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Acute ischemic stroke (AIS) is frequently associated with long-term post-stroke cognitive impairment (PSCI) and dementia. While the mechanisms behind PSCI are not fully understood, the brain and cognitive reserve concepts are topics of ongoing research exploring the ability of individuals to maintain intact cognitive performance despite ischemic injuries. Brain reserve refers to the brain's structural capacity to compensate for damage, with markers like hippocampal atrophy and white matter lesions indicating reduced reserve. Cognitive reserve involves the brain's ability to optimize performance and use alternative networks to maintain function. Advanced methods of MRI and EEG processing may better assess brain reserve and cognitive reserve, with emerging predictive models integrating these measures to improve PSCI prediction. This article provides the design of a hospital-based study investigating the predictive role of functional connectivity and MRI radiomics in assessing PSCI occurrence one year after AIS. One hundred forty-four patients will be enrolled following strict inclusion/exclusion criteria. The patients will undergo comprehensive assessments, including neuropsychological testing, brain MRI, and quantitative EEG (QEEG), across four visits over a year. The primary outcome will be PSCI occurrence, and it will be assessed at six and twelve months after AIS. Secondary outcomes will include PSCI severity, recurrent AIS, and mortality. Statistical analyses will be performed to identify predictive factors using Cox proportional hazards models, and predictive models based on QEEG, MRI radiomics, and clinical data will be built. Early detection of AIS patients prone to developing PSCI might outline more effective therapeutic approaches, reducing the social and economic burden of ischemic stroke. [ABSTRACT FROM AUTHOR]

Background: The global rise in obesity has been significantly influenced by shifts in dietary habits that have been exacerbated by external factors such as the COVID-19 pandemic. This study aims to analyze the trends in Romanian dietary habits from 2015 to 2023, focusing on the impact of the COVID-19 pandemic and the role of socio-economic factors, seasonality, and cultural practices. Methods: For dietary habits, we used nationally representative data from the Romanian Household Budget Survey provided by the Romanian National Institute of Statistics. The survey includes 30,000 households annually. From the same provider, we downloaded data about potential drivers of food consumption, such as income, the consumer price index, and the unemployment rate. The analysis mixes descriptive statistics and panel data analysis. Among the main drivers, the econometric models include seasonality and regional factors, ensuring a comprehensive understanding of the changes in dietary behavior. Results: During the COVID-19 pandemic, daily calorie consumption increased to over 3000 calories per person, representing a 20% increase compared to the pre-pandemic period. Post-pandemic, food consumption remains elevated, averaging 2500–2600 calories per person daily. The pandemic also led to a shift in dietary composition, with significant changes. Thus, we mark an increase in fat (p < 0.001) and carbohydrate intake (p < 0.01) and a decrease in protein intake (p < 0.001). Beyond the presence of health disruptors, we confirm the significant impact of income (p < 0.001) and seasonality (p < 0.001). Other factors like unemployment, the consumer price index, and hidden regional factors have a minor role. Conclusions: The COVID-19 pandemic has had a lasting impact on Romanian dietary habits, reinforcing unhealthy eating patterns that were already prevalent. The sustained increase in calorie consumption, particularly of nutrient-poor, energy-dense foods, poses a significant public health challenge. The study also highlights significant seasonal variations, with a marked increase in food intake during the last quarter of the year, driven by cultural and religious traditions. These findings underscore the need for targeted public health interventions and policies that address economic factors and cultural and regional influences to promote healthier dietary behaviors in Romania. [ABSTRACT FROM AUTHOR]

Background: The Improved Health Care in Neurology and Psychiatry—Longer Life (IHCNP) study was an 18-month prospective, observational, non-interventional research study focused on patients with mild cognitive impairment (MCI) following ischemic stroke. Objectives: Our secondary analysis of the IHCNP data aimed to document the progression of MCI in this patient group. Methods: A total of 100 patients from Romania were recruited, all of whom underwent cognitive assessments using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Rey Auditory Verbal Learning Test (RAVLT). Clinical evaluations were also conducted as part of the study. Baseline cognitive scores were recorded, and subsequent follow-ups documented cognitive changes over time. Results: At baseline, cognitive scores indicated mild impairment, with averages of MMSE 25.41, MoCA 23.27, and RAVLT 33.63. By the end of the study, patients exhibited a significant cognitive decline, with MMSE scores dropping by 8.7%, MoCA by 10.0%, and RAVLT by 29.5% (p < 0.0001 for all measures), reflecting the progressive nature of MCI post-stroke. Conclusions: These findings highlight the importance of early diagnosis and intervention to mitigate cognitive decline in post-stroke patients. The study underscores the need for ongoing cognitive monitoring to improve patient outcomes and manage MCI progression effectively. [ABSTRACT FROM AUTHOR]

Background: Cognitive deficits following ischemic stroke significantly impair quality of life, highlighting the need for effective interventions. This study evaluates the efficacy and safety of extended N-Pep-12 dietary supplementation in enhancing cognitive recovery post-stroke. Methods: In this randomized, open-label, controlled study, 106 patients with supratentorial ischemic stroke were enrolled to receive either 90mg N-Pep-12 or no supplementation daily for 360 days and were followed-up for 360 days. Cognitive function and emotional well-being were assessed using established neuropsychological scales at baseline, 90 days, and 360 days post-stroke. Safety was monitored through adverse events and mortality rates. Results: Significant improvements were observed in the N-Pep-12 group compared to controls, particularly in the Montreal Cognitive Assessment scores at both 90 and 360 days, and in the Digit Symbol Coding scores at 360 days, suggesting enhanced cognitive recovery with extended N-Pep-12 supplementation. A linear regression for a composite outcome analysis at day 360 further confirmed the efficacy of N-Pep-12 in contributing to cognitive improvement. Safety profiles were favorable, with no significant adverse effects attributed to N-Pep-12. Conclusions: Extended dietary supplementation with N-Pep-12 appears to offer a safe and effective approach to support cognitive recovery in ischemic stroke survivors. These findings underscore the potential of the supplement as an add-on intervention for managing post-stroke cognitive impairments. [ABSTRACT FROM AUTHOR]

Background: Ischemic stroke (IS) often leads to cognitive and motor impairments. This study aimed to investigate whether Memory-Guided Saccade Tasks (MGSTs) could be used to assess cognitive function in stroke patients. Methods: A secondary data analysis was conducted on 62 individuals with supratentorial IS. Eye-tracking metrics from MGST were correlated with established neuropsychological assessments, including the Montreal Cognitive Assessment (MoCA) and Hospital Anxiety and Depression Scale (HADS). Results: Age correlated negatively with memory-guided saccade (MGS) accuracy (ρ = −0.274) and positively with late errors (ρ = 0.327). Higher Montreal Cognitive Assessment (MoCA) scores were associated with faster corrective saccades (ρ = 0.259). Increased anxiety (HADS-A) and depression (HADS-D) levels correlated with higher early error rates (ρ = 0.325 and ρ = 0.311, respectively). The Color Trails Test and Digit Span test performance also correlated with various MGS parameters. Conclusions: While some correlations were found between cognitive measures and eye-tracking metrics, further research is needed to validate MGST as a tool for cognitive assessment in a more homogenous stroke population. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) presents a significant clinical challenge due to its profound motor and cognitive impacts. Early diagnosis is crucial for implementing effective, stage-based treatment strategies. Recently, eye-tracking technology has emerged as a promising tool for the non-invasive diagnosis and monitoring of various neurological disorders, including PD. This retrospective study analyzed eye-tracking parameters, specifically visually-guided saccades (VGS), in PD patients within a clinical setting. We reviewed eye-tracking data from 62 PD patients, focusing on eye movement performance in horizontal and vertical VGS tasks. Our findings revealed significant correlations between demographic profiles, Mini-Mental State Examination (MMSE) scores, pattern recognition, and spatial working memory tests with saccadic performance in PD patients. Despite the retrospective nature of the study, our results support the potential of eye-tracking technology as a valuable diagnostic tool in PD assessment and monitoring. Future research should prioritize longitudinal studies and more comprehensive assessments to further understand and enhance the clinical application of eye-tracking in PD. [ABSTRACT FROM AUTHOR]

Chronic pain (CP) significantly impacts quality of life and poses an increasing economic burden on healthcare systems worldwide. This study investigates the relationship between blink rate during saccadic eye movements and pain perception in patients with CP. Ninety-two patients with CP (24 men, 68 women) were assessed using eye-tracking technology during horizontal and vertical saccadic tasks. Pain perception was evaluated using the Central Sensitization Inventory - Part A and the McGill Pain Questionnaire, and anxiety levels were measured using the State-Trait Anxiety Inventory. The results revealed a significant correlation between blink rates in horizontal and vertical tasks (ρ = 0.668, P < 0.001). However, there was no correlation between blink rate and age, pain perception, or anxiety scores. Conversely, measures of pain perception were positively correlated with each other and with anxiety scores. These findings suggest that while blink rate may reflect oculomotor function, it is not directly influenced by pain perception or anxiety in patients with CP. The present study highlights the potential of eye tracking for the comprehensive assessment and management of patients with CP. [ABSTRACT FROM AUTHOR]

The economic and disease burden of dementia is forecasted to continue increasing. Considering its cognitive effects, timely diagnosis is important in developing a stage-based treatment plan and gathering data to support advocacy efforts and plan healthcare and social services. Eye-tracking technology has emerged as an efficient diagnostic tool in clinical practice and experimental studies. This review aimed to comprehensively analyze various aspects of eye-tracking technology, including pupillometry parameters, eye movements, eye-tracking devices, and neuropsychological tools. We conducted a systematic review retrieving articles published in the last ten years from six databases. Our results provide a complex overview for each included form of dementia/cognitive decline in terms of patient characteristics (age, sex-disaggregated by included pathologies), inclusion and exclusion criteria, devices, and neuropsychological tools. We also summarized findings on fixation stability tasks, saccadic evaluation, pupillometry, scene perception, object recognition, spatial memory, eye-tracking video tasks, and visual search. The eye-tracking method has become more common in cognitive assessments. [ABSTRACT FROM AUTHOR]

Low wages of health professionals are widely recognized as one of the drivers of informal payments in Romania's healthcare system. In January 2018, the government increased wages by an average of 70% to 172% in the public healthcare sector. This study examined the trends in patient-reported informal healthcare payments, discussing the effect of a one-time wage increase in 2018 and the impact of the COVID-19 pandemic in 2020 and 2021. It draws on monthly survey data of patient-reported informal payments collected between January 2017 and December 2021. We analyzed three periods: before the wage rise ("low pay"), between the wage rise and the COVID-19 pandemic ("high pay"), and during the COVID-19 pandemic. We found that patient-reported informal payments decreased between the "low pay" and "high pay" period but with a sharper decline during the COVID-19 pandemic. The share of respondents willing to report informal payments increased during the "high pay" period, indicating a stronger willingness to voice dissatisfaction with health services and informal payments, but slowed down during the first lockdown in 2020. Informal payments were more frequently reported in larger hospitals and the poorest geographical areas. While the 2018 wage increase may have contributed to less prevalent informal payments, survey coverage and design must be improved to draw robust, system-level conclusions to inform tailored policy actions. [ABSTRACT FROM AUTHOR]

The article discusses the transition of phages, viruses that infect bacteria, from being used for protein-protein interactions to gene therapy vectors targeting human cells. By displaying targeting peptides on phage coat proteins, researchers can identify peptides with high affinity for specific proteins or cell receptors. These phage-derived vectors offer benefits such as ease of production, systemic administration, and potential for treating brain tumors. Ongoing research aims to enhance targeting capabilities and transduction efficiency of these vectors for improved gene therapy applications. [Extracted from the article]

The article discusses Quantitative Electroencephalography that deals with modern electroencephalography (EEG) analysis that records digital EEG signals, which are processed, transformed, and analyzed using complex mathematical algorithms. Topics include neurotechnology establishes strategic connections between various disciplines, from neuroscience and medicine to engineering and artificial intelligence, tackling the more profound understanding of fundamental brain principles.

Introduction: Post-stroke depression (PSD) has complex pathophysiology determined by various biological and psychological factors. Although it is a long-term complication of stroke, PSD is often underdiagnosed. Given the diagnostic role of quantitative electroencephalography (qEEG) in depression, it was investigated whether a possible marker of PSD could be identified by observing the evolution of the (Delta + Theta)/(Alpha + Beta) Ratio (DTABR), respectively the Delta/Alpha Ratio (DAR) values in post-stroke depressed patients (evaluated through the HADS-D subscale). Methods: The current paper analyzed the data of 57 patients initially selected from a randomized control trial (RCT) that assessed the role of N-Pep 12 in stroke rehabilitation. EEG recordings from the original trial database were analyzed using signal processing techniques, respecting the conditions (eyes open, eyes closed), and several cognitive tasks. Results: We observed two significant associations between the DTABR values and the HADS-D scores of post-stroke depressed patients for each of the two visits (V1 and V2) of the N-Pep 12 trial. We recorded the relationships in the Global (V1 = 30 to 120 days after stroke) and Frontal Extended (V2 = 90 days after stroke) regions during cognitive tasks that trained attention and working memory. For the second visit, the association between the analyzed variables was negative. Conclusions: As both our relationships were described during the cognitive condition, we can state that the neural networks involved in processing attention and working memory might go through a reorganization process one to four months after the stroke onset. After a period longer than six months, the process could localize itself at the level of frontal regions, highlighting a possible divergence between the local frontal dynamics and the subjective well-being of stroke survivors. QEEG parameters linked to stroke progression evolution (like DAR or DTABR) can facilitate the identification of the most common neuropsychiatric complication in stroke survivors. [ABSTRACT FROM AUTHOR]

Background and aims. “Severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) is the name of the etiological agent of the pandemic Corona Virus Disease (COVID-19) which was declared on March 11, 2020 by the WHO and which affected all countries of the world, including Romania. Our study aimed to evaluate the psycho-affective implications and economic consequences for dentists in Romania during the COVID-19 (Corona Virus Disease) pandemic state of emergency and their opinion on the patients’ oral health impact. Methods. A cross-sectional observational and analytical study based on a questionnaire was conducted. Dentists who work in Romania affiliated in 2020 to the Romanian College of Dental Practitioners was the target population. Results. Three hundred and seventy-three dentists participated in this survey. The age of the respondents ranged from 24 to 70. Men and women have the same expectation regarding the lockdown effect of worsening the oral health of the general population (worst, 79.5% of women and 81.3% of men, P=0.8842). Conclusions. The anxiety regarding the bank rates, supplementary investments, risk of COVID-19 infection and exposure to COVID-19 related mass-media information proved to be significantly higher among young dentists. [ABSTRACT FROM AUTHOR]

Background and aims. On March 16, 2020, the state of emergency was established with drastic measures of isolation and quarantine. Among the measures taken in the context of the state of emergency was the closure of dental offices throughout the country. The aim of our questionnaire-based cross-sectional study was to identify the psycho-affective implications of the Romanian citizens induced by the COVID-19 pandemic period as well as their opinion related to the self-perceived oral health status during this period. Methods. An original questionnaire was designed consisting of 41 questions, which were distributed to the general population via the Internet. The first part of the questionnaire investigated the respondents' opinion regarding the impact of this COVID-19 pandemic period of isolation on their oral health and the attention paid by the subjects to oral hygiene during restrictions. The second part refers to their addressability to the dental services during this pandemic and the third part interrogates different characteristics, namely the presence of comorbidities, possible anxiety, and stress. Results. A total of 769 participants answered the questionnaire online. Conclusion. According to their responses most of the respondents were not afraid of the possibility of contracting Sars-Cov-2 during dental treatments, but were in certain periods deprived of accessing dental services due to lockdown restrictions. They are aware of their oral health problems and pay more attention to oral hygiene so that they do not get worse during restrictions. [ABSTRACT FROM AUTHOR]

The article discusses Quantitative Electroencephalography that deals with modern electroencephalography (EEG) analysis that records digital EEG signals, which are processed, transformed, and analyzed using complex mathematical algorithms. Topics include neurotechnology establishes strategic connections between various disciplines, from neuroscience and medicine to engineering and artificial intelligence, tackling the more profound understanding of fundamental brain principles.

Background: Stroke-induced aphasia significantly impacts communication and quality of life. Despite the standard treatment being speech and language therapy, outcomes vary, highlighting the need for additional therapies. Cerebrolysin, a neuroprotective and neurotrophic agent, has shown potential in stroke management. This study addresses the notable gap in research about the combined use of Cerebrolysin and speech therapy, evaluating their synergistic potential in the treatment of aphasia., Methods: The ESCAS trial (The Efficacy and Safety of Cerebrolysin in the Treatment of Aphasia After Acute Ischemic Stroke), a prospective, randomized-controlled, double-blinded study was conducted in 2 Romanian stroke centers. Participants included those with left middle cerebral artery territory ischemic stroke and nonfluent aphasia, enrolled 3 to 5 days poststroke. Inclusion criteria were right-handedness and Romanian as the mother tongue. Participants received Cerebrolysin or a placebo combined with speech and language therapy in 10-day cycles over 3 intervals, and evaluations were done at baseline, 30, 60, and 90 days respectively. The main outcome measure was Western Aphasia Battery for language function. Changes at days 30, 60, and 90 compared with baseline were quantified, and the effect estimand used was the difference in means between groups. Secondary outcome measurements were the National Institutes of Health Stroke Scale for neurological deficit, the modified Rankin Scale for global disability, and the Barthel Index for activities of daily living., Results: Out of 132 enrolled patients, 123 were included in the intention-to-treat analysis, and 120 in the per-protocol analysis. Overall, both groups showed improvement at subsequent visits compared with the baseline for Western Aphasia Battery and the National Institutes of Health Stroke Scale. The Cerebrolysin group showed greater improvements in Western Aphasia Battery (visit 4 mean increase of 35.579±16.316 [95% CI, 31.289-39.869] points; P <0.001) compared with the placebo group (20.774±12.486 [95% CI, 17.603-23.945] points; P <0.001), a difference in means of 14.805 (95% CI, 9.521-20.089) points ( P <0.001). The Cerebrolysin group also showed significant improvements (higher decreases) in National Institutes of Health Stroke Scale scores compared with the placebo group (2.085 [95% CI, 1.076-3.094] points; P <0.001). Safety analysis raised no concerns (number of patients with adverse events P =0.105, number of adverse events per patient P =0.134). Additionally, the Cerebrolysin group showed greater improvements in functional independence (Barthel Index) and a trend toward reduced disability (modified Rankin Scale) compared with the placebo group., Conclusions: Cerebrolysin combined with speech and language therapy offers promising potential for enhancing recovery in poststroke nonfluent aphasia. Significant improvements were observed in language and neurological deficits, underscoring the importance of adjunctive therapies in nonfluent aphasia rehabilitation. Further research with larger cohorts is needed to fully establish the efficacy of this combination therapy., Registration: URL: https://www.isrctn.com; Unique identifier: ISRCTN54581790.

Patients with traumatic brain injury (TBI) of varying severities are experiencing adverse outcomes during and after rehabilitation. Besides depression and anxiety, post-traumatic stress disorder (PTSD) is highly encountered in civilian and military populations. As more prospective and retrospective studies - focused on evaluating new or old psychological therapies in inpatient, outpatient, or controlled environments, targeting patients with PTSD with or without a history of TBI - are carried out, researchers are employing various scales to measure PTSD as well as other psychiatric diagnoses or cognitive impairments that might appear following TBI. We aimed to explore the literature published between January 2010 and October 2021 by querying three databases. Our preliminary results showed that several scales - such as the Clinician-Administered PTSD Scale (CAPS), the Posttraumatic Stress Disorder Checklist Military Version (PCL-M) as well as Specific Version (PCL-S), and Civilian Version (PCL-C) - have been frequently used for PTSD diagnosis and symptom severity. However, heterogeneity in the scales used when assessing and evaluating additional psychiatric comorbidities and cognitive impairments are due to the study aim and therapeutic approaches. Therefore, conducting an intervention focusing on post-TBI PTSD patients requires increased attention to patients' medical history in capturing multiple cognitive impairments and affected neuropsychological processes when designing the study and including validated instruments for measuring primary and secondary neuropsychological outcomes., (©2022 JOURNAL of MEDICINE and LIFE.)