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Abstract Background Sedentary lifestyles may affect cognitive capacities which are essential for daily tasks. There is a lack of research on the effects of replacing sedentary behaviour with physical activity on executive function, as well as the dose–response relationship between physical activity and executive function among young adults, underscoring the critical need for prompt investigation. Methods Employing a longitudinal experimental design, the study conducted two assessments (baseline and at three months) on a cohort of participants. A total of 78 young adults with a mean age of 25 years old were recruited for the study. Physical activity and sedentary behaviour were measured using accelerometer, which provided objective data on the intensity and duration of the participants’ daily activity. Executive function was measured using the Trail Making Test (TMT). An isotemporal substitution model was employed to analyze the effects of replacing sedentary time with physical activity of different intensities. Additionally, mixed-effect models were used to explore the dose–response relationships between physical activity, sedentary behaviour, and executive function. Results The reallocation of 30 min of daily time from sedentary behaviour (SED) to light physical activity (LPA) significantly reduced Trail Making Test (TMT) completion times, suggesting improvements in cognitive processing speed. Conversely, shifting the same duration from SED to moderate-to-vigorous physical activity (MVPA) enhanced the accuracy rate on the TMT. Sedentary time was associated with longer TMT completion times but did not significantly affect the accuracy rate. Additionally, a dose–response relationship was observed, with increases in MVPA, caloric expenditure, and step count correlating with shorter TMT completion times. In contrast, increases in LPA and caloric expenditure were associated with higher TMT correct response rates. Conclusion The substitution of sedentary behaviour with physical activity may be a beneficial strategy to enhance executive function among young adults. These results underscore the importance of reducing sedentary time and promoting physical activity in the daily routine of young individuals to support cognitive development. Future research should explore the underlying mechanisms.

Background The sleep characteristics of school-age children have a crucial impact on the development of emotional and behavioral problems. Sleep characteristics also play a role in the development of executive function in school-age children. There is a close relationship between the emergence of emotional and behavioral problems and the development of executive function in these children. Currently, there are few studies on the mediating effect of the relationship between sleep characteristics, executive function, and emotional and behavioral problems in school-age children. Objective To explore the relationship between sleep characteristics, executive function, and emotional and behavioral problems in school-age children, and to examine the mediating role of executive function in the relationship between sleep characteristics and emotional and behavioral problems. Methods From August 21 to October 8, 2021, a convenience sampling method was used to select 516 school-age children from grades 1 to 6 in Xiwu Primary School and the Fourth Experimental Primary School in Shexian County, Handan City, Hebei Province. The Children's Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), and the Behavior Rating Inventory of Executive Function (BRIEF) were used to assess the sleep characteristics, emotional and behavioral problems, and executive function of the school-age children, respectively. Correlation analysis, regression analysis, and mediation analysis were conducted using SPSS 27.0 and the PROCESS 4.1 plugin. Results A total of 516 questionnaires were distributed, and 496 valid questionnaires were recovered, with an effective recovery rate of 96.1%. Correlation analysis showed that the total score of the CSHQ was negatively correlated with the Behavioral Regulation Index (BRI), Metacognition Index (MI), inhibition, shifting, emotional control, task initiation, working memory, planning, organization, and monitoring factors of the BRIEF (P0.05) . Conclusion There is a close relationship between sleep characteristics, executive function, and emotional and behavioral problems in school-age children. Executive function has a complete mediating effect on the relationship between sleep characteristics and emotional and behavioral problems. This finding emphasizes the importance of good sleep for the behavioral and emotional well-being of school-age children and provides new perspectives and intervention approaches for enhancing executive function and overall development in school-age children.

Background Studies have confirmed that executive function in overweight and obese children is closely related to obesity and may have a bidirectional association. Aerobic exercise, as an effective intervention, can effectively promote their brain development and cognitive function, especially executive function, but the quantitative relationship of the improvement effect still needs to be further explored. Objective To systematically evaluate the intervention effect of aerobic exercise on executive function-related indexes in overweight and obese children. Methods Randomized controlled trials of aerobic exercise interventions for executive function in overweight and obese children were searched in CNKI, Wanfang Data, CBM, Cochrane Library, PubMed, Embase, and Web of Science databases, and the timeframe for searching was from the establishment of each database to July 2023. The quality of the included literature was assessed according to the Cochrane Risk of Bias Assessment Tool, and Meta-analysis of outcome indicators was performed using RevMan 5.3 and Stata 15.0 software. Results Nine randomized controlled trials, including 940 overweight and obese children, were finally included. The results of Meta-analysis showed that a single session of aerobic exercise intervention was effective in improving the executive function of overweight and obese children (WMD=-6.98, 95%CI=-11.89 to -2.07, P=0.005). Subgroup analyses showed no significant differences in the improvement of any of the executive function subcomponents in overweight and obese children with a single intervention duration of less than 30 minutes of aerobic exercise (WMD=-0.84, 95%CI=-9.37 to 7.68, P=0.85) ; aerobic exercise with a single intervention duration longer than 30 minutes improved inhibitory function in overweight and obese children (WMD=-10.50, 95%CI=-19.15 to -1.85, P=0.02). When a long-term exercise intervention was carried out (the intervention period was 8 weeks), in contrast to the control group, the aerobic exercise improved interference control in overweight and obese children (WMD=-0.16, 95%CI=-0.18 to -0.14, P

Abstract A positive association between pubertal maturity as assessed by skeletal development, and specific cognitive abilities has recently been demonstrated in a cohort of adolescent girls. The current study explores the impact of chronological age and relative pubertal maturity on executive function within the same cohort. Relative maturity, determined by the difference between chronological age and skeletal age, establishes the criteria for enrolling participants into average, advanced, or delayed relative maturity subgroups. Performance is assessed using the Numerical Stroop test and analyzed across four conditions, each with varying task requirements related to inhibition and task switching. The effects of chronological age and relative maturity on executive functions are tested by a linear mixed model. Within the examined age-range (12–15 y), a more protracted development was found for inhibition as compared to switching. In line with the previous findings, the results reveal significant development in executive performance as a function of chronological age, and relative maturity also demonstrated significant effect on the development of executing functioning. The significant interaction effect between Chronological Age and Relative Maturity suggests that the degree of interplay between these factors varies across the examined age range. Specifically, relative maturity may have a more noticeable impact on EF functioning in middle adolescence compared to early adolescence.

Abstract Background A growing body of literature links prenatal mood and substance use to children's cognitive and behavioral development. The relative contribution of these risk factors on children's executive function (EF) in the context of socioeconomic adversities needs further evaluation. To address this gap, we investigated the role of prenatal maternal anxiety and depression on childhood EF, specifically inhibitory control and working memory, within the context of socioeconomic adversities and prenatal substance use. We hypothesized that higher maternal mood symptoms, higher persistent prenatal drinking and smoking, and lower socioeconomic status would be associated with lower EF skills during early childhood. Methods We used data from 334 mother–child dyads followed prospectively through pregnancy and the offspring’s childhood. Prenatal maternal depression and anxiety were assessed via standardized questionnaires. Prenatal alcohol and tobacco consumption were assessed via a timeline follow-back interview. The EF touch battery assessed child inhibitory control and working memory at 3–5 years of age (4.76 ± 0.58 years, 171 females). Separate linear regression models were used to estimate the association of prenatal tobacco, alcohol, anxiety, and depression exposure with our two components of child EF, inhibitory control and working memory, while adjusting for gestational age, sex, and age at assessment. The following variables were also included as covariates: maternal educational achievement, employment status, parity, and household crowding index. Results Children of mothers with high trait anxiety scores had reduced inhibitory control compared to children of mothers without trait anxiety or depression (β = -0.12, 95% CI:-0.22,-0.01). Children of mothers in the moderate to high continuous smoking group showed lower inhibitory control (β = − 0.19, 95% CI:-0.38,-0.01) compared to children of mothers in the none smoking group. Additionally, lower maternal education and higher household crowding were each associated with reduced inhibitory control. We found no significant association between prenatal maternal depression, anxiety, or socioeconomic factors with working memory. Conclusions These results underscore the need for comprehensive context-specific intervention packages, including mental health support for women to promote healthy inhibitory control development in children.

This study examines the landscape of executive function (EF) assessments for Indonesian adolescents, focusing on their psychometric properties. The adolescent development phase, marked by cognitive growth, presents opportunities and risks, especially in education settings where well-developed EF is beneficial. This research used a qualitative approach, with a systematic literature review method using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis), analyzing peer-reviewed empirical studies from databases such as SCOPUS and others, focusing on EF measurements for adolescents in Indonesia from 2014 to 2024. Nine studies met the inclusion criteria, highlighting tools like the Behavior Rating Inventory of Executive Function (BRIEF)-Indonesian version, Executive Skills Questionnaire-Revised (ESQ-R), Executive Function Questionnaire (EFQ), and performance-based measures like the Wisconsin Card Sorting Test and Stroop Test. Using content analysis, this study reveals that while the BRIEF is widely used in clinical studies, its applicability in educational settings requires improvement. The findings highlight the importance of adapting EF tools with cultural sensitivity and developing new comprehensive assessments with clear psychometric properties regarding all critical EF components. In recommendations, the study pinpoints a multi-method approach combining inventory-based and performance-based measures to provide a thorough understanding of EF while maintaining practicality for educational settings. The implications for advancing EF research and practice in Indonesia, particularly in education, are discussed, emphasizing the need for reliable, valid, culturally sensitive, and accessible assessment tools.

BackgroundComorbid attention-deficit/hyperactivity disorder （ADHD） and emotional dysregulation may represent a distinct subtype of ADHD， which is characterized by an increased risk of anxiety or depressive disorder and a poor clinical prognosis， so research is urgently required to explore its unique executive functioning profile and clinical characteristics. However， there is limited research comparing the clinical symptoms and executive function in children with ADHD in terms of the presence or absence of emotional dysregulation.ObjectiveTo explore the executive function and clinical characteristics of ADHD children with emotional dysregulation.MethodsFrom June 2020 to December 2023， 118 children aged 7 to 12 with ADHD attending the Mental Health Center of West China Hospital， Sichuan University and fulfilling the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria were enrolled. Children were classified into emotional dysregulation group （n=68） and non-emotional dysregulation group （n=50） based on the standard T-scores of Achenbach's Child Behavior Checklist （CBCL）- anxious/depressed， aggressive behavior and attention problems subscales. All children were then subjected to complete the Chinese version of Swanson Nolan and Pelham，Version IV Scale-parent form （SNAP-IV）， Chinese Wechsler Intelligence Scale for Children （C-WISC）， Weiss Functional Impairment Scale-Parent form （WFIRS-P） and 4 tests of the Cambridge Neuropsychological Test Automated Battery （CANTAB）： ①Stockings of Cambridge （SOC） testing spatial planning. ②Intradimensional-extradimensional Set Shifting（IED） testing cognitive/attentional flexibility， adjusting the total errors across the task. ③Spatial Working Memory （SWM） testing spatial working memory. ④Rapid Visual Information Processing （RVP） testing sustained attention.ResultsThe SNAP-IV Inattention， Hyperactivity/Impulsivity and Oppositional Defiant Disorder domain scores and total score were all higher in emotional dysregulation group compared with non-emotional dysregulation group （t=3.206， 5.088， 6.316， 6.553， P

Abstract Patients with mental illnesses, particularly psychosis and obsessive‒compulsive disorder (OCD), frequently exhibit deficits in executive function and visuospatial memory. Traditional assessments, such as the Rey‒Osterrieth Complex Figure Test (RCFT), performed in clinical settings require time and effort. This study aimed to develop a deep learning model using the RCFT and based on eye tracking to detect impaired executive function during visuospatial memory encoding in patients with mental illnesses. In 96 patients with first-episode psychosis, 49 with clinical high risk for psychosis, 104 with OCD, and 159 healthy controls, eye movements were recorded during a 3-min RCFT figure memorization task, and organization and immediate recall scores were obtained. These scores, along with the fixation points indicating eye-focused locations in the figure, were used to train a Long Short-Term Memory + Attention model for detecting impaired executive function and visuospatial memory. The model distinguished between normal and impaired executive function, with an F 1 score of 83.5%, and identified visuospatial memory deficits, with an F 1 score of 80.7%, regardless of psychiatric diagnosis. These findings suggest that this eye tracking-based deep learning model can directly and rapidly identify impaired executive function during visuospatial memory encoding, with potential applications in various psychiatric and neurological disorders.

Abstract Background The present study aims to investigate the potential impact of eight sessions of Multiple Object Tracking (MOT) training on the executive function in basketball players. The purpose of the study was primarily to observe the effects of MOT training with and without feedback on the executive function of basketball players. Methods A sample of fifty-eight participants was selected from college students enrolled in a university basketball special selection class. The participants were divided into three equal groups. The first group received MOT training with instant feedback and was called feedback group, the second group received MOT training without instant feedback and was called no feedback group, and the third group did not receive any intervention and was called control group. Results After eight sessions of MOT training, feedback group demonstrated the best performance in the Go/No-go task and the 3-back task. After eight sessions of MOT training, there was no significant difference in test scores on the Stroop task between the feedback and no feedback groups. There was also no significant difference in test scores between the feedback and no feedback groups on the 2-back task after eight sessions of MOT training. The findings of this study suggest that MOT training can effectively enhance the executive function of basketball players. Conclusions MOT training was found to enhance the executive function of basketball players, irrespective of whether they received instant feedback. However, the feedback group exhibited superior improvements in the Go/No-go task and the 3-back task.

Abstract The complexity of psychological mechanisms in disordered eating behaviours was tested using a nonclinical sample (female adults from English speaking countries, N = 334). Concerning the development and maintenance of disturbed cognition and eating behaviour, theories of self‐esteem, executive function, and emotion regulation as well as interpersonal and transdiagnostic theories and theory of mind were applied with covariates of depression, anxiety, family functioning, and demographic variables. Structural Equation Modelling demonstrated seven variables mediated the impact of self‐esteem upon disordered eating. The theory of mind variable, when measured on the emotion recognition component, was a significant mechanism in explaining both anorexic eating and shape concerns, and bulimic symptoms. Meanwhile, thwarted belongingness, social evaluation, social conflict, and executive function—cognitive flexibility—were suggested mechanisms for shape and weight concerns, and restrictive eating. In contrast, emotion regulation and another executive function variable of negative urgency appeared as mechanisms of bulimic symptoms and behaviours.

IntroductionAs adolescent smoking rates rise, its impact on cognitive function has drawn greater attention. This study explores whether exercise can mitigate the negative effects of smoking on executive function in male college students.MethodsSixty male college students were divided into four groups (n = 15 each): sedentary smokers, sedentary nonsmokers, athletic smokers, and athletic nonsmokers. All participants completed the Eriksen flanker task, with prefrontal cortex activation measured using functional near-infrared spectroscopy. After the baseline test, all sedentary students engaged in 33 min of high-intensity interval training, followed by the same procedures as in the pre-test.ResultsIn the flanker task, college athletes exhibited superior executive function compared to sedentary students, with higher accuracy (p = 0.042), faster reaction times (p = 0.002), and more pronounced brain activation (p = 0.048). Post-exercise, reaction times improved significantly in sedentary groups (p < 0.05). Smoking impaired executive function both before and after exercise, with smokers showing lower accuracy (p < 0.001), slower reaction times (p < 0.001), and diminished brain activation (p < 0.001) compared to nonsmokers.DiscussionEngaging in acute aerobic exercise may improve executive function in sedentary smokers. Exercise may help mitigate smoking-related declines in executive function among college students.

BackgroundExecutive Function and the Approximate Number System are well-established as critical components in developing the Cardinality Principle in young children. However, most existing studies explore the relationship between these variables in isolation without examining whether Approximate Number System mediates the relationship between Executive Function and the Cardinality Principle and the role of age in this. This study aimed to address this gap by investigating the mediating role of the Approximate Number System in the relationship between Executive Function and the Cardinality Principle and the moderating role of age in young children.MethodsThis cross-sectional study was conducted in China from February to June 2024. A total of 203 young children (97 boys and 106 girls, Mean age = 68.93 ± 7.076 months) participated. Participants were assessed using a range of tests: the Day-Night Stroop Task, Digit Recall Task, Dimensional Change Card Sort Task, Panamath Test Software, How Many Task, and Give-N Task to measure Executive Function, Approximate Number System, and Cardinality Principle. Data were analyzed using SPSS 26.0 and PROCESS v4.1 (Model 4) to explore the relationships among Executive Function, the Approximate Number System, and the Cardinality Principle through Pearson correlations, multivariate regression, and mediation analysis with 5000 bootstrap samples.ResultsCorrelation analysis revealed that the Cardinality Principle was significantly and positively correlated with Inhibitory Control, Working Memory, Cognitive Flexibility, Executive Function, and the Approximate Number System. Regression analyses indicated that Executive Function positively predicted young children's Cardinality Principle. Specifically, Working Memory and Cognitive Flexibility were positive predictors of the Cardinality Principle, while Inhibitory Control was not. Mediation analysis results demonstrated that the Approximate Number System mediated the relationships between Inhibitory Control and the Cardinality Principle, Working Memory and the Cardinality Principle, and Cognitive Flexibility and the Cardinality Principle, respectively. In addition, the study found that young children's age negatively moderated the relationship between the Approximate Number System and the Cardinality Principle.ConclusionsThe study emphasizes that in developing young children's Cardinality Principle, emphasis should be placed on improving their Executive Function and Approximate Number System while considering the age differences of young children and developing appropriate educational methods for different age groups.

Midlife cardiovascular risk factors such as Type 2 Diabetes (T2DM) and obesity are associated with the later development of cognitive impairment and dementia. Systemic inflammation is postulated as a crucial mechanism, yet there are few studies examining this at the earliest stages prior to overt cognitive impairment. To assess this, we recruited a cohort of middle-aged cognitively-unimpaired individuals with and without uncomplicated T2DM. Comprehensive neuropsychological assessment was performed at baseline and at 4-year follow-up. Ten serum chemokines and cytokines (Eotaxin, MCP-1, MIP-1β, CXCL10, IL-6, IL-10, IL12p70, IL-17A, IFN-γ and TNF-α) were measured at both baseline and follow-up using high-sensitivity assays. Overall, 136 participants were recruited including 90 with uncomplicated midlife T2DM (age 52.6 ± 8.3; 47% female) and 46 without (age 52.9 ± 8.03; 61% female). Cognitive trajectories were stable over time and did not differ with T2DM. Yet on cross-sectional analyses at both baseline and follow-up, greater circulating IL-17A was consistently associated with poorer performance on tests of executive function/attention (β: 0.21; −0.40, −0.02, p = 0.03 at baseline; β: 0.26; −0.46, −0.05, p = 0.02 at follow-up). Associations persisted on covariate adjustment and did not differ by T2DM status. In summary, we provide evidence that greater circulating IL-17A levels were associated with poorer executive function in midlife, independent of T2DM. Long-term follow-up of this and other cohorts will further elucidate the earliest stages in the relationship between systemic inflammation and cognitive decline to provide further mechanistic insights and potentially identify those at greatest risk for later cognitive decline.

Executive function (EF) is a set of higher order cognitive processes through which learning and everyday goals are realised. They comprise the fundamental building blocks of how we plan, execute, monitor and regulate tasks, and impact our cognitive, socioemotional and behavioural responses. An important question to consider is how we can support children to develop effective EF skills through motivating and age-appropriate training. Virtual reality (VR) offers an interesting avenue to enhance motivation due to the experience of presence and immersion, however, whether children experience presence and immersion similarly to adults is unknown and could impact the educational utility of VR over other media. In order to understand whether VR is suitable for an educational setting we must understand the experience of key stakeholders, such as school-aged children and adults that will be facilitating use in the educational context. Therefore, the current study aims to understand the experience of key stakeholders using EF training delivered in a VR environment, to enable reflection on the feasibility and usability of the technology. This study aimed to explore the qualitative experiences of 8 primary school-aged children, 5 teachers and 13 training teaching assistants, after playing an EF training game, Koji's Quest, on a VR head mounted display. Firstly we found that most teachers and trainee teachers gave good ratings of usability, but in their subjective descriptions of use focused on hedonic experiences, whereas, children focused on pragmatic experiences. Results also indicate that adults may favour ‘being’ definitions of presence, whereas child participants appear to incorporate both ‘being’ and ‘doing’ definitions into their accounts. This research has implications for how VR based EF training can be maximised within an educational setting.

BackgroundAutism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are both associated with impairment in executive function, particularly in complex attention. Although previous studies using clinical assessments have attempted to delineate differences between these disorders, the findings have been inconclusive. Our study aims to elucidate the differences of endophenotype between ASD, ADHD, and their co-occurring condition utilizing a uniform computerized test.MethodsThe study included children diagnosed with ASD, ASD co-occurring with ADHD (ASD+ADHD), or ADHD who completed the comprehensive attention test (CAT) at Severance Hospital between October 2013 to May 2023. We excluded children with intellectual disability and comorbid major psychiatric or neurologic disorders possibly affecting attention measurement. The participants were categorized into three groups for the comparative analysis of CAT measures: (a) ASD (n=112), (b) ASD+ADHD (n=155), and (c) ADHD (n=104). The study also conducted an exploratory analysis utilizing multivariate linear regression analysis to examine the association between the CAT measures and parent-reported scales.ResultsNotably, the ASD+ADHD and ADHD groups exhibited higher frequency of commission errors (CE) and perseveration errors (PE) compared to the ASD group. In the exploratory analysis, a significant negative association was observed between reaction time (RT) and both the social communication questionnaire (SCQ) and the child behavior checklist (CBCL) externalization scores in the ASD+ADHD and ADHD groups. The ASD+ADHD group tended to show higher standard deviation of reaction time (RTSD) compared to the ASD group.ConclusionsOur findings suggest that impaired response inhibition is more pronounced in ADHD compared to ASD. We propose altered visual attention, reflecting response inhibition, may serve as potential endophenotypic markers differentiating ADHD from ASD in attentional assessment. Elevated RTSD in the ASD+ADHD group demonstrates additive pathology, suggesting that the neurological mechanisms underpinning impaired sustained attention may differ between the two conditions.

ObjectiveOverweight and obesity are serious public health issues worldwide and significantly impair children’s executive function (EF). However, there is no consensus regarding the benefits of aerobic exercise, on the EF of overweight and obese children. This study systematically evaluated the intervention effects of aerobic exercise on EF and its subcomponents (inhibitory control, working memory, and cognitive flexibility) in overweight and obese children.MethodsWe searched six databases—PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, and China National Knowledge Infrastructure—until March 17, 2024 for randomized controlled trials examining the effects of aerobic exercise on the EF of overweight and obese children the Cochrane Risk of Bias Assessment Tool. Following heterogeneity testing, RevMan 5.4 and Stata 17.0 were used for meta-analysis and subgroup analysis of the three indicators. The standardized mean difference (SMD) and 95% confidence intervals (CI) were used as statistical measures for effect analysis with the SMD value as the effect size and a p-value of ≤0.05 indicating statistical significance.ResultsEighteen studies involving 1,260 participants were included. Aerobic exercise significantly improved overall EF (SMD = −0.50, 95% CI [−0.68, −0.32], p 25 kg/m2) do not benefit from the intervention, highlighting the need for a specific focus on intervention outcomes in future studies.

Asthma is a highly prevalent inflammatory condition, significantly affecting nearly six million U.S. children and impacting various facets of their developmental trajectories including neurodevelopment. Evidence supports a link between pediatric environmental exposures in two key areas: asthma and executive function (E.F.). E.F.s are a collective of higher-order cognitive processes facilitating goal-oriented behaviors. Studies also identify asthma-associated E.F. impairments in children. However, limited research has evaluated the inter-relationships among environmental exposures, asthma, and E.F. in children. This review explored relevant research to identify and connect the potential mechanisms and pathways underlying these dynamic associations. The review suggests that the role of the pediatric exposome may function through (1) several underlying biological pathways (i.e., the lung-brain axis, neuroendocrine system, and hypoxia), which could drive asthma and maladaptive E.F. in children and (2) the relationships between the exposome, asthma, and E.F. is a bidirectional linkage. The review reveals essential synergistic links between asthma and E.F. deficits, highlighting the potential role of the pediatric exposome.

BackgroundType 2 diabetes mellitus is one of the most prevalent diseases， which imposes a heavy burden on patients' families and the society. Sleep disorders are recognized as risk factors for the development of diabetes， which may affect the onset and development of diabetes through neuro-endocrino-metabolic pathways， so identifying the factors responsible for the sleep quality of diabetic patients is of great importance in improving their sleep quality.ObjectiveTo investigate the relationship among fear of disease progression， executive function and sleep quality in patients with type 2 diabetes mellitus， so as to provide references for improvement of sleep quality in patients with type 2 diabetes mellitus.MethodsA sample of 197 patients with type 2 diabetes mellitus who were admitted to the Endocrinology Department of the Second Affiliated Hospital of the Air Force Military Medical University from January to May 2023 and met the criteria defined in the Guideline for the Prevention and Treatment of Type 2 Diabetes Mellitus in China （2020 edition） were consecutively selected. All subjects were assessed using Fear of Progression Questionnaire-Short Form （FoP-Q-SF）， Behavior Rating Inventory of Executive Function-Adult version （BRIEF-A） and Pittsburgh Sleep Quality Index （PSQI）. Then the Process macro for SPSS （Model 4） and Bootstrap technique were applied to examine the mediating effect of executive function on the relationship between fear of disease progression and sleep quality in patients with type 2 diabetes mellitus.Results①75 patients （38.07%） with type 2 diabetes mellitus were found to have sleep problems. ②PSQI score in patients with type 2 diabetes mellitus was positively correlated with FoP-Q-SF score and BRIEF-A score （r=0.159， 0.287， P

INTRODUCTION: The aim of this study was to evaluate executive function (EF), such as inhibition and working memory, in children with isolated growth hormone deficiency (IGHD) using performance-based tests and parent-report scales. METHODS: A total of seventy children between the ages of 7 and 12 years were included in the study. Half (n=35) had children with IGHD and half were healthy controls. To evaluate the EF performances of the participants, the Visual Aural Digit Span Test-B Form (VADS-B) and Stroop task were applied. EF was also evaluated using the Behavior Rating Inventory of Executive Function (BRIEF). RESULTS: Children with IGHD scored lower on the VADS-B form for short-term memory (p

Children with Attention Deficit Hyperactivity Disorder (ADHD) have non-adaptive behavioral problems related to social maturity, which impact their future lives as adults, thus necessitating access to appropriate treatment. This experimental study aims to examine the effect of executive function therapy on improving social maturity in children with ADHD. It adopts a comprehensive approach, employing a one-group pretest-posttest design on 20 children with ADHD. The social maturity scores of the children in the initial examination ranged from 32 to 86, measured using the Vineland Social Maturity Scale (VSMS), and then analyzed by one-way repeated measures ANOVA using SPSS. The results show an improvement after executive function therapy (Phase III/Post-test, M = 75.90; Phase II, M = 64.00; Phase I, M = 64.30; Pre-test, M = 61.35), thus indicating a significant influence of the therapy on the improvement of the social maturity of children with ADHD, F(3; 16) = 73.9; p .001, η_p2 = .795 showed moderate level of therapy effectiveness. This study suggested that executive function therapy is effective in improving social maturity in children with ADHD.

Abstract Background Oral frailty is reported to increase the risk of new onset of mild cognitive impairment. Whereas, the association of oral frailty with cognition among older adults in both physical frail and non-physical frail status has not been sufficiently explored, and whether there are sex differences in the association is unclear. This study investigated the association of oral frailty and physical frailty with global cognitive function and executive function among older adults, as well as the sex differences in such association. Methods This cross-sectional study included 307 participants aged ≥ 60 years old from communities between June 2023 and August 2023, in Nanjing, China. Global cognitive function and executive function were assessed by using the Montreal Cognitive Assessment (MoCA) and Trail Making Tests A (TMT-A), respectively. Oral frailty was identified by the combination of natural tooth, Oral Frailty Index-8 (OFI-8), and oral diadochokinesis. Physical frailty was measured by using Fried phenotype model which contained 5 criteria: unintentional weight loss, weakness, exhaustion, slowness, and low physical activity. Multiple linear regression analyses for overall participants and stratified by sex and presence or absence of physical frailty were performed, respectively, to examine the association between oral frailty and cognitive functions. Results The median age of participants was 70 years old. The study included 158 (51.5%) females, 53 (17.3%) individuals with physical frailty, and 65 (21.2%) participants with oral frailty. After adjustment, the association between oral frailty and global cognitive function was observed in the physical frailty group (B = -2.67, 95% Confidence Interval [CI]: -5.27 to -0.07, p = 0.045) and the females with physical frailty (B = -4, 95% CI: -7.41 to -0.58, p = 0.024). Oral frailty was associated with executive function in overall participants (B = 0.12, 95% CI: 0.01 to 0.22, p = 0.037), physical frailty group (B = 23.68, 95% CI: 1.37 to 45.99, p = 0.038). In the adjusted models, oral frailty was significantly associated with executive function in all females (B = 0.21, 95% CI: 0.05 to 0.36, p = 0.009), in females without physical frailty (B = 0.19, 95% CI: 0.02 to 0.36, p = 0.027), and in females with physical frailty (B = 48.69, 95% CI: 7.17 to 90.21, p = 0.024). Conclusions Physical frailty intensifies the positive association of oral frailty with poor global cognitive function and executive function among older adults, particularly among females. It is ponderable to consider sex differences and facilitate the management of physical frailty when it comes to promoting cognitive health based on the perspective of oral health among older adults.

Abstract Background Delays in early social and executive function are predictive of later developmental delays and eventual neurodevelopmental diagnoses. There is limited research examining such markers in the first year of life. High-risk infant groups commonly present with a range of neurodevelopmental challenges, including social and executive function delays, and show higher rates of autism diagnoses later in life. For example, it has been estimated that up to 30% of infants diagnosed with cerebral palsy (CP) will go on to be diagnosed with autism later in life. Methods This article presents a protocol of a prospective longitudinal study. The primary aim of this study is to identify early life markers of delay in social and executive function in high-risk infants at the earliest point in time, and to explore how these markers may relate to the increased risk for social and executive delay, and risk of autism, later in life. High-risk infants will include Neonatal Intensive Care Unit (NICU) graduates, who are most commonly admitted for premature birth and/or cardiovascular problems. In addition, we will include infants with, or at risk for, CP. This prospective study will recruit 100 high-risk infants at the age of 3–12 months old and will track social and executive function across the first 2 years of their life, when infants are 3–7, 8–12, 18 and 24 months old. A multi-modal approach will be adopted by tracking the early development of social and executive function using behavioural, neurobiological, and caregiver-reported everyday functioning markers. Data will be analysed to assess the relationship between the early markers, measured from as early as 3–7 months of age, and the social and executive function as well as the autism outcomes measured at 24 months. Discussion This study has the potential to promote the earliest detection and intervention opportunities for social and executive function difficulties as well as risk for autism in NICU graduates and/or infants with, or at risk for, CP. The findings of this study will also expand our understanding of the early emergence of autism across a wider range of at-risk groups.

Abstract Background Less is known about complex posttraumatic stress disorder (CPTSD) than postrraumatic stress disorder (PTSD) in military veterans, yet this population may be at greater risk of the former diagnosis. Executive function impairment has been linked to PTSD treatment outcomes. The current study therefore aimed to explore possible associations between each CPTSD symptom cluster and executive function to understand if similar treatment trajectories might be observed with the disorder. Methods A total of 428 veterans from a national charity responded to a self-report questionnaire which measured CPTSD symptom clusters using the International Trauma Questionnaire, and executive function using the Adult Executive Function Inventory. Single and multiple linear regression models were used to analyse the relationship between CPTSD symptom clusters and executive function, including working memory and inhibition. Results Each CPTSD symptom cluster was significantly associated with higher executive function impairment, even after controlling for possible mental health confounding variables. Emotion dysregulation was the CPTSD symptom cluster most strongly associated with executive function impairment. Conclusions This is the first study to explore the relationship between executive function and CPTSD symptom clusters. The study builds on previous findings and suggests that executive function could be relevant to CPTSD treatment trajectories, as is the case with PTSD alone. Future research should further explore such clinical implications.

Abstract This study explored the relationship between parenting stress, parenting style, parenting quality, and young children's executive function. In total, 243 firstborns aged 2–9 years old (SD = 3.82) and their parents from two-child families in Beijing participated in the study, which used executive function tasks and parenting questionnaires. The results found that (1) parenting stress negatively predicted parenting quality; (2) parenting style partially mediated the relationship between parenting stress and parenting quality; (3) children's executive function partially mediated the relationship between parenting stress and parenting quality; and (4) the spoiled, democratic, permissive, and authoritarian parenting styles each play a chain mediating role with young children's executive function between parenting stress and parenting quality. Taken together, these findings provide implications for scientific parenting of children with different psychological characteristics (such as executive function) in multiple-child families under Parenting stress.

Difficulties in executive function (EF) may be causative factors in clinical conditions, including learning disabilities, depression, and anxiety. However, defining the structure of EF is an ongoing issue, although Miyake’s three-factor structure is widely accepted. This study aims to discover the underlying factor structure of EF domains, as measured by five tests and the scores of 840 participants, to establish the domains’ validity and reliability. Five neuropsychological tests were included in the exploratory and confirmatory factor analyses (EFA and CFA): the Digit Span (DS); the Stroop Color Word Test (Stroop Test); the phonemic Verbal Fluency Test (pVFT); the Five Point Test (5PT); and the Trail Making Test (TMT). EFA could be meaningfully performed (KMO = .862, Bartlett’s test: 𝜒2 =1393.169, df 45, p .001) and yielded three factors closely mirroring the three core domains of EF. CFA of the model in which the 5PT loaded on factor 2 showed the best goodness of fit indicators, although the difference with the other three-factor models was small. Currently, these EF tests are available in Indonesia and suitable for use, although obtaining normative scores adjusted for demographic factors is necessary.

Abstract Background To evaluate the progression of physical fitness (PF), basic motor competence (BMC), and executive function (EF) over one year in children aged 4–5 years at a health center. Methods In this longitudinal analysis, children’s BMC was evaluated using the MOBAK KG test for object and self-movement. The PREFIT Battery gauged PF through handgrip strength, standing long jump, and other fitness measures, while the Early Years Toolbox appraised EF. Results Adjustments for confounding factors showed notable improvements in BMC, particularly in object movement (OM; mean difference 0.789, p = 0.044) and self-movement (SM; mean difference 0.842, p = 0.037), with overall MOBAK scores also increasing (mean difference 1.632, p = 0.018). Enhancements in the standing long jump (mean difference 9.036 cm, p = 0.014) and EF tasks “Mr. Ant” (mean difference 0.669, p

Background: Emotional regulation is a critical component of emotional intelligence, particularly during the preschool stage, a key period for children's development. Previous studies have demonstrated that executive function mediates the effect of gross motor skills on emotional understanding. However, studies specifically focusing on children from rural areas and investigating the role of psychological resilience are limited. The present study fills this knowledge gap by examining the effect of gross motor skills on emotional regulation and the roles of executive function and psychological resilience among Chinese rural preschool children. Methods: This study included 430 children (aged 61.01 ± 6.98 months, 48.8 % boys) and their teachers from three rural preschools in China. Children's gross motor skills, including locomotor and object control skills, were assessed using the Test of Gross Motor Development-3. Executive function was measured using the Head-Toes-Knee-Shoulder task, and emotional regulation was assessed using the Emotional Regulation Checklist. Furthermore, psychological resilience was examined using the Devereux Early Childhood Assessment. Demographic information was collected, and the cross-sectional relationships between gross motor skills and emotional regulation were investigated through mediation and moderation analyses. Results: Gross motor skills, executive function, and psychological resilience were associated with emotional regulation (p

Objective: The main aim of this research was to determine the relationships among executive function, fitness mobile applications (APPs), physical exercise activity and physical education consumption in community-dwelling older empty nesters. Methods: A cross-sectional design was applied to evaluate the relationships. A sample of 1104 community-dwelling older empty nesters completed the experiments. Physical education consumption scale, fitness APPs by smartphone application scale, physical exercise activity scale, and executive function scale were applied for the evaluation of the elderly alone in urban communities in southeast China. To explore mediating effects, structural equation modeling of AMOS 23.0, SPSS 25.0 and Process V3.5 software packages were applied for statistical processing. Result: Physical education consumption positively predicted executive function. Meanwhile, it was also found that physical education consumption and executive function were continuously mediated by fitness APP application and physical exercise activity, with indirect effect value of 0.267, accounting for 76 %. Conclusion: This research revealed how physical education consumption affected executive function of older empty nesters. The obtained results had certain implications for older empty nesters to better balance their executive function and life quality. Community managers should provide older empty nesters with favorable physical education environments in terms of positive physical and psychological environments, to improve their use ratio of fitness APPs usage and physical exercise activity, ultimately enhancing their executive function and life satisfaction.

Prior research highlighted the effect of home environment on the language development of young children. Recent research has mainly discussed the moderating effect of personality traits like temperament. Nevertheless, the precise mechanism about the relationship between home environments to children's language development remains incompletely understood. This study explored how home environment impacts the language development of 2-year-old toddlers and the role of temperament and executive function in this relationship. We used the Chinese Child Adaptive Behavior Scale, the Temperament Scale for 1–3 years old of toddlers and the Home Environment Scale for Infants' and Toddlers' families to assess children's language development, temperament, and home environment. Simultaneously, the research used the Stroop-like day-night task and the multiple location search task to evaluate children's executive function. A total of 117 2-year-old children as well as their parents were involved in the study. The results revealed that home environment significantly predicts children's language ability with executive function as a mediating role. Temperament dimensions including extraversion, independence, reactivity, and social inhibition play a moderating role between home environment and executive function. The findings contributed to the improved implementation of home education tailored to children with different temperament traits, offering effective support for the cognitive and language development of young children.

This study aims to evaluate the impact of early childhood executive function on emotional dysregulation. Participants were parents of children aged 5 to 6. Primary data was acquired by sending surveys via a Google Form. A correlational quantitative research approach was used. The research findings indicate that there is a relationship between executive function and emotional dysregulation in early childhood, particularly in Tanah Datar Regency. With a hypothesis test, the obtained value of r is 0.156, while the critical value (rtabel) for a sample size of 162 individuals is 0.148 at a significance level of 5%. The correlation test using SPSS 21 yields a significance value of 0.161, indicating a strong correlation between the two variables. The results showed that children's emotional dysregulation was highly influenced by their level of executive function in early childhood. This study emphasizes the need of recognizing and fostering executive function in early children to promote healthy emotional regulation, providing parents with vital insights into understanding and supporting their children's emotional development.

Abstract In genetic syndromes such as Down syndrome (DS) and Williams syndrome (WS), difficulties with executive functioning (EF) are a commonly reported feature and a key correlate of long-term success in everyday life. Despite a robust literature in children with these syndromes, it remains unclear how cross-syndrome characteristics of everyday EF relate to adaptive functioning and intelligence among adults with DS and WS, and if these relationships differ between these groups. This study aimed to characterise the profile of strengths and weaknesses in everyday EF using the Behaviour Rating Inventory of Executive Function-Adult Informant Version (BRIEF-A) in older adolescents and young adults with DS and WS. Associations between distinct EFs, adaptive/maladaptive functioning, and intellectual ability were also investigated. Results showed that the WS group displayed profound impairments in almost all BRIEF-A scales, with a large percentage of scores in the clinically significant range. Further, selective EFs (Inhibit, Organisation of Materials, Task Monitor) were able to discriminate between the two genetic syndromes. Contrary to previous research, in WS, Working Memory was linked to adaptive functioning and IQ. In DS, the Task-Monitor and Shift scales were unique predictors of externalising and internalising behaviours, respectively. These findings could have important implications for targeted cognitive interventions in these genetic syndromes.

Background: Children with ADHD demand for effective intervention with minimum side effect to improve executive function (EF) and health well-being. Method: This study used a three-arm partially-blinded randomized controlled trial to test the effects of two different kinds of 8-week game-based training programs (game-based HIIT program, GameHIIT; and game-based structured aerobic exercise program, GameSAE) on EF and other health indicators of children with ADHD, which was compared with a non-treatment control group. Results: A total of 49 children with ADHD completed the program. Analyses of EF tests and parental survey indicated that (i) there is no significant intragroup difference among all measures between pre-/post-intervention tests for two game-based intervention groups. The only significant intergroup difference was observed in self-monitor score of parent-reported child's EF between GameSAE group and the control (large effect). Similarly, cerebral hemodynamic responses also found no significant group effect for all EF tests. However, the time effects were observed in several channels in the GameHIIT group in two EF tests (Color Words Stroop Test and Tower of London Test). No significant change of participants' overall ADHD symptoms was found in the pre-/post-tests for three groups. Nonetheless, further analyses revealed that both of two game-based training programs exhibited the significant positive effects on child's PA levels and the large effects on levels of physical fitness, when they were compared to the control. Conclusion: By this study, a significant enhancement in physical fitness and PA levels were found in both game-based PA interventions when they were compared with control group. However, the effectiveness of game-based PA interventions on improving EF or reducing ADHD symptoms remains unclear. This implies that a larger intervention dosage or a tailored intervention design may be warranted to improve the EF of children with ADHD.

Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) often face significant deficits in executive function and adverse work-related outcomes. This study aimed to explore the role of executive function deficits in job burnout of employees with ADHD. We hypothesized that employees with ADHD, relative to employees without ADHD, will experience higher levels of job burnout and deficits in executive function. We also hypothesized that the ADHD-job burnout relationship would be mediated through executive function deficits, specifically by self-management to time and self-organization/problem-solving. A field study with 171 employees provided support for the research hypotheses and mediation model in which the employees' ADHD-job burnout relationship was mediated through executive function deficits. Additional mediation analyses indicated that the specific executive function of self-management to time and self-organization/problem-solving mediated the effect of ADHD on job burnout and its facets. Specifically, for physical fatigue, the mediation was realized through self-management to time, and for emotional exhaustion and cognitive weariness, the mediation was significant through self-organization/problem-solving. The present findings shed light on the relevance of referring ADHD among employees, their vulnerability to job burnout, and the role of executive function deficits in job burnout of employees with ADHD.

BackgroundPrevious studies have found that patients with generalized anxiety disorder （GAD） have impaired performance in executive function， and group cognitive behavioral therapy （CBT） has been shown to be effective in alleviating negative affect in patients with GAD， while its efficacy on executive function remains unclear.ObjectiveTo explore the efficacy of group CBT on anxiety symptom and executive function in GAD patients， so as to provide references for the rehabilitation program for GAD.MethodsA total of 80 consecutive patients with GAD who were hospitalized in Sleep and Psychosomatic Medical Center of Shiyan Taihe Hospital from March 2021 to August 2022 and met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for GAD were enrolled， and they were assigned into study group （n=40） and control group （n=40） using random number table methods. All patients were subjected to routine medication treatment and regular health education， based on this， study group received group CBT once a week （6 weeks， 60 to 90 minutes per session）. At the enrollment and after 6 weeks of treatment， patients were assessed using Hamilton Anxiety Scale （HAMA） and Frontal Assessment Battery （FAB）.ResultsANOVA with repeated measures on HAMA score revealed a significant time effect （F=1 870.320， P0.05）. Significant time effect， group effect and time×group interaction effect were reported on FAB scores （F=311.190， 4.399， 7.021， P

BackgroundThe development of executive function in adolescents is influenced by many environmental factors. Previous studies have found that perceived stress is closely related to executive function， whereas its role in the mediation of executive function remains poorly studied.ObjectiveTo explore the role of negative affect and self-hate in mediating the relationship between perceived stress and executive function in adolescents， so as to assist the improvement of executive function in adolescents.MethodsQuestionnaires were administered to 7 734 adolescents from five junior and five senior high schools in Rizhao city， Shandong province from 1 to 30 May 2022. Data were collected using a self-made questionnaire， and adolescents were assessed using Perceived Stress Scale （PSS）， Behavior Rating Inventory of Executive Function-Self Report Version （BRIEF-SR）， Patient Health Questionnaire （PHQ-4） and Self-Hate Scale （SHS）. Spearman correlation analysis was conducted to examine the correlation between variables. A Bootstrap method was chosen to examine the mediation effect of self-hate and negative affect on the relationship between perceived stress and executive function in adolescents.ResultsA total of 7 012 （90.66%） valid questionnaires were retrieved. BRIEF-SR score was positively correlated with PSS， PHQ-4 and SHS scores （r=0.564， 0.653， 0.597， P

Abstract Background Square dancing is a kind of aerobic fitness exercise without environmental restrictions that yields many benefits for physical and mental health; this exercise is popular among middle-aged and elderly people in China and in these populations in other countries. This study aimed to evaluate the effects of square dance exercise on the overall cognitive function of elderly individuals with mild cognitive impairment (MCI) and to research its mechanisms. Methods A total of 60 elderly people with MCI (60–69 years old) without square dance experience were selected and randomly divided into an experimental group (n = 30) and a control group (n = 30). The experimental group participated in square dance exercise for 12 weeks, while the control group maintained their original lifestyle habits. One week before and after the intervention period, the overall cognitive function, physical fitness, and executive function of both groups were measured. Results According to the results, square dance exercise directly improved the overall cognitive function of elderly individuals with MCI and indirectly affected overall cognitive function through the mediating effects of balance ability and executive function. Conclusions Square dance exercise represents a nonpharmacological intervention for the prevention and treatment of MCI. Importantly, it is best to combine this exercise with other forms of physical exercise and comprehensive treatment programs such as cognitive training, social interaction, and psychological intervention to realize its maximum effect.

Rongcui Sui,1– 3 Jie Li,4 Yunhan Shi,1– 3 Shizhen Yuan,1– 3 Huijun Wang,1– 3 Jianhong Liao,1– 3 Xiang Gao,1– 3 Demin Han,1– 3 Yanru Li,1– 3 Xingjun Wang4 1Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Obstructive Sleep Apnea-Hypopnea Syndrome Clinical Diagnosis and Therapy and Research Centre, Capital Medical University, Beijing, People’s Republic of China; 3Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, People’s Republic of China; 4Department of Electronic Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, People’s Republic of ChinaCorrespondence: Demin Han; Yanru Li, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Dongcheng District, Beijing, People’s Republic of China, Email deminhan_ent@hotmail.com; liyanruru@aliyun.comPurpose: This study aimed to investigate the association between sleep spindle metrics and executive function in individuals with obstructive sleep apnea (OSA). Furthermore, we examined the association of age and education on executive function.Patients and Methods: A total of 230 (40.90 ± 8.83 years, F/M = 45/185) participants were enrolled. Overnight electroencephalogram (C3-M2) recording detected sleep spindles by a novel U-Net-type neural network that integrates temporal information with time-frequency images. Sleep spindle metrics, including frequency (Hz), overall density (events/min), fast density (events/min), slow density (events/min), duration (sec) and amplitude (μV), were measured. Executive function was assessed using standardized neuropsychological tests. Associations between sleep spindle metrics, executive function, and demographic factors were analyzed using multivariate linear regression.Results: In fully adjusted linear regression models, higher overall sleep spindle density (TMT-A, B=− 1.279, p=0.009; TMT-B, B=− 1.813, p=0.008), fast sleep spindle density (TMT-A, B=− 1.542, p=0.048; TMT-B, B=− 2.187, p=0.036) and slow sleep spindle density (TMT-A, B=− 1.731, p=0.037; TMT-B, B=− 2.449, p=0.034) were associated with better executive function. And the sleep spindle duration both during N2 sleep time (TMT-A, B=− 13.932, p=0.027; TMT-B, B=− 19.001, p=0.034) and N3 sleep time (TMT-B, B=− 29.916, p=0.009; Stroop-incongruous, B=− 21.303, p=0.035) was independently associated with better executive function in this population. Additionally, age and education were found to be highly associated with executive function.Conclusion: Specific sleep spindle metrics, higher overall density, fast density and slow density during N2 sleep time, and longer duration during N2 and N3 sleep time, are independent and sensitive indicators of better executive function in young adult and middle-aged patients with OSA. Further research is needed to explore the underlying mechanisms and clinical implications of these findings.Keywords: sleep spindle metrics, executive function, obstructive sleep apnea, young adults, middle-aged adults

Elrika Anastasia Wijaya, Purboyo Solek, Dedi Rachmadi, Sri Endah Rahayuningsih, Rodman Tarigan, Dany Hilmanto Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, IndonesiaCorrespondence: Dany Hilmanto, Tel +628122266879, Email danyhilmanto@yahoo.comIntroduction: As the highest function in the brain that regulates our daily activity, executive dysfunction might affect someone’s health-related quality of life (HRQoL), especially in those with chronic diseases, including chronic kidney disease (CKD). Neurocognitive functions, including intelligence quotient (IQ) and executive function can be affected through various mechanisms in CKD. However, there was still no specific study regarding how IQ and executive function might affect HRQoL in children with CKD.Purpose: To assess Executive Function’s impact on HRQoL and to find association between treatment modalities and CKD stages with HRQoL in children with CKD.Methods: A cross sectional study was conducted at Pediatric Nephrology Clinic at Hasan Sadikin General Hospital, Bandung, Indonesia from September 2022 to April 2023. We included 38 children whose age range were 6– 16 years 11 months old with CKD stage III – V. Assessment tools used were: BRIEF questionnaire for executive function; WISC III tool for IQ; PedsQLTM questionnaire generic module for HRQoL. Data was analyzed using SPSS ver. 26.0.Results: Total number of samples was 38. Complete examinations were done on 30 patients. Eight other patients did not undergo the IQ test. There was a negative correlation between executive function components scores (GEC, BRI, MI) with HRQoL scores on parents’ proxy in all domains. We found no correlation between HRQoL and IQ scores, but we found a correlation between IQ and CKD stage. There was a significant difference in HRQoL from the children’s perspective among the three modalities; children who underwent conservative treatment were having the best HRQoL scores.Conclusion: Interventions to improve executive function of children with CKD should be done to improve their HRQoL in the future. Early diagnosis and treatment of CKD should be done at the earliest to improve neurocognitive function and HRQoL.Keywords: chronic kidney disease, neurocognitive function, children, executive function, intelligence quotient, health related quality of life

With a focus on its implications for cognitive behavioral therapy (CBT), this review study seeks to investigate the possible advantages of martial arts training on attention and executive function. Common cognitive impairments seen in a variety of psychiatric diseases, such as depression and attention deficit hyperactivity disorder, include difficulties in attention and executive function. Training in martial arts, which is known for its demanding physical and mental requirements, has drawn interest as a potential intervention for improving cognitive function. An overview of the most recent research on how martial arts training affects focus and executive function is given in this publication. The results demonstrate the potential of martial arts as a strategy for enhancing executive function and attention-related cognitive functions. The article also explores the implications of adding martial arts instruction to CBT therapies, arguing that doing so might be a beneficial supplementary strategy to improve treatment outcomes. With information on the possible advantages of martial arts training for attention and executive function, this review paper adds to the expanding corpus of research on non-pharmacological therapies for cognitive enhancement.

Abstract Background Elevated levels of executive function and physical fitness play a pivotal role in shaping future quality of life. However, few studies have examined the collaborative influences of physical and mental health on academic achievement. This study aims to investigate the key factors that collaboratively influence primary school students' academic achievement from executive function, physical fitness, and demographic factors. Additionally, ensemble learning methods are employed to predict academic achievement, and their predictive performance is compared with individual learners. Methods A cluster sampling method was utilized to select 353 primary school students from Huai'an, China, who underwent assessments for executive function, physical fitness, and academic achievement. The recursive feature elimination cross-validation method was employed to identify key factors that collaboratively influence academic achievement. Ensemble learning models, utilizing eXtreme Gradient Boosting and Random Forest algorithms, were constructed based on Bagging and Boosting methods. Individual learners were developed using Support Vector Machine, Decision Tree, Logistic Regression, and Linear Discriminant Analysis algorithms, followed by the establishment of a Stacking ensemble learning model. Results Our findings revealed that sex, body mass index, muscle strength, cardiorespiratory function, inhibition, working memory, and shifting were key factors influencing the academic achievement of primary school students. Moreover, ensemble learning models demonstrated superior predictive performance compared to individual learners in predicting academic achievement among primary school students. Conclusions Our results suggest that recognizing sex differences and emphasizing the simultaneous development of cognition and physical well-being can positively impact the academic development of primary school students. Ensemble learning methods warrant further attention, as they enable the establishment of an accurate academic early warning system for primary school students.

This meta-analysis investigated the concurrent validity between virtual reality (VR)-based assessments and traditional neuropsychological assessments of executive function, with a focus on subcomponents such as cognitive flexibility, attention, and inhibition. A total of 1605 articles were identified through searches of PubMed, Web of Science, and ScienceDirect from 2013 to 2023. After removing duplicates, 1313 articles were screened based on their titles and abstracts, with 77 articles selected for full-text eligibility review. Of these, nine articles fully met the inclusion and exclusion criteria for this study. The effect size for overall executive function was assessed, with subcomponents categorized based on the specific assessment tools used in the studies. The effect size for each subcomponent—cognitive flexibility, attention, and inhibition—was then analyzed to provide a more detailed understanding of their relationships with traditional measures. The results revealed statistically significant correlations between VR-based assessments and traditional measures across all subcomponents. Additionally, sensitivity analyses confirmed the robustness of the findings, even when low-quality studies were excluded. These results support the use of VR-based assessments as a valid alternative to traditional methods for evaluating executive function. Moreover, the study highlights the potential of VR-based assessments as a valid alternative to traditional methods, emphasizing the need to address variability in executive function subcomponents and integrate diverse cognitive and motor metrics for greater ecological validity.

The purpose of this research was to investigate the effectiveness of executive functions training program on sleep quality and moral judgment of children with attention deficit/hyperactivity disorder. The research method was semi-experimental with a pre-test-post-test design and follow-up with a control group. The statistical population of the research included all 9-12-year-old boys with attention deficit/hyperactivity disorder in Urmia city in 2022. The sample size includes 30 subjects from the statistical population were selected by available sampling method and they were placed in two control and experimental groups. The research tools included the Child Sleep Habits Questionnaire and the moral judgment Test. The results showed that the training program of executive functions had a significant effect on improving sleep quality and moral judgment in the post-test and follow-up stages. The findings of this research provide useful information related to the executive functions program, and counselors and psychologists can use this intervention to improve sleep quality and moral judgment in children with attention deficit/hyperactivity disorder.

ObjectiveExecutive dysfunction is a core symptom of vascular cognitive impairment (VCI), which seriously affects patients’ prognosis. This paper aims to investigate the effectiveness of rTMS on executive function in VCI.MethodsThe databases selected for this study included Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), and China Biology Medicine Disc (CBM). The screening times were conducted from the time of library construction until August 23, 2023. The inclusion criteria for this meta-analysis were randomized controlled trials (RCTs) on rTMS for VCI, which include executive function scores. The primary metrics were executive subscale scores of the Cognitive Comprehensive Scale and total scores of the Executive Specificity Scale. The secondary metrics were subscale scores of the Executive Specificity Scale. The quality of each eligible study was assessed using the Cochrane Risk of Bias tool. Meta-analysis and bias analysis were performed using Stata (version 16.0) and RevMan (version 5.3).ResultsA total of 20 high-quality clinical RCTs with 1,049 samples were included in this paper. The findings from the primary outcomes revealed that within the rTMS group, there were significantly higher scores observed for the executive sub-item on the cognitive composite scale (SMD = 0.93, 95% CI = 0.77–1.08, p

IntroductionResearch has indicated that language and executive function relate closely to first-order false belief reasoning, yet their roles in second-order false belief reasoning are under-explored, and their interplay in theory of mind development remains obscure.MethodsThis study assessed 160 Mandarin-speaking preschoolers’ and early primary schoolers’ language, executive function, and theory of mind abilities to examine the unique roles and interplay of language and executive function in first-order and second-order false belief reasoning.ResultsResults showed that language significantly uniquely predicted the children’s first-order as well as second-order false belief reasoning when controlling for the effects of age and executive function. Although executive function significantly predicted first-order FB reasoning when controlling for age, it was no longer a significant predictor of first-order FB reasoning when language was included in the model. However, executive function played a significant unique role in second-order FB reasoning when controlling for the effects of age and language.DiscussionThe current findings suggest that language plays a greater role than executive function in Mandarin-speaking children’s theory of mind development and the contributors to theory of mind development vary in different levels of false belief reasoning.

Researchers have found that there may be a correlation between physical activity, executive function, and depression for college students with depression. However, there is limited information available regarding the relationship and interaction between subclinical depression, physical activity, and executive function among college students with subclinical depression. The purpose of this study is to assess the correlation and interaction between subclinical depression, physical activity, and executive function in female college students with subclinical depression. The ActiGraph GT3X was utilized to measure physical activity time, and the colour-word Stroop task was employed to evaluate the executive function of the participants. The findings revealed that female college students with subclinical depression had a significantly lower time for moderate-intensity physical activity compared to healthy female college students. Additionally, the subclinical depression group took significantly longer to complete the colour-word Stroop task compared to the healthy group of female college students. The results of correlation and mediation analyses suggest a negative correlation between BDI-II scores and physical activity time and executive function in female college students with subclinical depression. Moreover, executive function appears to play a partial mediating role in the relationship between physical activity and subclinical depression.

The documented challenges of the early care and education (ECE) workforce include poor well-being, inadequate compensation, and high turnover rates. The COVID-19 pandemic not only exacerbated these issues, but also imposed additional demands such as virtual instruction, highlighting the need to understand how teachers’ well-being relates to their adaptability in teaching. The present study examined whether early childhood teachers’ well-being is directly and indirectly related to adaptability to virtual instruction via teachers’ executive function during the COVID-19 pandemic. With a research-practice partnership project in a Head Start program in a metropolitan area in the central United States, data were collected from the Early Head Start/Head Start annual teacher survey (n = 148). Mediation analysis showed that teachers who demonstrated higher well-being displayed higher levels of executive function, which in turn was associated with greater adaptability in virtual instruction. Beyond the pandemic, findings highlight the importance of supporting teachers’ well-being and executive functions to promote adaptability, which is critical not only in virtual instruction, but also in successfully navigating other challenges of the teaching profession.

IntroductionThe aim of this cross-sectional study was to investigate the association between breakfast patterns and executive function among adolescents in Shanghai, China.MethodsIn 2022, we randomly recruited 3,012 adolescents aged 12–13 years from all administrative districts in Shanghai. Breakfast information was collected by parents using a one-day recall method. Executive function was measured using the Behavior Rating Inventory of Executive Function-Parent Version. Latent Class Analysis was performed to identify breakfast patterns based on the food groups in the Diet Quality Questionnaire for China.ResultsBreakfast patterns were classified into three categories: “Egg and milk foods”, “Grain foods”, and “Abundant foods”, except for adolescents who skipped breakfast. Logistic regression was used to estimate the multivariate odds ratio (ORs) and 95% confidence intervals (95% CI) for the association between breakfast patterns and potential executive dysfunction. Adolescents in the “Abundant foods” class had a lower risk of executive dysfunction in terms of initiate (OR: 0.36; 95% CI: 0.17–0.76), and organization of materials (OR: 0.18; 95% CI: 0.04–0.94), compared to those who skipped breakfast. Similarly, the breakfast patterns of “Grain foods” and “Egg and milk foods” were associated with a lower risk of executive dysfunction, including initiate and working memory.DiscussionOur findings suggest that breakfast patterns were associated with executive function. The improvement of breakfast patterns among adolescents should be a significant public health intervention.

IntroductionSleep and stress processes shape executive function. Evidence suggests that poor sleep regulation can lead to significant impairments in executive functions. Psychological stress can also directly impact a variety of executive functions, often leading to declines, but may additionally reduce executive function via its negative impact on sleep. Rates of perceived stress and poor sleep have skyrocketed in recent years. As such, it has become increasingly important to understand how daily stress exposures and sleep processes modulate executive functions.MethodsIn a remote 21-day app-based study, 227 participants completed sleep and stress assessments three times a day. They also completed three executive functioning tasks at various timepoints across the 21-day study interval that assessed cognitive inhibition (Emotional Stroop task), cognitive flexibility (Trail Making Test A and B), and working memory (Backwards Digit Span).ResultsParticipants with consistent sleep/wake schedules reported fewer acute stress events when compared to those with inconsistent sleep schedules. Those with greater sleep/wake regularity also had faster responses to self-relevant negative probes (vs. general negative and neutral) in the Stroop task. Further, variability in sleep/wake timing and reported acute stress exposures across the 21-day study interval interacted to predict performance on the Emotional Stroop task. Specifically, as the number of acute stress events experienced across the 21-day interval increased, participants with more regular sleep schedules had slower overall response times on the Stroop. Higher acute stress exposures led to specific response time delays to neutral and self-relevant negative probes for those with high sleep/wake regularity. We found no impact of the number of acute stress events or stress intensities on working memory span, Stroop accuracy, or Trails response time.DiscussionThese data may indicate that sleep/wake regularity preserves adaptive inhibitory control responses to cumulative acute stress.

Abstract Physical exercise is recognized for its beneficial effects on brain health and executive function, particularly through the careful manipulation of key exercise parameters, including type, intensity, and duration. The aim of this systematic review and meta-analysis was to delineate the optimal types, intensities, and durations of exercise that improve cognitive functions in older adults with mild cognitive impairment (MCI) or dementia. A comprehensive search was conducted in Scopus, Web of Science, and PubMed from their inception until December 2023. The methodological quality and publication bias of the included studies were assessed using the PEDro scale and Egger’s regression test, respectively. Separate meta-analyses were performed to assess the overall impact of exercise on cognitive assessments and to explore the effects of different exercise types (i.e., aerobic, resistance, dual-task, mind-body, and multi-component exercises) and intensities (i.e., low, moderate, and high) on executive function. Results were presented as standardized mean differences (SMD) and 95% confidence intervals (95% CI). A meta-regression analysis was conducted to examine the correlation between exercise duration and mean effects. In total, 15,087 articles were retrieved from three databases, of which 35 studies were included in our final analyses. The results indicated high overall methodological quality (PEDro score = 8) but a potential for publication bias (t = 2.08, p = 0.045). Meta-analyses revealed that all types of exercise (SMD = 0.691, CI [0.498 to 0.885], p

Abstract The present study was conducted investigating the psychometric properties of the Behavioral Rating Inventory of Executive Functions - Second Edition (BRIEF-2) in students with externalizing behavior problems. The method was based on correlation research. The statistical population consisted of all male students with behavioral problems between the ages 7 and 12 in East Azarbayejan province who were studying in the academic year 2021-2022. To select the sample, first, students with externalizing behavior problems were identified. Then their parents completed the parent form of Behavioral Rating Inventory of Executive Functions - Second Edition (BRIEF-2) and Coolidge's Neuropsychological Questionnaire (2002). The data was analyzed with 599 people. Cronbach's alpha coefficient, confirmatory factor analysis, and criterion validity were used to analyze the data. The results showed that the behavioral rating inventory of executive functions - second edition (BRIEF-2) has good reliability and validity. Therefore, this scale can be used to evaluate executive functions in students with externalizing behavior problems. Keywords: psychometric properties, behavior rating inventory of executive function, externalizing behavioral problems. Extended Abstract Introduction Externalizing problems such as disruptive behavior, aggression, and breaking rules can be a significant public health issue. These symptoms can have serious consequences for individuals, including dealing with disruptive behavior, feeling insecure or victimized, and incurring economic costs for prevention, treatment, and trials (Constanty et al., 2021). When evaluating children with externalizing behavior problems, it's important to assess their executive functions. Executive functions refer to the cognitive processes that are involved in regulating behavior, such as attention, working memory, and self-control. There is a relationship between executive functions and externalizing behavior problems, which means that how well a child can regulate their behavior is linked to their cognitive abilities. By assessing executive functions, we can better understand the cognitive and behavioral factors that contribute to externalizing behavior problems in children. The Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2) is currently the most widely used tool for measuring executive functions in children (Pino Muñoz et al., 2021; Parhoon et al., 2022). While BRIEF-2 is a comprehensive tool for assessing executive functions in children, its psychometric features have not been fully examined in children with externalizing behavior problems. The current research aims to answer the question of whether the psychometric characteristics of the BRIEF-2 parent form are appropriate for use in assessing executive functions in students with externalizing behavior problems. Research Question Are the psychometric characteristics of the BRIEF-2 parent form suitable for assessing executive functions in students with externalizing behavior problems? Literature Review Anastasiadis (2023) conducted a study to examine the clinical usefulness of the BRIEF-2 and its associated scales in differentiating between pediatric ADHD presentations and comorbidity. The study used archival data from 211 children between the ages of 5 and 12 who were seen at a university-based ADHD Evaluation Clinic. Ratings from parents and teachers were analyzed separately. The results of the study were consistent with predictions, showing that the Emotional Regulation Index (ERI) was highest in the combined presentation of ADHD. Parhoon et al., (2021) conducted a study to examine the psychometric properties of the Persian version of BRIEF-2 parent-form in children between the ages of six and 12 years. The study used confirmatory factor analysis to analyze the internal structure of the BRIEF-2. The results showed that the model with three indexes (Behavioral, Emotional, and Cognitive) and nine scales (Inhibit, Shift, Self-Monitor, Emotional Control, Initiate, Working Memory, Plan/Organize, Organization of Materials, and Task-Monitor) had a good fit. Jiménez & Lucas-Molina (2019) conducted a study to examine two aspects of BRIEF-2 in a sample of primary school-aged children. The results of the study showed that the confirmatory factor analysis of BRIEF-2 revealed a good fit for the sample. The model with three indexes (Behavioral, Emotional, and Cognitive) and nine scales (Inhibit, Shift, Self-Monitor, Emotional Control, Initiate, Working Memory, Plan/Organize, Organization of Materials, and Task-Monitor) was found to be an appropriate fit for the data. Methodology The current research used a descriptive correlational-normative study method. The statistical population for this study included all male students between the ages of 7 and 12 years old who had behavioral problems and were studying in East Azarbaijan province during the academic year of 2021-2022. The final analysis of the current research included data from 599 questionnaires. The researchers used three different tools to collect data: The Child Behavior Checklist (CBCL), the Behavioral Rating Scale of Executive Functions - Second Edition (BRIEF-2), and the Coolidge Neuropsychological Questionnaire. The researchers used two different software programs, SPSS and Lisrel, to examine the psychometric properties of the BRIEF-2. Results The results of the confirmatory factor analysis of BRIEF-2 in Table 1 and Figure 2 showed that all fit indices, including the square root of the mean error of approximation (RMSEA), were within the desired range. This indicates that the model used in the questionnaire data is an appropriate fit for the data. Table 1. All fit indices of BRIEF-2 confirmatory factor analysis. Fitness indices Values RMSEA 0.098 NFI 0.96 NNFI 0.95 CFI 0.97 GFI 0.94 AGFI 0.89 Fig. 1. Estimation of standardized coefficients Discussion The results of the study showed that the BRIEF-2 has good reliability, as indicated by the examination of Cronbach's alpha coefficients and internal consistency. Additionally, the confirmatory factor analysis confirmed the three-factor model of the scale and its nine components. This suggests that the three-factor structure of the BRIEF-2 is desirable and acceptable in the studied population of school-aged children with externalizing behavioral problems. This finding is in line with the research results of Parhoon et al. (2022), Parhoon et al. (2021), Anastasiadis (2023) and Jiménez & Lucas-Molina (2019). One limitation of this study is that the statistical population was limited to primary school-aged male students with externalizing behavioral problems. Therefore, caution should be taken when generalizing the results to other groups of children. Additionally, the data used in this study was limited to participants from East Azarbaijan province. This means that the results may not be representative of other regions or populations. Besides all limitations, it is suggested that the BRIEF-2 be used as an evaluation and diagnostic tool for assessing executive functions in primary school-aged students with externalizing behavior problems. Conclusion The results of this study suggest that children with high levels of behavioral problems may experience more difficulties with executive functions, which can negatively impact their emotional and motivational abilities. Based on the desirable psychometric properties of the BRIEF-2 and its appropriate criterion validity, it can be used as a tool to evaluate the executive functions of primary school-aged students with externalizing behavior problems. Acknowledgments The researchers express their sincere gratitude and appreciation to all the participants who contributed to the implementation of this research. Without their participation, this study would not have been possible.