Search Results (475)

Background and Objective: The accurate detection of sleep stages and disorders in older adults is essential for the effective diagnosis and treatment of sleep disorders affecting millions worldwide. Although Polysomnography (PSG) remains the primary method for monitoring sleep in medical settings, it is costly and time-consuming. Recent automated models have not fully explored and effectively fused the sleep features that are essential to identify sleep stages and disorders. This study proposes a novel automated model for detecting sleep stages and disorders in older adults by analyzing PSG recordings. PSG data include multiple channels, and the use of our proposed advanced methods reveals the potential correlations and complementary features across EEG, EOG, and EMG signals. Methods: In this study, we employed three novel advanced architectures, (1) CNNs, (2) CNNs with Bi-LSTM, and (3) CNNs with a transformer encoder, for the automatic classification of sleep stages and disorders using multichannel PSG data. The CNN extracts local features from RGB spectrogram images of EEG, EOG, and EMG signals individually, followed by an appropriate column-wise feature fusion block. The Bi-LSTM and transformer encoder are then used to learn and capture intra-epoch feature transition rules and dependencies. A residual connection is also applied to preserve the characteristics of the original joint feature maps and prevent gradient vanishing. Results: The experimental results in the CAP sleep database demonstrated that our proposed CNN with transformer encoder method outperformed standalone CNN, CNN with Bi-LSTM, and other advanced state-of-the-art methods in sleep stages and disorders classification. It achieves an accuracy of 95.2%, Cohen’s kappa of 93.6%, MF1 of 91.3%, and MGm of 95% for sleep staging, and an accuracy of 99.3%, Cohen’s kappa of 99.1%, MF1 of 99.2%, and MGm of 99.6% for disorder detection. Our model also achieves superior performance to other state-of-the-art approaches in the classification of N1, a stage known for its classification difficulty. Conclusions: To the best of our knowledge, we are the first group going beyond the standard to investigate and innovate a model architecture which is accurate and robust for classifying sleep stages and disorders in the elderly for both patient and non-patient subjects. Given its high performance, our method has the potential to be integrated and deployed into clinical routine care settings. Full article

Background/Objectives: In Japan, the number of elementary and junior high school students who do not attend school is increasing. Sleep problems are considered a contributing factor. Methods: This study utilized self-administered questionnaires about the sleep patterns and backgrounds of 25,257 students from the 3rd–10th grades across 91 elementary schools, 51 junior high schools, and 36 high schools in Japan. Latent class analysis was performed to assess sleep regularity. Logistic regression analysis was conducted to examine the relationship between sleep regularity and school attendance status, as well as the relationship with protective factors against non-attendance. Results: Overall, 19,005 students responded. The response rate was 75.2%. Sleep regularity was categorized into Class 1, Regular; Class 2, Somewhat Irregular; Class 3, Irregular; and Class 4, Schedule-Dependent. Class 1 decreased with grade, from 61.8% in the 3rd grade to 46.2% in the 10th grade. Class 3 comprised 10.0% of students not experiencing school non-attendance, 37.9% among students with persistent school non-attendance, and 17.9% among students who had resumed school attendance after school non-attendance in the previous year. Classes 2, 3, and 4 showed a negative relationship with protective factors against non-attendance such as good relationships with teachers and family, good communication, academic performance, proficiency in athletic activities, and the presence of a place to belong outside school. Conclusions: Sleep irregularity is related to school non-attendance and may serve as a barometer of students’ communication and academic difficulties. Additionally, we propose an early intervention for sleep problems to prevent the exacerbation of school non-attendance. Full article

Asthma continues to affect millions of adults in the United States, with indoor environmental exposures playing a major role in symptom burden and control. Limited research has examined the combined influence of multiple household and environmental determinants on adult asthma morbidity, particularly in diverse states such as Texas. We analyzed pooled data from 1596 Texas adults with asthma who completed the Asthma Call-Back Survey between 2019 and 2022. Multivariable logistic regression models, adjusted for survey design and demographic covariates, were used to examine associations between household and environmental determinants and four morbidity outcomes: asthma attacks, recent symptoms, sleep difficulty, and limited activity due to asthma. Current smoking, lack of bathroom or kitchen ventilation, and absence of air purifier use were consistently associated with higher odds of morbidity. Protective associations were observed for homes without mold, rodents, or furry pets. Disparities were also evident, with older adults, women, and non-Hispanic Black respondents reporting greater morbidity. These findings highlight the importance of addressing modifiable exposures such as indoor smoking, ventilation, and allergen control within comprehensive asthma management strategies. Targeted interventions that combine environmental modifications with health education may help reduce asthma disparities and improve the quality of life for adults with asthma. Full article

Traffic police officers represent a critical occupational group with high vulnerability to vehicular air pollution, a severe environmental health threat in rapidly urbanizing metropolises such as Addis Ababa. This cross-sectional study explored occupational exposure, protective practices, health risks, perceptions, and awareness of air-quality-associated health risks among 120 traffic police officers in Addis Ababa. The officers were mostly male (80%) and married (93.3%), with the majority (62.6%) having served for more than ten years. While vehicle emissions were consistently recognized as the main source of air pollution, critical knowledge gaps were identified, i.e., only 24.2% had received pollution-related training, fewer than half (45.8%) were aware of government policies, and just 9.2% reported collaboration with environmental authorities. Awareness of the Air Quality Index (AQI) was generally low, and regular monitoring of AQI was limited. Self-reported health symptoms were highly prevalent among participants, with cough (75.0%), eye irritation (61.7%), sneezing (58.3%), and runny nose (55.8%) being the most frequently reported. Notably, sneezing, runny nose, eye irritation, and psychological stress showed significant association with perceived pollution levels at the workplace (p < 0.05), while blood pressure, cough, difficulty concentrating, and sleep loss were not significantly associated (p > 0.05). A higher prevalence of symptoms was generally observed in groups experiencing moderate-to-very high levels of pollution. Protective measures were applied inconsistently; while 63.3% of participants reported using masks, their beliefs about the effectiveness of using masks varied. Relocation (60%) and use of face covers/glasses (13.3%) were less commonly practiced. Overall, traffic police officers are exposed to occupational air pollution, which is associated with various health symptoms. These findings highlight the need for enhanced training, clearer communication of policies, stronger institutional engagement, the provision of standardized protective masks, and the promotion of AQI utilization to reduce occupational health risks and safeguard the wellbeing of traffic police officers in Addis Ababa. Full article

Sensory processing differences, reported in up to 97% of individuals with autism spectrum disorder (ASD), are increasingly recognized as a defining feature of the condition, shaping perception, cognition, and adaptive behavior. Atypical sensory responsivity, ranging from hyper- to hypo-reactivity and sensory seeking, emerges early in development and contributes to the clinical and neurobiological heterogeneity of autism. Alterations in neural connectivity, the balance of excitation and inhibition, and multisensory integration are thought to underlie these sensory profiles, influencing emotional regulation, attention, and social interaction. Sensory features also interact with co-occurring conditions such as anxiety, attention deficit hyperactivity disorder, and sleep and feeding difficulties, thereby shaping developmental trajectories and influencing adaptive behavior. Clinically, these sensory dysfunctions have a significant impact on daily participation and quality of life, extending their effects to family functioning. Understanding individual sensory phenotypes is therefore essential for accurate assessment and personalized intervention. Current therapeutic approaches include Sensory Integration Therapy, Sensory-Based Interventions, Sequential Oral Sensory Approach, and structured physical activity programs, often complemented by behavioral and mindfulness-based techniques. Emerging neuroplasticity-oriented methods for targeted modulation of sensory processing networks include neurofeedback and non-invasive brain stimulation. Overall, current evidence highlights the central role of sensory processing in ASD and underscores the need for multidisciplinary, individualized approaches to optimize developmental trajectories and enhance adaptive functioning. This review provides an updated synthesis of sensory processing in ASD, integrating neurobiological, developmental, and clinical evidence to highlight established knowledge, unresolved questions, and priorities for future research. Full article

Prader–Willi syndrome (PWS) is a rare, multisymptomatic genetic disorder caused by the absence or dysfunction of specific genes on chromosome 15. The genetic abnormality is anticipated to cause a dysfunction of the hypothalamus, which is also central in the regulation of the autonomic nervous system (ANS). Typical symptoms of PWS indicating a hypothalamic dysfunction include muscular hypotonia, poor growth, short stature, and feeding difficulties in infancy, which in early childhood are replaced by hyperphagia, leading to a high risk of obesity. Other characteristics, such as sleep difficulties, altered pain perception, delayed gastric emptying and constipation, blood pressure irregularities and dysregulated stress response, altered temperature regulation, delayed pupillary reaction, and urine retention and incontinence, all indicate a dysfunction of ANS. The ANS is usually divided into three parts: the sympathetic nervous system (SNS), which activates the fight-or-flight response during stress; the parasympathetic nervous system (PNS), which promotes calm and digestion; and the independent enteric nervous system (ENS), which regulates the gastrointestinal tract. Noradrenaline is the main neurotransmitter for the SNS, and acetylcholine for the PNS, while the ENS is regulated mainly by acetylcholine and serotonin. However, the ENS is modulated by both the SNS and the PNS, as well as many neuropeptides. Peptides regulating behavior, metabolism, appetite, and satiety have been extensively studied in PWS. However, studies of the role of neuropeptides in regulating other autonomic functions are limited and remain poorly understood. This review aims to synthesize current evidence from both animal models and human studies to explore potential mechanisms by which neuropeptides may contribute to autonomic dysfunction in individuals with PWS. Full article

Background: According to the National Institute for Health and Care Excellence (NICE), long COVID refers to symptoms persisting for four weeks or more after acute infection, with over 100 identified, including fatigue, cognitive dysfunction, and breathlessness. Women aged 45–54 are disproportionately affected, overlapping with the typical age for perimenopause and menopause. This scoping review aimed to provide an overview of existing research on the intersection between long COVID and the menopausal transition. Methods: Five database (CINAHL ultimate, MEDLINE, ScienceDirect, Cochrane, and Scopus) searches yielded 387 articles; after removing 40 duplicates and screening 347 titles and abstracts, fourteen studies were reviewed in full, with seven meeting the inclusion criteria (examined both long COVID and menopause in their scope and are written in English language). Results: This scoping review identified a significant symptomatic overlap between long COVID and menopause reported by participants, particularly fatigue, cognitive difficulties, mood changes, and sleep disturbances. Preliminary evidence also suggests that hormonal fluctuations may influence symptom severity, though biological mechanisms remain insufficiently understood. Methodological limitations restrict generalisability, underscoring the need for longitudinal symptom tracking, diverse samples, and biomarker-informed studies. Recognising the intersection of long COVID and menopausal transition is essential for improving assessment, management, and targeted care for affected women. Full article

Background: Idiopathic intracranial hypertension (IIH), also known as primary pseudotumor cerebri, is characterized by increased intracranial pressure (ICP) without an identifiable cause. It can lead to significant morbidity, including permanent vision loss, especially in younger children. The exact cause of IIH is still unclear, but excess adiposity seems to be a key risk factor. Current treatment options are unsatisfactory, but research is exploring novel therapies targeting obesity-related mechanisms. Methods: Narrative review of the literature aimed at summarizing current knowledge regarding the epidemiology, pathophysiology, clinical features, treatment options and long-term outcomes for pediatric IIH, with a particular focus on the link with obesity. Results: The incidence of IIH is rising, mirroring the obesity epidemic. Excess adiposity, predominantly visceral, might cause IIH through several factors such as decreased venous return, hormone dysregulation, inflammation, obstructive sleep apnea, and dysfunction of the glymphatic system. The extent of weight loss required and the most appropriate strategy to achieve it are still uncertain. Given the difficulty in achieving and maintaining weight loss with dietary strategies, bariatric surgery and weight loss medications are emerging as effective options for long-term remission of both obesity and IIH. Conclusions: IIH is a rare and poorly understood disease. At present, weight loss represents the only treatment that addresses the pathophysiology of IIH. The role and potential as standalone or synergistic therapies of weight loss drugs and bariatric surgery for IIH in adolescents require future research. Full article

Female cancers, including breast and gynecological malignancies, are among the most prevalent oncological conditions worldwide. Advances in screening, diagnosis, and treatment have markedly improved survival, resulting in a growing population of female cancer survivors. Consequently, long-term health and quality of life have become essential aspects of comprehensive cancer care. Among survivorship issues, sleep disturbances—particularly insomnia—are highly prevalent and associated with adverse outcomes including mood and cognitive impairment, fatigue, immune and cardiometabolic dysregulation, and reduced adherence to therapy. Insomnia, defined as difficulty initiating or maintaining sleep or experiencing poor sleep quality with daytime impairment, affects 6–10% of the general population and is more common in women. In cancer survivors, poor sleep quality appears to be three times more frequent, reaching 62% in breast cancer survivors, although these data may be underestimated, especially for other cancer types, due to the small sample size and heterogeneity of the studies. The pathogenesis of insomnia in female cancer patients is multifactorial, involving cancer-related inflammation, hypothalamic–pituitary–adrenal axis dysregulation, neuroimmune alterations, treatment effects, psychological distress, and behavioral factors. Hormonal disruption plays a central role, as oncological treatments are often the cause of iatrogenic menopause, leading to vasomotor symptoms, mood and cognitive disturbances, sexual dysfunction, and genitourinary complaints, all contributing to sleep disruption. Importantly, estrogens and progesterone independently regulate sleep–wake pathways via central mechanisms, influencing sleep quality even in the absence of vasomotor symptoms. Management requires a multidisciplinary approach integrating oncology, gynecology, and sleep medicine. Cognitive Behavioral Therapy for Insomnia (CBT-I) is first-line, while pharmacologic options include benzodiazepines, Z-drugs, SSRIs/SNRIs, melatonin, or new medication like DORAs. Menopausal hormone therapy (MHT) should be considered for premature menopause management in selected women without contraindications, improving both vasomotor symptoms and sleep quality. Emerging neurokinin receptor (NK-R) antagonists show promise, and ongoing trials suggest significant potential even in breast cancer survivors. Full article

Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by persistent social communication difficulties, restricted interests, repetitive behaviors, and frequent medical comorbidities. Although early brain development in ASD has been extensively investigated, its biological progression across adulthood and aging remains largely unexplored. Growing evidence suggests that perivascular space (PVS) abnormalities may indicate impaired neurovascular integrity and reduced glymphatic clearance in ASD. Enlarged perivascular spaces (ePVS) in children commonly present alongside increased extra-axial CSF accumulation and more severe clinical manifestations, consistent with early alterations in CSF homeostasis and neuroimmune signaling. However, whether these abnormalities persist or evolve with aging remains unknown. Given that glymphatic and vascular integrity decline with age, and adults with ASD show elevated rates of sleep, metabolic, and cardiovascular disorders, PVS alterations may represent a unifying mechanism linking early neurodevelopmental divergence with later neurovascular vulnerability and cognitive aging. Advances in ultra-high-field MRI and automated segmentation now enable precise in vivo quantification of PVS burden, offering new opportunities for lifespan studies. By combining structural and functional methodologies, researchers may determine whether PVS constitute enduring traits, dynamic indicators of disease, or actionable therapeutic targets. Understanding their trajectories could provide critical insights into the continuum between neurodevelopmental and neurodegenerative phenomena in autism. Full article

Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) exhibits substantial clinical heterogeneity and poor prognosis in relapsed/refractory (R/R) settings. PRO-MIND is a prospective, multicenter real-world study evaluating tafasitamab–lenalidomide followed by tafasitamab monotherapy in patients with transplant-ineligible R/R DLBCL in Italy. This ad hoc, cross-sectional, baseline analysis aimed to characterize health-related quality of life (HRQoL) and symptom burden before tafasitamab–lenalidomide initiation in the PRO-MIND cohort. Methods: Thirty-eight patients across 30 centers completed the EORTC QLQ-C30 and QLQ-NHL-HG29 questionnaires at pretreatment baseline, prior to starting tafasitamab–lenalidomide. EORTC QLQ-C30 scores (0–100) were compared with age-specific normative values for the Italian general population using Welch’s t-test. Differences of ≥5 points were considered clinically meaningful and ≥10 points clearly clinically important. Effect sizes (Cohen’s d) were calculated to complement p-values for between-group comparisons. Results: Compared with normative data, the PRO-MIND cohort had significantly lower EORTC QLQ-C30 functioning scores for physical (Δ 12.7, p = 0.0135), role (Δ 16.1, p = 0.0168), social (Δ 15.2, p = 0.0019), and cognitive (Δ 8.5, p = 0.0460) functioning. Symptom scales revealed worse fatigue (Δ 14.8, p = 0.0097), insomnia (Δ 13.9, p = 0.0291), appetite loss (Δ 9.4, p = 0.0435), and pain (Δ 8.7, p = 0.0430) in the PRO-MIND cohort versus normative data, with effect sizes in the small-to-moderate range. EORTC QLQ-NHL-HG29 scores indicated a high prevalence of concerns about future health (84.2%), disease recurrence (81.6%), and dependency (78.9%), as well as physical symptoms, including lack of energy (71.1%), sleep difficulties (63.2%), and pain or discomfort (60.5%). Conclusions: This cross-sectional, baseline-only analysis of the PRO-MIND real-world cohort showed that patients with transplant-ineligible R/R DLBCL scheduled to receive tafasitamab–lenalidomide already had pronounced impairments in physical, role, social, and cognitive functioning, along with substantial fatigue, insomnia, pain, appetite loss, and psychological concerns. These baseline benchmarks underscore the importance of systematic HRQoL assessment and targeted supportive interventions focusing on these domains before and during treatment. Future longitudinal PRO-MIND analyses will complement these findings by describing how HRQoL evolves after tafasitamab–lenalidomide initiation. Full article

Early adolescence is a sensitive period for digital media overdependence; however, persistent high-risk patterns remain poorly understood. Using data from the 2008 birth panel of the Panel Study on Korean Children (n = 1354), we examined predictors measured from early childhood to Grades 1–2 (2014–2016) and modeled digital media overdependence from Grades 3 to 6 (2017–2020). Hidden Markov Models (HMMs) were used to identify developmental trajectories, and machine learning models characterized risk signals using SHAP-informed feature importance. Five trajectories emerged, including one subgroup that maintained persistently high risk. The predictive model showed good discriminative performance (strong predictive performance [Receiver Operating Characteristic Area Under the Curve (ROC AUC) = 0.84]). Executive function difficulties in Grade 1 and their worsening through Grade 2 predicted an elevated risk, whereas longer or increasing sleep duration, stronger family interactions, and appropriate parental control were protective. In contrast, higher maternal parenting stress, greater overall media use time, and a larger proportion of game-centered media use functioned as risk factors. These findings identify modifiable early childhood and early elementary predictors of high-risk maintenance trajectories of media overdependence and may inform early screening and preventive interventions in families, schools, and communities. Full article

Background and Objectives: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by social communication deficits, restricted interests, and repetitive behaviors. At present, there is no pharmacological intervention that reliably targets the core symptoms of ASD; instead, medications are primarily used to manage associated or concurrent symptoms such as irritability, aggression, anxiety, attention difficulties, and sleep disturbances. This review summarizes the current evidence for pharmacological treatments in ASD, emphasizing how these interventions are used in a symptom-focused, adjunctive manner, and highlighting efficacy, mechanisms, limitations, and emerging therapeutic targets. Methods: A comprehensive literature review was conducted across PubMed, Cochrane Library, and Embase to identify clinical trials, systematic reviews, meta-analyses, and preclinical studies on pharmacological interventions for ASD. Seventy-seven references were integrated to reflect the current state of evidence. Results: Established pharmacological strategies include atypical antipsychotics for severe irritability and aggression, as well as antidepressants, stimulants and non-stimulant agents, mood stabilizers, and anxiolytics for selected comorbid symptoms, although efficacy is often modest and variable, and side effects can be significant. Adjunctive and investigational approaches targeting glutamatergic and GABAergic neurotransmission, monoaminergic systems, and neuroinflammatory and oxidative stress pathways show preliminary promise but remain experimental. Across all categories, pharmacological treatments are most effective when embedded in individualized, multimodal care plans that integrate behavioral, rehabilitative, and psychological interventions. Conclusions: This review maps pharmacologic strategies in ASD onto their underlying neurobiological mechanisms and clarifies how evidence strength differs across drug classes and symptom domains. Ongoing advances in genetics, synaptic and circuit-level neuroscience, and neuroimmune signaling are expected to yield more specific, mechanism-based pharmacological approaches for autistic behaviors, with the potential to improve long-term functioning and quality of life when combined with comprehensive psychosocial care. Full article

This paper reviews existing research on infant mattress design to promote safe and comfortable sleep and proposes evidence-based design recommendations. Focusing on safety related to Sudden Unexpected Infant Death (SUID) and comfort associated with infant development and thermoregulation, we examine mattress firmness, pressure distribution, breathability, and thermal properties. Since infants have difficulty turning over and possess immature thermoregulatory functions, mattress characteristics directly influence sleep quality and safety. Based on international studies, we clarify the requirements for infant mattresses and provide insights into future product development and evaluation standards. Full article

Long COVID is frequently accompanied by enduring neurocognitive and physical symptoms that substantially affect quality of life. Cognitive complaints—including difficulties in memory, attention, and executive functioning—often co-occur with physical manifestations such as fatigue, dyspnea, and headache. Despite growing research, openly available datasets integrating demographic, cognitive, and physical symptom profiles assessed during chronic phases of Long COVID remain scarce. Here, we present two complementary self-report datasets collected ≥6 months after the most recent COVID-19 infection. The first dataset (“Neuro–Long COVID-212”) includes demographic information, binary neurocognitive symptom indicators, and a 14-item Post-COVID Cognitive Impairment Scale assessing memory and attention complaints. The second dataset (“Neuro–Long COVID–210”) provides a broad range of physical symptoms—operationally defined as somatic and neurological complaints (e.g., fatigue, pain, sleep disturbance, anosmia/ageusia)—recorded as binary indicators (present/absent). Data were collected online via the Porsline platform using individualized links, with remote researcher support to ensure accuracy. Quality assurance procedures included duplicate-response removal, consistency checks, and transparent handling of missing values. The datasets are released in Excel (.xlsx) format, fully de-identified and accompanied by a detailed data dictionary to facilitate reuse. These datasets enable reproducibility, secondary analyses, and meta-analyses on cognitive and physical outcomes in Long COVID, and may inform future cross-disciplinary rehabilitation research. Full article