Uric acid has increasingly been associated with insulin resistance, hyperinsulinemia, and type 2 diabetes mellitus. Diabetic patients who are hyperuricemic have a risk of developing diabetic complications. Pathogenesis of uric acid may decrease nitric oxide bioavailability in vascular smooth muscle, endothelial cells and direct scavenging of nitric oxide by uric acid. A decrease in endothelial nitric oxide production by uric acid has also been associated with endothelial dysfunction and insulin resistance. This study aims to determine the relationship between uric acid (...) and glucose levels in patients with type 2 diabetes mellitus. The study included 161 Libyan patients (67 males and 94 females) diagnosed with type 2 diabetes mellitus. Both levels of serum uric acid and hemoglobin A1c (HbA1c) were determined. The patients were divided into two groups. The controllable diabetic group with HbA1c of less than 06.0% and the uncontrollable diabetic group with HbA1c of more than 06.0%. Patients who are suffering from type 2 diabetes mellitus without complications were included whereas patients with smoking, alcoholism, nephrotic disease, malignancy, hepatitis, and renal failure or kidney disease were excluded. The mean and standard deviation of uric acid, HbA1c and Pearson correlation coefficient test were considered. In the controllable diabetic group, serum uric acid mean was found to be 4.807±1.39 and HbA1c was found to be 5.032±1.39. In the uncontrollable diabetic group, serum uric acid was 4.897±1.66 and HbA1c was 8.396±1.65. Uric acid level has significantly been correlated with HBA1C in controlled and uncontrolled diabetic patients (p<0.05). In addition, the uric acid level was found to be higher in the uncontrolled diabetic group than that in the controlled group (p<0.05). A possible relationship between serum uric acid and the incidence of type 2 diabetes mellitus was noted. Thus, uric acid can be used as a potential biomarker to indicate impaired glucose metabolism. (shrink)

Previous research has shown that short-term fasting in healthy individuals is associated with changes in risky decision-making. The current experiment was designed to examine the influence of short-term fasting in healthy individuals on four types of impulsivity: reflection impulsivity, risky decision-making, delay aversion, and action inhibition. Participants were tested twice, once when fasted for 20 hours, and once when satiated. Participants demonstrated impaired action inhibition when fasted; committing significantly more errors of commission during a food-related Affective Shifting (...) Task. Participants also displayed decreased reflection impulsivity when fasted, opening significantly more boxes during the Information Sampling Task (IST). There were no significant differences in performance between fasted and satiated sessions for risky decision-making or delay aversion. These findings may have implications for understanding eating disorders such as Bulimia Nervosa (BN). Although BN has been characterised as a disorder of poor impulse control, inconsistent findings when comparing individuals with BN and healthy individuals on behavioural measures of impulsivity question this characterisation. Since individuals with BN undergo periods of short-term fasting, the inconsistent findings could be due to differences in the levels of satiation of participants. The current results indicate that fasting can affect performance on the IST, a measure of impulsivity previously studied in BN, whilst performance on other impulsivity measures were unaffected. However, the results from the IST were contrary to the original hypothesis and should be replicated before specific conclusions can be made. (shrink)

The aim of this analysis was to examine the concept of time to rejuvenate and extend existing narratives of time within the nursing literature. In particular, we hope to promote a new trajectory in nursing research and practice which focuses on time and person‐centred care, specifically of older people with cognitive impairment hospitalized in the acute care setting. We consider the explanatory power of concepts such as clock time, process time, fast care, slow care and time debt for elucidating the (...) relationship between ‘good care’ and ‘time use’. We conclude by offering two additional concepts of time, plurotemporality and person‐centred time (PCT) which we propose will help advance of nursing knowledge and practice. Nurse clinicians and researchers can use these alternative concepts of time to explore and describe different temporal structures that honour the patient's values and preferences using experiential, observation‐based nursing research approaches. (shrink)

The purpose of this study was to observe whether aerobic exercise is able to alleviate the impairment of cognitive control ability in college students by sleep deprivation through cognitive control and blood-based markers. Taking 30 healthy college students as participants, using a random cross-over design within groups, respectively perform one night of sleep deprivation and one night of normal sleep. The exercise intervention modality was to complete a 30-min session of moderate-intensity aerobic exercise on a power bicycle. Change in cognitive (...) control was assessed using the Go/NoGo task paradigm; 5-ht and blood glucose contentwere determined by enzyme-linked immuno sorbent assay and glucose oxidase electrode Measurement, respectively. The results showed that sleep deprivation could significantly reduce the response inhibition ability and response execution ability, and significantly reduce the blood 5-ht content. Thirty minutes of moderate intensity aerobic exercise intervention significantly increased response inhibition ability and response execution ability, significantly increased blood 5-ht content, and did not change serum glucose levels. Conclusion: An acute aerobic exercise can alleviate the cognitive control impairment caused by sleep deprivation, and 5-ht may be one of the possible mechanisms by which aerobic exercise alleviates the cognitive control impairment caused by sleep deprivation. (shrink)

Common symptoms of multiple sclerosis (MS) include motor impairments of the lower extremities, particularly gait disturbances. Loss of balance and muscle weakness, representing some peripheral effects, have been shown to influence these symptoms, however, the individual role of cortical and subcortical structures in the central nervous system is still to be understood. Assessing [18F]fluorodeoxyglucose (FDG) uptake in the CNS can assess brain activity and is directly associated with regional neuronal activity. One potential modality to increase cortical excitability and improve motor (...) function in patients with MS (PwMS) is transcranial direct current stimulation (tDCS). However, tDCS group outcomes may not mirror individual subject responses, which impedes our knowledge of the pathophysiology and management of diseases like MS. Three PwMS randomly received both 3 mA tDCS and SHAM targeting the motor cortex (M1) that controls the more-affected leg for 20 min on separate days before walking on a treadmill. The radiotracer, FDG, was injected at minute two of the 20 min walk and the subjects underwent a Positron emission tomography (PET) scan immediately after the task. Differences in relative regional metabolism of areas under the tDCS anode and the basal ganglia were calculated and investigated. The results indicated diverse and individualized responses in regions under the anode and consistent increases in some basal ganglia areas (e.g., caudate nucleus). Thus, anodal tDCS targeting the M1 that controls the more-affected leg of PwMS might be capable of affecting remote subcortical regions and modulating the activity (motor, cognitive, and behavioral functions) of the circuitry connected to these regions. (shrink)

Working memory is developed in one region of the brain called the dorsolateral prefrontal cortex. The dysfunction of this region leads to synaptic neuroplasticity impairment. It has been reported that several biochemical parameters and anthropometric measurements play a vital role in cognition and brain health. This study aimed to investigate the relationships between cognitive function, serum biochemical profile, and anthropometric measurements using DLPFC activation. A cross-sectional study was conducted among 35 older adults who experienced mild cognitive impairment. For this purpose, (...) we distributed a comprehensive interview-based questionnaire for collecting sociodemographic information from the participants and conducting cognitive tests. Anthropometric values were measured, and fasting blood specimens were collected. We investigated their brain activation using the task-based functional MRI, specifically in the DLPFC region. Positive relationships were observed between brain-derived neurotrophic factor and Mini-Mental State Examination ; however, negative relationships were observed between serum triglyceride and serum malondialdehyde with right DLPFC activation while the participants performed 1-back task after adjustments for age, gender, and years of education. In conclusion, higher serum triglycerides, higher oxidative stress, and lower neurotrophic factor were associated with lower right DLPFC activation among older adults with MCI. A further investigation needs to be carried out to understand the causal-effect mechanisms of the significant parameters and the DLPFC activation so that better intervention strategies can be developed for reducing the risk of irreversible neurodegenerative diseases among older adults with MCI. (shrink)

Normals display selective deficits in morphology and syntax under adverse processing conditions. Digit loads do not impair processing of passives and object relatives but do impair processing of grammatical morphemes. Perceptual degradation and temporal compression selectively impair several aspects of grammar, including passives and object relatives. Hence we replicate Caplan & Waters's specific findings but reach opposite conclusions, based on wider evidence.

BackgroundAlthough gait patterns disturbances are known to be related to cognitive decline, there is no consensus on the possibility of predicting one from the other. It is necessary to find the optimal gait features, experimental protocols, and computational algorithms to achieve this purpose.PurposesTo assess the efficacy of the Stable Sparse Classifiers procedure for discriminating young and healthy older adults, as well as healthy and cognitively impaired elderly groups from their gait patterns. To identify the walking tasks or combinations of (...) tasks and specific spatio-temporal gait features that allow the best prediction with SSC.MethodsA sample of 125 participants was studied. They underwent assessment with five neuropsychological tests that explore different cognitive domains. A summarized cognitive index, based on the Mahalanobis distance from normative data, was calculated. The sample was divided into three groups using k-means clustering of MDCog in addition to Age. The participants executed four walking tasks and their gait patterns, measured with a body-fixed Inertial Measurement Unit, were used to calculate 16 STGF and dual-task costs. SSC was then employed to predict which group the participants belonged to. The classification's performance was assessed using the area under the receiver operating curves and the stable biomarkers were identified.ResultsThe discrimination HE vs. MCI-E revealed that the combination of the easy dual-task and the fast walking task had the best prediction performance. The features related to gait variability and to the amplitude of vertical acceleration had the largest predictive power. SSC prediction accuracy was better than the accuracies obtained with linear discriminant analysis and support vector machine classifiers.ConclusionsThe study corroborated that the changes in gait patterns can be used to discriminate between young and healthy older adults and more importantly between healthy and cognitively impaired adults. A subset of gait tasks and STGF optimal for achieving this goal with SSC were identified, with the latter method superior to other classification techniques. (shrink)

Substantial evidence implicates fast axonal transport (FAT) defects in neurodegeneration. In Alzheimer's disease (AD), it is controversial whether transport defects cause or arise from amyloid‐β (Aβ)‐induced toxicity. Using a novel, unbiased genetic screen, Morihara et al. identified kinesin light chain‐1 splice variant E (KLC1vE) as a modifier of Aβ accumulation. Here, we propose three mechanisms to explain this causal role. First, KLC1vE reduces APP transport, leading to Aβ accumulation. Second, reduced transport of APP by KLC1vE triggers an ER stress response (...) that activates the amyloidogenic pathway. Third, KLC1vE impairs transport of other KLC1 cargos that regulate amyloidogenesis, promoting Aβ retention within the secretory pathway. Collectively, KLC1vE perpetuates a vicious cycle of Aβ generation, kinase dysregulation, and global FAT impairment that inevitably leads to cellular toxicity. These concepts implicate alternative splicing of KLC1 in AD and suggest that the reciprocal influence of transport mechanisms on disease states contributes to neurodegeneration. (shrink)

Objective Diabetes is a global public health concern. Management of diabetes depends on successful implementation of strategies to alleviate decline in executive functions (EFs), a characteristic of diabetes progression. In this review, we describe recent research on the relationship between diabetes and EF, summarize the existing evidence, and put forward future research directions and applications. Methods Herein, we provide an overview of recent studies, to elucidate the relationship between DM and EF. We identified new screening objectives, management tools, and intervention (...) targets for diabetes management. We also discuss the implications for clinical practice. Results In both types 1 and 2 diabetes mellitus (DM), hyperglycemia substantially impairs EF in people of all age groups and ethnicities. Hypoglycemia can similarly impair EF. Interestingly, a decline in EF contributes to DM progression. Glucose dysregulation and EF decline exacerbate each other in a vicious cycle: poor blood glucose control, impaired EF, diabetes management task failure, then back to poor blood glucose control. Many pathophysiological indexes (e.g., obesity, metabolic index, inflammatory and immune factors), neuropsychological indexes (e.g., compliance, eating habits, physical exercise, sleep, and depression), and genetic factors are changed by this pathological interaction between DM and EF. These changes can provide insight into the pathophysiological mechanisms of diabetes-related EF decline. Conclusion Further studies, including large-scale prospective and randomized controlled trials, are needed to elucidate the mechanism of the interaction between diabetes and EF and to develop novel strategies for breaking this cycle. (shrink)

Isthmin‐1 (Ism1) was first described to be syn‐expressed with Fgf8 in Xenopus. However, its biological role has not been elucidated until recent years. Despite of accumulated evidence that Ism1 participates in angiogenesis, tumor invasion, macrophage apoptosis, and glucose metabolism, the cognate receptors for Ism1 remain largely unknown.Ism1deficiency in mice results in renal agenesis (RA) with a transient loss ofGdnftranscription and impaired mesenchyme condensation at E11.5. Ism1 binds to and activates Integrin α8β1 to positively regulate Gdnf/Ret signaling, thus promoting (...) mesenchyme condensation and ureteric epithelium branching morphogenesis. Here, we propose the hypothesis underlying the mechanism by which Ism1 regulates branching morphogenesis during early kidney development. (shrink)

Microbes can influence host physiology and behavior in many ways. Here we review evidence suggesting that some microbes can contribute to host stress (and other microbes can contribute to increased resilience to stress). We explain how certain microbes, which we call “stress microbes,” can potentially benefit evolutionarily from inducing stress in a host, gaining access to host resources that can help fuel rapid microbial replication by increasing glucose levels in the blood, increasing intestinal permeability, and suppressing the immune system. (...) Other microbes, which we term “resilience microbes,” can potentially benefit from making hosts more resilient to stress. We hypothesize that “stress microbes” use a fast life history strategy involving greater host exploitation while “resilience microbes” use a slow life history strategy characterized by more aligned evolutionary interests with the host. In this paper, we review the evidence that microbes affect host stress and explain the evolutionary pressures that could lead microbes to manipulate host stress, discuss the physiological mechanisms that are known to be involved in both stress and microbial activity, and provide some testable predictions that follow from this hypothesis. (shrink)

Background: Diabetes mellitus (DM) is a noncommunicable disease that stills being a burden in health system. Some trace minerals such as selenium and zinc was postulated having role in blood and insulin regulation in Type 2 Diabetes Mellitus. The objective of this study is conducted to determine the level of selenoium and zinc serum in Type 2 Diabetes Mellitus patient, and its correlation with glycemic control parameter. Methods: A cross sectional study was conducted at Abdul Moeloek and Hasan Sadikin Hospital (...) from endocrinology outpatient clinic from october to december 2022 with random sampling. Patient was tested for glycated albumin, fasting blood glucose, and glycated hemoglobin as marker od glycemic control Data then analyzed descriptively and underwent bivariate analysis with Spearman Rank Correlation. Results: Low level of Zinc, but with normal level of selenium was found among research subject. Bivariate analysis between the variables showed that there is positive, weak, and insignificant correlation of zinc and selenium with fasting blood glucose, HbA1C, and glycated albumin. (Selenium with HbA1C: r:0,131, p:0.099, Selenium with FBG: r:0,135, p:0.092, Selenium with glycated albumin: r: 0.084, p:0,223, Zinc with HbA1C: r:0.069, p:0,389, Zinc with FBG: r:0,084, r:0,544, Zinc with glycated albumin: r:0.007, p:0,920) Conclusion: There is a positive, weak, and insignificant correlation of serum selenium and zinc with glycemic control parameters. (shrink)

ObjectiveProcessing Speed, the ability to perceive and react fast to stimuli in the environment, has been shown to be impaired in children with attention deficit hyperactivity disorder. However, it is unclear whether PS can be improved following targeted treatments for ADHD. Here we examined potential changes in PS following application of transcranial electric stimulation combined with cognitive training in children with ADHD. Specifically, we examined changes in PS in the presence of different conditions of mental fatigue.MethodsWe used a randomized (...) double-blind active-controlled crossover study of 19 unmedicated children with ADHD. Participants received either anodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex or transcranial random noise stimulation, while completing CT, and the administration order was counterbalanced. PS was assessed before and after treatment using the MOXO-CPT, which measures PS in the presence of various conditions of mental fatigue and cognitive load.ResultstRNS combined with CT yielded larger improvements in PS compared to tDCS combined with CT, mainly under condition of increased mental fatigue. Further improvements in PS were also seen in a 1-week follow up testing.ConclusionThis study provides initial support for the efficacy of tRNS combined with CT in improving PS in the presence of mental fatigue in pediatric ADHD. (shrink)

ObjectiveType 2 diabetes mellitus (T2DM) is a high risk of cognitive decline and dementia, but the underlying mechanisms are not yet clearly understood. This study aimed to explore the functional connectivity (FC) and topological properties among whole brain networks and correlations with impaired cognition and distinguish T2DM from healthy controls (HC) to identify potential biomarkers for cognition abnormalities.MethodsA total of 80 T2DM and 55 well-matched HC were recruited in this study. Subjects’ clinical data, neuropsychological tests and resting-state functional magnetic (...) resonance imaging data were acquired. Whole-brain network FC were mapped, the topological characteristics were analyzed using a graph-theoretic approach, the FC and topological characteristics of the network were compared between T2DM and HC using a general linear model, and correlations between networks and clinical and cognitive characteristics were identified. The support vector machine (SVM) model was used to identify differences between T2DM and HC.ResultsIn patients with T2DM, FC was higher in two core regions [precuneus/posterior cingulated cortex (PCC)_1 and later prefrontal cortex_1] in the default mode network and lower in bilateral superior parietal lobes (within dorsal attention network), and decreased between the right medial frontal cortex and left auditory cortex. The FC of the right frontal medial-left auditory cortex was positively correlated with the Montreal Cognitive Assessment scales and negatively correlated with the blood glucose levels. Long-range connectivity between bilateral auditory cortex was missing in the T2DM. The nodal degree centrality and efficiency of PCC were higher in T2DM than in HC (P < 0.005). The nodal degree centrality in the PCC in the SVM model was 97.56% accurate in distinguishing T2DM patients from HC, demonstrating the reliability of the prediction model.ConclusionFunctional abnormalities in the auditory cortex in T2DM may be related to cognitive impairment, such as memory and attention, and nodal degree centrality in the PCC might serve as a potential neuroimaging biomarker to predict and identify T2DM. (shrink)

A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. (...) In order for visual identifiers to be used effectively in acute care settings, thorough consideration must be given to the ethical and legal issues that are engaged in this context, and their potential benefits and harms must be weighed and balanced. This paper proposes a set of legal and ethical principles that can be used to guide the implementation of visual identifiers. Together, these principles provide a framework applicable in the design and implementation phases to systematically identify relevant considerations arising from the use of these tools. We outline some tensions that arise between principles and conclude that selecting a preferred moral framework could help to guide decision-making, as does clarity around the purpose and objectives of the identifier. (shrink)

When information activated in memory involves emotional associations, the ability to shift attention away from an emotional cue is impaired compared to an emotionally neutral cue. The purpose of the present study was to investigate how emotional stimuli modulate attentional processes, and how this is reflected in localised brain electrical activity. Eight emotion and eight neutral words served as cues in a covert attention spatial orienting task. The cues were either valid or invalid indicators of which hemifield the target (...) would be presented to. In the remaining trials, no cue was presented prior to the target. Twenty subjects were instructed to manually respond to the target as fast as possible. Event-related potentials (ERPs) showed an enhanced P3 component to the emotion words. The ERPs to the target showed enhanced P1 and P3 components on invalid trials, with emotional cues. There were faster reaction times (RTs) to validly cued targets, but only when the emotion words served as cues. The results demonstrated that the emotional cues elicited sustained focused attention, facilitating an engage mechanism of spatial orienting. (shrink)

The act of slowness is by its very nature an implied reduction of physical engagement that one might argue has as much to do with impairment as it does with temporal devaluation. Yet when placed in a twenty-first century context there are a growing number of arguments that position slowness as a mediator of resistance to fast-paced communication transactions thus impacting on the ways in which human interaction coexists between digital technology and cultural immediacy. While it may be suggestive to (...) position this new emergence as a collective of technoanthropological treaties as found, for example, in the Slow Media Manifesto , there is an under-valued relation that I will discuss throughout this paper when considering the role that slow motion plays out as a condition rather than an effect of lens based practice. Discussion will integrate the ideas of Proust, Mearleu Ponty, and Murch with review of contributions from Wes Anderson, The Wachowski Siblings, Bill Viola, and Adam Magyar. These perspectives will align with discussion of my own lens-based practice with regards to a slow motion experimental called The 51 Paintings Suite. (shrink)

IntroductionAlthough the motor signs of Parkinson’s disease are well defined, nonmotor symptoms, including higher-level language deficits, have also been shown to be frequent in patients with PD. In the present study, we used a lexical decision task to find out whether access to the mental lexicon is impaired in patients with PD, and whether task performance is affected by bradykinesia.Materials and MethodsParticipants were 34 nondemented patients with PD, either without medication or under optimum medication. A total of 19 age-matched (...) control volunteers were also recruited. We recorded reaction times to the LDT and a simple RT task. In each task, stimuli were either visual or auditory. Statistical analyses consisted of repeated-measures analyses of variance and Tukey’s HSD post hoc tests.ResultsIn the LDT, participants with PD both off and on medication exhibited intact access to the mental lexicon in both modalities. In the visual modality, patients off medication were just as fast as controls when identifying real words, but slower when identifying pseudowords. In the visual modality of the control task, RTs for pseudowords were significantly longer for PD patients off medication than for controls, revealing an unexpected but significant lexicality effect in patients that was not observed in the auditory modality. Performances of patients on medication did not differ from those of age-matched controls.DiscussionMotor execution was not slowed in patients with PD either off or on medication, in comparison with controls. Regarding lexical access, patients off medication seemed to have difficulty inhibiting a cognitive-linguistic process when it was not required, and exhibit a specific pseudoword processing deficit in the LDT, which may have been related to impaired lateral word inhibition within the mental lexicon. These deficits seemed to be compensated by medication. (shrink)

Metabolic dysfunction is a ubiquitous underlying feature of many neurological conditions including acute traumatic brain injuries and chronic neurodegenerative conditions. A central problem in neurological patients, in particular those with traumatic brain injuries, is an impairment in the utilization of glucose, which is the predominant metabolic substrate in a normally functioning brain. In such patients, alternative substrates including ketone bodies and lactate become important metabolic candidates for maintaining brain function. While the potential neuroprotective benefits of ketosis have been recognized (...) for up to almost a century, the majority of work has focused on the use of ketogenic diets to induce such a state, which is inappropriate in cases of acute disease due to the prolonged periods of time (i.e., weeks to months) required for the effects of a ketogenic diet to be seen. The following review seeks to explore the neuroprotective effects of exogenous ketone and lactate preparations, which have more recently become commercially available and are able to induce a deep ketogenic response in a fraction of the time. The rapid response of exogenous preparations makes their use as a therapeutic adjunct more feasible from a clinical perspective in both acute and chronic neurological conditions. Potentially, their ability to globally moderate long-term, occult brain dysfunction may also be relevant in reducing lifetime risks of certain neurodegenerative conditions. In particular, this review explores the association between traumatic brain injury and contusion-related dementia, assessing metabolic parallels and highlighting the potential role of exogenous ketone and lactate therapies. (shrink)

Temporal expectation is the ability to focus attention at a particular moment in time to optimize performance, which has been shown to be driven by regular rhythms. However, whether the rhythm-based temporal expectations rely upon automatic processing or require the involvement of controlled processing has not been clearly established. Furthermore, whether the mechanism is affected by tempo remains unknown. To investigate this research question, the present study used a dual-task procedure. In a single task, the participants were instructed to respond (...) to a visual target preceded by a regular or an irregular visual rhythm under a fast or slow tempo. The dual-task simultaneously combined a working memory task. The results showed temporal expectation effects in which the participants responded faster to the regular than to the irregular conditions in a single task. Moreover, this effect persisted under dual-task interference in the fast tempo condition but was impaired in the slow tempo condition. These results revealed that rhythmic temporal expectation induced by fast tempo was dependent on automatic processing. However, compared with the faster tempo, temporal expectation driven by a slower tempo might involve more controlled processing. (shrink)

Pancreatic β‐cells in the islet of Langerhans produce the hormone insulin, which maintains blood glucose homeostasis. Perturbations in β‐cell function may lead to impairment of insulin production and secretion and the onset of diabetes mellitus. Several essential β‐cell factors have been identified that are required for normal β‐cell function, including six genes that when mutated give rise to inherited forms of diabetes known as Maturity Onset Diabetes of the Young (MODY). However, the intracellular signaling pathways that control expression of (...) MODY and other factors continue to be revealed. Post‐transplant diabetes mellitus in patients taking the calcineurin inhibitors tacrolimus (FK506) or cyclosporin A indicates that calcineurin and its substrate the Nuclear Factor of Activated T‐cells (NFAT) may be required for β‐cell function. Here recent advances in our understanding of calcineurin and NFAT signaling in the β‐cell are reviewed. Novel therapeutic approaches for the treatment of diabetes are also discussed. BioEssays 29:1011–1021, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Alzheimer’s Disease (AD) and Autism Spectrum Disorder (ASD) represent two distinct but equally impactful challenges in the field of neurology and cognitive health. AD is a degenerative neurological condition characterized by its progressive nature, typically affecting individuals in later stages of life. The hallmark features include cognitive impairment, mem- ory deterioration, and alterations in behavior. In contrast, ASD is a developmental disorder typically diagnosed in childhood, marked by difficulties in social interaction, communication, and repetitive behaviors. This paper explores the potential (...) of the time-frequency feature extraction model known as the Left-Right Fast Fourier Transform (LR-FFT) in the context of these two disorders. While AD and ASD differ significantly in their onset, presentation, and demographic affected, both necessitate early and accurate diagnosis to enable timely intervention and tailored treatment strategies. Our research yields promising results, with classification accuracies reaching 88.26% for AD and 99.86% for ASD, demonstrating the LR-FFT’s potential to enhance diagnostic accuracy. By contributing to improved differentiation between these complex neurological conditions, this work aims to advance our understanding and management of AD and ASD, ultimately benefiting patients, their families, and healthcare practitioners. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The 12–Minute JourneyHeather A. CarlsonI met Jack for the first time when he was in the intensive care unit as he was just waking up from his emergent tracheostomy surgery. As I walked into his room he opened his eyes in panic and he struggled to take in a deep breath, fighting the ventilator that was trying to deliver slow steady breaths for him. His face was flooded with (...) fear and the ventilator alarms were blaring. He was surrounded by nurses and respiratory technicians all trying to calm him down, while adjusting the settings on the machine. “Just try and breathe slowly,” they instructed him, though this seemed to be impossible for him as he continued to try and suck in as much air as possible through the new hole in his throat. As his arm flailed out I grabbed his hand and while holding it in mine I just tried to emulate tranquility for him. I thought to myself this is exactly how I would react if I woke up in this condition and could imagine the fear that he was now feeling. While nurses rushed around with suction equipment and the respiratory technicians made adjustments and monitored the results I stood there holding his hand silently praying that he become calm. With all of our support he did eventually relax and find the ability to sync his breathing with the ventilator settings.I am a palliative care nurse practitioner and had been asked to see Jack to help with symptom management and establishing his goals of care as he had recently been diagnosed with head and neck cancer. He had presented to the hospital with complaints of difficulty breathing and it didn’t take long for the emergency room physician to determine that his airway was almost completely occluded by tumor. Jack had actually been diagnosed with this cancer the month before, and had met with a radiation oncologist who planned to start radiation as soon as possible to avoid tumor growth that could impair his breathing. Unfortunately Jack was so anxious and scared about this treatment plan that he never went back to the cancer center. Instead, he stayed in his room in the boarding house that he lived in, smoking cigarettes to calm his nerves. Jack was a recovering alcoholic who had previously been homeless and out on the streets for many years before becoming sober and finding shelter at the boarding house where he now lived. He was a heavy smoker and found that it was one thing that helped to ease his anxiety. The thought of being strapped down to a table with a tight mask over his head while radiation zapped the cancer in his neck had terrified him. His anxiety and claustrophobia had prevented him from following through with his cancer treatment.My initial visits with Jack were spent trying to treat his anxiety as well as the pain he experienced in his neck and head.Because he had undergone a tracheostomy and was now on a ventilator he was unable to speak. To communicate he pointed to a picture board that had common sayings on it, like “I have pain” and “I have to go to the bathroom”. He also used a clipboard with paper and pen and could write what he wanted to say, but this was a time consuming endeavor. Despite this, he was a very animated gentleman who had a lot to say and he wasn’t going to let the loss of his voice impair him. I found myself enjoying my visits with him each day, as he would tell me more about himself. I quickly discovered that he was a very spiritual man and his faith was his inspiration. He wrote on his clipboard “this cancer is actually a gift” and went on to explain that he had been on a fast track toward self destruction, but now feels as though he has been given another chance at life. He spent his time in the hospital reflecting on his life’s journey and how he would be able to help others in similar circumstances. He wrote on his [End Page 192] clipboard multiple... (shrink)

During recovery from psychosis (diagnosed as schizophrenia) things must often be done slower than normally expected. The tempo of the socially shared reality is often experienced as being too fast for the recovering person. We will describe how this impairment stems from the pre-reflective mental structure underlying psychosis and how it can be transferred into an active skill supporting recovery, often including social retreat. In this paper, co-written by a psychiatrist and a person experienced in psychosis (= participatory health research), (...) we will draw on personal experiences, (participatory) qualitative research and first-hand accounts for our arguments. We will sketch out the process and three crucial building blocks of recovery: laid-back situations, switch-off skills, places to talk. We will then describe the acquired skill of slowing-down as an amalgam of the building blocks ‘switch-off skill’ and ‘laid-back situation’, since slowing-down answers the situation in a laid-back manner and enforces a slow behavioral pace on it. While this might be okay in private and in some situations shared with others (i.e. during serene situations), it may be tantalizing for others in many everyday situations resulting in stigma or exclusion (i.e. during work). Slowing-down therefore challenges the surrounding others and demonstrates the necessity to synchronize private and public tempos. This is most challenging while living in two realities at once, being the second and often a long-lasting stage of recovery (stage of double realities). (shrink)

Anticipation is a crucial perceptual-cognitive skill in fast-ball sports, and the effect of high anxiety on performance has attracted more attention from sports psychologists. Related studies mainly focus on the effect of anxiety on influencing processing efficiency and attentional control during information processing in sport. Attentional Control Theory has been supported by several studies. However, these studies have been criticized by the low ecological validity of task design, such as neglecting the dynamic process of anticipation, and inadequate performance analysis, such (...) as analyzing response accuracy and time separately. Using temporal occlusion paradigm, we tested ACT in a dynamic anticipation process. Eighteen skilled and eighteen less-skilled table tennis players were required to anticipate the serves of opponents under dynamic task constraints and anxiety conditions. High cognitive state anxiety decreased processing efficiency for both groups whereas performance effectiveness did not differ. In addition, it negatively affected processing efficiency in early anticipation compared with late anticipation tasks, suggesting that high cognitive state anxiety may have a greater impact on top-down attentional control. Our findings provide support for ACT and show that anxiety impairs anticipation efficiency and performance, possibly due to an ineffectively attentional shift from external kinematic cues to internal long-term working memory. Findings also have implications for the adaptation of attentional strategies and anxiolytic training. (shrink)

Cognitive fatigue is a problem for the safety of critical systems as it can lead to accidents, especially during unexpected events. In order to determine the extent to which it disrupts adaptive capabilities, we evaluated its effect on online and anticipatory control. Despite numerous studies conducted to determine its effects, the exact mechanism affected by fatigue remains to be clarified. In this study, we used distribution and electromyographic analysis to assess whether cognitive fatigue increases the capture of the incorrect automatic (...) response or if it impairs its suppression, and whether the conflict adaptation effect is reduced. To this end, we evaluated the evolution of the performance over time during the Simon task, a classic conflict task that elicits incorrect automatic responses. To accentuate the presence of fatigue during the Simon task, two groups previously performed a dual-task with two different cognitive load levels to create two different levels of fatigue. The results revealed that time on task impaired online control by disrupting the capacity to suppress the incorrect response but leaving unaffected the expression of the automatic response. Furthermore, participants emphasized speed rather than accuracy with time on task, with in addition more fast guesses, suggesting that they opted for a less effortful response strategy. As the implementation of the suppression mechanism requires cognitive effort, the conjunction of these results suggests that the deficits observed may be due to disengagement of effort over time rather than reflecting an incapacity to make an effort. (shrink)

Traumatic brain injury (TBI) is a major cause of death and disability in Western society, and often results in functional and neuropsychological abnormalities. Memory impairment is one of the most significant cognitive implications after TBI. In the current study we investigated procedural memory acquisition by observational training in TBI patients. It was previously found that while practicing a new motor skill, patients engage in all three phases of skill learning–fast acquisition, between-session consolidation, and long-term retention, though their pattern of learning (...) is atypical compared to healthy participants. A different set of studies showed that training by observing a motor task, generally prompted effective acquisition and consolidation of procedural knowledge in healthy participants. The aim of our study was to (i) evaluate the potential benefit of action observation in TBI patients. (ii) Examine the possibility of general improvement in performance between the first (24 h post-training) and second (2 weeks post-training) stage of the study. (iii) Investigate the link between patients’ ability to benefit from observational learning (viaperformance gains–speed and accuracy) and common measures of injury (such as severity of injury, functional and cognitive measures).Materials and methodsPatients hospitalized after moderate to severe TBI, were trained by observation for the finger opposition sequence (FOS) motor task. They were then tested for the observation-trained sequence (A) and a similar control sequence (B), at two different time-points (24 h post-training and 2 weeks later).Results revealed(i) a significant difference in performance between the trained (A) and untrained (B) sequences, in favor of the trained sequence. (ii) An increase in performance for both sequences A and B toward the second (retention) session. (iii) The advantage for sequence A was stable and preserved also in the second session. (iv) Participants with lower moderate Functional Independence Measure (FIM) scores gained more from observational-procedural learning, compared with patients with higher functional abilities.ConclusionOverall, these findings support the notion that TBI patients may achieve procedural memory consolidation and retention through observational learning. Moreover, different functional traits may predict the outcomes of observational training in different patients. These findings may have significant practical implications in the future, regarding skill acquisition methods in TBI patients. (shrink)

Several bioethicists have recently advocated the force-feeding of prisoners, based on the assumption that prisoners have reduced or no autonomy. This assumed lack of autonomy follows from a decrease in cognitive competence, which, in turn, supposedly derives from imprisonment and/or being on hunger strike. In brief, causal links are made between imprisonment or voluntary total fasting and mental disorders and between mental disorders and lack of cognitive competence. I engage the bioethicists that support force-feeding by severing both of these (...) causal links. Specifically, I refute the claims that VTF automatically and necessarily causes mental disorders such as depression, and that these mental disorders necessarily or commonly entail cognitive impairment. Instead, I critically review more nuanced approaches to assessing mental competence in hunger strikes, urging that a diagnosis of incompetence be made on a case-by-case basis—a position that is widely shared by the medical community. (shrink)

The effects of mental fatigue on both cognitive and physical performance are well described in the literature, but the recovery aspects of mental fatigue have been less investigated. The present study aimed to fill this gap by examining the persistence of mental fatigue on behavior and electrophysiological mechanisms. Fifteen participants performed an arm-pointing task consisting of reaching a target as fast as possible, before carrying out a 32-min cognitively demanding task [Time Load Dual Back task], and immediately, 10 and 20 (...) min after completion of the TLDB task. During the experiment, electroencephalography was continuously recorded. The significant increase in mental fatigue feeling after the TLDB task was followed by a decrease during the 20 min of recovery without returning to premeasurement values. Brain oscillations recorded at rest during the recovery period showed an increase in both theta and alpha power over time, suggesting a persistence of mental fatigue. Arm-pointing movement duration increased gradually over time during the recovery period, indicating that behavioral performance remained impaired 20 min after the end of the cognitively demanding task. To conclude, subjective measurements indicated a partial recovery of mental fatigue following a cognitively demanding task, whereas electrophysiological and behavioral markers suggested that the effects of mental fatigue persisted for at least 20 min. While the subjective evaluation of mental fatigue is a very practical way to attest the presence of mental fatigue, electrophysiological and behavioral measures seem more relevant to evaluate the time course of mental fatigue effects. (shrink)

Objective: The value of spontaneous EEG oscillations in distinguishing patients in vegetative and minimally conscious states was studied. Methods: We quantified dynamic repertoire of EEG oscillations in resting condition with closed eyes in patients in vegetative and minimally conscious states (VS and MCS). The exact composition of EEG oscillations was assessed by the probability-classification analysis of short-term EEG spectral patterns. Results: The probability of delta, theta and slow-alpha oscillations occurrence was smaller for patients in MCS than for VS. Additionally, only (...) patients in MCS demonstrated fast-alpha oscillation occurrence. Depending on the type and composition of EEG oscillations, the probability of their occurrence was either aetiology dependent or independent. The probability of EEG oscillations occurrence differentiated brain injuries with different aetiologies. Conclusions: Spontaneous EEG oscillations have a potential value in distinguishing patients in VS and MCS. Significance: This work may have implications for clinical care, rehabilitative programs and medical–legal decisions in patients with impaired consciousness states following coma due to acute brain injuries. (shrink)

This article poses a response to one argument supporting the force feeding of political prisoners. This argument assumes that prisoners have moral autonomy and thus cannot be force fed in the early stages of their hunger strike. However, as their fasting progresses, their cognitive competence declines, and they are no longer autonomous. Since they are no longer autonomous, force feeding becomes justified. This article questions the recurrent citation of a paper in empirical support of the claim that hunger strike (...) causes mental disorders or cognitive impairments. The paper, written by Daniel Fessler, partially relies on the Minnesota Starvation Experiment conducted in 1944 to 1945 for scientific support. Using widely accepted criteria for assessing the ethical acceptability of clinical research, we argue that the Minnesota Starvation Experiment had significant scientific shortcomings and is a case of unethical research. From this, we question the appropriateness of citing the Minnesota Starvation Experiment and consequently Fessler’s paper. If Citing Fessler’s paper becomes problematic, this particular argument for the force feeding of prisoners loses much of its strength. (shrink)

Events such as industrialization, population growth and old age have made the disability more visible. We think that the disabled people's attitude towards being disabled and religion is an important issue to be investigated in terms of formation of the social sensitivity about the learning of the thoughts of disabled people. In this context, it is aimed to investigate the function of the religion in terms of how the disabled identify, understand and overcome the problems related to being disabled. The (...) sample of the study consisted of 58 people, 20 (34.5%) female and 38 (65.5%) male. Semi-structured interview technique was used as the research qualitative research method and descriptive analysis technique was used in the analysis of the data. In the article, the relation between disability and religion has been tried to be understood in terms of sociology of religion in the context of functionalist approach. In general, disabled people evaluate disability (81.1%) as "examination", (10.3%) as "problem" and (8.6%) as "difference”. It is concluded that religion affects the thoughts of disabled person in a positive way to understand and accept the disability. It has been seen that the disabled people have applied to the state, social support systems and spiritual values ​​to overcome their problems. However, it is the duty of all social institutions to increase the social sensitivity to the disabled people.Summary: Events such as industrialization, population growth and old age have further increased disability. It is important that the social sensitivity towards disabled people and disabled people’s thoughts about disability should be learned. We think that the disabled people's attitude towards being disabled and towards religion is an important issue to be investigated. In this study, the functions of religion to overcome the problems related to the disability and the way how the disabled people define and understand the disability will be investigated. In this context, we think that an individual's overcoming the problems related to disability is an important issue that should be examined in terms of religion-referenced behavior.The sample of the study consisted of 58 people, 20 (34.5 %) female and 38 (65.5 %) male. Semi-structured interview technique was used as the research qualitative research method and descriptive analysis technique was used in the analysis of the data. In the article, the relation between disability and religion has been tried to be perceived in terms of sociology of religion in the context of functionalist approach.It is a fact that various approaches to disability in various societies have been made during the historical process. These approaches are known as moral, medicinal/medical, social, human rights and limitative models. Each of these approaches points to a specific direction and problems of disability. In other words, each model handles and predicts a different dimension of the subject.According to the Qur’ân, disability means not to be in a bodily sense, but to stay away from the truth and expressed in the way of not seeing the truth, not grasping and not hearing, that is, figuratively meaningful. Again from the point of view of the Qur’ân, the first cause of disability comes to people through the divine will and test. The others are due to people's own mistakes.The changing paradigm shift with the enlightenment process has changed the way people view each other. In this context, with the thought and modernization of enlightenment, people's view of human beings and environment has changed. The body which is thought as the trust of God has turned into a body in which one is his proprietor. Therefore, this situation brought the contest, the debate, the comparison and the alienation together.Today, people with disabilities face many financial, spiritual, social and cultural problems. Poverty arising from unemployment, livelihood, accommodation constitute financial problems that are the first to come to mind; access to places of worship, instruction of worship, fulfillment of worship, lack of spiritual care and support constitute spiritual problems; education, health, access and social exclusion constitute social and cultural problems.Disabled people ask themselves these questions related to disability: Why did it happen to me? If it is a test, why do not I start the test on equal conditions with healthy people? Here the disabled person consults the religion to understand and find an answer to the situation that he is in. Because religion is an important factor that responds to the search for meaning, it reduces the feeling of deprivation, and fulfills the task of compensation mechanism. In addition to this, religion gives life a goal and power to the person to overcome the problems he encounters with.In our research on the relationship between disability and religion, religion as in many subjects has contributed positively to the individual’s view towards the fact of disability and to overcome some problems. For example, as a result of the research, the participants evaluated "disability" (81.1 %) as ‘test’ (10.3%) as ‘problem’ and (8.6 %) as ‘difference’.They answered the question ‘How has the disability affected your religious thoughts?’, 71% of the participants expressed that it has affected in a positive way (as a test, made me closer to God, increased my loyalty to God, a motivation source). Besides, 23 % of the participants expressed that it hasn't caused any changes (already believed, fate, disability isn't an obstruct to worship) and 6 % of the participants expressed that it has affected in a negative way (my life is upside down, I am questioning this situation).In addition to those who answered the question ‘Has the disability affected your life?’ in a ‘positive’ way, there is a considerable amount of people who said that the entrances of the mosques are not suitable for the disabled people. In addition, the disabled people stated that they have problems with the way of worshipping (orthopedically disabled), listening to the Qur’ân, hearing the azan (hearing impaired), and cannot go to the mosques and cannot fast because of the health problems, all of which have affected their religious life in a ‘negative’ way. We can gather the answers given to the question in three categories about what kind of behaviors the disabled people do to overcome/eliminate problems. The first is that they receive a variety of services and assistance by applying to the state for material support in order to overcome the problems related to disability and the second is that the social support services are mainly given within the family and friends, and the third is they worship, pray and fast, which are must of Islam, to eliminate the spiritual distress.The rate of people, whose answers are ‘positive’ to this question ‘Does your religious belief have an effect to deal with the disability?’ because they believe the afterlife and who say they feel relieved by praying and worshipping, is very high (95%). Moreover, it is remarkable that the ones say they are ‘not positive’ still explain this with religious concepts such as test and examination which require patience. In short, religion relieves disabled people by fulfilling the task of compensation mechanism with understanding disability and overcoming problems.Almost half of the participants (45%) said no to the following question: Is there any kind of material/spiritual support given to you by the religious officials or religious people in your community? Some factors affecting this situation are that religious officials have no knowledge and education about how to treat disabled people and how to help them.As a result, disabled people face various financial and spiritual problems. They consult religion to solve some of these problems. The vast majority of the disabled consider disability as a test and a fate. Therefore, religion plays an important role for disabled people to understand disability and cope with it. Besides, disabled people have stated that they face various problems in fulfilling their worship and in accessing the places of worship. In this context, physically disabled people also need the supportive power of religion just like other disabled people. (shrink)

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