Cognitive Problems Research Articles

Preliminary validation of a dual‐task gait assessment in early Alzheimer’s Disease

AbstractBackgroundEarly stages of Alzheimer’s disease (eAD) are marked by changes in gait characteristics that may be measured using simple smartphone‐based gait tasks. Here we present an assessment of cognitive‐motor‐interference where participants walk for 30 seconds with a smartphone placed in a running belt while counting backwards, called the 30‐Second Walk Test Dual Task (30sWTDT). We report the preliminary reliability and validation of the 30sWTDT in a cohort of healthy individuals (HC), individuals with subjective cognitive decline amyloid‐PET negative and positive (SCDn and SCDp, respectively) and eAD.Method123 participants (32 HC, 31 SCDn, 30 SCDp and 30 eAD) were recruited as a part of a Proof‐of‐Concept study of the Alzheimer’s Disease Digital Assessment Suite (AD‐DAS) (https://www.isrctn.com/ISRCTN17035495). Participants performed 9 sessions of 30sWTDT over 28 days on provisioned smartphones. Feasibility was evaluated as the proportion of completed 30sWTDT relative to the total number of expected sessions. Two gait characteristic metrics were estimated: variability in step frequency (VSF) and the 25th percentile in step power (25SP). Intraclass correlation coefficients (ICC) tested the metrics’ reliability. Convergent validity was established as partial correlation between VSF/25SP and adjusted mean duration in Timed 25 foot Walk Test (T25WT). Clinical validity was evaluated using a proportional odds logistic regression model to differentiate between groups.ResultAmong the 97.5% of participants who completed the study (i.e., n = 120), participants completed 88.9% of all assigned 30sWTDT tasks, with no group difference in adherence. VSF and 25SP metrics showed moderate (ICC = 0.74) and good (ICC = 0.79) reliability, respectively. Both metrics significantly distinguished between HC and all other study groups (odds ratio = [0.012,0.029]), and were associated with T25WT adjusted mean duration (adjusted r2 = [0.09,0.069]).ConclusionPreliminary findings demonstrate that a smartphone‐based 30sWTDT can be successfully self‐administered by cognitively healthy participants and individuals on the eAD continuum. Participants show high adherence in an ecologically valid environment. 30sWTDT differentiated HC from all other groups with subjective or objective cognitive problems, indicating a lack of specificity of gait characteristics to differentiate between increasing levels of cognitive impairment. These findings require replication in larger independent datasets.

Social Assistive Robotics to Motivate Cognitive Training in Patients with Chronic Depression

AbstractBackgroundApproximately 280 million people in the world suffer from depression, which can become chronic and often leads to cognitive problems. International literature shows that depression is known as one of the 12 main modifiable risk factors for dementia, and therefore, cognitive training is essential to foster cognition and to reduce the risk for dementia. In the last years new technologies, like robots, have been developed to support health care professionals with limited resources in their daily practice. The aim of the Austrian project AMIGA is to develop and test a gender‐sensitive and customizable Social Assisting Robotic Technology (SAR) including a cognitive training to enhance cognition and to improve the quality of life of people with chronic depression in psychiatric hospitals.MethodIn the first step of the project, the requirements of the target group will be determined using qualitative and quantitative methods (e.g. survey, interviews). Based on the results, the interactive SAR prototype will be developed which will use human‐robot interactions to motivate users to perform cognitive training with the BRAINMEE‐App on a daily basis. Target group‐specific as well as gender‐sensitive content for holistic stimulation with visual, auditory and interactive elements will be included. The prototype will then be tested in a usability study with 12 end users including patients to revise the robot. At the end, a randomized controlled trial with additional interviews including 60 patients will be conducted to test the final robotic platform.ResultAt the conference, the first results of the project will be presented.ConclusionAMIGA is the first project to investigate, on a scientific basis using neuropsychological theories, care requirements and human factor measurement technologies, the fundamental design parameters for interactions with social robotics, which contribute to increasing motivation for cognitive training, to efficiently relieve stress and strengthen the resilience of patients with depression during training. AMIGA, as a research prototype, will lay the foundation for future system developments that provide motivational support for improved adherence to training activities in the mental health care field, which includes depression and other mental illnesses, like dementia and further brain‐related disorders as well as learning disorders.

Social Assistive Robotics to Motivate Cognitive Training in Patients with Chronic Depression

AbstractBackgroundApproximately 280 million people in the world suffer from depression, which can become chronic and often leads to cognitive problems. International literature shows that depression is known as one of the 12 main modifiable risk factors for dementia, and therefore, cognitive training is essential to foster cognition and to reduce the risk for dementia. In the last years new technologies, like robots, have been developed to support health care professionals with limited resources in their daily practice. The aim of the Austrian project AMIGA is to develop and test a gender‐sensitive and customizable Social Assisting Robotic Technology (SAR) including a cognitive training to enhance cognition and to improve the quality of life of people with chronic depression in psychiatric hospitals.MethodIn the first step of the project, the requirements of the target group will be determined using qualitative and quantitative methods (e.g. survey, interviews). Based on the results, the interactive SAR prototype will be developed which will use human‐robot interactions to motivate users to perform cognitive training with the BRAINMEE‐App on a daily basis. Target group‐specific as well as gender‐sensitive content for holistic stimulation with visual, auditory and interactive elements will be included. The prototype will then be tested in a usability study with 12 end users including patients to revise the robot. At the end, a randomized controlled trial with additional interviews including 60 patients will be conducted to test the final robotic platform.ResultAt the conference, the first results of the project will be presented.ConclusionAMIGA is the first project to investigate, on a scientific basis using neuropsychological theories, care requirements and human factor measurement technologies, the fundamental design parameters for interactions with social robotics, which contribute to increasing motivation for cognitive training, to efficiently relieve stress and strengthen the resilience of patients with depression during training. AMIGA, as a research prototype, will lay the foundation for future system developments that provide motivational support for improved adherence to training activities in the mental health care field, which includes depression and other mental illnesses, like dementia and further brain‐related disorders as well as learning disorders.

P76: Agreement between nursing-home caregivers’ observations of residents’ depression, wellbeing, and quality of life

Objective:In nursing home residents, outcomes are often assessed using proxies, especially in residents with severe cognitive problems. Although caregivers are commonly involved as proxies, studies assessing their agreement for proxy measures are scarce. Therefore, secondary analysis was performed on a dataset with proxy-reported scores of several scales in Dutch and Flemish nursing home residents with and without dementia.Methods:To assess the agreement between the observations of 81 pairs of caregivers, we calculated Cohen’s Kappa, Weighted Kappa, and Prevalence- and Bias-Adjusted Kappa (PABAK and PABAK- OS for ordinal data) coefficients for the items on the Nijmegen observer-rated depression scale for detection of depression in nursing home residents (NORD), the social wellbeing of nursing-home residents scale (SWON-3), and two subscales (i.e., “social relations” and “having something to do”) of the QUALIDEM. In addition, coefficients were calculated for the item concerning subjective judgment of the residents’ depressive symptoms (“no,” “yes, mild or light,” or “yes, severe”) and for the item concerning whether the caregivers believed a depression diagnosis had been established (“yes,” “no”).Results:In general, PABAK and PABAK-OS coefficients were higher than the Cohen’s and Weighted Kappa coefficients, suggesting a considerable amount of prevalence or bias. For the total sample, most items were above .40, indicating acceptable agreement. The results showed higher levels of agreement for proxy scores of residents with lower levels of dementia, compared to residents with more severe dementia.Conclusion:The general finding of different levels of agreement between coefficients with and without correction for prevalence and bias, suggest the importance of exploring both values to enable adequate interpretation of the reliability of these items. The result of limited levels of agreement between caregivers concerning residents with more severe dementia underscores challenges for measurements in this population. We believe that practitioners and researchers should be aware of these challenges when using and interpreting scores derived from proxies. Moreover, understanding why different raters reach different conclusions regarding the same residents is important for interpreting the meaning of proxy-reported scores.

Spatiotemporal Relationship Cognitive Learning for Multirobot Air Combat

Relationship cognition is crucial to learning-based Multi-Robot Systems (MRSs). As an advanced application of MRSs for fierce confrontation, the relationships among autonomous air combat robots inherently present complex time-varying characteristics, which makes relationship cognition even more difficult. However, previous studies have only focused on spatial cooperative relationships, thus ignoring the potential impact of the temporal dynamics of relationships on long-term cooperative behaviors. To tackle this drawback, we propose a novel Multi-Agent Deep Reinforcement Learning (MADRL) based autonomous air combat robots collaboration algorithm, called Spatio-Temporal Aerial robots Relationship Co-Optimization (STARCO). STARCO formulates the complex dynamic relationship cognition problem into a spatio-temporal deep Graph Neural Network (GNN) learning problem. On this basis, we overcome the limitations of previous methods, by accurately capturing the key spatio-temporal patterns from aggressive air combat, and enable global collaborative decision-making through joint strategy optimization. An empirical study shows that STARCO outperforms several state-of-the-art MARL baselines by 24.6% in learning performance. We also demonstrate that STARCO is capable of evolving various cooperative strategies comparable to human expert knowledge.

The Implication of the Sima’an Ahad Pahing on the Qur'an Memorization at PPTQ Al-Hasan Ponorogo

The digital era leaves problems of credibility and authenticity for those who memorize the Qur'an. The question of credibility could be seen by the decrease in the quality of reading, such as makharij and tajwid. In contrast, the question of authentication is evidenced by the low quality of students' memorization. This study aims to discuss the implications of the Sima’an Ahad Pahing activity on students’ memorization at PPTQ Al-Hasan Ponorogo. This study departs from cognitive, affective, and psychomotoric problems with the reinforcement of the psychological theory of behaviorism developed by John Watson. This study uses a qualitative method with a psychological approach. Data sources were obtained through interviews with 1 kiai, 4 ustadz, and 5 students. The analysis used in this study is Huberman & Saldana, which includes three steps, namely data compaction, data presentation, and drawing conclusions. The results showed that implicitly the Sima’an at PPTQ Al-Hasan Ponorogo provided a new method for maintaining the credibility and authenticity of the students' memorization.

AN ANALYSIS OF STUDENTS’ DIFFICULTIES IN WRITING ARGUMENTATIVE ESSAYS AT THE SIXTH SEMESTER OF ENGLISH EDUCATIONAL DEPARTMENT IN PGRI UNIVERSITY OF BANYUWANGI

This research is analysis research on students’ difficulties in writing argumentative essays at the Sixth Semester of English Educational Department in PGRI University of Banyuwangi. The aims of this research was to find out the dominant of writing difficulties of the students’ difficultiesin writing argumentative essays on cognitive problems by Byrne (1988) and their causes by Graham and Harris in Glynn note this (2006). Using a purposive sample, students in the sixth-semester of the 2019/2020 academic year were selected as samples in this study. This study used a qualitative descriptive method. The instruments used in this research were questionnaires. In carrying out the research, researchers used an online platform to obtain instrument. The results showed that the dominant in writing difficulties of students’ difficulties in writing argumentative essays are content problems. This was evidenced by the finding of difficulties in students’ argumentative essay categorized by Guttman scale. Content problems get very bad category, which means there are only 2 out of 12 the sixth semester English education students who have good ability on content problems in writing argumentative essays. The causes of students’ difficulties in writing argumentative essays on cognitive problems at the sixth semester of English educational department in PGRI University of Banyuwangi are the lack of knowledge, lack of an effective strategy, and lack of proficiency. Based on the results above, it was concluded that the sixth semester students of English Educational Department in PGRI University of Banyuwangi has difficulties in writing argumentative essays on cognitive problems.

Influence of BPPV and Meniere's Disease on Cognitive Abilities: A Questionnaire-Based Study

The vestibular system connects the inner ear to the midbrain and subcortical structures and can affect cognition. Patients with vertigo often experience cognitive symptoms such as attention deficits, memory problems, and spatial perception difficulties. This study aimed to explore the cognitive impairments associated with Benign paroxysmal positional vertigo (BPPV) and Meniere's Disease (MD). A non-experimental group comparison design was used with 107 participants divided into three groups: Group I (clinically normal), Group II (BPPV), and Group III (MD). Participants completed a questionnaire with 10 cognition-related questions, and their responses were scored. The data were found to be non-normally distributed. The analysis revealed a significant difference in scores between Group I and both Group II and Group III. Chi-square tests showed that the responses to cognition-related questions varied among the groups, with Group II exhibiting more cognitive problems. Associated conditions like hypertension, diabetes, and hearing loss did not significantly influence the responses within each group. This study suggests a significant relationship between cognitive problems and patients with BPPV and MD. However, there was no association found between the cognitive problems experienced in BPPV and MD patients. These findings align with previous research indicating that vestibular disorders can lead to deficits in spatial memory, attention, and other cognitive functions. By understanding the link between cognition and vestibular disorders, we can improve diagnosis and rehabilitation services to enhance the quality of life for these patients.

Perinatal morphine but not buprenorphine affects gestational and offspring neurobehavioral outcomes in mice

Within the national opioid epidemic, there has been an increase in the number of infants exposed to opioids in utero. Additionally, opioid agonist medications are the standard of care for women with opioid use disorder during pregnancy. Buprenorphine (BUP), a partial µ -opioid receptor agonist, has been successful in improving gestational and neonatal outcomes. However, in utero exposure has been linked to childhood cognitive and behavioral problems. Therefore, we sought to compare offspring cognitive and behavioral outcomes after prenatal exposure to a clinically relevant low dose of BUP compared to morphine (MO), a full µ -opioid receptor agonist and immediate metabolite of heroin. We used a mouse model to assess gestational and offspring outcomes. Mouse dams were injected once daily s.c. with saline (SAL, n = 12), MO (10 mg/kg, n = 15), or BUP (0.1 mg/kg, n = 16) throughout pre-gestation, gestation, and lactation until offspring were weaned on postnatal day (P)21. Offspring social interaction and exploratory behavior were assessed, along with executive function via the touchscreen 5 choice serial reaction time task (5CSRTT). We then quantified P1 brain gene expression in the frontal cortex and amygdala (AMG). Perinatal MO but not BUP exposure decreased gestational weight gain and was associated with dystocia. In adolescent offspring, perinatal MO but not BUP exposure increased social exploration in males and grooming behavior in females. In the 5CSRTT, male MO exposed offspring exhibited increased impulsive action errors compared to male BUP offspring. In the AMG of P1 MO exposed offspring, we observed an increase in gene expression of targets related to activity of microglia. Importantly, both MO and BUP caused acute hyperlocomotion in the dams to a similar degree, indicating that the selected doses are comparable, in accordance with previous dose comparisons on analgesic and reward efficacy. These data suggest that compared to MO, low dose BUP improves gestational outcomes and has less of an effect on the neonatal offspring brain and later adolescent and adult behavior.

Impaired visual-motor functional connectivity in first-episode medication-naïve patients with major depressive disorder.

The perceptual dysfunctions have been fundamental causes of cognitive and emotional problems in patients with major depressive disorder. However, visual system impairment in depression has been underexplored. Here, we explored functional connectivity in a large cohort of first-episode medication-naïve patients with major depressive disorder (n = 190) and compared it with age- and sex-matched healthy controls (n = 190). A recently developed individual-oriented approach was applied to parcellate the cerebral cortex into 92 regions of interest using resting-state functional magnetic resonance imaging data. Significant reductions in functional connectivities were observed between the right lateral occipitotemporal junction within the visual network and 2 regions of interest within the sensorimotor network in patients. The volume of right lateral occipitotemporal junction was also significantly reduced in major depressive disorder patients, indicating that this visual region is anatomically and functionally impaired. Behavioral correlation analysis showed that the reduced functional connectivities were significantly associated with inhibition control in visual-motor processing in patients. Taken together, our data suggest that functional connectivity between visual network and sensorimotor network already shows a significant reduction in the first episode of major depressive disorder, which may interfere with the inhibition control in visual-motor processing. The lateral occipitotemporal junction may be a hub of disconnection and may play a role in the pathophysiology of major depressive disorder.

Palliative Care for the Elderly With Heart Diseases in Tertiary Health care: A Concept Analysis.

The increasing incidence of heart failure (HF) in the elderly leads to increased mortality, hospitalization, length of hospital stay, and health care costs. Older adults often face multiple drug treatments, comorbidities, frailty, and cognitive problems, which require early palliative care. However, these patients do not receive adequate palliative care. This concept analysis aimed to develop an in-depth understanding of palliative care for elderly patients with cardiac diseases in tertiary care. The analysis was guided by Walker and Avant's method, and databases were searched using keywords, such as palliative care, tertiary care, elderly, and heart. Covidence was used to review the results using the inclusion and exclusion criteria. The World Health Organisation's definition of palliative care is widely accepted. Palliative care for older adults with heart disease in tertiary care is preceded by chronic illness, polypharmacy, symptom burden, physical and cognitive decline, comorbidities, and psychosocial/spiritual issues. The main attributes of palliative care for this population include health care professionals and patient education, holistic patient/family-centered care, symptom management, shared decision-making, early integration, advanced care planning, and a multidisciplinary approach. Palliative care improves elderly cardiac patients' and their family satisfaction while reducing readmission, hospital stays, and unnecessary invasive procedures. Collaboration between hospitals, community organizations, transitional palliative care services, and research has the potential to improve early palliative care and the well-being of the elderly cardiac population. Advanced Practice Nurses (APNs) competencies play a crucial role in promoting palliative care in the elderly HF population.

Homeostatic NREM sleep and salience network function in adult mice exposed to ethanol during development.

Developmental exposure to ethanol is a leading cause of cognitive, emotional and behavioral problems, with fetal alcohol spectrum disorder (FASD) affecting more than 1:100 children. Recently, comorbid sleep deficits have been highlighted in these disorders, with sleep repair a potential therapeutic target. Animal models of FASD have shown non-REM (NREM) sleep fragmentation and slow-wave oscillation impairments that predict cognitive performance. Here we use a mouse model of perinatal ethanol exposure to explore whether reduced sleep pressure may contribute to impaired NREM sleep, and compare the function of a brain network reported to be impacted by insomnia-the Salience network-in developmental ethanol-exposed mice with sleep-deprived, saline controls. Mice were exposed to ethanol or saline on postnatal day 7 (P7) and allowed to mature to adulthood for testing. At P90, telemetered cortical recordings were made for assessment of NREM sleep in home cage before and after 4 h of sleep deprivation to assess basal NREM sleep and homeostatic NREM sleep response. To assess Salience network functional connectivity, mice were exposed to the 4 h sleep deprivation period or left alone, then immediately sacrificed for immunohistochemical analysis of c-Fos expression. The results show that developmental ethanol severely impairs both normal rebound NREM sleep and sleep deprivation induced increases in slow-wave activity, consistent with reduced sleep pressure. Furthermore, the Salience network connectome in rested, ethanol-exposed mice was most similar to that of sleep-deprived, saline control mice, suggesting a sleep deprivation-like state of Salience network function after developmental ethanol even without sleep deprivation.

Path to Improve the Professional Quality of Students Majoring in Financial News: Micro Evidence from 300 Questionnaires from Three Universities

<p class="MsoNormal" style="margin-top: 12pt; text-align: justify;"><span lang="EN-US" style="font-family: arial, helvetica, sans-serif;">There must be a better match between the supply of financial news graduates in colleges and the media's demand for financial news talents. Based on 300 questionnaires and in-depth interviews from three universities, namely Shanghai University of Finance and Economics, Nanjing University of Finance and Economics, and Jiangxi University of Finance and Economics, this paper uses the interview method to excavate the professional quality improvement path for majoring in financial news students. Results reveal that undergraduates majoring in financial news have problems such as low professional identity, insufficient recognition of the discipline system, poor sense of professional identity, common matching between job selection and majors, and worrying about the status quo of professional literacy. Therefore, the improvement of the professional quality of students majoring in financial news and the reform of the training program needs to drive the professional quality of students in multiple dimensions, change their professional cognitive problems, strengthen their professional identity, and achieve an effective match between supply and demand of financial media professionals.</span></p>

Seclusion within the first 24 h following admission into inpatient mental health services and associations with referral pathways, recent service contact and HoNOS ratings.

WHAT IS KNOWN ON THE SUBJECT?: Seclusion is a harmful and traumatising intervention for people accessing mental health services. People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission. There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission. People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h. People referred from police or justice services are three times more likely to be secluded within the first 24 h. People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress. Mental health staff should consider the person's cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission. Strengthening the focus on nurturing relationships, cultural understanding and non-coercive de-escalation approaches requires leadership support and strategic workforce development. ABSTRACT: Introduction People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion People's cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non-coercive de-escalation approaches can support better outcomes for people recently admitted.

In vitro assessment of dietary bioactives for TFEB activation as a possible target to support cognitive and emotional wellbeing

Aging and chronic stress are associated with altered brain plasticity and an increased risk of developing cognitive and emotional health problems. A key cellular mechanism involved is autophagy, which is known to be important for memory encoding and information processing, and is also thought to be important for psychiatric and emotional health. Activation of the autophagic system can be established by the transcription factor EB (TFEB), which regulates both autophagosome formation and lysosomal biogenesis and function. As well-known activators of autophagy like caloric restriction, fasting, or regular exercise require intervention programs that are hard to adhere to, the search for nutritional solutions with similar effects, is increasing. We therefore evaluated pro-autophagic dietary bioactives for effects specifically through TFEB activation and assessed whether combining bioactives can lead to synergistic or additive effects. We also discuss current evidence supporting the use of these natural dietary compounds to promote cognitive and emotional wellbeing. MethodsPrimary cortical astrocytes were treated with 13 different ingredients and analyzed for their effect on TFEB nuclear translocation by high content imaging. Effective ingredients were then evaluated at different concentrations for their effect on TFEB downstream signaling by analyzing mRNA levels of Beclin1, LC3, Lamp-1 and Cathepsin D. Furthermore, the synergistic effects of sub-optimal concentrations of different ingredient combinations were evaluated on the same TFEB downstream signaling markers. Potential signs of toxicity of all ingredients and their combinations were evaluated by analysis of ATP production and nuclear counts. ResultsDHA, EPA, 7,8-DHF, ellagic acid, curcumin and spermidine increased TFEB nuclear localization. DHA and spermidine exhibited the strongest effects when measuring mRNA levels of TFEB downstream signaling markers. The most significant synergies were observed when combining spermidine with ellagic acid or when combining DHA with curcumin. None of the ingredients alone or in combination presented any sign of toxicity at the concentrations tested. Discussion/ConclusionThe results of our study show for the first time a synergistic effect of spermidine and ellagic acid and of DHA and curcumin on TFEB signaling and thus its ability to act on the autophagic system in brain cells. These combinations may hold potential as dietary promoters of cognitive and emotional wellbeing.

Association between pain intensity and cognitive function in primary headache

Background: Patients suffering from primary headaches such as migraine, tension-type headache, and cluster headache frequently report cognitive problems, particularly with attention and memory. The aim of this study was to see if there was a link between pain intensity and cognitive function in people who had primary headaches. Methods: This cross-sectional study included 69 primary headache patients (37 migraines, 27 tension-type headaches and 5 cluster headaches; age range 18–80 year). Migraine, tension-type headache and cluster headache diagnosis were determined according to the International Classification of Headache Disorders 3rd edition beta version (ICHD-3 beta) diagnostic criteria. All eligible subjects underwent cognitive function examination using Montreal Cognitive Assessment Indonesian version (MoCA-INA), Trail Making test A (TMT-A), Trail Making test B (TMT-B), Trail Making test C (TMT-C), Forward Digit Span and Backward Digit Span. The intensity of pain was assessed using Numeric Rating Scale (NRS). Results: There were 69 primary headache patients included in this study, 52 (75.4%) patients had abnormal MoCA-INA, 52(75.4%) patients had abnormal Forward Digit Span and 48(69.6%) patients had abnormal Backward Digit Span. There was significant correlation between pain intensity and cognitive function in migraine, TTH and cluster headaches patients. The MoCA-INA, Forward Digit Span and Backward Digit Span had negative correlations with pain intensity, whereas TMT A-time, TMT A-error, TMT B-time and TMT B-error had positive correlation. Conclusion: There were significant associations between pain intensity of and cognitive function in primary headaches with p<0.05. It is suggested that the more severe pain intensity, the more impair of cognitive function.

Exploring the association between self-care behaviour, knowledge and cognition in patients with heart failure: a secondary analysis from the HF-Wii study

Abstract Background Self-care is vital for patients with heart failure and is influenced by different factors, Knowledge and the ability to reflect on behaviors is important to make decisions on self-care. Cognition may also be an important factor in relation to both knowledge and self-care. It has been found that cognitive impairment in patients with heart failure is common, with a reported prevalence of 20–80%. Aim To explore association between self-care behaviour, knowledge and cognition in patients with heart failure. Methods This is a secondary analysis of the baseline measures from the HF-Wii study with data from 605 patients, mean age 70 ± 12, 29% female, 30 % in New York Heart Association Class III-IV. Data on self-care was collected with European Self-care Behaviour Scale (EHFScBS) (possible range 0-100). Knowledge was collected with the Dutch HF Knowledge Scale (possible range 0-15 points). Cognition was assessed Montreal Cognitive Assessment (MoCA). Knowledge was dichotomised into low vs. high knowledge (cut off 13) and cognition into mild, moderate or severe cognitive problems vs. no or light cognitive problems. Results The total score on the EHFScBS was 64.6 ± 21.0 with 41% (N=245) of the patients performing good self-care (score > 70). The mean score on the Dutch HF Knowledge Scale was 12.3 ± 1.9 and 308 patients had high knowledge (score > 13). The majority of the patients (61%; N=371) had mild cognitive problems and 195 (32%) had no or light cognitive problems with a mean MOCA score of 24.4 ± 3.8. Self-care was significantly correlated to total knowledge (r = .23; p < .001), but it was not correlated to cognition. Furthermore, there was a positive correlation between total knowledge and cognition (r = .43; p <.001). Out of the 308 patients with high level of knowledge (>13), 130 had mild, moderate or severe cognitive problems. The other 178 patients with high knowledge had no or only light cognitive problems. Patients with high knowledge had a significantly higher score on the self-care behavior scale, independently of their cognitive function. In a multivariable logistic regression analysis, higher age [odds ratio (OR) 1.03; 95% confidence interval (CI) 1.02-1.06), better quality of life (OR .95; 95% CI .90 - .99) and higher levels of knowledge (OR 1.25; OR 1.13 – 1.38) were independently related to self-care. Conclusion HF knowledge and cognition are related in patients with heart failure, but only knowledge, not cognition, was independently related to self-care.

Climate migrations as a subject of the American national security policy

This article draws attention to the growing importance of climate migration as a subject of national security. The United States of America (USA) was cited as a global leader upon which the international community places its hopes in combating climate change. With this in mind, an analysis was conducted on the institutional and normative actions of the American administration during the presidency of Joe Biden, which were a direct response to the effects of the climate crisis. These actions show the increased involvement of the USA administration in trying to define climate migration as a serious national security problem. In the article, we argue that with the change in the presidency in 2021, there was an increased commitment to climate migrants accompanied by a growing awareness of climate change. In the analysis of the cognitive problem, research methods characteristic of the following sciences were used: political (decision-making method), legal (dogmatic method), and historical sciences. The article is descriptive and explanatory.

Pathogenesis and Pathophysiology of Acute Bacterial Meningitis

Bacterial meningitis is a serious medical disorder that requires a timely diagnosis and immediate treatment as soon as it is suspected. Meningitis is typically caused by two strains of bacteria that are extremely dangerous to humans: streptococcus pneumoniae and neisseria meningitidis. Antibiotic resistance is quickly becoming a problem that will need to be addressed. Researchers have developed a more comprehensive understanding of the particular mechanisms that contribute to brain damage, following problems, and cognitive deficits as a result of both clinical and experimental studies. We present a succinct summary of the current understanding of the underlying mechanisms of acute bacterial meningitis and detail the most up-to-date ways for its treatment. In addition, we discuss the implications of this understanding for future research. These infections multiply by taking advantage of the unique properties that the immune system possesses in the central nervous system (CNS), which then leads to inflammation. In bacterial meningitis, the recruitment of leukocytes that have been intensely stimulated into the cerebrospinal fluid (also known as CSF) is a crucial component of the disease. Inflammation of the meninges can be brought on by a wide variety of factors, including microorganisms such as bacteria, viruses, and fungi, as well as non-infectious factors such as systemic and neoplastic illnesses. In most cases, the inflammatory process affects not only the meninges that surround the brain but also the parenchyma of the brain (meningoencephalitis), the ventricles (ventriculitis), and spreads throughout the spinal cord. This condition is referred to as meningoencephalitis. Neuronal damage, namely in the areas of the hippocampus, has been identified as a potential cause of long-term cognitive problems in survivors of traumatic brain injuries.

The chemotherapeutic agent doxorubicin induces brain senescence, with modulation by APOE genotype

Many cancer patients experience serious cognitive problems related to their treatment, which can greatly affect their quality of life. The molecular mechanisms of this cancer chemotherapy-induced cognitive impairment (CICI) are unknown, thus slowing the development of preventative approaches. We hypothesized that cancer chemotherapies could induce cellular senescence in the brain, creating a pro-inflammatory environment and damaging normal brain communication. We tested this hypothesis using the common chemotherapeutic agent doxorubicin in two independent mouse models. In the first model, we used mice that express tdTomato under the pdkn2a (p16) promoter; p16 is a regulator of cellular senescence, and its upregulation is denoted by the presence of fluorescently tagged cells. Two weeks after exposure to three doses of 5 mg/kg doxorubicin, the number of tdTomato positive cells were increased nearly three-fold in both the cerebral cortex and the hippocampus. tdTomato staining co-localized with neurons, microglia, oligodendrocyte precursor cells, and endothelial cells, but not astrocytes. In the second model, we used APOE knock-in mice, since the APOE4 allele is a risk factor for CICI in humans and mouse models. We isolated RNA from the cerebral cortex of APOE3 and APOE4 mice from one to 21 days after a single dose of 10 mg/kg doxorubicin. Using NanoString analysis of over 700 genes related to neuroinflammation and RT-qPCR analysis of cerebral cortex transcripts, we found two-fold induction of four senescence-related genes at three weeks in the APOE4 mice compared to the APOE3 control mice: p21(cdkn1a), p16, Gadd45a, and Egr1. We conclude that doxorubicin promotes cellular senescence pathways in the brain, supporting the hypothesis that drugs to eliminate senescent cells could be useful in preventing CICI.