assessing-perceptions-exposure-to-artificial-intelligence-among

Assessing Perceptions and Exposure to Artificial Intelligence Among Medical Educators and Clinicians in Saudi Arabia: A Cross-Sectional Study

Artificial intelligence (AI) is transforming healthcare through advances in diagnostics and decision-making, yet most studies have focused on medical ...

King Abdulaziz University

It is well known that the efficacy of treatment effects, including those of placebos, is heavily dependent on positive expectations regarding treatment outcomes. For example, positive expectations about pain treatments are essential for pain reduction. Such positive expectations not only depend on the properties of the treatment itself, but also on the context in which the treatment is presented. However, it is not clear how the preceding threat of pain will bias positive expectancy effects. One hypothesis is that threatening contexts trigger fearful and catastrophic thinking, reducing the pain-relieving effects of positive expectancy. In this study, we investigated the disruptive influence of threatening contexts on positive expectancy effects while 41 healthy volunteers experienced laser-induced heat pain. A threatening context was induced using pain-threatening cues that preceded the induction of positive expectancies via subsequent pain-safety cues. We also utilised electroencephalography (EEG) to investigate potential neural mechanisms underlying these effects. Lastly, we used the Fear of Pain Questionnaire to address whether the disruptive effect of negative contexts on cued pain relief was related to the degree of fear of pain. As predicted, participants responded less to pain-safety cues (i.e., experienced more pain) when these were preceded by pain-threatening cues. In this threatening context, an enhancement of the N2 component of the laser-evoked potential was detected, which was more pronounced in fearful individuals. This effect was localised to the midcingulate cortex, an area thought to integrate negative affect with pain experience to enable adaptive behaviour in aversive situations. These results suggest that threatening contexts disrupt the effect of pain relief cues via an aversive priming mechanism that enhances neural responses in the early stages of sensory processing.

Negative expectations interfere with the analgesic effect of safety cues on pain perception by priming the cortical representation of pain in the midcingulate cortex.

Chronic pain is exacerbated by maladaptive cognition such as pain catastrophizing (PC). Biomarkers of PC mechanisms may aid precision medicine for chronic pain. Here, we investigate EEG biomarkers using mass univariate and multivariate (machine learning) approaches. We test theoretical notions that PC results from a combination of augmented aversive-value encoding ("magnification") and persistent expectations of pain ("rumination"). Healthy individuals with high or low levels of PC underwent an experimental pain model involving nociceptive laser stimuli preceded by cues predicting forthcoming pain intensity. Analysis of EEG acquired during the cue and laser stimulation provided event-related potentials (ERPs) identifying spatially and temporally-extended neural representations associated with pain catastrophizing. Specifically, differential neural responses to cues predicting high vs. low intensity pain (i.e. aversive value encoding) were larger in the high PC group, largely originating from mid-cingulate and superior parietal cortex. Multivariate spatiotemporal EEG patterns evoked from cues with high aversive value selectively and significantly differentiated the high PC from low PC group (64.6% classification accuracy). Regression analyses revealed that neural patterns classifying groups could be partially predicted (R = 28%) from those neural patterns classifying the aversive value of cues. In contrast, behavioural and EEG analyses did not provide evidence that PC modifies more persistent effects of prior expectation on pain perception and nociceptive responses. These findings support the hypothesis of magnification of aversive value encoding but not persistent expression of expectation in pain catastrophizers. Multivariate patterns of aversive value encoding provide promising biomarkers of maladaptive cognitive responses to chronic pain that have future potential for psychological treatment development and clinical stratification.

Neural representations of aversive value encoding in pain catastrophizers.

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Working memory deficits underlie many of the behavioural symptoms of ADHD. Alongside psychostimulant medications, strategies to improve working memory may play an important adjuvant role in the management of ADHD. In this study, we review the role of working memory deficits in ADHD, the evidence surrounding working memory training strategies in the management of the condition, and the factors affecting the success of these strategies in alleviating ADHD symptoms. More specifically, we review several non-pharmacological interventions that target working memory deficits in ADHD, with special emphasis on cognitive working memory training. We conclude that the development of evidence-based interventions such as computerised cognitive training (CCT) could provide an alternative or adjunct to the use of psychostimulants, especially in cases where side effects are a major issue.

A Review of Working Memory Training in the Management of Attention Deficit Hyperactivity Disorder.

Social media usage (SMU) and its relationship with working memory (WM) and academic performance remain unclear, and there is a lack of experimental evidence. We investigated whether WM mediates the association between SMU and academic performance, including the roles of depression, anxiety, and disordered social media use as possible contributors. A sample of 118 undergraduate students aged 19 to 28 from Saudi Arabia performed a WM test twice; for one assessment, participants were required to interact with social media before the test, and the other test was preceded by painting online. We also measured grade point average (GPA), habitual social media usage (SMU), depression (PHQ-9), anxiety (GAD-7), and disordered social media usage (SMDS). There was no significant difference between WM scores in the social media condition compared to the control condition, but when solely considering at least moderately depressed participants social media use predicted significantly more errors in the social media condition compared to the control condition. Furthermore, higher SMDS scores were significantly predicted by higher PHQ-9 scores and more hours of habitual SMU. GPA scores were not predicted by WM performance or SMU. The present study is one of the first experimental attempts to compare the relationship between SMU and WM and highlights the priming effect of depression on the relationship between SMU and WM.

Social Media Usage, Working Memory, and Depression: An Experimental Investigation among University Students.

Working memory training has been proven effective for improving cognitive functioning in patients with Attention Deficit/Hyperactivity Disorder (ADHD). However, the feasibility of this type of training for children in Saudi Arabia has not been previously explored. We investigated the feasibility of implementing Cogmed Working Memory Training (CWMT) in a sample of 29 Saudi children with ADHD. We found no significant demographic or clinical differences between compliant and noncompliant children. Although compliant children were initially better at following instructions and reported better improvements in working memory and math skills compared to those who did not complete the CWMT, all children who participated in the program showed improvements in performing the CWMT tasks. Most parents found the Cogmed training feasible for their children, were satisfied and keen to continue with the program, and felt the training helped them to address their problems. Most children did not encounter any difficulties in using the software, and many families were, therefore, likely to continue using the techniques from the program. We conclude that CWMT for children with ADHD is feasible in Saudi Arabia. Larger case-controlled studies are needed to thoroughly investigate the effects of CWMT compared to other interventions in Saudi children with ADHD.

COGMED working memory training in children with Attention Deficit/Hyperactivity Disorder (ADHD): A feasibility study in Saudi Arabia.

Sleep deprivation is a growing challenge in modern society and places a burden on people's physical and mental well-being. However, only a few studies have investigated sleep patterns and awareness of the associated risks of sleep deprivation in Middle Eastern countries. This study aimed to explore these issues in adults in Saudi Arabia.

Sleep patterns and awareness of the consequences of sleep deprivation in Saudi Arabia.

Sleep and mental health can affect cognition and academic performance. The present study aimed to investigate the relationships between sleep, mental health, working memory, and academic performance. We collected demographic data from university students during the non-academic summer period and the academic term. We also measured academic performance (GPA), sleep (PSQI), depression (PHQ-9), anxiety (GAD-7), and disordered social media use (SMDS). Working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). We assessed 83 students (42.2% male) with a mean age of 21 years. Compared to the non-academic summer period, students had significantly worse sleep and distress scores in the academic term. Anxiety, depression, and distress scores were significantly correlated with worse sleep quality. Despite worse mental health and sleep in the academic term, working memory improved compared to the non-academic summer period and was also correlated with a higher GPA. However, a higher GPA was significantly associated with longer sleep latency, increased sleep disturbances, and increased use of sleep medication. Students experiencing poor sleep suffered from poor mental health, although they maintained high GPA and working memory scores. Cognitive resilience, including higher working memory, may mask poor sleep quality and mental health among university students.

The Impact of Sleep and Mental Health on Working Memory and Academic Performance: A Longitudinal Study.

Optimal cognitive functions, including working memory (WM), are crucial to enable trainee physicians to perform and excel in their clinical practice. Several risk factors, including on-call shifts, poor mental health, burnout, and sleep problems, can impair clinical practice in trainee physicians, potentially through cognitive impairment; however, these associations have not been fully explored.

Impact of on-call shifts on working memory and the role of burnout, sleep, and mental well-being in trainee physicians.

The relationship between stress and working memory (WM) is crucial in determining students' academic performance, but the interaction between these factors is not yet fully understood. WM is a key cognitive function that is important for learning academic skills, such as reading, comprehension, problem-solving, and math. Stress may negatively affect cognition, including WM, via various mechanisms; these include the deleterious effect of glucocorticoids and catecholamines on the structure and function of brain regions that are key for WM, such as the prefrontal cortex and hippocampus. This review explores the mechanisms underlying how stress impacts WM and how it can decrease academic performance. It highlights the importance of implementing effective stress-management strategies to protect WM function and improve academic performance.

Stress, working memory, and academic performance: a neuroscience perspective.

Quality of life (QoL) in patients with inflammatory bowel disease (IBD) is influenced by several factors, many of which may also impact cognitive function. However, the extent of the interaction among these factors, QoL, and disease outcomes in IBD patients remains unknown. We thus aim to characterize the relationships among psychological disorders, coping mechanisms, cognitive function, and the overall impact on QoL and disease outcomes in patients with IBD. This cross-sectional observational study was conducted at an academic care center. QoL was evaluated using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and disease severity was evaluated using the Harvey-Bradshaw Index (HBI) for Crohn's disease (CD) and the Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC). We also used the Hospital Anxiety and Depression scale (HADS). Regression models were used to test the associations among QoL, number of hospitalizations, disease severity, cognitive functioning (working memory [WM] and reaction time), and coping strategies while controlling for anxiety and depressive symptoms, age, and sex. This study included 41 patients (24 patients with CD and 17 with UC) whose mean age was 28.2 (±8.4) years (23 males) and mean SIBDQ score was 51.5 (±10.0). Patients with more WM errors had lower QoL scores (P = .041), whereas patients with higher anxiety levels had lower QoL and more active UC (P = .008 and P = .016, respectively). The use of avoidant coping mechanisms was associated with a significantly higher number of hospitalizations (P = .038), and patients who adopted more emotion-focused coping strategies had a longer illness duration (P = .021). Finally, patients with higher education levels were found to use more active coping mechanisms than others. These results confirm the impact of cognitive, psychological, and coping factors on QoL and disease outcomes in patients with IBD; however, the mechanisms by which these factors interrelate remain unclear. Therapies aimed at improving both cognitive functions and psychological conditions may thus be effective at improving QoL and disease outcomes in IBD patients, and education may play a positive role in promoting the adoption of more effective coping strategies among IBD patients.

The impact of cognitive functions, psychological disorders, and coping strategies on quality of life and disease outcomes in patients with inflammatory bowel diseases: A cross-sectional study.

 There is growing interest in neuroscience-informed education, as well as neuroscience-derived strategies that maximise learning. Studies on neuroscience literacy and neuromyths, i.e., understandings or misconceptions about the brain, have primarily focused on their prevalence in educators, and few studies have examined their impact on students' study habits or academic performance.  To address this gap, we surveyed 576 university students in different academic programmes to investigate the relationship between neuromyths and academic outcomes in university students. In this quantitative, cross-sectional study design, we used a validated neuroscience knowledge survey and the Revised Two-factor Study Process (R-SPQ-2F) Questionnaire. We also inquired about students' interest in, exposure to, and awareness of neuroscience, as well as their academic grades.  Students showed significant awareness of and interest in neuroscience; this was highest among students in health science programmes and lowest among students in computer and engineering programmes. The most common sources of general neuroscience knowledge were internet articles. Higher neuroscience literacy was associated with higher interest in neuroscience and having taken more neuroscience courses. Neuromyth scores were also better among those with higher neuroscience literacy scores. Higher neuroscience literacy scores were significantly associated with higher grades, higher surface strategy scores, and lower surface motive study habits.  Our study sheds light on the variations in foundational neuroscience literacy among students in different academic programmes. It also provides insight into how this foundation affects academic performance and study habits. This insight may help guide educational policymakers to adopt neuroscience-based strategies that may be beneficial for learning.

Neuroscience Literacy and Academic Outcomes: Insights from a University Student Population.

Following the Coronavirus Disease 2019 (COVID-19) pandemic, many patients have reported ongoing smell and taste issues. This study aims to investigate the prevalence of olfactory and gustatory dysfunction among patients with a history of COVID-19 and its association with autonomic dysfunction and disability.

Persistent Post-COVID-19 Olfactory Dysfunction and Its Association with Autonomic Nervous System Function: A Case-Control Study.

Although artificial intelligence (AI) has gained increasing attention for its potential future impact on clinical practice, medical education has struggled to stay ahead of the developing technology. The question of whether medical education is fully preparing trainees to adapt to potential changes from AI technology in clinical practice remains unanswered, and the influence of AI on medical students' career preferences remains unclear. Understanding the gap between students' interest in and knowledge of AI may help inform the medical curriculum structure.

Article	Year
Negative expectations interfere with the analgesic effect of safety cues on pain perception by priming the cortical representation of pain in the midcingulate cortex. PloS one\| PubMed ID: 28665973	2017
Neural representations of aversive value encoding in pain catastrophizers. NeuroImage\| PubMed ID: 30243959	2019
A Review of Working Memory Training in the Management of Attention Deficit Hyperactivity Disorder. Frontiers in behavioral neuroscience\| PubMed ID: 34366803	2021
Social Media Usage, Working Memory, and Depression: An Experimental Investigation among University Students. Behavioral sciences (Basel, Switzerland)\| PubMed ID: 35049627	2022
COGMED working memory training in children with Attention Deficit/Hyperactivity Disorder (ADHD): A feasibility study in Saudi Arabia. Applied neuropsychology. Child\| PubMed ID: 35549563	2023
Sleep patterns and awareness of the consequences of sleep deprivation in Saudi Arabia. Sleep & breathing = Schlaf & Atmung\| PubMed ID: 36319929	2023
The Impact of Sleep and Mental Health on Working Memory and Academic Performance: A Longitudinal Study. Brain sciences\| PubMed ID: 36358451	2022
Impact of on-call shifts on working memory and the role of burnout, sleep, and mental well-being in trainee physicians. Postgraduate medicine\| PubMed ID: 38656827	2024
Stress, working memory, and academic performance: a neuroscience perspective. Stress (Amsterdam, Netherlands)\| PubMed ID: 38910331	2024
The impact of cognitive functions, psychological disorders, and coping strategies on quality of life and disease outcomes in patients with inflammatory bowel diseases: A cross-sectional stud... Medicine\| PubMed ID: 39058817	2024
Neuroscience Literacy and Academic Outcomes: Insights from a University Student Population. Brain sciences\| PubMed ID: 39851411	2025
Persistent Post-COVID-19 Olfactory Dysfunction and Its Association with Autonomic Nervous System Function: A Case-Control Study. Diseases (Basel, Switzerland)\| PubMed ID: 39851468	2024
Assessing the disconnect between student interest and education in artificial intelligence in medicine in Saudi Arabia. BMC medical education\| PubMed ID: 39881303	2025

Abeer F. Almarzouki

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