Neurologic and Neuropsychological Outcomes for Treatment of Unruptured Middle Cerebral Artery Aneurysms: Standard Pterional Versus Minipterional Approach in a Retrospective Single-Center Analysis.

BACKGROUND: In accordance with technique advancement and minimal invasiveness surgical approaches, the minipterional has progressively replaced the standard pterional approach for treatment of unruptured middle cerebral artery (MCA) aneurysms. Nowadays, multimodal intraoperative resources including microDoppler and microflow probes, indocyanine green videoangiography, and neurophysiologic monitoring constitute a fundamental prerequisite for increasing the safety of the clipping procedure. Our study investigated and compared in a single-center experience the effect of the evolution of a minimally invasive and multimodal approach in unruptured MCA aneurysm surgery by measuring postoperative complication rate, recovery time, and long-term neuropsychological and functional outcomes. METHODS: One hundred and thirty-one patients who underwent surgical treatment for unruptured MCA aneurysms at our institution were evaluated retrospectively. Patients' clinical, radiologic, and surgical reports were collected. Cognitive evaluation and quality of life were assessed through validated tests in telephone interviews. Patients who met the inclusion criteria were divided into 2 groups: "PT (pterional)" and "MPT (minipterional)." RESULTS: Ninety-two patients were included in the analysis. A significant reduction of postoperative complication rates and new-onset postoperative seizures was recorded in the MPT group (P value = 0.006). Severe cognitive deficits were lower in the MPT group, although without a clear statistical correlation. CONCLUSIONS: Decreased complication rates, faster recovery time, and a trend toward better cognitive and functional performances were documented for the MPT group of patients. In our experience, the minipterional approach with multimodality-assisted microsurgery reduced neurologic complications and recovery time and improved long-term cognitive outcome and quality of life.

Strategies used during the cognitive evaluation of older adults with dual sensory impairment: a scoping review.

BACKGROUND: Dual sensory impairment (DSI), the combination of visual and hearing impairments, is associated with increased risk for age-related cognitive decline and dementia. Administering cognitive tests to individuals with sensory impairment is challenging because most cognitive measures require sufficient hearing and vision. Considering sensory limitations during cognitive test administration is necessary so that the effects of sensory and cognitive abilities on test performance can be differentiated and the validity of test results optimized. OBJECTIVE: To review empirical strategies that researchers have employed to accommodate DSI during cognitive testing of older adults. METHODS: Seven databases (MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, Global Health and the Evidence-Based Medicine Reviews databases) were searched for relevant articles integrating the three concepts of cognitive evaluation, aging, and DSI. Given the inclusion criteria, this scoping review included a total of 67 papers. RESULTS: Twenty-eight studies reported five categories of strategies for cognitive testing of older adult participants with DSI: the assistance of experts, the modification of standardized test scoring procedures, the use of communication strategies, environmental modifications, and the use of cognitive tests without visual and/or auditory items. CONCLUSIONS: The most used strategy reported in the included studies was drawing on the assistance of team members from related fields during the administration and interpretation of cognitive screening measures. Alternative strategies were rarely employed. Future research is needed to explore the knowledge-to-practice gap between research and current clinical practice, and to develop standardized testing strategies.

Cognitive evaluation and rehabilitation in high- and low-income countries.

Starting from her own personal experience, in the First Part of the article, the author reconstructs how the specialized sectors of cognitive evaluation and rehabilitation evolved in Western countries (Europe, the United States, Canada, and Australia, in particular) during the second half of the last century and the first decades of this century. In the Second Part, she describes her personal experience in setting up a rehabilitation centre dedicated to traumatic brain-injured subjects and her commitment to international cooperation (Bolivia, Rwanda, Myanmar, Tanzania) in the field of cognitive evaluation and rehabilitation in favour of people with congenital and acquired cerebral pathology, especially in the paediatric age, since there is an almost total lack of diagnostic, but above all, rehabilitative procedures for cognitive functions in low-middle income countries. In the Third Part of the article, the author carries out an extensive review of the international literature on the differences in access to cognitive diagnostic evaluation and cognitive rehabilitation in middle- and low-income countries - but not only - underlining the urgent need to launch a major international collaborative effort to reduce and eliminate these discrepancies.

Neuropsychological measures of post-COVID-19 cognitive status.

Background: COVID-19 may result in persistent symptoms in the post-acute phase, including cognitive and neurological ones. The aim of this study is to investigate the cognitive and neurological features of patients with a confirmed diagnosis of COVID-19 evaluated in the post-acute phase through a direct neuropsychological evaluation. Methods: Individuals recovering from COVID-19 were assessed in an out-patient practice with a complete neurological evaluation and neuropsychological tests (Mini-Mental State Examination; Rey Auditory Verbal Test, Multiple Feature Target Cancellation Test, Trial Making Test, Digit Span Forward and Backward, and Frontal Assessment Battery). Pre- and post-COVID-19 global and mental health status was assessed along with the history of the acute phase of infection. Post-COVID-19 cognitive status was modeled by combining persistent self-reported COVID-related cognitive symptoms and pathologic neuropsychological tests. Results: A total of 406 individuals (average age 54.5 ± 15.1 years, 45.1% women) were assessed on average at 97.8 ± 48.0 days since symptom onset. Persistent self-reported neurological symptoms were found in the areas of sleep (32%), attention (31%), and memory (22%). The MMSE mean score was 28.6. In total, 84 subjects (20.7%) achieved pathologic neuropsychological test results. A high prevalence of failed tests was found in digit span backward (18.7%), trail making (26.6%), and frontal assessment battery (10.9%). Cognitive status was associated with a number of factors including cardiovascular disease history, persistent fatigue, female sex, age, anxiety, and mental health stress. Conclusion: COVID-19 is capable of eliciting persistent measurable neurocognitive alterations particularly relevant in the areas of attention and working memory. These neurocognitive disorders have been associated with some potentially treatable factors and others that may stratify risk at an early stage.

A New Validation of Montreal Cognitive Assessment on a Large Sample of Elderly Patients Undergoing Elective Orthopedic Surgery.

Objective: The hip and knee arthroplasties are reliable and suitable surgical procedures aimed at restoring the patients' functioning. The most representative age range for these replacement surgeries is between 65 and 84 years for females. With aging, the likelihood of developing cognitive deficits increases, and there is evidence that elderly patients undergoing surgery orthopedic are at higher risk of developing cognitive problems in the postoperative phase. The Montreal Cognitive Assessment (MoCA) is often used for cognitive evaluation, but different cut-offs and validations are available in the literature. Given the importance of the problem, in this work we studied a hospitalized population candidate for orthopedic surgery to determine a new specific validation of the MoCA to assess the risk of MCI. Method: We applied MoCA and Mini-Mental State Examination (MMSE) to a sample of 492 (333 women) hospitalized patients for knee (74%) or hip surgery. A non-parametric receiver operating characteristic (ROC) curve analysis was conducted to investigate the predictive accuracy of the MoCA to assess cognitive impairment, using MMSE as the gold standard. Results: A score of 22.52 gives a sensitivity of 70% and a specificity of 78%. This value is providing a more coherent diagnosis with the MMSE as compared to the other cut-offs presented in the other available validations. No differences were found between patients in terms of age and gender, suggesting a general uniformity of the selected sample. Conclusions: Deepening the coherence in MCI diagnosis between MMSE and the other MoCA's scoring considered, our new cut-off seems reasonably better than previous Italian validation on an elderly population in matching MMSE classification.

Cognitive outcomes after multimodal treatment in adult glioma patients: A meta-analysis.

BACKGROUND: Cognitive functioning is increasingly assessed as a secondary outcome in neuro-oncological trials. However, which cognitive domains or tests to assess, remains debatable. In this meta-analysis, we aimed to elucidate the longer-term test-specific cognitive outcomes in adult glioma patients. METHODS: A systematic search yielded 7098 articles for screening. To investigate cognitive changes in glioma patients and differences between patients and controls 1-year follow-up, random-effects meta-analyses were conducted per cognitive test, separately for studies with a longitudinal and cross-sectional design. A meta-regression analysis with a moderator for interval testing (additional cognitive testing between baseline and 1-year posttreatment) was performed to investigate the impact of practice in longitudinal designs. RESULTS: Eighty-three studies were reviewed, of which 37 were analyzed in the meta-analysis, involving 4078 patients. In longitudinal designs, semantic fluency was the most sensitive test to detect cognitive decline over time. Cognitive performance on mini-mental state exam (MMSE), digit span forward, phonemic and semantic fluency declined over time in patients who had no interval testing. In cross-sectional studies, patients performed worse than controls on the MMSE, digit span backward, semantic fluency, Stroop speed interference task, trail-making test B, and finger tapping. CONCLUSIONS: Cognitive performance of glioma patients 1 year after treatment is significantly lower compared to the norm, with specific tests potentially being more sensitive. Cognitive decline over time occurs as well, but can easily be overlooked in longitudinal designs due to practice effects (as a result of interval testing). It is warranted to sufficiently correct for practice effects in future longitudinal trials.

Sleep Parameters and Plasma Biomarkers for Cognitive Impairment Evaluation in Patients With Cerebral Small Vessel Disease.

OBJECTIVES: Cognitive impairment caused by cerebrovascular disease accounts for more than half of vascular dementia. However, neuropsychological tests are limited by their subjectivity. Additional effective approaches to evaluate cognitive impairment in patients with cerebrovascular disease are necessary. METHOD: One hundred and thirty-two patients with cerebrovascular disease were recruited. One hundred participants met the criteria and completed neuropsychological scales. Sixty-nine participants proceeded with polysomnography, and 63 of them had their peripheral blood biomarkers measured. According to Mini-Mental State Examination scores, patients were divided into cognitively impaired and cognitively normal groups. The differences in biomarkers and sleep parameters between the groups were compared, and decision tree models were constructed to evaluate the evaluation ability of these indicators on cognitive decline. RESULTS: The integrated decision tree model of sleep parameters yielded an area under curve (AUC) of 0.952 (95% confidence interval [CI]: 0.911-0.993), while that of plasma biomarkers yielded an AUC of 0.872 (95% CI: 0.810-0.935) in the assessment of cognition status. Then the participants were automatically clustered into mild and severe cognitive impairment groups by multiple neuropsychological test results. The integrated plasma biomarker model showed an AUC of 0.928 (95% CI: 0.88-0.977), and the integrated sleep parameter model showed an AUC of 0.851 (95% CI: 0.783-0.919) in the assessment of mild/severe cognitive impairment. DISCUSSION: Integrated models which consist of sleep parameters and plasma biomarkers can accurately evaluate dementia status and cognitive impairment in patients with cerebral small vessel disease. This innovative study may facilitate drug development, early screening, clinical diagnosis, and prognosis evaluation of the disease.

Psychometric properties of the Cognitive Appraisal Inventory for Patients with Chronic Pain in Mexican population / Propiedades psicométricas del Inventario de Evaluación Cognoscitiva para pacientes con dolor crónico en población mexicana

Abstract Introduction Cognitive assessment is the process whereby individuals assess the effect an adverse circumstance has on their well-being (primary assessment) and their ability to cope with it (secondary assessment), which is closely related to the emotional and behavioral response they show as a result. Objective To determine the validity and internal consistency of the Spanish version of the Cognitive Assessment Inventory (CAI) for patients with chronic pain for Mexican population. Method A total of 191 adults with chronic pain completed the Spanish version of the CAI, as well as self-report measures of disability, daily activities, anxiety, and depression. Results The confirmatory factor analysis for each type of primary cognitive assessment included in the CAI yielded models with satisfactory goodness of fit and Cronbach's α indices (loss/damage: CMIN/DF = 1.132, NFI = .935, CFI = .992, AGFI = .939, SRMR = .046, RMSEA = .026, α = .73; threat: CMIN/DF = 1.132, NFI = .935, CFI = .992, AGFI = .939, SRMR = .046, RMSEA = .026, α = .81; and challenge: CMIN/DF = 1.567, NFI = .939, CFI = .977, AGFI = .926, SRMR = .044, RMSEA = .055, α = .86). Cognitive assessments of loss/harm and threat were positively associated with the degree of disability, depression, and anxiety, and negatively associated with the performance of daily activities. The opposite occurred with the cognitive assessment of challenge. Discussion and conclusion The Spanish version of the CAI is a valid, quick, easy, and reliable tool for evaluating the primary cognitive assessment of pain, a construct closely related to physical disability and emotional suffering in response to this experience, which may be modified through brief cognitive interventions.

Resumen Introducción La evaluación cognoscitiva es el proceso mediante el cual un individuo valora el efecto que ejerce una circunstancia adversa en su bienestar (evaluación primaria) junto con las capacidades con que cuenta para afrontarla (evaluación secundaria), con ello guarda una estrecha relación con la respuesta emocional y conductual que despliega en consecuencia. Objetivo Determinar la validez y consistencia interna de la versión en español del Inventario de Evaluación Cognoscitiva (IEC) para pacientes con dolor crónico en población mexicana. Método Un total de 191 adultos con dolor crónico completaron la versión en español del IEC, así como medidas de autorreporte de discapacidad, actividades cotidianas, ansiedad y depresión. Resultados El análisis factorial confirmatorio para cada tipo de evaluación cognoscitiva primaria incluida en el IEC arrojó modelos con índices de bondad de ajuste y α de Cronbach satisfactorios (pérdida/daño: CMIN/DF = 1.132, NFI = .935, CFI = .992, AGFI = .939, SRMR = .046, RMSEA = .026, α = .73; amenaza: CMIN/DF = 1.132, NFI = .935, CFI = .992, AGFI = .939, SRMR = .046, RMSEA = .026, α = .81; y desafío: CMIN/DF = 1.567, NFI = .939, CFI = .977, AGFI = .926, SRMR = .044, RMSEA = .055, α = .86). Las evaluaciones cognoscitivas de pérdida/daño y de amenaza se asociaron positivamente con el grado de discapacidad, depresión y ansiedad, y de forma negativa con la ejecución de actividades cotidianas. Lo contrario ocurrió con la evaluación cognoscitiva de desafío. Discusión y conclusión La versión en español de la IEC es una herramienta fácil, rápida, válida y confiable para evaluar la evaluación cognoscitiva primaria del dolor, constructo íntimamente relacionado con la discapacidad física y el sufrimiento emocional ante esta experiencia susceptible de modificación mediante intervenciones cognoscitivas breves.

The correlation between neutrophil-to-lymphocyte ratio, carcinoembryonic antigen, and carbohydrate antigen 153 levels with chemotherapy-related cognitive impairment in early-stage breast cancer patients.

Background: The changes in inflammation and tumor biomarkers are associated with the anti-tumor immunological processes. Early detection and intervention are of great significance to the clinical management of cancer-related diseases. Peripheral blood biomarkers [e.g., neutrophil-to-lymphocyte ratio (NLR), carcinoembryonic antigen (CEA), and carbohydrate antigen 153 (CA153)] are obtained in real-timely, conveniently, and less invasively, and proved to availably predicted the disease states and prognosis of various cancers, including breast cancer (BC). Inflammation and poor disease management promote cognitive impairment. Chemotherapy-related cognitive impairment (CRCI) hazard long-term survival and quality of life (QOL) of BC patients, but its correlation with NLR, CEA, and CA153 is not clear. Purpose: This study aimed to investigate changes in NLR, CEA, and CA153 levels before and after chemotherapy and their correlation with CRCI in patients with early-stage BC. Materials and methods: The 187 patients with BC who were measured for NLR, CEA, and CA153 values within the first 24 hours of admission, were assigned into two groups: the before/after chemotherapy group (BCG/ACG). The ACG was assigned into two subgroups based on the cognitive assessment results: the cognitive normal/impaired group (CNG/CIG). Patients' self-perceived cognitive impairments were evaluated using a mini-mental state examination (MMSE), prospective and retrospective memory (PM and RM) questionnaire (PRMQ), and functional assessment of cancer therapy-cognitive function version 3 (FACT-Cog, version 3, including CogPCI, CogOth, CogPCA, and CogQOL). Their QOL was also evaluated. Results: The NLR and CA153 levels were elevated after chemotherapy (BCG vs ACG: Z = -1.996 and -1.615, P = 0.046 and 0.106, respectively), and significantly elevated in patients with CRCI (BCG vs CIG: Z = -2.444 and -2.293, P = 0.015 and 0.022; respectively). However, there was not reach significant difference in CEA levels between the four groups. In addition, there was a weak to moderate correlation between peripheral blood biomarkers (NLR, CEA, and CA153) levels and CRCI (r = -0.404, -0.205, -0.322; respectively; P < 0.001). Cognitive impairment scores (MMSE, PM, RM, and FACT-Cog) had a strong correlation with QOL in patients with early-stage BC (r = -0.786, 0.851, 0.849, and 0.938; respectively; P < 0.001). Conclusion: NLR and CA153 m be valuable diagnostic adjuncts of CRCI, and CRCI has a strong correlation with QOL in patients with early-stage BC.

Effects of Organ System Courses of the First Two Years of Medical School on the Performance of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 2-Cognitive Evaluation.

OBJECTIVES: The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 2-Cognitive Evaluation (CE) is a board examination that medical students usually take in the third or fourth year of medical school. A few researchers have investigated the prediction of COMLEX Level 2-CE scores based on the performance in third-year clerkships. However, given how close the clerkships are to the board exam, this type of prediction is too late for students to have adequate time to get assistance to prepare for COMLEX Level 2-CE. We aimed to investigate the predictive value of each organ system course during the first two years in predicting COMLEX Level 2-CE performance. Our findings will help students at risk focus on important basic and clinical sciences much earlier before preparing for COMLEX Level 2-CE. METHODS: Academic data from students enrolled at Rocky Vista University College of Osteopathic Medicine from 2011 to 2017 were retrieved. Data included the Medical College Admission Test (MCAT) scores, course grades in the first two years of medical school, COMLEX Level 1 scores, and COMLEX Level 2-CE scores. Pearson correlation coefficients, a multiple linear regression model, and a backward stepwise regression model were generated for analysis. RESULTS: The highest correlation with COMLEX Level 2-CE scores was the COMLEX Level 1 score, followed by the performances in the third-semester Cardiovascular System II (CV II) and Renal System II (REN II) courses. Multiple linear regression and backward stepwise regression predictive models found that scores on third-semester CV II and Principles of Clinical Medicine III (PCM III) were the most significant predictors of performance on Level 2-CE. Both models explained 46% of the variance in COMLEX Level 2-CE scores. CONCLUSIONS: Performances in third-semester courses are the most important predictors of COMLEX Level 2-CE scores.

The Impact of Positive Verbal Rewards on Organizational Citizenship Behavior-The Mediating Role of Psychological Ownership and Affective Commitment.

Organizational citizenship behavior (OCB) can foster organizational competitiveness and survival especially, facing a rapidly changing environment. There are some empirical pieces of research that shed light on the effects of OCB on extrinsic rewards, since OCB, through performance appraisal, affects extrinsic rewards which will influence OCB as well. However, researchers have overlooked the reverse effect of extrinsic rewards (i.e., positive verbal rewards) on OCB. It is necessary to explore the mechanism between positive verbal rewards and OCB. This study integrated psychological ownership and affective commitment to form a structural model based on social exchange theory and cognitive evaluation theory. These results show that positive verbal rewards are positively correlated with psychological ownership, psychological ownership is positively correlated with affective commitment and OCB, and affective commitment is positively correlated with OCB. As refers to the mediating effects, psychological ownership fully mediates the relationship between positive verbal rewards and affective commitment. Furthermore, affective commitment plays a partial mediating role in the effect of psychological ownership on OCB. Accordingly, this psychological mechanism between positive verbal rewards and OCB reveals important theoretical and practical implications.

A Questionnaire on Relative Deprivation of University Students and Its Application in Measuring Mental Health.

Objective: Relative deprivation is associated with collective and individual variables in psychology. However, so far, there are few studies on measuring the relative deprivation of university students. Therefore, this study designs the University Students' Relative Deprivation Questionnaire (USRDQ), verifies its validity and reliability, and then uses it to measure the mental health of students. Methods: After reviewing the relevant studies and conducting a theoretical analysis and an open questionnaire survey, this article determined the structural dimension of USRDQ. A total of 103 university students were selected to take the open questionnaire survey, 200 were selected to engage in the item analysis, exploratory factor analysis, and internal consistency reliability test, 257 were selected to engage in the confirmatory factor analysis, and 287 were selected to take the retest reliability. Results: The USRDQ includes 19 items under the three dimensions, namely, social comparison, cognitive evaluation, and emotional experience. Factor loads range from 0.49 to 0.87, which accounted for 63.39% of the total variation. The questionnaire has good fitting indicators (χ2/df = 2.64, NFI = 0.89, CFI = 0.93, GFI = 0.91, RMSEA = 0.08). The Cronbach's α coefficient of the questionnaire is 0.916, and the coefficients of the three factors range from 0.805 to 0.934. The results of the survey show that the relative deprivation of students is quite high with a mean of 76.78 and a standard deviation of 16.96.

Food neophobia and the evaluation of novel foods in adults; the sensory, emotional, association (SEA) model of the decision to taste a novel food.

Reluctance to eat new foods, known as food neophobia, is well researched in children but not adults. Two studies were carried out to understand the emotional, sensory, and cognitive factors associated with food neophobia in an adult sample, and to propose a preliminary explanation of the decision to taste a novel food named the SEA model (Sensory, Emotional, cognitive Association model). Participants were recruited through opportunity sampling of a university population in the Leicester region of the UK. Study one (n = 534) was a cross sectional study examining associations between self-report measures of food neophobia, emotional variables and sensory variables. In study two (n = 160), participants completed an online cognitive evaluation of 7 images of novel fruits and vegetables, rating perceived familiarity, categorisation as fruit or vegetable, cognitive associations based on appearance (what does the food look like), liking of any associated foods, and expected liking of the novel food. In study 1 it was found that tactile sensitivity and disgust sensitivity were the main sensory and emotional variables associated with food neophobia. In study 2, it was found that food neophobia and lower expected liking of novel foods were associated with disgust sensitivity, associating the novel foods with disliked foods, and lower perceived familiarity. The SEA model further proposes that underlying tendencies and automatic reactions to foods, combine with cognitive associations based on negative memories and negative beliefs about tasting new foods, to create expected disliking of a food and a decreased likelihood that it will be tried. Further work is needed to fully test the SEA model of the decision to taste a novel food, in particular to further examine how associations are formed.

A cognitive evaluation and equity-based perspective of pay for performance on job performance: A meta-analysis and path model.

Pay for performance, as one of the most important means of motivating employees, has attracted the attention of many scholars and managers. However, controversy has continued regarding whether it promotes or undermines job performance. Drawing on a meta-analysis of 108 independent samples (N = 71,438) from 100 articles, we found that pay for performance was positively related to job performance. That pay for performance had a more substantial positive effect on task performance than contextual performance in workplace settings. From the cognitive evaluation perspective, we found that pay for performance enhanced employees' task performance and contextual performance by enhancing intrinsic motivation and weakened task performance and contextual performance by increasing employee pressure. From the equity perspective, our results indicated that the relationship between pay for performance and task performance was partially mediated by employee perceptions of distributive justice and procedural justice, with distributive justice having a more substantial mediating effect than procedural justice. However, the relationship between pay for performance and contextual performance was only partially mediated by procedural justice. Further tests of moderating effects indicated that the varying impacts of pay for performance are contingent on measures of pay for performance and national culture. The findings contributed to understanding the complex mechanisms and boundary conditions of pay-for-performance's effects on job performance, which provided insights for organizations to maximize its positive effects.

Social Robots for Evaluating Attention State in Older Adults.

Sustained attention is essential for older adults to maintain an active lifestyle, and the deficiency of this function is often associated with health-related risks such as falling and frailty. The present study examined whether the well-established age-effect on reducing mind-wandering, the drift to internal thoughts that are seen to be detrimental to attentional control, could be replicated by using a robotic experimenter for older adults who are not as familiar with online technologies. A total of 28 younger and 22 older adults performed a Sustained Attention to Response Task (SART) by answering thought probes regarding their attention states and providing confidence ratings for their own task performances. The indices from the modified SART suggested a well-documented conservative response strategy endorsed by older adults, which were represented by slower responses and increased omission errors. Moreover, the slower responses and increased omissions were found to be associated with less self-reported mind-wandering, thus showing consistency with their higher subjective ratings of attentional control. Overall, this study demonstrates the potential of constructing age-related cognitive profiles with attention evaluation instruction based on a social companion robot for older adults at home.

The Journey of Business Opportunity Evaluation: When and Why Does Opportunity Novelty Promote Vs. Inhibit Opportunity Adoption?

As a typical characteristic of entrepreneurial opportunities, novelty is essential for firms to establish and maintain a sustainable competitive advantage under the current complex and dynamic business environment. However, why is it that some entrepreneurs adopt novel opportunities but others do not. Little is known about the precise nature of cognitive evaluation for opportunity novelty. Drawing upon information processing theory and construal level theory (CLT), we propose that the effects of opportunity novelty on adoption decisions depend on entrepreneurs' construal level through which information is processed. We design an experiment and find partial support for our hypotheses. Results indicate that entrepreneurs using a low-level construal perceive more risk for opportunity novelty, which in turn decreases the possibility of opportunity adoption. Meanwhile, opportunity novelty also positively influences entrepreneurs' creativity perception, which in turn increases the possibility of opportunity adoption. But construal level does not play any role in this evaluation path. Taken together, the findings improve our understanding of "how entrepreneurs evaluate an opportunity based on its objective characteristics" by providing empirical insights into the cognitive information processing process from opportunity novelty to adoption. Additionally, we discuss implications for entrepreneurial practice and future research.

Risk Assessment During Longitudinal Progression of Cognition in Older Adults: A Community-based Bayesian Networks Model.

BACKGROUND: Cognitive dysfunction, particularly in Alzheimer's disease (AD), seriously affects the health and quality of life of older adults. Early detection can prevent and slow cognitive decline. OBJECTIVE: This study aimed at evaluating the role of socio-demographic variables, lifestyle, and physical characteristics in cognitive decline during AD progression and analyzing the probable causes and predicting stages of the disease. METHODS: By analyzing data of 301 subjects comprising normal elderly and patients with mild cognitive impairment (MCI) or AD from six communities in Taiyuan, China, we identified the influencing factors during AD progression by a Logistic Regression model (LR) and then assessed the associations between variables and cognition using a Bayesian Networks (BNs) model. RESULTS: The LR revealed that age, sex, family status, education, income, character, depression, hypertension, disease history, physical exercise, reading, drinking, and job status were significantly associated with cognitive decline. The BNs model revealed that hypertension, education, job status, and depression affected cognitive status directly, while character, exercise, sex, reading, income, and family status had intermediate effects. Furthermore, we predicted probable cognitive stages of AD and analyzed probable causes of these stages using a model of causal and diagnostic reasoning. CONCLUSION: The BNs model lays the foundation for causal analysis and causal inference of cognitive dysfunction, and the prediction model of cognition in older adults may help the development of strategies to control modifiable risk factors for early intervention in AD.