Clinical characteristics and type of antithrombotic treatment in a Spanish cohort of elderly patients with atrial fibrillation according to dependency, frailty and cognitive impairment

Background Available data regarding clinical profile and management of elderly patients with atrial fibrillation （AF） according to dependency, fragility and cognitive impairment are scarce. The objective of the study was to analyze the biodemographic data, clinical profile and antithrombotic treatment according to dependency, fragility and cognitive impairment in elderly AF patients. Methods Cross- sectional and multi-center study performed in consecutive AF patients ≥ 75 years treated with oral anticoagulants ≥ 3 months attended in Internal Medicine Departments in Spain. Results A total of 837 patients （83.0 ± 5.0 years; CHA2DS2-VASc： 5.0 ± 1.4; HAS-BLED： 2.1 ± 0.9） were included. 44.4% of patients had some degree of dependency, 43.3% were fragile, and 32.3% had cognitive impairment. Patients with any of these conditions were older, had a worse clinical profile, with more comorbidities and higher risks of thromboembolic and bleeding events. All these conditions were independently associated among them. Overall, 70.8% of patients were taking vitamin K antagonists, the remaining 29.2% direct oral anticoagulants and 9.7% oral antiplatelets. This distribution was independent of the presence of dependency or fragility, but there was a trend to a higher prescription of vitamin K antagonists in those patients with cognitive impairment （75.2% vs. 68.8%; P = 0.05）. Conclusions Approximately 32%-44% of elderly anticoagulated AF patients attended have some degree of dependency, fragility and/or cognitive impairment. Patients with any of these conditions are older and have a worse clinical profile. Ap？proximately 71% of patients are taking vitamin K antagonists, regardless dependency or frailty, but with a trend to higher prescription in patients with cognitive impairment.

P300 change and cognitive behavioral therapy in subjects with Internet addiction disorder A 3-month follow-up study

Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls （N2： P = 0.035; P3a： P = 0.031 P3b： P = 0.043） and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b （P3a： P = 0.045; P3b： P = 0.062）. These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.

Research progress on the relationship between proBDNF and alcohol dependence and its related cognitive impairment

Brain-derived neurotrophic factor(BDNF)plays an important role in the growth,develop-ment,differentiation,injury,repair,survival and apoptosis of nerve cells.Precursor of BDNF(proBDNF)is an im-portant regulator of neurodegeneration,long-term hippo-campal inhibition and synaptic plasticity.Alcohol depen-dence syndrome(ADS)is a group of chronic recurrent diseases with unknown etiology.Current studies believe that proBDNF plays an important role in the occurrence,development and outcome of ADS.Alcohol dependence patients,like other neurodegenerative diseases,will also have different degrees of cognitive impairment.This arti-cle reviews the research progress on the relationship be-tween BDNF,proBDNF,alcohol dependence and cogni-tive impairment.

A Clinical Study:Therapeutic Effects of Repetitive Transcranial Magnetic Stimulation and Cognitive Behavioral Therapy on Cognitive Impairment in Alcohol-Dependent Patients

Objective To observe the effects of repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy(CBT)on cognitive function in alcohol-dependent patients.Methods Data from 285 alcohol-dependent patients were collected from Mudanjiang Medical University and Sun Yat-sen Memorial Hospital at Sun Yat-sen University between 2019 and 2021.The patients were divided into groups depending on alcohol abstinence and non-abstinence.There were 43 patients in the alcohol consumption(AC)group.The patients in the abstinence group were randomly assigned to treatment regimens with different combinations of rTMS and CBT using the Elton system.There were 49 patients in the TB+C0 group,36 in the TB+C1 group,44 in the TL+C0 group,36 in the TL+C1 group,37 in the TR+C0 group,and 40 in the TR+C1 group.Cognitive function was assessed by using the Montreal Cognitive Assessment Scale(MoCA).Results The proportion of patients with cognitive impairment in the AC group at 24 weeks was higher than that at baseline(P<0.05),whereas the proportion of cognitive impairment in the other groups did not differ significantly over time.The percentage of patients with cognitive impairment at 24 weeks was 52.3%in the TL+C0 group and 47.2%in the TL+C1 group,which was significantly lower than that in the AC group(P<0.05).MoCA scores at different time points in the AC group were significantly higher than those in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups,respectively.MoCA scores were significantly higher at 12 weeks compared with the baseline in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups(P<0.05),and similar changes were observed at 24 weeks.The MoCA scores in the TL+C1 and TL+C0 groups were higher than those in the TR+C0 group at 12 weeks after the intervention(P<0.05).Furthermore,MoCA scores in each of the TB+C1,TL+C1,TL+C0,TR+C1,and TR+C0 groups were higher than those in the AC group at 24 weeks(P<0.05).Conclusion Alcohol consumption impairs cognitive function,as evidenced by a significantly higher proportion of cognitive impairment after 24 weeks of non-abstinence.Most of the tested treatment regimens improved cognitive function.High frequency rTMS of the left dorsolateral prefrontal cortex(DLPFC)was associated with a greater improvement in cognitive function than that of the right DLPFC in alcohol-dependent patients at 12 weeks of abstinence.There does not appear to be a therapeutic advantage of CBT for cognitive impairment in alcohol-dependent patients.Screening for impaired cognitive function should be seriously considered for patients who engage in heavy drinking,and measures should be taken to reduce the risk of dementia induced by alcohol dependence.

Abstinence Following a Motivation-Skill-Desensitization-Mental Energy Intervention for Heroin Dependence: A Three-year Follow-up Result of a Randomized Controlled Trial

The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (h=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=O.O33) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.

Jidong cognitive impairment cohort study: objectives, design, and baseline screening

The risk of dementia increases in patients with cognitive impairment.However,it is not clear what factors contribute to the onset of dementia in those with cognitive impairment.In this prospective cohort study,we will investigate the every-five-year incidence of cognitive impairment and prognostic factors for cognitive impairment.The Jidong cognitive impairment cohort was established from April 2012 to August 2015,during which we recruited 5854 healthy participants(55.1%male)older than 45 years(mean,57 years).Participants received a health examination in the Staff Hospital,Jidong Oilfield Branch,China National Petroleum Corporation.Baseline data and blood samples were collected.Cognitive impairment was evaluated using the Mini-Mental State Examination,and was defined as a Mini-Mental State Examination score of less than 24.Dementia was assessed using the criteria of Diagnostic and Statistical Manual of Mental Disorders(Fourth edition),the International Working Group criteria,and the Mini-Mental State Examination score.The follow-up will continue until December 2024,during which a prognostic model will be constructed.The primary outcome is the presence/absence of dementia and the secondary outcome is quality of life.Baseline screening results showed the following:(1)Cognitive impairment was apparent in 320 participants(5.5%).These participants will be excluded from the Jidong cohort study,and the remaining participants will be followed up.(2)Of the 320 participants with cognitive impairment,there was a significantly higher prevalence of illiteracy than other education levels(35.9%,P<0.05).Age,arterial hypertension,alcohol consumption,and passive smoking differed significantly between the cognitive impairment and healthy groups(P<0.05).Multivariate logistic regression models showed that age(odds ratio[OR]=1.059,95%confidence interval[CI]:1.044-1.074)and arterial hypertension(OR=1.665,95%CI:1.143-2.427)were risk factors for mild cognitive impairment.With the increase of educational level(illiteracy,primary school,junior high school,high school,university,and above),cognitive impairment gradually decreased(OR<1,P<0.05).(3)This cohort study has initially screened for several risk factors for cognitive impairment at baseline,and subsequent prospective data will further describe,validate,and evaluate the effects of these risk factors on cognitive impairment and dementia.These results can provide clinical evidence for the early prevention of cognitive impairment and dementia.The study was approved by the Ethics Committee of Kailuan General Hospital of Tangshan City and the Medical Ethics Committee,Staff Hospital,Jidong Oilfield Branch,China National Petroleum Corporation on July 12,2013(approval No.2013 YILUNZI 1).

Learners＇ Cognitive Styles and Foreign Language Teaching

Individual learners possess distinctive cognitive styles which have a great effect on foreign language learning. The present paper intends to study the relationship between foreign language learning proficiency and cognitive styles from the perspectives of psychology, psycholinguistics, and second language acquisition. Through the analysis, the author has arrived at a conclusion that learners with different cognitive styles adopt quite different strategies in learning a foreign language. The best-matched methods fitting for different cognitive styles may help learners improve their learning proficiency. Therefore, in order to improve teaching proficiency, foreign language teachers should keep a match between learners＇ cognitive styles and teaching methodologies.

GLYX-13 pretreatment ameliorates long-term isoflurane exposure-induced cognitive impairment in mice

Accumulating evidence indicates that inhalation anesthetics induce or increase the risk of cognitive impairment. GLYX-13（rapastinel） acts on the glycine site of N-methyl-D-aspartate receptors（NMDARs） and has been shown to enhance hippocampus-dependent learning and memory function. However, the mechanisms by which GLYX-13 affects learning and memory function are still unclear. In this study, we investigated these mechanisms in a mouse model of long-term anesthesia exposure. Mice were intravenously administered 1 mg/kg GLYX-13 at 2 hours before isoflurane exposure（1.5% for 6 hours）. Cognitive function was assessed using the contextual fear conditioning test and the novel object recognition test. The mRNA expression and phosphorylated protein levels of NMDAR pathway components, N-methyl-D-aspartate receptor subunit 2B（NR2B）-Ca2+/calmodulin dependent protein kinase II（CaMKII）-cyclic adenosine monophosphate response element binding protein（CREB）, in the hippocampus were evaluated by quantitative RT-PCR and western blot assay. Pretreatment with GLYX-13 ameliorated isoflurane exposure-induced cognitive impairment and restored NR2B, CaMKII and CREB mRNA and phosphorylated protein levels. Intracerebroventricular injection of KN93, a selective CaMKII inhibitor, significantly diminished the effect of GLYX-13 on cognitive function and NR2B, CaMKII and CREB levels in the hippocampus. Taken together, our findings suggest that GLYX-13 pretreatment alleviates isoflurane-induced cognitive dysfunction by protecting against perturbation of the NR2B/CaMKII/CREB signaling pathway in the hippocampus. Therefore, GLYX-13 may have therapeutic potential for the treatment of anesthesia-induced cognitive dysfunction. This study was approved by the Experimental Animal Ethics Committee of Drum Tower Hospital affiliated to the Medical College of Nanjing University, China（approval No. 20171102） on November 20, 2017.

综合心理行为护理对后续精神分裂症患者负性情绪和认知功能的影响

目的:探讨综合心理行为护理对精神分裂症后续情绪行为反应和功能情况的影响。方法:选择2022年10月1日~2023年11月30日收治的248例精神分裂症患者,根据随机数字表法分为对照组和研究组各124例,两组均按照医嘱服用药物治疗,对照组采用常规护理,研究组采用综合心理行为护理;比较两组护理前后认知功能[采用MATRICS共识认知成套测验(MCCB)]、负性情绪[采用焦虑自评量表(SAS)、抑郁自评量表(SDS)],患者对护理的满意度。结果:护理后,研究组MCCB中语言流畅性、连线、数字序列、空间广度、语言记忆、持续操作管理、情绪管理维度均高于护理前(P<0.01,P<0.05),对照组语言流畅性、连线、数字序列、空间广度、持续操作管理、情绪管理维度评分均高于护理前(P<0.01,P<0.05),研究组语言流畅性、连线、数字序列、空间广度、语言记忆、视觉记忆、持续操作管理、情绪管理维度评分均高于对照组(P<0.01,P<0.05);护理后,两组SDS、SAS评分均低于护理前(P<0.01),且研究组低于对照组(P<0.01);研究组患者对护理的满意度高于对照组(P<0.01)。结论:综合心理行为护理对后续神经分裂症患者负性情绪、认知功能均具有改善作用,提高患者对护理的满意度。

基于随访系统的延续性护理干预在酒精依赖患者中的应用

目的探讨基于随访系统的延续性护理干预在酒精依赖患者中的应用效果。方法采用方便抽样法,选取2021年3月-2022年8月在我院成瘾医学科住院治疗的酒精依赖患者120例,采用随机数字表法分为对照组和干预组,各60例。对照组出院后接受常规药物治疗,干预组在对照组基础上接受为期6个月的基于随访系统的延续性护理干预。比较2组患者干预前后对酒精的渴求程度和生活质量,以及干预后1个月、3个月和6个月对酒精的依赖状态和复饮率。结果干预前,2组患者对酒精的渴求程度和生活质量比较,差异无统计学意义(P>0.05);干预后,干预组对酒精的渴求程度和生活质量显著优于对照组(P<0.05)。干预后1个月、3个月、6个月,干预组对酒精的依赖状态和复饮率均显著优于对照组(P<0.05)。结论基于随访系统的延续性护理干预能降低酒精依赖患者对酒精的渴求和依赖程度,降低复饮率,改善患者生活质量,为酒精依赖患者院外康复管理提供了新的护理理念及干预方法。

伴攻击行为的住院男性酒精依赖患者认知功能与人格特征的相关性

背景近年来,酒精依赖相关的健康问题备受关注,酒精依赖不仅会影响个人的行为控制能力,还会给家庭和社会带来不利影响。目的分析伴攻击行为的男性酒精依赖患者认知功能与人格特征的关系,以期为改善伴攻击行为的男性酒精依赖患者的认知功能提供参考。方法选取2020年3月—2022年3月湖南省脑科医院收治的、符合《国际疾病分类(第10版)》(ICD-10)的男性酒精依赖患者为研究对象。根据外显攻击行为量表(MOAS)评分,按1∶1选取伴攻击行为和不伴攻击行为的男性酒精依赖患者各80例。采用艾森克人格问卷简式量表中国版(EPQ-RSC)、重复性成套神经心理状态测验(RBANS)分别评定人格特征与认知功能。采用Pearson相关分析考查伴攻击行为的酒精依赖患者EPQ-RSC评分与RBANS评分之间的相关性。结果伴攻击行为组RBANS各因子评分均低于不伴攻击行为组(t=2.176、2.580、2.076、2.308、2.193,P均<0.05)。伴攻击行为组EPQ-RSC各维度评分均高于不伴攻击行为组(t=4.497、5.242、6.459,P均<0.01)。Pearson相关分析结果显示,伴攻击行为的酒精依赖患者EPQ-RSC内外向、神经质、精神质维度评分与RBANS即刻记忆、视觉空间/结构、言语功能、注意、延时记忆维度评分均呈正相关(r=0.294~0.482、0.362~0.511、0.265~0.475,P均<0.05)。结论伴攻击行为的酒精依赖患者认知功能可能与人格特征存在一定的关联性。

基于“4Y到位”的照片启发访谈随访对卒中后认知障碍病人照顾者决策疲劳的影响

目的:探讨基于“4Y到位”的照片启发式访谈随访对卒中后认知障碍病人照顾者决策疲劳的影响。方法:2022年1月—11月选择桂林市社区居住的67名卒中后认知障碍病人照顾者为研究对象,随机分为对照组34人和干预组33人,对照组实施常规的微信随访,干预组基于“4Y到位”照片启发技术的随访,即计划到位(yes plan)、责任到位(yes duty)、检查到位(yes check)、激励到位(yes drive),干预3个月后,以决策疲劳量表评价干预效果。结果:干预3个月后,两组照顾者决策疲劳得分均低于干预前(P<0.05),且干预组照顾者决策疲劳得分[(17.79±1.95)分]低于对照组[(20.65±2.77)分],差异有统计学意义(P<0.001)。结论:基于“4Y到位”的照片启发访谈随访能够有效降低卒中后认知障碍病人照顾者的决策疲劳。

手机成瘾的大学生自我损耗对抑制控制的影响

目的:考察情绪损耗和认知损耗情况下大学生的手机成瘾对抑制控制的影响。方法:招募大学生553人,使用手机成瘾倾向量表(MPATS)筛选出手机成瘾组和非成瘾组各108、194人,选取其中99人参与实验1,考察情绪损耗对手机成瘾大学生抑制控制的影响。另选取其中101人参与实验2,考察认知损耗对手机成瘾大学生抑制控制的影响。使用GO/NOGO范式比较不同情绪损耗和认知损耗情况下不同手机成瘾大学生的正确率和反应时。结果:实验1中,情绪损耗的主效应有统计学意义[F(1,55)=6.16、178.91,P<0.05或P<0.001],高情绪损耗组抑制控制正确率、反应时均低于低情绪损耗组。实验2中,组别的主效应有统计学意义[F(1,57)=17.90、19.06,均P<0.001],手机成瘾组的抑制控制正确率低于非成瘾组,而抑制控制反应时高于非成瘾组;组别与认知损耗类型的交互作用有统计学意义[F(1,57)=7.95,P<0.01],高认知损耗情况下手机成瘾组的抑制控制正确率更低。结论:大学生的情绪损耗和认知损耗可能会降低其抑制控制能力,且手机成瘾的大学生更容易受到认知损耗的影响。

志愿服务参与能培育大学生非认知能力吗——基于追踪调研和双重差分技术的因果分析

已有众多研究基于人格特质理论和经验学习理论,揭示了志愿服务参与和大学生非认知能力存在双向因果关系。本文基于湖南省高校大学生发展追踪调查数据,采用双重差分法检验志愿服务参与和非认知能力的因果关系,以揭示志愿服务参与究竟是筛选还是培育了大学生的非认知能力。研究结果证实了志愿服务参与对外向性和尽责性有筛选作用,对宜人性有培育作用,对情绪稳定性和开放性既没有筛选作用,也没有培育作用。这些结果表明高校志愿服务主要通过人格特质机制筛选了学生的非认知能力,对非认知能力的培育作用有限,促使我们重新审视高校志愿服务如何发挥实践育人的功能。

认知-行为模型的团体心理干预对改善大学生手机依赖的效果

目的:探讨以认知-行为模型为理论基础设计的团体心理干预对于缓解大学生手机依赖问题的治疗效果。方法:采用便利取样的方式选择某大学存在手机依赖困扰的45名大学生,随机分为实验组(n=15)、安慰剂组(n=15)和对照组(n=15),对实验组进行基于认知-行为模型的手机依赖心理干预,安慰剂组接受与手机依赖主题无关的团体心理干预,对照组则正常生活,不参加任何心理辅导或咨询活动。3组被试均使用手机依赖指数量表(MPAI)中文版作为测评工具,同时结合个体的日均手机使用时长来共同探究干预前后各组实验数据的差异。结果:在前测中,各组的MPAI得分与日均手机使用时长均不存在显著差异(MPAI前测:F=0.79,P>0.05;日均手机使用时长前测:F=1.51,P>0.05)。但在后测中,实验组的MPAI得分与日均手机使用时长均得到了显著的改善(P<0.001),且都显著低于安慰剂组、对照组(P<0.01)。干预后1个月追踪测量显示,实验组各项数据依然显著低于其他两组,且与前测存在显著差异(P<0.001)。结论:基于认知-行为模型的团体心理干预能够有效缓解大学生的手机依赖水平,帮助其尽早摆脱对手机的过度使用,回归并保持健康的身心状态与生活方式。

AI认知依赖的多维影响与应对策略研究

人工智能技术带来的便利性极大减轻了个体的认知负荷,人们在利用其提高工作效率和生活质量的同时,逐渐将更多的认知和决策权外包给AI,进而引发了一种新的社会问题——AI认知依赖。文章依据心理学与社会学的相关文献,界定了其核心概念与类型,并从技术、心理、社会及其他外部环境因素深入分析其成因,揭示了AI认知依赖对个体的多维影响。在此基础上,文章提出当前需要通过AI教育提高公众的AI素养,通过适度的政策法规引导AI的健康发展,更要善于利用AI本身研究和治理AI。该研究为理解人智交互的复杂影响提供了新的视角,对促进AI技术的健康发展和构建可持续的AI应用生态具有重要的理论和实践意义。

氧化应激与酒精依赖认知损害的关系

酒精是中枢神经系统的抑制剂,长期大量饮酒会形成酒精依赖。酒精依赖是一种复杂而严重精神疾病,可导致日常身体、心理和社会功能的紊乱。目前,酒精依赖患病率约为2.6%,临床缺乏有效的预防策略、治疗措施和康复方案是导致酒精依赖全球健康负担不断增加的主要因素。长期反复饮酒和戒断可引起大脑结构和功能改变,造成神经心理认知功能损害,严重者可导致痴呆,严重危害人类的身心健康。酒精依赖造成的认知损害病因复杂,其中氧化应激在酒精依赖认知功能损害中起着关键作用。本综述针对酒精依赖所致认知损害与氧化应激的关系进行文献综述,以期为酒精依赖所致认知功能障碍的诊断和治疗提供一定借鉴。

高频重复经颅磁刺激在酒精成瘾及酒精性精神行为障碍患者中的临床疗效

目的 探究高频重复经颅磁刺激在酒精成瘾及酒精性精神行为障碍患者中的临床疗效。方法 选取2021年7月—2023年7月徐州医科大学附属徐州东方医院收治的80例酒精成瘾及酒精性精神行为障碍患者作为研究对象。采取红蓝球法随机分为对照组、观察组,各40例。对照组予以奥沙西泮和复合维生素B治疗,观察组在对照组基础上实施高频重复经颅磁刺激治疗。比较两组临床疗效、认知功能及成瘾情况。结果 观察组治疗总有效率(95.00%)高于对照组(80.00%),差异有统计学意义(χ^(2)=4.114,P<0.05)。观察组洛文斯顿作业疗法认知评定量表评分高于对照组,强制饮酒量表、冲动行为量表评分均低于对照组,差异有统计学意义(P均<0.05)。结论 采用高频重复经颅磁刺激有助于降低患者的成瘾性,并改善其冲动性和认知功能。

The Use of Field Dependence/Independence in Language Acquisition

Field dependence/independence in Language Acquisition are discussed by many language learners.In this article,we will mainly focus on talking about the cognitive style,including the concept of Field-dependence/independence,their character istics and differences and functions in language acquisition.