Search Results (295)

This study examined acute pre- to post-match changes in perceived mental fatigue, subjective workload, and psychomotor performance in professional male soccer players, and whether cognitive changes were associated with GPS-derived external-load metrics, match outcome, and playing position. The dataset comprised 101 player–match measurements from 40 elite players, with paired pre–post psychomotor assessments yielding n = 202 total measurements. Pre–post comparisons were analysed using repeated-measures ANOVA, supplemented by linear mixed-effects models with a random intercept for player. Soccer matches produced large increases in perceived exertion, mental fatigue, mental demand, physical demand, and effort (all p < 0.001), and significant deteriorations in reaction time, accuracy, processing speed, and response variability (all p ≤ 0.005), confirmed in the mixed-effects analyses (all p ≤ 0.014). In the initial player–match-level analyses, high-intensity accelerations (>3 m·s⁻²) were weakly associated with greater Δreaction-time slowing (r = 0.203), increased response variability (r = 0.276), and reduced Rate Correct Score (r = −0.242), while high metabolic load distance was weakly associated with post-match perceived mental fatigue but not with psychomotor-performance changes. One-way ANOVAs indicated greater post-match psychomotor decrements following losses than draws. Once within-player dependence was modelled, the effects of match outcome, playing position, and most external-load metrics were attenuated, except for a residual match-outcome effect on accuracy and a high-intensity deceleration effect on accuracy. These findings indicate that competitive soccer match play is followed by acute psychomotor-performance decrements and increased perceived mental fatigue, whereas the contributions of mechanical load, match outcome, and playing position appear modest and partly reflect stable between-player differences. Full article

Background: Out-of-hospital cardiac arrest (OHCA) remains a major public health problem. Many patients contact primary health care (PHC) services shortly before cardiac arrest, yet data on PHC staff preparedness to provide guideline-concordant basic life support (BLS) remain limited. This study assessed BLS knowledge and chest compression quality among medical and non-medical PHC staff. Methods: This multicentre cross-sectional simulation-based study was conducted in Poznań and Poznań County, Poland. PHC staff with direct patient contact were included (n = 162). Assessment comprised an author-developed 15-item knowledge test based on European Resuscitation Council guidelines and a two-minute continuous chest compression trial on a Resusci Anne QCPR manikin. Correlations were analysed using Spearman’s rank correlation coefficient, group differences using the Kruskal–Wallis test with Dunn–Bonferroni post hoc comparisons, and predictors using multivariable linear regression. Results: The median BLS knowledge score was 9/15 points (mean 8.74). Mean chest compression depth was 41.3 mm, below the recommended range, with only 23.5% of compressions meeting depth criteria. Correct compression rate was maintained in 30.2% of compressions, and full chest recoil was observed in 55.0% of attempts. Age was negatively correlated with compression rate. In participant-level regression, higher BLS knowledge was associated with better QCPR performance; however, this association was attenuated and no longer statistically significant in mixed-effects models accounting for clustering by practice. Conclusions: PHC staff demonstrated gaps in BLS knowledge and inadequate simulated chest compression performance, particularly regarding compression depth and rate. These findings support recurrent, simulation-based BLS training for all PHC personnel. Full article

This study proposes a human-centered multimodal framework for characterizing safety-relevant driver functional domains in professional bus drivers. Unlike conventional approaches that rely on isolated psychological or physical assessments, the proposed framework integrates self-perception, psychomotor performance, and cognitive–perceptual assessment to provide an exploratory, structured characterization of driver-related functional capacities. Eighteen professional bus drivers participated in this study. Self-perception data were obtained from all 18 participants, whereas psychomotor and cognitive–perceptual assessments were completed by 16 participants. These measurements were used to examine multiple domains relevant to driving safety, including behavioral awareness, motor coordination, attention, visual tracking, and hazard-perception-related processing. Given the modest sample size, the study should be regarded as an exploratory pilot investigation. Data were analyzed using a laboratory-based cross-sectional between-subjects design to examine age- and gender-related differences across the assessed domains. The findings suggested that selected age- and gender-related differences and descriptive tendencies were observable across multiple domains. Male drivers descriptively showed higher self-rating scores, female drivers showed different performance tendencies in selected psychomotor tasks, and male drivers demonstrated substantially greater grip strength. Older drivers showed slower and less efficient performance in several cognitive–perceptual measures, with the clearest age-related effect observed in the tachistoscopic traffic test, where older participants showed a higher error tendency under time-constrained traffic-scene processing conditions. The constructs and measures proposed in this study are intended as general laboratory-based assessments of driver-related capabilities rather than direct measures of actual driving performance, real-time driver-state indicators, or validated sensor-based monitoring indicators. As candidate human-factor constructs, they may inform future driver monitoring research by helping clarify how driver-related signals or behaviors could eventually be linked to underlying functional and safety-related meaning in intelligent transportation environments. Full article

Healthcare professionals must acquire and maintain both declarative knowledge and fine psychomotor skills across a wide range of clinical procedures. Human working memory is physiologically limited, and the high cognitive demands of clinical environments frequently contribute to medical errors and adverse events. Intra-individual performance variability—driven by fatigue, stress, and motivation—represents a further challenge that conventional medical safety education has not adequately addressed. According to the World Health Organization, patient harm ranks fourteenth in the global burden of disease, with approximately 10% of hospitalised patients in high-income countries experiencing harm within healthcare facilities. This study reports the design, theoretical rationale, and preliminary outcomes of an augmented reality (AR) glasses system for hands-free, self-directed medical procedural training, developed from a human factors and ergonomics (HFE) perspective. The system integrates a see-through head-mounted display (HMD; Epson Moverio BT-40S), bone-conduction earphones (Shokz OpenComm), and an industrial-grade voice recognition application (NEC Solution Innovators), achieving fully hands-free operation compatible with aseptic technique. Content design is grounded in cognitive load theory (CLT) and the cognitive theory of multimedia learning (CTML), extended by neuroscientific evidence on multisensory integration and memory consolidation. More than 40 procedure-specific modules have been developed in-house at Tokyo University of Technology, spanning airway management, vascular access, respiratory therapy, dialysis, and cardiac support. In a four-year longitudinal survey (virtual reality (VR) simulator; n = 286), major satisfaction items consistently exceeded the scale midpoint. In an AR endotracheal suctioning cohort (n = 38/22), procedural flow understanding was rated 3.95/5.0. A peer-reviewed randomised controlled trial (Clinical Simulation in Nursing, n = 36) demonstrated significantly superior skill improvement (p < 0.001) and learning motivation (p = 0.001) in the AR group versus textbook self-practice. Principal ergonomic limitations of current HMD hardware—excessive weight, narrow field of view, and absence of medical-grade certification—are documented, and AI-based real-time procedural assessment is identified as a priority for the next research phase. Full article

Aim: Female athletic performance is shaped by the convergence of menstrual-cycle timing, circadian rhythms, fatigue, and ergogenic supplementation; yet no prior study has examined these factors simultaneously in a sport-specific setting. This study investigated the independent and combined effects of acute caffeine ingestion, calendar-based testing window, time of day, and match-induced fatigue on psychophysiological, cognitive, and physical performance in trained female volleyball players. Methods: Thirteen elite eumenorrheic female volleyball players (age: 24.23 ± 4.06 years) completed a randomized, double-blind, placebo-controlled crossover protocol comprising 12 sessions corresponding to all combinations of testing window (menstrual, follicular, luteal), supplementation (caffeine 6 mg·kg⁻¹ vs. placebo), and time of day (08:00 h vs. 18:00 h). Assessments included the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Spiegel questionnaire, Profile of Mood States, Hooper Index, Stroop task, Countermovement Jump (CMJ), Modified Agility T-Test (MAT), and Reactive Agility Test (RAT), administered before and after a one-hour simulated match. Results: Significant main effects of testing window, caffeine, time of day, and fatigue state were observed across all outcome domains (all p < 0.05). Caffeine reduced daytime sleepiness (F(1,12) = 23.84, p < 0.001, ηp² = 0.665), enhanced vigor (F(1,12) = 114.10, p < 0.001, ηp² = 0.905), and improved MAT performance (F(1,12) = 33.27, p < 0.001, ηp² = 0.735). The follicular window was associated with superior cognitive, neuromuscular, and mood-related outcomes relative to the menstrual and luteal windows. Exploratory higher-order interactions suggested condition-specific caffeine benefits for MAT, RAT, and CMJ, particularly in afternoon post-fatigue conditions; these patterns require replication in larger samples. Conclusions: Acute caffeine ingestion improved several psychophysiological, cognitive, and neuromuscular outcomes in trained female volleyball players, with effects that varied across calendar-based testing windows, time of day, and fatigue state. Individualized supplementation strategies incorporating cycle timing and circadian context remain investigational; prescriptive recommendations require replication in larger, hormonally verified samples before clinical or applied adoption. Full article

Aim: To examine the effects of attentional focus on adolescents’ response time performance and investigate whether sports participation moderates this effect. Methods: Fifty-eight adolescents (16.46 years) were randomly assigned to one of three groups: external focus of attention (EF), internal focus of attention (IF), or control. Participants performed a response-time task using a visual stimulus. A 3 × 2 factorial ANOVA was conducted, with attentional focus group (external, internal, control) and sports participation (yes, no) as between-subjects factors. Results: A significant main effect of attentional focus was found, with the EF group outperforming the IF and control groups. Sports participation alone was not a significant factor, and the interaction between attentional focus and sports participation was not statistically significant. However, exploratory analyses suggested a possible tendency for adolescents engaged in sports practice to respond more favorably to an EF strategy, though these findings should be interpreted with caution. No significant differences were observed among non-sports participants. Conclusion: These findings reinforce the benefits of an external attentional focus for adolescent response-time performance. Although exploratory, the results suggest that adolescents engaged in sports practice may respond more favorably to EF, highlighting the potential relevance of reconsidering commonly used IF instructions in youth sports and educational contexts. Full article

Introduction: Scopolamine is a tropane alkaloid and non-selective muscarinic receptor antagonist capable of inducing a central anticholinergic toxidrome with pronounced neuropsychiatric and autonomic manifestations. Despite its well-characterized pharmacology, diagnosis remains clinically challenging due to variable presentation and often absent or unreliable exposure history, particularly in non-medical contexts. Methods: We report a case of a 34-year-old female presenting with an acute onset of altered mental status following a social event. Clinical findings included delirium, hallucinations, psychomotor agitation, dysarthria, bilateral mydriasis with preserved light reflex, sinus tachycardia, and marked urinary retention. Routine laboratory investigations were largely within normal limits, and standard urine toxicology screening was negative except for iatrogenic benzodiazepines. Given the characteristic toxidrome, extended toxicological analysis using gas chromatography–mass spectrometry (GC–MS) was performed, confirming the presence of scopolamine. Supportive treatment, including benzodiazepines and off-label intravenous galantamine, was administered, resulting in progressive clinical improvement and complete recovery without sequelae. Results: This case underscores the diagnostic limitations of routine toxicology screening for tropane alkaloids and highlights the importance of a pattern-based toxidrome approach. Given the absence of reliable exposure history and the presence of marked anterograde amnesia, an exogenous exposure cannot be excluded; however, no direct forensic evidence supports intentional administration. Furthermore, galantamine may represent a pharmacologically plausible alternative to physostigmine in settings where it is unavailable, although evidence remains limited. Conclusions: Scopolamine intoxication should be considered in cases of acute anticholinergic syndrome with negative standard screening, and confirmation requires advanced analytical methods such as GC–MS. Full article

Background: White matter hyperintensities (WMHs) have been implicated in late-onset psychiatric disorders, but their contribution to this clinical phenotype remains insufficiently understood. Methods: We conducted a cross-sectional transdiagnostic study of 90 consecutively admitted acute patients with schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD) meeting the predefined inclusion criteria. Patients with a late onset were compared to earlier onset (EO) psychiatric patients. Late onset was defined as the median age of the disorder onset of the sample (≥40 years). Multidimensional clinical, cognitive, psychomotor, metabolic, and neuroimaging data were evaluated (WHM burden and cerebral atrophy), and a cognitive-psychopathologic composite index was derived. Correlations and sensitivity analysis were performed. A multivariable linear regression was performed to assess the independent effects of age, vascular risk factors, and WMH severity on cognitive performance and psychiatric symptoms. Results: In patients with LO psychiatric disorders, greater WMH burden was significantly associated with poorer global cognition and specific cognitive domains, lower delusional symptoms severity, and greater suicidal thoughts/behavior intensity. These associations were markedly weaker or not present in EO patients. The regression model explained 36.5% of the variance in the cognitive-psychopathologic composite index. After adjusting for age and cumulative risk factors, Fazekas was the only significant independent predictor (β = −0.495, p = 0.001). Conclusions: WMH burden was associated with differences in clinical characteristics in LO psychiatric disorders, including cognitive and neuropsychiatric symptoms. Our findings support a possible vascular-neuropsychiatric interaction in LO phenotypes. Full article

(1) Background: Augmented reality (AR) simulation may accelerate psychomotor skill acquisition in clinical education, but comparative evidence is scarce. This three-arm randomized controlled trial compared AR simulation, basic task-trainer simulation, and lecture-based instruction for urinary catheterization training. We hypothesized that AR would be associated with higher performance compared to the other two methods. (2) Methods: Primary outcomes included male and female catheterization skills assessed with checklists. Secondary outcomes included knowledge and confidence. One-way ANOVA with Tukey’s HSD post hoc tests constituted the primary analysis; Kruskal–Wallis tests and Bayesian ANOVA provided convergent evidence. (3) Results: A total of 176 trainees were assigned to AR simulation, basic simulator, or lecture-only control groups (N = 60, 58, and 58, respectively). AR simulation was associated with higher skill scores than both basic simulation and the control for male catheterization (p < 0.001, η² = 0.574) and female catheterization (p < 0.001, η² = 0.535), with large effect sizes (Cohen’s d = 3.11, AR vs. control). Knowledge showed no group difference (p = 0.11). Confidence moderately favored AR (d = 0.69 vs. Control). Bayesian analysis supported a high probability of AR outperforming Control. (4) Conclusions: AR simulation training was associated with superior catheterization skills compared to both basic simulation and lecture-based instruction, with large effect sizes observed across both frequentist and Bayesian analyses. Knowledge was consistent across groups, suggesting a possible ceiling effect. Full article

Background and Clinical Significance: NMDAR autoimmune encephalitis is a rare but potentially life-threatening autoimmune disorder that can be hard to recognize initially because it has nonspecific symptoms. In the early phase of the disease, clinical presentation is often dominated by psychiatric symptoms, which can be misleading. A diagnosis is established by demonstrating specific anti-NMDA receptor antibodies, with cerebrospinal fluid analysis considered the most reliable diagnostic method. Timely initiation of immunomodulatory therapy, including corticosteroids, intravenous immunoglobulins, and therapeutic plasmapheresis, significantly improves disease outcomes, while second-line therapies are used in refractory cases. Case Presentation: A 21-year-old female patient (M.B.) was admitted to the Psychiatry Clinic at the University Clinical Center of Vojvodina due to the sudden onset of behavioral changes, including social withdrawal, absence of verbal communication, and unusual orofacial grimacing. During hospitalization, the patient was intermittently in a state of severe psychomotor agitation and poorly communicative, with pronounced orofacial dyskinesias and involuntary tongue movements. Anti-NMDA receptor autoantibodies were detected in both serum and cerebrospinal fluid, and the patient was subsequently transferred to the Intensive Care Unit of the Neurology Clinic. Due to the lack of an adequate clinical response to pulse corticosteroid therapy, six cycles of therapeutic plasmapheresis were performed. Following this treatment, significant clinical improvement was observed. Conclusions: Timely recognition of this condition and a multidisciplinary approach allow for early initiation of immunomodulatory therapy and significantly improve treatment outcomes. Full article

Background: Accurate three-dimensional positioning of dental implants is critical for ensuring biomechanical stability, prosthetic passivity, and long-term clinical success. While computer-assisted navigation systems achieve high precision, their complexity and cost often limit accessibility. This study presents the development and preclinical experimental validation of a low-cost prototype designed to enhance angular accuracy in dental implant placement within a controlled 3D haptic simulation environment. Methods: A preclinical experimental design was implemented using a 3D haptic simulator (Virteasy, Montpellier, France). The prototype incorporated high-precision inertial measurement units (IMUs) and an Extended Kalman Filter (EKF) for real-time angular feedback. Ninety-seven simulated implant placements were performed—both freehand and with prototype assistance—under identical virtual conditions by a single experienced operator. Angular deviations in mesiodistal and buccolingual planes were recorded, combined into a composite 3D index, and analyzed using paired t-tests and linear mixed-effects models. The study was conducted in a controlled simulation environment, which does not fully replicate clinical conditions. Results: The prototype significantly reduced angular deviation from 13.49° to 2.99° in the mesiodistal plane (−77.8%) and from 13.56° to 5.59° in the buccolingual plane (−58.8%), achieving an overall 67% improvement in three-dimensional orientation (p < 0.001; Cohen’s d = 1.47). Agreement with an optical reference system (OptiTrack) was excellent (bias = +0.36°, RMSE = 0.39°). Intra-operator reliability exceeded 0.95 (ICC), confirming strong reproducibility and measurement stability. Conclusions: The proposed inertial sensor-based prototype achieved angular accuracy within the range reported for computer-guided systems while maintaining advantages of portability, low cost, and usability. Its integration into haptic simulators provides a valid tool for both educational and preclinical applications, offering real-time feedback that enhances spatial perception and psychomotor learning. Future clinical studies should validate its performance in cadaveric and patient-based contexts to determine its practical impact on surgical precision and implant success. Full article

Introduction: Growing evidence indicates that diet quality significantly influences metabolic parameters and cognitive functioning. In healthy individuals, higher consumption of minimally processed foods and products rich in omega-3 fatty acids is associated with a more favorable lipid profile and better cognitive performance. Patients with schizophrenia present an increased risk of metabolic disturbances and reduced cognitive functioning. This suggests that this group may be particularly sensitive to nutritional factors. However, relatively few studies have simultaneously examined the relationships between diet, metabolism, and cognitive profile in patients with schizophrenia and healthy individuals. Aim: The aim of the study was to compare the relationships between the frequency of consumption of selected food categories and metabolic parameters (glycemia, lipid profile, and insulin resistance), as well as cognitive functions (Stroop Test, Trail Making Test, and verbal fluency), in patients with schizophrenia and healthy men. Methods: The study included 21 patients with schizophrenia and 20 healthy men. All participants completed a questionnaire assessing the frequency of food consumption. Blood samples were collected to determine glucose, insulin, HDL, LDL, and triglyceride levels, and the HOMA-IR index was calculated. Cognitive functioning was assessed using the Stroop Test (RCNb, NCWd) and the Trail Making Test (TMT-A and TMT-B), which measure psychomotor speed and visuospatial working memory, respectively, and the verbal fluency test (semantic and phonological). Correlation analyses were performed separately in both groups. Due to the small sample size, all correlations are treated as exploratory and are analyzed with correction for multiple comparisons. Results: Exploratory analyses identified several patterns of associations between the frequency of consumption of selected food categories, metabolic parameters, and cognitive performance in both healthy men and patients with schizophrenia. The observed patterns differed between groups, suggesting that clinical status and treatment-related factors may modify diet–metabolism–cognition relationships. These findings highlight potential pathways linking dietary habits with metabolic and cognitive outcomes and provide a basis for further hypothesis-driven research. Conclusions: Diet quality may be related to metabolic status and cognitive functioning. However, the pattern of these associations differs between patients with schizophrenia and healthy individuals. The findings suggest that diet may play a role in metabolic health and cognitive functioning, particularly in clinical populations. Full article

Tyrosol, a phenolic compound derived from olive products, exhibits anti-inflammatory, neuroprotective, and cardiometabolic properties, whereas creatine is a well-established ergogenic aid with documented benefits for muscular performance and emerging evidence for cognitive support. This 5-week randomized, double blind, placebo-controlled trial examined the effects of Tyrosol, creatine, their combination, and placebo on resistance and aerobic exercise performance and psychomotor vigilance in healthy adults. Participants (n = 48; 18–50 years) consumed their assigned supplement for 4 weeks, after which changes in upper and lower body strength, submaximal resistance performance, aerobic capacity, lactate responses, plyometric performance, and acute cognitive function were assessed. The Tyrosol + Creatine condition produced the most consistent improvements in upper body resistance performance, particularly for higher load, higher volume bench press work. In contrast, neither the Tyrosol-alone group, the creatine-alone group, nor the placebo group achieved this effect, which suggests there is a synergistic effect between Tyrosol and creatine. No significant effects were observed for intermediate resistance loads, isometric lower body strength, grip strength, aerobic endurance, lactate responses, plyometric outcomes, or acute psychomotor vigilance. Collectively, these findings support the use of short-term co-supplementation with Tyrosol and low-dose creatine (without a loading phase) as a potentially beneficial strategy to enhance upper-body training quality in specific tests and improve upper-body strength endurance. Full article

Introduction. Bronchiolitis is the leading cause of Pediatric Intensive Care Unit (PICU) admission for lower respiratory tract infection in infants. Although survival has improved, concerns remain regarding potential long-term functional impairments, including alterations in psychomotor development, learning, and behavior. This study aimed to describe the epidemiological and clinical characteristics of children admitted to the PICU for bronchiolitis and to evaluate their functional outcomes at 12-month follow-up. Methods. A retrospective descriptive cohort study was conducted, including all patients admitted to the PICU for bronchiolitis during the 2021–2022 period. Epidemiological, clinical, microbiological, and laboratory data were collected. Functional health status was assessed using the Pediatric Overall Performance Category (POPC), Pediatric Cerebral Performance Category (PCPC), and Functional Status Scale (FSS) at PICU discharge and 12 months. Changes in functional status were categorized as improved, stable, or worsened. Exploratory unadjusted analyses were performed to describe differences between outcome groups. Results. A total of 164 patients were included (43.9% female), with a median age of 51 days (IQR 26.25–118.5). Respiratory syncytial virus was identified in 79.7% of cases. Invasive mechanical ventilation was required in 31.1% of patients, and 45.7% developed complications during PICU admission. Mortality was 0.6%. At 12 months, functional deterioration was observed in 14.6% of patients according to POPC, 16.5% according to PCPC, and 3.6% according to FSS. Higher proportions of functional deterioration were observed among patients with underlying medical conditions, those requiring invasive mechanical ventilation, those with complications, and those with longer PICU and hospital stays, particularly in the PCPC scale. Conclusions. Most children admitted to the PICU for bronchiolitis showed stable or improved functional status at 12 months. However, a subset experienced functional deterioration, more frequently observed in patients with greater clinical severity and complexity during admission. These results support the need for further studies to better characterize long-term outcomes and to identify children who may benefit from closer follow-up. Full article

Background/Objectives: A psychiatric consultation is a professional evaluation aimed at establishing a diagnosis, a prognosis, and developing a treatment plan. The objective was to assess psychiatric consultations (PCs) at the Community Mental Health Center (CMHC), Emergency Room (ER) and General Hospital (GH) to highlight differences across settings. Methods: With a retrospective design, we examined all PCs performed between 1 January 2024 and 31 December 2024 at the CMHC, ER and GH of Baggiovara in Modena. Descriptive statistical analysis and a multivariate logistic regression were performed. Results: We collected a total of 3174 PCs for 1801 patients, performed in the three settings: 52% in ER, 30% in CMHC and 18% in GH. In ER, PCs were most frequently requested for suicide risk (26%), psychomotor agitation (14%) and substance intoxication (14%). In CMHC, the most common diagnoses were depressive disorders (22%), acute anxiety (20%) and acute psychotic episodes (13%). In GH, consultations mainly addressed psychiatric symptoms associated with medical and eating disorders. The overall rate of psychiatric hospitalization after PCs was 16.2%, reaching 23.4% for consultations in ER. Discontinuation of pharmacological therapy was significantly associated with an increased risk of hospitalization (p < 0.001), which rose to 17% when therapy had been interrupted for more than one year. Conclusions: PCs at ER were the access point for most hospitalizations. Therapeutic discontinuation, acute psychosis and substance use represented the main predictors of hospitalization. Strengthening shared care pathways among CMHC, ER and GH represents an effective model of integration between hospital and community services, ensuring continuity of care. Full article