Search Results (94)

Objectives: COVID-19, caused by the SARS-CoV-2 virus, has infected over 777 million individuals and led to approximately 7 million deaths worldwide. Despite significant efforts to develop effective therapies, treatment remains largely supportive, especially for severe complications like acute respiratory distress syndrome (ARDS). Numerous compounds from diverse pharmacological classes are currently undergoing preclinical and clinical evaluation, targeting both the virus and the host immune response. Methods: Despite the large number of articles published and after a preliminary attempt was published, we discarded the option of a systematic review. Instead, we have done a description of therapies with these results and a tentative mechanism of action. Results: Preliminary studies and early-phase clinical trials have demonstrated the potential of Mesenchymal Stem Cells (MSCs) in mitigating severe lung damage in COVID-19 patients. Previous research has shown MSCs to be effective in treating various pulmonary conditions, including acute lung injury, idiopathic pulmonary fibrosis, ARDS, asthma, chronic obstructive pulmonary disease, and lung cancer. Their ability to reduce inflammation and promote tissue repair supports their potential role in managing COVID-19-related complications. This review demonstrates the utility of MSCs in the acute phase of COVID-19 and postulates the etiopathogenic role of mitochondria in Long-COVID. Even more, their combination with other therapies is also analyzed. Conclusions: While the therapeutic application of MSCs in COVID-19 is still in early stages, emerging evidence suggests promising outcomes. As research advances, MSCs may become an integral part of treatment strategies for severe COVID-19, particularly in addressing immune-related lung injury and promoting recovery. However, a full pathogenic mechanism may explain or unify the complexity of signs and symptoms of Long COVID and Post-Acute Sequelae (PASC). Full article

Background: Dementia is a syndrome with a high global prevalence that includes a number of progressive diseases of the brain affecting various cognitive domains such as memory and thinking and the performance of daily activities. It manifests as symptoms which often include significant mood and behaviour changes that are highly varied. Changed moods and behaviours due to dementia may reflect distress and may be stressful for both the person living with dementia and their informal and formal carers. To provide dementia care support specific to mood and behaviour changes, the Behaviours in Dementia Toolkit website (BiDT) was developed using human-centred design principles. The BiDT houses a user-friendly, digital library of over 300 free, practical, and evidence-informed resources to help all care partners better understand and compassionately respond to behaviours in dementia so they can support people with dementia to live well. Objective: (1) To characterize the users that visited the BiDT; and (2) to understand the platform’s early impact on these users. Methods: A multi-method, descriptive study was conducted in the early post-website launch period. Outcomes and measures examined included the following: (1) reach: unique visitors, region, unique visits, return visits, bounce rate; (2) engagement: engaged users, engaged sessions, session duration, pages viewed, engagement rate per webpage, search terms, resources accessed; (3) knowledge change; (4) behaviour change; and (5) website impact: relevance, feasibility, intention to use, improving access and use of dementia guidance, recommend to others. Data was collected using Google Analytics and an electronic survey of website users. Results: From 4 February to 31 March 2024, there were 76,890 unique visitors to the BiDT from 109 countries. Of 76,890 unique visitors to the BiDT during this period, 16,626 were engaged users as defined by Google Analytics (22%) from 80 countries. The highest number of unique engaged users were from Canada (n = 8124) with an engagement rate of 38%. From 5 March 2024 to 31 March 2024, 100 electronic surveys were completed by website users and included in the analysis. Website users indicated that the BiDT validated or increased their dementia care knowledge, beliefs, and activities (82%) and they reported that the website validated their current care approaches or increased their ability to provide care (78%). Further, 77% of respondents indicated that they intend to continue using the BiDT and 81.6% said that they would recommend it to others to review and adopt. Conclusions: The BiDT is a promising tool for sharing practical and evidence-informed information resources to support people experiencing dementia-related mood and behaviour changes. Early evaluation of the website has demonstrated significant reach and engagement with users in Canada and internationally. Survey data also demonstrated high ratings of website relevance, feasibility, intention to use, knowledge change, practice support, and its contribution to dementia guidance. Full article

Crack sealant is commonly used to fill pavement cracks and improve the Pavement Condition Index (PCI). However, during asphalt pavement hot in-place recycling (HIR), irregular shapes and random distribution of crack sealants can cause issues like agglomeration and ignition. To address these problems, it is necessary to mill large areas containing crack sealant or pre-mark locations for removal after heating. Currently, detecting and recording crack sealant locations, types, and distributions is conducted manually, which significantly reduces efficiency. While deep learning-based object detection has been widely applied to distress detection, crack sealants present unique challenges. They often appear as wide black patches that overlap with cracks and potholes, and complex background noise further complicates detection. Additionally, no dataset specifically for crack sealant detection currently exists. To overcome these challenges, this paper presents a specialized dataset created from 1983 pavement images. A deep learning detection algorithm named YOLO-CS (You Only Look Once Crack Sealant) is proposed. This algorithm integrates the RepViT (Representation Learning with Visual Tokens) network to reduce computational complexity while capturing the global context of images. Furthermore, the DRBNCSPELAN (Dilated Reparam Block with Cross-Stage Partial and Efficient Layer Aggregation Networks) module is introduced to ensure efficient information flow, and a lightweight shared convolution (LSC) detection head is developed. The results demonstrate that YOLO-CS outperforms other algorithms, achieving a precision of 88.4%, a recall of 84.2%, and an mAP (mean average precision) of 92.1%. Moreover, YOLO-CS significantly reduces parameters and memory consumption. Integrating Artificial Intelligence-based algorithms into HIR significantly enhances construction efficiency. Full article

In the context of new quality productive forces, enterprises must leverage technological innovation and intelligent management to enhance financial risk resilience. This article proposes a financial distress prediction model based on deep learning, combined with a CNN, BiLSTM, and attention mechanism, using SMOTE for sample imbalance and Hyperband for hyperparameter optimization. Among four CNN-BiLSTM-AT model structures and seven mainstream models (CNN, BiLSTM, CNN-BiLSTM, CNN-AT, BiLSTM-AT, CNN-GRU, and Transformer), the 1CNN-1BiLSTM-AT model achieved the highest validation accuracy and relatively faster training speed. We conducted 100 repeated experiments using data from two companies, with validation on 2025 data, confirming the model’s stability and effectiveness in real-world scenarios. This article lays a solid empirical foundation for further optimization of financial distress warning models. Full article

Given the suboptimal responses to medication and cognitive behavioral therapies in the treatment of post-traumatic stress disorder (PTSD), new approaches are needed. Background/Objectives: Therapies that include a somatic component such as Emotional Freedom Techniques (EFT) and Eye Movement Desensitization and Reprocessing (EMDR) have demonstrated efficacy in the treatment of PTSD in numerous clinical trials. This case series introduces the Trauma Reintegration Process (TRP), a psychotherapeutic process developed by the author that can be combined with somatic therapies to enhance their effectiveness, especially in patients with dissociation. Methods: This case series describes the use of TRP in combination with EFT, an energy-based somatic treatment that engages the meridian system of the body through gentle tapping on acupressure points. TRP uses EFT in combination with a focused guided imagery sequence. This case series describes the treatment of two patients: a 20-year-old woman who experienced PTSD and somatic symptoms following a serious motor vehicle accident (MVA) and a 45-year-old woman with a history of severe abuse as a child as well as adult trauma who had also been in a serious MVA. The cases contrast the way TRP can be applied in patients with single versus multiple traumas and who experience dissociation. Results: In both cases, EFT treatment stalled when the patient dissociated. After TRP was introduced, however, the EFT treatment regained momentum, leading to significant improvement in PTSD symptoms including a reduction of nightmares and flashbacks and resolution of other somatic symptoms. Conclusions: The trauma reintegration process (TRP) in combination with EFT has the potential to assist in the memory processing of patients with dissociation and complicated trauma presentation without retraumatizing the client and causing further distress or dissociation. In addition, it provides the patient with a self-empowering method to alleviate any additional traumatic sequelae. Full article

Long COVID remains a public health challenge, impacting over 65 million people globally and manifesting as persistent, multisystemic symptoms that complicate both diagnosis and treatment. To address the need for a standardized, patient-centered assessment tool, this study introduces the Memorial Symptom Assessment Scale-Long COVID (MSAS-LC), which evaluates symptom prevalence, frequency, severity, and distress. The MSAS-LC was developed by modifying the Memorial Symptom Assessment Scale to include 45 prevalent Long COVID symptoms. A cross-sectional survey of 261 U.S. adults (129 with Long COVID and 131 without) assessed validity and group differences. Symptom prevalence was analyzed using logistic regression, while symptom burden (frequency, severity, and distress) was compared using generalized linear models. Participants with Long COVID reported significantly higher symptom prevalence and burden across all systems. Memory problems (73.4% vs. 30.5%; OR = 6.29, p < 0.001) and post-exertional fatigue (OR = 8.55, p < 0.001) were among the most burdensome symptoms. These findings offer preliminary evidence supporting the potential utility of MSAS-LC and underscore the continued public health relevance of individual and collective symptom presentations. The findings suggest the distinct symptom burden, emphasizing the importance of future research to inform diagnostic and treatment strategies. With continued validation, the MSAS-LC may contribute to improved symptom monitoring and care planning in clinical and public health settings. Full article

Background/Objectives: Inflammatory bowel diseases (IBD), including mainly ulcerative colitis (UC) and Crohn’s disease (CD), have been associated with cognitive and psychological changes, though the mechanisms remain unclear. Methods: This prospective case-control study aimed to evaluate cognitive performance and biomarkers (homocysteine, serum amyloid A, brain-derived neurotrophic factor, and S100B protein) in IBD patients. Results: A total of 90 individuals (34 UC, 21 CD, and 35 controls) were assessed using the Montreal Cognitive Assessment (MoCA), the Memory Impairment Index (MIS), and biomarker analysis. MoCA and MIS testing showed significant differences between UC, CD, and the controls, with lower scores observed in IBD groups (p = 0.003, p = 0.015). Regarding trail-making tests, digit symbol substitution tests, and forward and backward digit spans, no significant changes were observed. No functional deficits were observed in daily activities. Biomarker analysis revealed lower brain-derived neurotrophic factor and higher serum amyloid A levels in IBD patients, correlated to MOCA and MIS scores. There were no significant differences in psychological distress between IBD patients and the controls. Subtle cognitive declines were noted across all groups during the 1-year follow-up, without any statistical significance when groups were compared. Conclusions: In conclusion, IBD patients reported lower cognitive scores compared to the controls, while no differences in depression and anxiety scores were observed. Higher BDNF levels correlated with better cognitive functioning, while higher serum amyloid A correlated with lower cognitive functioning. Full article

Objectives: To compare the health status, exercise capacity, and health-related quality of life (HRQoL) in survivors of COVID-19-associated acute respiratory distress syndrome (ARDS) at 8, 12, and 24 months post-diagnosis. Methods: We conducted a prospective, single-center follow-up study embedded within a larger multicenter cohort of adults with COVID-19 who required hospital admission. Eligible participants underwent clinical interviews, physical examinations, chest radiography, and the 6-min walk test (6MWT). Standardized scales were used to assess post-traumatic stress disorder (PTSD), anxiety, depression, and HRQoL. Results: Out of 1295 patients with COVID-19, 365 developed ARDS, of whom 166 survived. After excluding deaths and loss to follow-up, 95 patients were monitored for 24 months. Over 60% of patients had persistent symptoms, though significant improvements were recorded in quality of life and physical recovery. More than 70% recovered their previous physical capacity, but 15% did not return to their usual lifestyle habits. Symptoms such as arthralgia and fatigue decreased, but cognitive issues, such as memory loss and insomnia, persisted. Radiological improvements were noted, although pulmonary function remained impaired. The prevalence of PTSD and anxiety decreased, while depression remained stable at around 30%. Conclusions: Long COVID continues to impose significant physical, mental, and social challenges. Symptoms like fatigue and anxiety have a profound impact on daily life. Strategies are urgently needed to help patients regain health and resume their normal lives. Full article

Background/Objectives: The widespread phenomenon of “brain rot”, named the Oxford Word of the Year 2024, refers to the cognitive decline and mental exhaustion experienced by individuals, particularly adolescents and young adults, due to excessive exposure to low-quality online materials, especially on social media. The present study is exploratory and interpretative in nature, aiming to investigate the phenomenon of “brain rot”, with a focus on its key pillars, psychological factors, digital behaviors, and the cognitive impact resulting from the overconsumption of low-quality digital content. Methods: This study employs a rapid review approach, examining research published between 2023 and 2024 across PubMed, Google Scholar, PsycINFO, Scopus, and Web of Science. It explores the causes and effects of brain rot, focusing on the overuse of social media, video games, and other digital platforms. Results: The findings reveal that brain rot leads to emotional desensitization, cognitive overload, and a negative self-concept. It is associated with negative behaviors, such as doomscrolling, zombie scrolling, and social media addiction, all linked to psychological distress, anxiety, and depression. These factors impair executive functioning skills, including memory, planning, and decision-making. The pervasive nature of digital media, driven by dopamine-driven feedback loops, exacerbates these effects. Conclusions: The study concludes by offering strategies to prevent brain rot, such as controlling screen time, curating digital content, and engaging in non-digital activities. Given the increasing prevalence of digital engagement, it is essential to explore a variety of strategies, including mindful technology use, to support cognitive health and emotional well-being. The results can guide various stakeholders—policymakers, practitioners, researchers, educators, and parents or caregivers—in addressing the pervasive impact of brain rot and promoting a balanced approach to technology use that fosters cognitive resilience among adolescents and young adults. Full article

Background/Objectives: Cancer diagnosis and oncological treatments often lead to cognitive impairments, particularly in prospective memory, which affects the ability to recall future intentions. These difficulties can significantly impact therapeutic adherence, especially in the early stages of treatment, where timely medication and appointment adherence are critical. Despite this, effective measures for assessing prospective memory in cancer survivors remain limited. The current study aimed to translate and culturally adapt the Short Form of the Metacognitive Prospective Memory Inventory (MPMI-s) for use with Portuguese cancer survivors. Methods: The translation process involved back-translation, expert review, and pre-testing to ensure content validity. Psychometric evaluation was conducted with a sample of 111 cancer survivors [M(SD) = 49.3(9.4), ages 18–65], assessing internal consistency, factorial validity through principal components analysis, and convergent validity. Results: A final 18-item version of the MPMI-S demonstrated strong reliability and validity, comprising four factors: prospective forgetting, monitoring and planning strategies, imagery and visualization strategies, and external aid strategies. Significant correlations were found between these dimensions and traits such as conscientiousness, agreeableness, emotional stability, as well as distress and cognitive functioning. Conclusions: These findings underscore the potential of the MPMI-S as a valuable tool in clinical settings, offering insights not only into self-reported prospective memory abilities but also into the compensatory strategies employed by individuals in their daily routines. By integrating these aspects, this measure helps to identify key opportunities for rehabilitation aimed at minimizing the functional impact of the disease. Full article

The plague of cyberbullying on social media exerts a dangerous influence on human lives. Due to the fact that online social networks continue to daily expand, the proliferation of hate speech is also growing. Consequentially, distressing content is often implicated in the onset of depression and suicide-related behaviors. In this paper, we propose an innovative framework, named as the trustable LSTM-autoencoder network (TLA NET), which is designed for the detection of cyberbullying on social media by employing synthetic data. We introduce a state-of-the-art method for the automatic production of translated data, which are aimed at tackling data availability issues. Several languages, including Hindi and Bangla, continue to face research limitations due to the absence of adequate datasets. Experimental identification of aggressive comments is carried out via datasets in Hindi, Bangla, and English. By employing TLA NET and traditional models, such as long short-term memory (LSTM), bidirectional long short-term memory (BiLSTM), the LSTM-autoencoder, Word2vec, bidirectional encoder representations from transformers (BERT), and the Generative Pre-trained Transformer 2 (GPT-2), we perform the experimental identification of aggressive comments in datasets in Hindi, Bangla, and English. In addition to this, we employ evaluation metrics that include the F1-score, accuracy, precision, and recall, to assess the performance of the models. Our model demonstrates outstanding performance across all the datasets by achieving a remarkable 99% accuracy and positioning itself as a frontrunner when compared to previous works that make use of the dataset featured in this research. Full article

Purpose: Over the past decade, tele-neurorehabilitation (TNR) has emerged as a vital and effective tool for delivering continuous care to stroke patients, playing a key role in enhancing functional recovery and ensuring consistent access to rehabilitation services. In the field of TNR, various protocols are utilized to ensure effective cognitive stimulation at home. Recent preliminary studies highlight the employment of multidomain cognitive interventions, which would seem to induce more stable and relevant cognitive recovery in stroke patients. A randomized controlled trial (RCT) study was conducted to compare the effectiveness of a TNR multidomain cognitive approach to conventional face-to-face cognitive treatment. Methods: A total of 30 patients with stroke were equally enrolled and randomly assigned to the experimental and control groups. In the experimental group, patients received sessions of home-based cognitive virtual reality rehabilitation system (VRRS) training. The control group underwent traditional face-to-face cognitive multidomain treatment at the hospital. The therapy was given for one hour every day for four weeks in both groups. Specific cognitive domains, including memory, praxis skills, executive functions, and speech therapy, were stimulated in the procedure. Neuropsychological evaluations were performed at three timepoints: at baseline (T0), at the end of TNR (T1), and six months later (T2). Results: The TNR group demonstrated significant improvements in working memory and language abilities, as well as in depressive symptoms and caregiver burden, with an average decrease of 2.07. Most of this improvement persisted 6 months after treatment. The group that received face-to-face cognitive treatment showed improvements (not persisting at T2) after treatment in a task measuring constructive apraxia and alternating attention with the cognitive skill of set-shifting. Conclusions: According to our findings, multidomain cognitive TNR may be useful in enhancing cognitive outcomes in stroke populations (even six months after treatment concludes). TNR may also be a viable way to deliver these interventions since it boosts people’s motivation to train and, consequently, their adherence to treatment while also having a positive effect on caregivers’ distress management. Full article

Background: Patients undergoing endoscopic submucosal dissection under monitored anesthesia care (MAC) with remimazolam may develop respiratory distress during the procedure. In these cases, low doses of flumazenil improved respiratory distress without completely reversing sedation, which is a novel phenomenon. This study aimed to explore the ED90 of flumazenil to selectively improve respiratory distress in patients with MAC treated with remimazolam. Methods: Flumazenil dose determination followed a biased-coin up-and-down design. Starting with a dose of 5 mcg, if respiratory distress improved, the biased-coin method was used to give the same dose in the next patient with a probability of 8/9, and a decreased dose of 5 mcg in the next patient with a probability of 1/9. Any improvement in respiratory distress within 30 s of flumazenil administration was recorded. After the procedure, patients were asked whether they had any memory recall during the procedure. Centered isotonic regression was used to determine the ED90 of flumazenil. Results: Sixty patients were included in the study. The estimated ED90 was 76.72 mcg (95% CI: 68.07–102.62). Memory recall occurred in two of thirteen patients (15%) near the ED90 dose range (75 mcg and 80 mcg). None of the patients developed major postoperative complications (bleeding, perforation, or aspiration) within the 2-day postoperative period. Conclusions: This study determined that the ED90 of flumazenil for effectively alleviating respiratory distress in patients undergoing MAC with remimazolam was 76.7 mcg, without reversing consciousness. These findings provide valuable guidance for the care of patients undergoing sedation. Full article

Dementia, including Alzheimer’s disease (AD) and frontotemporal dementia (FTD), presents critical challenges for correctional systems, particularly as global populations age. AD, affecting 60–80% of dementia cases, primarily impairs memory and cognition in individuals over 65. In contrast, FTD, rarer than AD but not uncommon in those under 65, affects the frontal and temporal brain regions, leading to deficits in social behavior, language, and impulse control, often resulting in antisocial actions and legal consequences. Behavioral variant FTD is especially associated with socially inappropriate and impulsive behaviors due to frontal lobe degeneration. The prevalence of cognitive impairment in incarcerated populations is high, exacerbated by prison environments that compound distress and limited access to specialized healthcare. Studies indicate that up to 11% of United States state prison inmates over the age of 55 exhibit cognitive impairments, often undiagnosed, resulting in punitive rather than rehabilitative responses to symptoms like disinhibition and aggression. Ethical concerns around criminal responsibility for individuals with dementia are increasingly prominent, particularly regarding their ability to comprehend and engage in legal proceedings. The growing elderly prison population necessitates reform in correctional healthcare to include early cognitive assessment, targeted intervention, and tailored post-release programs. Addressing these needs is essential to ensure appropriate treatments, alleviate healthcare demands, and support reintegration for cognitively impaired inmates. Full article

Background/Objectives: Mechanical power (MP) refers to ventilator-delivered energy to the lungs, which may induce lung injury. We examined the relationship between MP and mortality in patients with acute respiratory distress syndrome (ARDS) who underwent prone positioning. Methods: This multicenter retrospective study included data on all patients admitted to the intensive care units of eight referral hospitals in Taiwan from October 2015 to March 2016, and in Chang Gung Memorial Hospital Linkou branch from January 2017 to October 2023. The data were obtained from the electronic medical records of each hospital by using a standard case report form. MP was calculated as follows: MP (J/min) = 0.098 × VT × RR × (Ppeak − 1/2 × ΔP). Results: We included 135 patients who underwent prone positioning. Among them, 28-day survivors had significantly lower MP (22.6 ± 6.5 vs. 25.3 ± 6.2 J/min, p = 0.024), MP/predicted body weight (PBW) (396.9 ± 118.9 vs. 449.3 ± 118.8 10⁻³ J/min/kg, p = 0.018), MP/compliance values (0.8 ± 0.3 vs. 1.1 ± 0.4 J/min/mL/cmH₂O, p = 0.048) after prone positioning, and significantly lower changes in MP, MP/PBW, and MP/compliance (−0.6 ± 5.7 vs. 2.5 ± 7.4 J/min, p = 0.007; −9.2 ± 97.5 vs. 42.1 ± 127.9 10⁻³ J/min/kg, p = 0.010; −0.1 ± 0.3 vs. 0.2 ± 0.3 J/min/mL/cmH₂O, p < 0.001, respectively). Multivariate Cox regression revealed that the change in MP/compliance (HR: 7.972, p < 0.001) was an independent predictive factor for 28-day mortality. Conclusions: In ARDS patients treated with prone positioning, MP/compliance, and change in MP, MP/PBW, and MP/compliance after prone positioning differed significantly between 28-day survivors and nonsurvivors. Further randomized controlled research is required to elucidate the potential causality of decreased MP and improved clinical outcomes. Full article