

The integration of digital serious games into speech learning (rehabilitation) has demonstrated significant potential in enhancing accessibility and inclusivity for children with speech disabilities. This review of the state of the art examines the role of serious games, Artificial Intelligence (AI), and Natural Language Processing (NLP) in speech rehabilitation, with a particular focus on interaction modalities, engagement autonomy, and motivation. We have reviewed 45 selected studies. Our key findings show how intelligent tutoring systems, adaptive voice-based interfaces, and gamified speech interventions can empower children to engage in self-directed speech learning, reducing dependence on therapists and caregivers. The diversity of interaction modalities, including speech recognition, phoneme-based exercises, and multimodal feedback, demonstrates how AI and Assistive Technology (AT) can personalise learning experiences to accommodate diverse needs. Furthermore, the incorporation of gamification strategies, such as reward systems and adaptive difficulty levels, has been shown to enhance children’s motivation and long-term participation in speech rehabilitation. The gaps identified show that despite advancements, challenges remain in achieving universal accessibility, particularly regarding speech recognition accuracy, multilingual support, and accessibility for users with multiple disabilities. This review advocates for interdisciplinary collaboration across educational technology, special education, cognitive science, and human–computer interaction (HCI). Our work contributes to the ongoing discourse on lifelong inclusive education, reinforcing the potential of AI-driven serious games as transformative tools for bridging learning gaps and promoting speech rehabilitation beyond clinical environments. Full article

Background/Objectives: Cigarette smoking has been causally linked to 90% of all cases of lung cancer, contributing to its high mortality rate. Lung cancer screening centers offer low-dose computed tomography, the only recommended diagnostic screening tool for lung cancer detection. A previous Texas-based study found that centers with lung cancer screening programs failed to consistently provide evidence-based tobacco cessation and relapse prevention interventions recommended by clinical practice guidelines to their patients, who are primarily people who currently or previously smoked. This represents a missed opportunity to assist patients by providing evidence-based tobacco use care during a particularly relevant clinical encounter. Methods: To improve cigarette smoking cessation care delivery and relapse prevention in this setting, this protocol paper seeks to provide a framework for adapting Taking Texas Tobacco Free, a comprehensive, evidence-based tobacco-free workplace program, to lung cancer screening centers. The adapted program, Project SWITCH, will be developed through a formative evaluation process with center stakeholders to identify proactive adaptations to programming based on center-specific contexts. Project SWITCH is expected to be implemented in at least nine lung cancer screening centers in Texas and will be disseminated more broadly to centers statewide. Results: Quantitative and qualitative data will be collected from multiple stakeholders throughout the intervention using a convergent parallel mixed methods design to make additional program adaptations and comprehensively evaluate the achievement of the project’s implementation and dissemination goals. Conclusions: Results from this project’s implementation and dissemination phases are expected to reduce lung cancer morbidity and mortality in Texas by providing an evidence-based, sustainable framework for tobacco-free workplace programs in this specific setting that improves cancer prevention and control practices. Full article

Background/Objectives: Globally, one in eight people live with a mental disorder, with depression being a leading cause of disability. This study aimed to identify sociodemographic factors associated with public belief and perception of mental disorders among adults in Poland. Methods: A cross-sectional study with a self-prepared questionnaire (5-point Likert scale) was administered to a nationally representative quota sample of 1114 Polish adults (March 2025). The computer-assisted web interview (CAWI) method was applied. Results: A cross-sectional survey of 1114 adults found that 23.2% had visited psychiatrists, 15.9% psychotherapists, and 21.1% reported a family history of mental disorders. Most respondents (73.8%) believed employers are reluctant to hire individuals with mental disorders, and 53.8% perceived discrimination. Additionally, 19.4% thought mental health patients receive lower-quality care than those with physical illnesses like diabetes. Respondents from large cities (≥500,000 residents, aOR: 1.67; 95%CI: 1.11–2.51; p = 0.01), with higher education (aOR: 1.62; 95%CI: 1.26–2.07; p < 0.001), or a family history of mental disorders (p < 0.05) were more likely to hold this view. Higher education (aOR: 1.47; 95%CI: 1.11–1.94; p = 0.01), good economic status (aOR: 1.60; 1.06–2.40; p = 0.02), and personal psychiatric experience (aOR: 1.89; 95%CI: 1.24–2.87; p = 0.003) increased belief in treatment effectiveness. Males (aOR: 1.88; 95%CI: 1.36–2.61; p < 0.001) and medium-city residents (aOR: 1.82; 95%CI: 1.01–3.27; p = 0.04) more often perceived mental disorders as a sign of weakness, while women (aOR: 1.74; 95%CI: 1.36–2.22; p < 0.001) and those with affected relatives (p < 0.05) more frequently reported discrimination. Older respondents (p < 0.05), those with higher education (aOR: 1.65), and individuals with a family history of mental disorders (p < 0.05) were more likely to state that employers fear hiring people with psychiatric conditions. Conclusions: These findings underscore the need for public health interventions to reduce stigma, improve awareness, and address misconceptions about mental disorders in Poland. Full article

Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide, underscoring the need for continuous innovation in diagnostics and treatment. Mock circulation loops (MCLs) systems have recently emerged as new research platforms capable of replicating the hemodynamics of the human cardiovascular system. This review explores the expanding applications of MCLs to cardiovascular diseases beyond their traditional role in testing ventricular assist devices and heart failure management. We focus on their versatility in simulating various cardiovascular conditions, particularly arterial diseases such as atherosclerosis, stenosis, and aneurysms. This review traces the evolution of MCLs and their integration with computational simulations and real-time data acquisition systems. MCLs provide detailed insights into hemodynamic responses under diverse conditions, enhancing the precision and safety of cardiovascular interventions. This comprehensive review emphasizes the critical role of MCLs in advancing cardiovascular research, refining clinical interventions, and improving patient outcomes. Full article

Background: Mental health issues among youth are a growing public health concern. Schools play a vital role in the early detection and prevention of mental health issues, with principals being central to the implementation of mental health initiatives. This study assessed the attitudes, preparedness, and practices of school principals regarding mental health promotion and prevention among school-aged children. Methods: A cross-sectional survey using computer-assisted web interviewing (CAWI) was conducted between March and April 2025. A 19-item questionnaire was sent to all 1564 primary and secondary school principals in the Lodz region. Data from 605 respondents (response rate: 38.7%) were analyzed. Results: A total of 94.9% of the principals reported an increase in student mental health problems over the past five years. Over one-quarter of school principals (26.3%) declared a very good or rather good level of preparation for teachers to work with students diagnosed with a mental disorder. Moreover, 42.3% declared a very good or rather good level of preparation of teachers for conversations with parents about mental health problems observed in their children. Mental health education was conducted in 94.7% of schools, and teacher training in 73.2% of schools. Secondary schools more often offered such training (81.9% vs. 70.7%; p = 0.01) and reported stronger support from specialist teachers (79.7% vs. 67.7%; p = 0.01) than primary schools did. Rural schools rated teacher-parent communication more positively (47.0% vs. 37.7%; p = 0.02) despite fewer training initiatives (68.7% vs. 77.7%; p = 0.01). Suicide response procedures were implemented in 78.5% of schools. Conclusions: The findings confirm a marked rise in student mental health needs and reveal structural disparities in providing school-based support. Enhancing school leadership, expanding teacher training, and ensuring systemic support may facilitate mental health promotion interventions in schools. Full article

Background/Objectives: The COVID-19 pandemic has had a profound impact on the mental health of the general population, particularly older adults. This study aimed to explore the association between loneliness and mental health disorders in this demographic during the pandemic. Methods: A cross-sectional survey was conducted in Portugal using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) database between June and August 2020, during the COVID-19 pandemic (Wave 8 COVID-19 Survey), using computer-assisted telephone interviews. Results: The final sample included 836 participants, with 387 (46.4%) men and a mean age of 74.5 years (SD = 6.7). Mental health indicators revealed that 441 (52.1%) reported feelings of nervousness, 384 (45.3%) experienced sadness or depression, 349 (41.2%) encountered sleeping difficulties, and 280 (33.1%) reported experiencing loneliness often or some of the time. Increased feelings of loneliness were notably associated with women in poorer health, those with heightened fear of falling, dizziness, fatigue, anxiety, depression, and concurrent health and sleep issues. Age and medication use did not significantly impact feelings of loneliness. Conclusions: The findings highlight a potential association between adverse mental health outcomes among older adults during the initial phase of the pandemic. Future research, employing longitudinal research designs, is warranted to explore these relationships more rigorously, in a post-pandemic context, and to inform effective intervention development and strategies to prevent mental health problems within this vulnerable population. Full article

Background: Nasal reconstruction requires a balance between aesthetic and functional restoration. Recent advances in three-dimensional (3D) printing have introduced new approaches to this field, enabling precise, patient-specific interventions. This review explores the applications, benefits, and challenges of integrating 3D printing in nasal reconstruction. Methods: A literature search was conducted using PubMed, Scopus, and Web of Science to identify studies on 3D printing in nasal reconstruction. Peer-reviewed articles and clinical trials were analyzed to assess the impact of 3D-printed models, implants, and bioengineered scaffolds. Results: 3D printing facilitates the creation of anatomical models, surgical guides, and implants, enhancing surgical precision and patient outcomes. Techniques such as stereolithography (SLA) and selective laser sintering (SLS) enable high-resolution, biocompatible constructs using materials like polylactic acid, titanium, and hydroxyapatite. Computational fluid dynamics (CFD) tools improve surgical planning by optimizing nasal airflow. Studies show that 3D-printed guides reduce operative time and improve symmetry. Emerging bioprinting techniques integrating autologous cells offer promise for tissue regeneration. Challenges and Future Directions: Challenges include high costs, imaging limitations, regulatory hurdles, and limited vascularization in bioprinted constructs. Future research should focus on integrating bioactive materials, artificial intelligence-assisted design, and regulatory standardization. Conclusions: 3D printing offers specific advantages in nasal reconstruction, improving precision and outcomes in selected cases. Addressing current limitations through technological and regulatory advancements will further its clinical integration, potentially enhancing reconstructive surgery techniques. Full article

Chronic pancreatitis (CP) is a progressive condition that is associated with severe complications. Diagnosis of late CP is easy due to characteristic clinical presentation and pathognomonic imaging findings, such as pancreatic calcifications. Early changes, such as lobularity and a dilated main pancreatic duct, are very subtle and challenging to detect with ultrasonography (US) or even computed tomography (CT). Data were accumulating on the usefulness of EUS in the early diagnosis of CP. The sensitivity values for detecting early CP (ECP) by US, MRI, and EUS were 67–69%, 77–78%, and 81–84%, respectively. The specificity values for detecting ECP by US, MRI, and EUS were 90–98%, 83–96%, and 90–100%, respectively. Pancreatic cancer (PDAC) is one of the leading cancers worldwide, with increasing morbidity. Due to its poor prognosis and survival, early diagnosis is crucial. For this indication, EUS also shows better outcomes compared to other imaging methods, especially in tumors < 2 cm. The sensitivity and specificity for diagnosing PDAC with MRI and EUS were 52.3–93%, 77.1–89%, 72–100%, and 90%, respectively. In addition, EUS can detect precancerous conditions that are associated with a higher risk of PDAC. EUS-assisted new techniques, like elastography and contrast enhancement, facilitate the diagnosis of pancreatic lesions and make it even more accurate. Early PDAC changes, such as main pancreatic duct dilatation or irregular margins of pancreatic solid masses, may be detected with EUS. This review describes the efficacy of different imaging techniques in the early detection of CP and PDAC. In addition, we describe the useful interventions made possible by early diagnosis of PDAC and CP. Full article

Hepatitis C virus (HCV) infection remains a significant global health burden, driven by the emergence of drug-resistant strains and the limited efficacy of current antiviral therapies. A promising strategy for therapeutic intervention involves targeting the NS3 protease, a viral enzyme essential for replication. In this study, we present the first computational model specifically designed to identify NS3 protease inhibitory peptides (NS3IPs). Using amino acid composition (AAC) and K-spaced amino acid pair composition (CKSAAP) features, we developed machine learning classifiers based on support vector machine (SVM) and random forest (RF), achieving accuracies of 98.85% and 97.83%, respectively, validated through 5-fold cross-validation and independent testing. To support the accessibility of the strategy, we implemented a web-based tool, iDNS3IP, which enables real-time prediction of NS3IPs. In addition, we performed feature space analyses using PCA, t-SNE, and LDA based on AAindex descriptors. The resulting visualizations showed a distinguishable clustering between NS3IPs and non-inhibitory peptides, suggesting that inhibitory activity may correlate with characteristic physicochemical patterns. This study provides a reliable and interpretable platform to assist in the discovery of therapeutic peptides and supports continued research into peptide-based antiviral strategies for drug-resistant HCV. To enhance its flexibility, the iDNS3IP web tool also incorporates a BLAST-based similarity search function, enabling users to evaluate inhibitory candidates from both predictive and homology-based perspectives. Full article

Artificial intelligence (AI) and assistive robotics can transform older-person care by offering new, personalised solutions for an ageing population. This paper outlines recent advances in AI-driven applications and robotic assistance in silver care, emphasising their role in improved healthcare services, quality of life and ageing-in-place and alleviating pressure on healthcare systems. Advances in machine learning, natural language processing and computer vision have enabled more accurate early diagnosis, targeted treatment plans and robust remote monitoring for elderly patients. These innovations support continuous health tracking and timely interventions to improve patient outcomes and extend home-based care. In addition, AI-powered assistive robots with advanced motion control and adaptive response mechanisms are studied to support physical and cognitive health. Among these, companion robots, often enhanced with emotional AI, have shown potential in reducing loneliness and increasing connectedness. The combined goal of these technologies is to offer holistic patient-centred care, which preserves the autonomy and dignity of our seniors. This paper also touches on the technical and ethical challenges of integrating AI/robotics into eldercare, like privacy and accessibility, and alludes to future directions on optimising AI-human interaction, expanding preventive healthcare applications and creating an effective, ethical framework for eldercare in the digital age. Full article

Background/Objectives: Breastfeeding is a cornerstone of infant nutrition, promoting optimal development and health benefits for both mother and child. Despite high initiation rates in Poland (97%), exclusive breastfeeding (EBF) drops sharply, reaching only 4% by six months postpartum. The aim of this study is to identify factors associated with breastfeeding practices and barriers to exclusive breastfeeding (EBF) among Polish women during the postpartum period, with particular emphasis on the role of medical personnel support and maternal stress levels. Methods: A cross-sectional observational study, adhering to STROBE guidelines, was conducted from January to May 2023. The study included 1092 Polish women, surveyed using the Computer-Assisted Web Interview (CAWI) methodology. The women exclusively breastfeeding accounted for 79% (n = 863) of the study group. The remaining women supplemented their child with modified milk (n = 229; 21%). Statistical analyses were performed using IBM SPSS Statistics (Version 26.0), and logistic regression to assess associations between variables and breastfeeding outcomes. Results: Logistic regression analysis indicated that in the women experiencing low or medium stress, none of the analysed support factors significantly influenced the likelihood of exclusive breastfeeding discontinuation. However, women experiencing high stress, receiving counselling for effective breastfeeding (OR = 0.467; 95% CI: 0.232–0.941; p = 0.033) and assistance with proper breastfeeding (OR = 0.424; 95% CI: 0.220–0.819; p = 0.011) were associated with a lower likelihood of introducing formula feeding. The main reported reasons for early breastfeeding cessation included breast health issues, mental exhaustion, lack of medical support and infant-related difficulties. Conclusions: The findings allow us to underscore the urgent need for targeted interventions to improve breastfeeding rates in Poland. New evidence indicates that women experiencing higher levels of stress require increased support from medical personnel in order to breastfeed exclusively. Full article

Background/Objectives: Mild cognitive impairment in Parkinson’s disease (PD-MCI) affects approximately 20–50% of patients, and it is associated with an increased risk of dementia. Computer-assisted cognitive interventions (CCTs) have been proposed as a promising method of improving cognitive function in these patients. This review aims to (1) demonstrate the effectiveness of computer-based intervention in PD-MCI, and (2) determine the most effective iteration. Methods: A review was performed using PubMed, Google Scholar, and ScienceDirect. Full texts of randomized clinical trials (RCTs) involving CCT intervention in PD-MCI and published in English language journals between 2014 and 2024 were included. Results: Of the 747 studies identified, 6 studies fulfilled the eligibility criterion for this review. Patients receiving CCTs showed significant improvements in global cognition and executive function, while mood was not significantly affected in most studies. Conclusions: CCT improves cognitive functions, particularly memory and executive abilities, but has little effect on mood. Although the results are encouraging, there are potential methodological biases that need to be considered. Full article

Background: From 1 January 2024, Poland legally banned the sale of energy drinks (EDs) containing caffeine and taurine to minors under 18. EDs are rich in stimulants, making them particularly popular among adolescents and young adults seeking energy boosts. Their consumption is associated with adverse health effects and engagement in risky behaviors. This descriptive snapshot study explores energy drink consumption, motivations, and risk perception among Polish adults. Methods: A cross-sectional, nationwide survey (N = 1121) was conducted over a three-day period using the computer-assisted web interviewing (CAWI) method. The sample was representative of the adult Polish population in terms of gender, age, and geographical location. Data collection occurred 14 months after the implementation of legal restrictions on ED sales to minors. Results: Among 1121 adults (54.3% female), 15.1% reported weekly ED consumption, 9.7% monthly, 13.3% less than monthly, and 62.0% never. Younger age (p < 0.05), male gender (aOR = 1.63 [1.25–2.13]; p < 0.001), and active occupational status (aOR = 1.63 [1.19–2.24]; p = 0.002) were significantly associated with ED use. Overall, 83.0% of respondents perceived EDs as harmful, and 87.2% supported the sales ban to minors, although only 45.6% considered the ban effective. Additionally, 31.8% had observed minors consuming EDs in the past 30 days. Sociodemographic characteristics were associated with risk perception and support for regulation: women (aOR = 1.50), individuals with higher education (aOR = 1.44), and those with good financial status (aOR = 2.35) were more likely to perceive EDs as harmful and endorse regulatory measures. Conclusions: Educational interventions should prioritize young adults, particularly males, who constitute the primary consumers. There is also a need to enhance enforcement mechanisms to limit minors’ access to energy drinks and curb their marketing and availability, thereby improving public health protection. Full article

Background/Objectives: Discrimination is a phenomenon of special relevance in adolescence, as this is a key period in the development of young people, so measures that accurately and reliably assess it are essential. The aim of this research is to study the psychometric properties of the Spanish version of the Everyday Discrimination Scale in a sample of Spanish adolescents. Methods: The scale was applied to 1000 adolescents using Computer Assistance Web Interview (CAWI) methodology by means of a stratified random sampling by age, gender and territorial distribution. Results: The results reveal an unifactorial structure of the scale, with adequate measures of reliability and validity that confirm that it is a suitable instrument for assessing everyday discrimination in this population. Conclusions: This study has implications for understanding the experiences of discrimination in adolescents and for developing interventions to reduce discrimination and promote equality. Limitations and implications for the future are also discussed. Full article