Search Results (4,584)

Background: Cognitive impairment is a major health problem, so several studies worldwide have studied its aggravating and protective factors. However, few studies have looked into the prediction of better or worsening cognitive status based on the presence of the most relevant biopsychosocial factors. Thus, the aim of this study is to predict cognitive status classification, specifically into normal cognitive status, mild cognitive impairment, and severe cognitive impairment, based on the most studied risk and protective factors in the context of the Survey of Health, Ageing and Retirement in Europe and Harmonized Cognitive Assessment Protocol association (SHARE-HCAP) project. Methods: Participants were from five European countries, and measures included their cognitive status classification from SHARE-HCAP and several associated factors previously measured in the eighth wave of SHARE. Results: A multinomial logistic regression was performed, with normal cognition as the reference category. Most individuals were correctly classified. Conclusions: Frequent participation in social activities and good cognitive task performance were associated with a lower likelihood of mild cognitive impairment compared to normal cognitive status. In turn, higher scores in depression and social network were associated with an increased likelihood of being classified as MCI in contrast to normal cognition. Additionally, being a woman and having worse cognitive performance were predictors of severe cognitive impairment classification over normal cognition status. Depression also contributed to a higher likelihood of being classified as mild and severe cognitive impairment, in contrast to a normal cognitive status. These findings highlight the importance of preventive medical check-ups and interventions before the onset of the first cognitive decline symptoms. Full article

Background: Ageing leads to physical, cognitive, and social changes that affect people’s functioning and social participation. Health literacy, sociodemographic, and environmental factors influence health outcomes and access to care. This study aimed to characterize the health and functioning of Portuguese adults aged 65 and over, focusing on sociodemographic factors, health status, lifestyle, fall risk, functional capacity, and social participation, and on comparing rural and urban populations. Materials and Methods: An exploratory, cross-sectional study was conducted using data from older adults who completed the FallSensing screening protocol. Participants were classified by residence type (rural vs. urban), and group comparisons were made. Results: The sample (n = 474) was predominantly female (66.5%) with a mean age of 74.62 (±6.49) years. Rural participants were older (76.87 ± 6.89 vs. 73.50 ± 5.87) and had higher body mass index (BMI) (28.32 ± 4.31 vs. 27.51 ± 4.12), lower educational attainment—for example, 22.9% had no formal education compared to 7.0% of urban participants—and a higher prevalence of hypertension (72.6% vs. 55.4%), whereas urban participants experienced higher rates of osteoporosis (24.4% vs. 14.3%), hearing loss (41.9% vs. 26.9%), and alcohol consumption (12.7% vs. 2.3%) (p ≤ 0.05). Rural residents also demonstrated significantly poorer results for grip strength (21.03 ± 7.36 vs. 23.73 ± 8.61), gait speed (1.17 ± 0.44 vs. 1.45 ± 0.39), and the Timed Up and Go (TUG) test (13.4 ± 10.40 vs. 9.62 ± 4.43), as well as lower exercise self-efficacy (12.83 ± 4.97 vs. 14.28 ± 4.40) (p < 0.001), and more pronounced moderate-to-severe restrictions in social participation (28.0% vs. 15.7%) (p = 0.013). They reported greater use of assistive devices and more severe limitations in social participation. Although falls were reported more often in urban areas, rural residents experienced greater fall frequency. Conclusions: These findings suggest that rural living is associated with lower functional capacity and poorer health, underscoring the need for targeted physiotherapy and primary care strategies in rural settings. Full article

Background/Objectives: Computational studies using drift diffusion models on go/no-go escape tasks consistently show that individuals with suicidal ideation (SI) preferentially engage in active escape from negative emotional states. This study extends these findings by examining how individuals with SI update beliefs about action–outcome contingencies and uncertainty when trying to escape an aversive state. Methods: Undergraduate students with (n = 58) and without (n = 62) a lifetime history of SI made active (go) or passive (no-go) choices in response to stimuli to escape or avoid an unpleasant state in a laboratory-based negative reinforcement task. A Hierarchical Gaussian Filter (HGF) was used to estimate trial-by-trial trajectories of contingency and volatility beliefs, along with their uncertainties, prediction errors (precision-weighted), and dynamic learning rates, as well as fixed parameters at the person level. Bayesian mixed-effects models were used to examine the relationship between trial number, SI history, trial type, and all two-way interactions on HGF parameters. Results: We did not find an effect of SI history, trial type, or their interactions on perceived volatility of reward contingencies. At the trial level, however, participants with a history of SI developed progressively stronger contingency beliefs while simultaneously perceiving the environment as increasingly stable compared to those without SI experiences. Despite this rigidity, they maintained higher uncertainty during escape trials. Participants with an SI history had higher dynamic learning rates during escape trials compared to those without SI experiences. Conclusions: Individuals with an SI history showed a combination of cognitive inflexibility and hyper-reactivity to prediction errors in escape-related contexts. This combination may help explain difficulties in adapting to changing environments and in regulating responses to stress, both of which are relevant for suicide risk. Full article

Background/Objectives: Physical inactivity is associated with increased cardiometabolic disease risk and poor cognition in children and their parents. Family-based physical activity offers an opportunity for children and their parents to engage in physical activity concurrently. The present study examined the effect of an acute bout of family-based tag rugby on risk factors for cardiometabolic disease and cognition in families. Additionally, this study qualitatively explored families’ perceptions of enjoyment and factors affecting implementation with considerations for socioeconomic status. Methods: Sixteen families (27 children, 20 parents) participated in an exercise (45 min family-based tag rugby) and resting control trial (45 min seated rest), separated by seven days. Postprandial gylcaemia, insulinaemia, lipaemia and cognitive function were measured following exercise/rest. Families also participated in whole-family focus groups and separate parent and child interviews. Results: In parents, postprandial plasma insulin concentrations were lower on the exercise trial than the rested control trial at 30 min (p = 0.004) and 120 min following the consumption of a standardised lunch (p = 0.011). In children, a significant trial*time interaction for inverse efficiency scores on the Sternberg paradigm (three-item) was exhibited (p = 0.016). In parents, a significant trial*time interaction for inverse efficiency score on the Stroop congruent test was exhibited (trial*time interaction; p = 0.012), whereby inverse efficiency scores improved immediately post-exercise, compared with the rested control trial (p = 0.016). Qualitatively, families from all socioeconomic backgrounds agreed that tag rugby is an inclusive, enjoyable mode of physical activity that families want to participate in together, which can be adapted to overcome the barriers associated with the cost of and access to local facilities. Conclusions: An acute bout of tag rugby improved postprandial insulin concentrations in parents and cognitive function in children and their parents. Tag rugby was deemed an appropriate exercise modality for families from a range of socioeconomic backgrounds. Full article

Against the backdrop of China’s “East-West Computing Resource Transfer” and “Digital-Real Integration” national strategies, computing power has emerged as a core engine driving the digital economy. However, existing research lacks in-depth exploration of the micro-level mechanisms through which computing power operates as a strategic digital resource at the firm level and transforms into competitive advantages. This study examines a sample of manufacturing firms listed on China’s A-share markets from 2011 to 2022, treating the establishment of intelligent computing centers by firms as a quasi-natural experiment. Employing a staggered difference-in-differences model combined with causal inference strategies such as double machine learning, we empirically test the impact of computing power investment on firms’ new quality productivity. The findings reveal that computing power investment significantly enhances new quality productivity, primarily through enabling dynamic capabilities: it strengthens risk perception capabilities by improving information environments, enabling intelligent risk monitoring, and enhancing decision-making resilience; it elevates innovation opportunity-capturing capabilities by expanding the scope of innovation search, accelerating innovation iteration, and facilitating cross-domain knowledge integration; and it achieves data element reconstruction through constructing data infrastructure capabilities, improving data operational efficiency, and optimizing data ecosystem collaboration. Further analysis demonstrates that this promotional effect is more pronounced in firms with strong executive digital cognition and intense market competition, and is more significant among non-heavily polluting, high-tech firms with high absorptive capacity, those located in eastern regions, and those with superior digital endowments. Extended analysis also reveals that the new quality productivity gains from computing power investment drive optimal allocation of human capital while potentially inducing strategic information concealment behaviors as firms seek to protect competitive advantages. By conceptualizing computing power as a contestable strategic resource at the micro level, this study unveils the micro-mechanisms of digital transformation through a dynamic capability framework, offering important implications for firms and governments in optimizing digital strategies. Full article

Background: Chronic rhinosinusitis (CRS) affects nearly 9% of the global population with a rising incidence over recent decades. Neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease pose significant global burden, and emerging evidence suggests pathophysiological links through shared bioenergetic dysfunction, peripheral-to-central inflammatory signaling, and altered nasal microbiota. This review evaluates the evidence for CRS as a potentially modifiable peripheral contributor to neurodegenerative disease progression. Methods: A systematic review was conducted using PubMed, Cochrane, Web of Science, Embase, and CENTRAL from January 2000 to July 2025. Search terms included “Chronic Rhinosinusitis,” “Neurodegeneration,” “Mild Cognitive Impairment,” “Alzheimer’s Disease,” “Parkinson’s Disease,” “Bioenergetics,” and “Microbiome.” Clinical and experimental studies exploring epidemiological links, mechanistic pathways, biomarkers, and therapeutic targets were included. Results: Twenty-one studies involving over 100,000 participants met the inclusion criteria. Existing meta-analytic evidence demonstrated significant associations between CRS and cognitive impairment, with patients scoring approximately 9% lower on global cognitive measures than controls. However, other large-scale cohort studies did not pinpoint an increased dementia incidence, suggesting CRS may contribute to early, potentially reversible cognitive decline without directly driving dementia onset. Neuroimaging studies revealed altered frontoparietal connectivity and orbitofrontal hyperactivity in CRS patients. Mechanistic studies support peripheral inflammatory cytokines disrupting the blood–brain barrier, autonomic dysfunction impairing mucociliary clearance, microbiome-driven amyloid cross-seeding, and compromised cerebrospinal fluid clearance via olfactory–cribriform pathways. Discussion: Evidence supports complex, bidirectional relationships between CRS and neurodegeneration characterized by convergent inflammatory, autonomic, and bioenergetic pathways. Therapeutic strategies targeting sinonasal inflammation, microbiome dysbiosis, and mitochondrial dysfunction represent promising intervention avenues. Recognizing CRS as a treatable factor in neurodegenerative risk stratification may enable earlier diagnosis and prevention strategies. Full article

At the intersection of the circular economy and artificial intelligence (AI), high-value secondhand trading faces a “triple decision dilemma” of cognitive overload, trust risk, and emotional attachment. To address the limits of traditional human-centered theories, this study develops and empirically tests a novel framework of Algorithmic Empowerment. Drawing on data from 1396 users of Chinese secondhand luxury platforms and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM), the findings reveal that users’ empowerment perception arises from three dimensions—Algorithmic Connectivity (AC), Human–Agent Symbiotic Trust (HAST), and Algorithmic Value Alignment (AVA). This perceived empowerment affects participation willingness through two parallel pathways: the social pathway, where algorithmic curation shapes social norms and recognition, and the cognitive pathway, where AI enhances decision fluency and reduces cognitive friction. The results confirm the dual mediating effects of these mechanisms. This study advances understanding of human–AI collaboration in sustainable consumption by conceptualizing empowerment as the bridge linking algorithmic functions to user engagement, and provides actionable implications for designing AI systems that both enhance efficiency and foster user trust and identification. Full article

The transition to electric mobility requires salespeople to go beyond technical expertise and develop advanced social–cognitive skills that shape consumer decision-making. This study examines how empathy, perspective-taking, and trust influence interactions between salespeople and potential buyers of electric vehicles (EVs). Through a systematic literature review and bibliometric analysis, we identify the key cognitive and emotional competencies that enable sales professionals to interpret customer intentions, manage uncertainty, and guide rational yet emotionally influenced purchase decisions. Findings suggest that successful EV sales rely on understanding consumer beliefs about sustainability, risk, and technology, as well as on the salesperson’s ability to align messages with these cognitive frames. Based on this analysis, we propose a competency development framework that emphasizes empathy-driven communication, adaptive reasoning, and the integration of social cognition into training strategies. This perspective contributes to the broader understanding of how social–cognitive processes affect human judgment and decision-making in the emerging electric vehicle market. Full article

Based on the cumulative risk model and cognitive appraisal theory, this study examined the complex relationships between economic pressure, emotional neglect, and anxiety among left-behind children (LBC), focusing on the mediating role of perceived discrimination and nonlinear risk patterns. A cross-sectional survey was conducted with 618 LBC (aged 11–16 years) using standardized scales. Polynomial regression combined with Response Surface Analysis (RSA) was utilized to analyze congruence and incongruence effects. The results revealed that under congruent conditions, the association of economic pressure and emotional neglect with anxiety showed a marginally significant nonlinear accelerating trend, whereas their prediction of perceived discrimination followed a linear trend. Under incongruent conditions, emotional neglect demonstrated a stronger independent predictive effect on anxiety compared to economic pressure. Furthermore, perceived discrimination partially mediated the relationships between these risk factors and anxiety. These findings validate the cumulative risk model within the LBC context, demonstrating that risk factors operate in complex, non-additive ways. This highlights the necessity for differentiated interventions and suggests that reshaping LBC’s subjective cognitive appraisals is key to reducing anxiety. Full article

Suicide remains one of the leading causes of death worldwide, yet psychiatry continues to assess risk primarily through suicidal ideation. This narrow focus overlooks a critical factor: sleep. A growing body of evidence demonstrates that insomnia, nightmares, and circadian disruption are consistent and potentially modifiable correlates of suicidal behavior across various diagnoses and age groups, supported primarily by longitudinal and prospective studies. Despite this, structured sleep assessment is seldom integrated into routine psychiatric care, predominantly due to cultural inertia and inadequate training. This perspective necessitates a shift: sleep assessment should be regarded alongside mood and cognition in every evaluation of suicide risk. Brief questionnaires and targeted interventions are readily accessible and feasible for implementation, thereby presenting concrete opportunities for prevention. By incorporating sleep evaluation into standard practice and future predictive models, psychiatry can advance toward more precise, actionable, and timely suicide prevention. To continue neglecting sleep is to overlook one of the most accessible and effective means of saving lives. Full article

Background/Objectives: School violence represents a significant concern for educational communities worldwide, affecting student well-being and academic development. While prior research has documented prevalence rates and risk factors, limited studies have examined social–cognitive factors associated with antisocial behavior specifically within vocational education contexts using integrated analytical approaches. This exploratory cross-sectional study examined social–cognitive factors—specifically self-reported attitudes about aggression norms, prosocial attitudes, and school climate perceptions—associated with violence-supportive attitudes among Greek vocational students. Methods: A cross-sectional design employed validated self-report instruments and traditional statistical methods. The sample comprised 76 vocational high school students (38.2% male; ages 14–18; response rate 75.2%) from one school in Patras, Greece. Validated instruments assessed attitudes toward interpersonal peer violence (α = 0.87), peer aggression norms across four subscales (α = 0.83–0.90), and school climate dimensions (α = 0.70–0.75). Analyses included descriptive statistics, Pearson correlations with bootstrapped confidence intervals, MANOVA for multivariate group comparisons, independent samples t-tests, propensity score matching for urban–rural comparisons, polynomial regression for developmental patterns, and path analysis for theoretical model testing. Results: Strong associations emerged between perceived school-level and individual-level aggression norms (r = 0.80, p < 0.001, 95% CI [0.71, 0.87]), representing one of the strongest relationships documented in school violence research. Violence-supportive attitudes demonstrated inverse associations with prosocial alternative norms (r = −0.37, p < 0.001, 95% CI [−0.55, −0.16]). Significant gender differences emerged for teacher–student relationships (d = −0.78, p = 0.002), with females reporting substantially more positive perceptions. Propensity-matched urban students demonstrated higher aggression norm endorsement compared to rural students across multiple indicators (d = 0.61–0.78, all p < 0.020). Polynomial regression revealed curvilinear developmental patterns with optimal teacher relationship quality during mid-adolescence (ages 15–16). Path analysis supported a sequential association model wherein school-level norms related to individual attitudes through prosocial alternative beliefs (indirect effect β = −0.22, p = 0.002, 95% CI [−0.34, −0.11]). Conclusions: This preliminary investigation identified social–cognitive factors—particularly normative beliefs about aggression at both individual and environmental levels—as strongly associated with violence-supportive attitudes in Greek vocational education. The exceptionally strong alignment between school-level and individual-level aggression norms (r = 0.80) suggests that environmental normative contexts may play a more substantial role in attitude formation than previously recognized in this educational setting. Gender and urban–rural differences indicate meaningful heterogeneity requiring differentiated approaches. Future research should employ longitudinal designs with multi-informant assessment and larger multi-site samples to establish temporal precedence, reduce method variance, and test causal hypotheses regarding relationships between normative beliefs and behavioral outcomes. Full article

Multiple sclerosis (MS) is a chronic, immune-mediated disorder of the central nervous system, increasingly recognized as a disease continuum that begins years before the first neurological event. Genetic susceptibility, environmental exposures, and silent neuroinflammation contribute to early disease activity. Recent studies have highlighted a preclinical phase that includes both a biological stage, characterized by elevated biomarkers such as serum neurofilament light chain up to 10 years before onset, and a prodromal phase, marked by subtle but measurable symptoms. Population-based cohorts consistently show increased healthcare use, higher prevalence of psychiatric and cognitive disturbances, fatigue, pain, and gastrointestinal disorders years before diagnosis, which may represent prodromal symptoms. Radiologically isolated syndrome (RIS), defined by incidental demyelinating lesions in asymptomatic individuals, represents the visible form of this phase and provides a unique opportunity to study the transition to clinical disease. Approximately half of RIS patients develop MS within a decade, with predictors including younger age, male sex, CSF oligoclonal bands, and spinal cord involvement. Recent randomized controlled trials demonstrated that early use of disease-modifying therapies in RIS significantly reduces conversion risk. Defining the preclinical and prodromal phases of MS offers a major opportunity to refine risk stratification, enable earlier intervention, and ultimately prevent or delay the onset of clinically definite MS. Full article

Background: Postoperative delirium (POD) is commonly observed after surgical aortic valve replacement (SAVR) and could have serious consequences. Its prevalence varied among prior published series. With increasing patient age, a worsening of this problem can be expected. Methods: The association between POD and other adverse events, as well as its effect on 30-day mortality, long-term survival, and later dementia development, was investigated in 1500 consecutive patients (1527 operations) undergoing SAVR with a biological prosthesis, with or without concomitant procedures. An observational retrospective file analysis was performed, using chi-square, Student’s t-test, logistic regression, and Kaplan–Meyer analyses. Results: POD was recorded in 183/1527 (12.0%) of the patient files. Its independent predictors were need for reintervention, age over 80 years, male gender, peripheral artery disease, smoking, need for non-elective SAVR, atrial fibrillation, and a prior TIA. POD was associated with all other postoperative adverse events and increased need for resources. Thirty-day mortality was almost four times higher with POD: 35/182 (19.1%) vs. 59/1345 (4.4%), p < 0.001. Five-year survival was significantly reduced in patients with POD: 79.8 ± 1.2% versus 59.5 ± 4.3%, p < 0.001. The mean time to occurrence of dementia was 89 (84–95) months in patients without POD versus 60 (50–71) months in patients with POD. Five-year freedom from dementia was 69.1 ± 2.9% versus 44.4 ± 6.8%, p < 0.001. Conclusions: POD is associated with short-term complication rates, increased need for resources and hospital mortality, a reduced long-term survival rate, and an increased risk of dementia development. The limitations of this investigation include its retrospective and observational nature; in addition, it did not detect preoperative mild cognitive impairment. Full article

Despite valuable insights into the individual roles of genetic factors and personality traits, their combined contribution to addiction susceptibility remains insufficiently characterized. Within this framework, the potential influence of epigenetic mechanisms, particularly those mediated by the gut microbiome, also remains underexplored. This comprehensive review aims to address these gaps in an integrative manner by examining: (i) the association of gene regulation with personality traits; (ii) the genetics of substance use disorders; (iii) the roles of genes and personality in addiction; and (iv) epigenetic influences on addiction, with a particular focus on the role of the gut microbiome. Genetic influences on personality act primarily via regulatory variants that modulate gene expression during neurodevelopment, shaping cognitive, emotional, and behavioral traits that contribute to individual differences. Substance use disorders share partially overlapping genetic foundations, with specific loci, heritability estimates, and causal pathways differing across substances, reflecting both shared vulnerability and substance-specific genetic influences on addiction susceptibility. Impulsivity, novelty-seeking, and stress responsiveness are heritable personality traits that interact to shape susceptibility to substance use disorders, with genetic factors modulating risk across different forms of addiction. Environmental factors, early-life stress, and social influences interact with the gut microbiome to shape neurobiological and behavioral pathways that modulate addiction risk. These interactions highlight the multifactorial nature of substance use disorders, in which epigenetic, microbial, and psychosocial mechanisms converge to influence susceptibility, progression, and maintenance of addictive behaviors. Full article

This study investigated how consumers’ food consumption needs and perceptions influence their attitudes and behavioral intentions toward food truck dining. Drawing on the stimulus–organism–response (SOR) framework, perceived risks and benefits were conceptualized as external stimuli; food consumption needs (necessity vs. enjoyment) and attitudes represented the organism; and behavioral intentions denoted the response. Data were collected via Amazon Mechanical Turk and analyzed using structural equation modeling and multigroup comparisons based on prior food truck experience. Perceived benefits and food enjoyment positively influenced attitudes, whereas perceived risks negatively influenced attitudes. Attitude significantly predicted future behavioral intentions, whereas food as a necessity did not. The multigroup analysis revealed that prior experience moderated these relationships; perceived benefits and risks primarily guided inexperienced consumers, whereas experienced consumers formed attitudes mainly through hedonic needs. These findings contribute to the literature by integrating the SOR and value–attitude–behavior hierarchies to explain cognitive and motivational mechanisms underlying food truck patronage. They also highlight the moderating role of prior experience, which reshapes the strength of the model’s key paths. The study offers practical implications for food truck operators seeking to balance risk mitigation with perceived benefits to encourage repeat patronage. Full article