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Orexin Receptor Antagonists for the Prevention and Treatment of Alzheimer’s Disease and Associated Sleep Disorders
Orexins/hypocretins are neuropeptides produced by the hypothalamic neurons, binding two G-protein coupled receptors (orexin 1 and orexin 2 receptors) and playing a critical role in regulating arousal, wakefulness, and various physiological functions. Given the high prevalence of sleep disturbances in Alzheimer’s disease (AD) and their reported involvement in AD pathophysiology, the orexin system is hypothesized to contribute to the disease pathogenesis. Specifically, recent evidence suggests that orexin’s influence may extend beyond sleep regulation, potentially affecting amyloid-β and tau pathologies. Dual orexin receptor antagonists (DORAs), namely suvorexant, lemborexant, and daridorexant, demonstrated efficacy in treating chronic insomnia disorder across diverse clinical populations. Considering their stabilizing effects on sleep parameters and emerging evidence of a possible neuroprotective role, these agents represent a promising strategy for AD management. This leading article reviews the potential use of orexin receptor antagonists in AD, particularly focusing on their effect in modulating disease-associated sleep disturbances and clinical outcomes. Overall, clinical studies support the use of DORAs to enhance sleep quality in patients with AD with comorbid sleep and circadian sleep–wake rhythm disorders. Preliminary results also suggest that these compounds might influence AD pathology, potentially affecting disease progression. Conversely, research on selective orexin receptor antagonists in AD is currently limited. Further investigation is needed to explore orexin antagonism not only as a symptomatic treatment for sleep disturbances, but also for its broader implications in modifying AD neurodegeneration, emphasizing mechanisms of action and long-term outcomes
Cognitive Study Strategies and Motivational Orientations among University Students: A Latent Profile Analysis
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Cognitive Study Strategies and Motivational Orientations among University Students: A Latent Profile Analysis
by Conny De Vincenzo
1,* and Matteo Carpi
2,* [ORCID]
1
Department of Education Science, Roma Tre University, 00185 Rome, Italy
2
Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
*
Authors to whom correspondence should be addressed.
Educ. Sci. 2024, 14(7), 792; https://doi.org/10.3390/educsci14070792
Submission received: 13 June 2024 / Revised: 4 July 2024 / Accepted: 19 July 2024 / Published: 22 July 2024
(This article belongs to the Special Issue Challenges and Trends for Modern Higher Education)
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Abstract
Cognitive study strategies and motivational orientations play a crucial role in promoting successful learning and academic achievement. This study aims to explore the presence of different cognitive–motivational profiles among Italian university students using latent profile analysis. A sample of 476 university students (mean age: 26.5 ± 9.6 years; 71.6% female) participated in a cross-sectional online survey, including the Self-Regulated Knowledge Scale-University, the Academic Motivation Scale, the Students’ Self-Efficacy Scale, the Outcome Questionnaire-45, and a brief measure of dropout intention. Latent profile analysis identified three distinct configurations of self-regulated learning strategies and motivational orientations: “autonomous-motivated deep learners” (AUT-Learn; 60.5%), “externally-motivated balanced strategists” (EXT-Bal; 36.8%), and “externally-motivated task performers” (EXT-Task; 6.8%). The three profiles exhibit significant differences in self-efficacy, dropout intention, grade point average (GPA), and psychological wellbeing. The AUT-Learn profile showed higher self-efficacy than EXT-Bal and EXT-Task, and higher GPA than EXT-Task. Additionally, AUT-Learn participants reported lower dropout intention and higher psychological wellbeing compared to EXT-Bal and EXT-Task, while EXT-Bal showed lower dropout intention and better wellbeing than EXT-Task. The predictive validity and practical implications of this classification warrant further investigation in dedicated longitudinal studies
The Mediating Role of Sleep Quality in the Relationship between Negative Emotional States and Health-Related Quality of Life among Italian Medical Students
Sleep problems have been shown to be related to adverse outcomes concerning physical and mental well-being. Furthermore, mental health issues and sleep problems were reported to be highly prevalent among medical students and physicians, and were found to be associated with worse academic and clinical performance in these populations. This study aims to investigate the prevalence of poor sleep to examine the associations between sleep quality and health-related quality of life (HRQoL), and to explore the possible mediating role of sleep in the relationship between psychological distress and HRQoL itself in a sample of medical and dental students attending a large Italian university. Participants (n = 407, mean age: 24.2 ± 2.4) answered an online questionnaire comprising the 21-item Depression Anxiety Stress Scale, the Pittsburgh Sleep Quality Index, and the Short Form-12 health survey. Up to 62% of the participants reported poor sleep quality. Controlling for psychological distress, sleep quality components were found to be associated with physical and mental HRQoL. Mediation analysis showed that overall sleep quality mediated all the single associations between anxiety, depression, and stress and HRQoL. These preliminary findings suggest that the quality of sleep is important for the well-being of medical students and that targeting sleep issues in this academic population may be beneficial
Sleep Biomarkers for Predicting Cognitive Decline and Alzheimer's Disease: A Systematic Review of Longitudinal Studies
Background: Sleep disturbances are considered a hallmark of dementia, and strong evidence supports the association between alterations in sleep parameters and cognitive decline in patients with mild cognitive impairment and Alzheimer's disease (AD). Objective: This systematic review aims to summarize the existing evidence on the longitudinal association between sleep parameters and cognitive decline, with the goal of identifying potential sleep biomarkers of AD-related neurodegeneration. Methods: Literature search was conducted in PubMed, Web of Science, and Scopus databases from inception to 28 March 2023. Longitudinal studies investigating the association between baseline objectively-measured sleep parameters and cognitive decline were assessed for eligibility. Results: Seventeen studies were included in the qualitative synthesis. Sleep fragmentation, reduced sleep efficiency, reduced REM sleep, increased light sleep, and sleep-disordered breathing were identified as predictors of cognitive decline. Sleep duration exhibited a U-shaped relation with subsequent neurodegeneration. Additionally, several sleep microstructural parameters were associated with cognitive decline, although inconsistencies were observed across studies. Conclusions: These findings suggest that sleep alterations hold promise as early biomarker of cognitive decline, but the current evidence is limited due to substantial methodological heterogeneity among studies. Further research is necessary to identify the most reliable sleep parameters for predicting cognitive impairment and AD, and to investigate interventions targeting sleep that can assist clinicians in the early recognition and treatment of cognitive decline. Standardized procedures for longitudinal studies evaluating sleep and cognition should be developed and the use of continuous sleep monitoring techniques, such as actigraphy or EEG headband, might be encouraged
Burnout and perceived stress among Italian physical therapists during the COVID-19 pandemic: a cross-sectional study
: High levels of burnout and psychological distress have been reported for healthcare workers, with seemingly worse outcomes after the outbreak of the COVID-19 pandemic. However, to date, scarce evidence has been gathered about the condition of physical therapists. This cross-sectional study investigated the three burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment as measured by the Maslach Burnout Inventory (MBI) and assessed perceived stress with the 10-item Perceived Stress Scale (PSS) in a sample of Italian physical therapists with the aim of examining the relationships between these variables and demographic and work-related factors. An anonymous questionnaire was administered to a convenience sample of 671 professionals from the whole nation and associations between burnout, perceived stress, and work-related variables were investigated with descriptive and inferential statistical methods. Overall, 25% of the participants showed high burnout risk (40% scored high on emotional exhaustion, 36% scored high on depersonalization, and 19% scored low on personal accomplishment), whereas 50% reported high levels of perceived stress. Having been exposed to verbal or physical aggressive behaviors at work (OR = 4.06) was associated with high burnout risk, and participants at risk were significantly younger than those showing no burnout risk (d = 0.27). Having a partner (OR = 0.54) and having children (OR = 0.56) were associated on the other hand with reduced burnout risk. Regression models identified weekly working hours (β = 0.16), exposure to aggressive behaviors at work (β = 0.12), and perceived stress (β = 0.66) as significant predictors of emotional exhaustion, gender (β = 0.18), exposure to aggressive behaviors (β = 0.09), and perceived stress (β = 0.37) as predictors of depersonalization, and gender (β=-0.1) and perceived stress (β=-0.35) as predictors of personal accomplishment.In summary, this study found high rates of burnout and psychological distress among Italian physical therapists a year after the outbreak of COVID-19. Significant relations were found between burnout, psychological distress, and both socio-demographic and work-related variables
Sleep Quality and Its Associations with Physical and Mental Health-Related Quality of Life among University Students: A Cross-Sectional Study
The association between sleep problems and quality of life has been well documented and the COVID-19 pandemic seemingly had an impact on both sleep quality and health-related quality of life (HRQoL). However, recent evidence about this relationship among university students is limited. The aims of this study are to investigate the prevalence of poor sleep quality and insomnia and to explore the associations between these outcomes, perceived stress, and HRQoL among Italian university students. An anonymous questionnaire comprising the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, the Short Form-12 health survey, and the Perceived Stress Scale was administered to a convenience sample of 1279 students (1119 females and 160 males, mean age: 23.4 ± 2.5 years) attending one of the largest Italian universities. A total of 65% of the participants showed poor sleep quality, whereas 55% reported insomnia symptoms. Students reporting poor sleep quality and insomnia obtained higher perceived stress scores and lower physical and mental HRQoL scores. Controlling for health-related variables and perceived stress, hierarchical regression analyses showed that sleep quality components added a significant contribution to the prediction of both physical (ΔR2 = 0.1) and mental (ΔR2 = 0.02) HRQoL. As a whole, these findings confirm the relevance of sleep for university students’ well-being and might inform the development of health promotion interventions for this population
Going Beyond Counting First Authors in Author Co-citation Analysis
The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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