Annals of the New York Academy of Sciences

Objective: To develop the first inventory to measure psychosocial concerns about use of the non-preferred hand, toward the long-term goal of identifying the casual factors of left-right hand choices ("hand usage"). Design: Cross-sectional Setting: Online question battery Participants: 181 healthy adults Interventions; Not applicable Main Outcome Measures: Self-reported concerns about emotional and physical consequences of using the non-preferred hand. Results: Emotional and physical consequences reflected internally consistent categories (Cronbach's > 0.9) that were moderately correlated with each other ({rho} = 0.783 p = 0.002). Concerns were activity-dependent in each category ({rho} < 1x10-100). Reliability analysis and principal components analysis were used to reduce the battery to the 51-item Changed Hand Usage Concerns inventory, which encompasses everyday tasks and concerns about physical and emotional consequences of using the non-preferred hand in those tasks. Conclusions: Concerns about emotional vs. physical consequences of non-preferred hand use reflect coherent and internally consistent categories The Changed Hand Usage Concerns inventory allows assessment of psychosocial concerns about usage of the non-preferred hand for future attempts to manipulate hand usage via rehabilitation in patients with unilateral or asymmetric impairment.

Objective: To evaluate the feasibility of nurse-led ultrasound hip screening for newborns and infants during home visits, focusing on whether trained public health nurses (PHNs) can obtain interpretable images for orthopedic pediatric surgeons' diagnosis, imaging error patterns, immediate operational challenges, and follow-up results of infants with suspected developmental dysplasia of the hip (DDH). Design: Pilot prospective cohort study. Sample: Forty-two infants were screened. PHNs conducted ultrasound hip screenings during home visits. Measurements: Diagnostically interpretable images, as determined by two pediatric orthopedic surgeons. Results: Diagnostically interpretable images of 75/84 (89.3%) hips were obtained. Surgeons identified three error patterns: incomplete visualization of the ilium (n = 2), joint capsule (n = 1), or bony roof (n = 2). Infant crying was an operational challenge (n = 1). Thirty-three (78.6%) hips were normal, four (9.5%) had abnormal findings requiring abduction exercises, three (7.1%) were referred to a hospital, and two (4.8%) failed imaging. One hip was diagnosed with subluxation, which went undetected by physical or risk screening. Conclusion: Nurse-led ultrasound hip screening for newborns and infants during home visits is feasible and may aid in early DDH detection. Further studies should assess diagnostic accuracy, cost-effectiveness, and long-term outcomes.

Objective: A questionnaire survey was conducted on the willingness and demand for acupuncture treatment in patients with malignant tumors, and the possible factors affecting patients' willingness and demand for acupuncture treatment were explored. Methods: A voluntary, anonymous survey was conducted between February and May 2025 among patients with malignant tumors aged 18 years and older who visited Beijing Cancer Hospital. The questionnaire included 16 questions addressing three dimensions:current medical purposes,Traditional Chinese Medicine(TCM) literacy, and acupuncture treatment needs.The questionnaire was posted online and completed by respondents using a smartphone interface. Results: A total of 511 valid questionnaires were retrieved in the survey, and 481 patients(94.1%) are willing to receive acupuncture treatment. Among the 481 patients willing to receive acupuncture treatment, the top five symptoms they hoped to improve with acupuncture were: disturbed sleep (245 participants, 50.9%); pain (229 participants, 47.6%); fatigue (177 participants, 36.8%); numbness (165 participants, 34.3%); and poor appetite (144 participants, 29.9%). Among patients who chose to "explicitly accept" acupuncture treatment and those who "accepted acupuncture treatment upon doctor's recommendation", 55% and 56% respectively had good knowledge of traditional Chinese medicine (TCM) culture. In contrast, this proportion was only 36.7% among patients who refused acupuncture treatment, and the difference was statistically significant (P<0.05). The survey results also show that Female patients reported significantly higher demands for pain relief and improved sleep than male patients, with statistically significant differences (P<0.05). Furthermore, those aged 18-45 and with better TCM literacy were more likely to desire acupuncture to improve sleep, with statistically significant differences (P<0.05). Conclusion: Differences in TCM literacy can influence patients' willingness to choose acupuncture treatment. Strengthening patient health education and improving TCM literacy will help increase cancer patients' willingness to choose TCM acupuncture treatment, thereby enabling them to benefit from acupuncture. For patients aged 18-45, those with good TCM literacy female with high acupuncture needs, acupuncture treatment may be recommended as a priority.

Background/Objective: The Network Pain Rehabilitation Limburg (NPRL) was established to provide integrated, biopsychosocial-based rehabilitation care for patients with chronic musculoskeletal pain, emphasizing the delivery of appropriate care by the right person at the right place and cost. This study examines the perceived interprofessional collaboration practice (ICP) and work satisfaction among primary care healthcare professionals engaged in NPRL. Patients and Methods: A mixed-methods approach involved seven general practitioners (GPs), twenty-four therapists (physiotherapists and occupational therapists), and five mental health practice nurses in eleven semi-structured focus groups and one interview conducted from 2017 to 2020. The Interprofessional Collaboration Attainment Survey quantitatively measured healthcare professionals' ICP abilities before and after NPRL participation. Qualitative analysis, structured around existing ICP frameworks and the Quadruple Aim, was based on interview data. Results: Findings revealed stable ICP and work satisfaction, with discussions focusing on transitioning to a biopsychosocial perspective on chronic pain and its implications, along with concerns about GP burden and insurer reimbursement issues. Significant enhancements were noted in communication and team functioning (p < 0.05). Conclusions: Overall, healthcare professionals reported positive experiences with NPRL's integrated approach, showcasing dedication to providing rehabilitation care for chronic musculoskeletal pain in primary care. Recommendations for improving ICP included advocating for a broader societal biopsychosocial view of chronic pain, introducing case managers in primary care to support GPs, and exploring alternative reimbursement models with insurers. However, significant transformations to impact work satisfaction and ICP may necessitate more time and consideration.

Humanity has always admired and created artwork, but the neurocognitive mechanisms behind artistic experience are still elusive. Professional artists and their intimate relationship with their artworks provide a unique opportunity to study the nature of art experience due to their expertise in both art making and art appreciation. During two fMRI tasks, professional artists (N=20) made aesthetic judgments on their own and other artists paintings (aesthetic appreciation task); they also mentally reconstructed the moments when they conceived their artworks or, as a control condition, when they visited now-familiar places for the first time (reconstruction by imagery task). During art appreciation of their own (as compared to other artists) paintings, participants showed stronger recruitment of bilateral posterior parietal cortices, the left lateral occipitotemporal cortex, and the dorso-central sector of the right insula, that is, action-related brain regions also involved in encoding the emotional components of movements. The reconstruction of their own artistic creation (as compared to episodic memory retrieval) involved the left fronto-parietal network associated with motor cognition. Altogether, these results suggest that the mental representations of the actions involved in creating art are integral to the overall artistic experience of painters, supporting an embodied view of the artists experience of art.

Prosthetic devices balance functionality and usability to support activities of daily living (ADLs). However, many designs rely on rigid end effectors that, while anthropomorphic in form, lack biomimetic design principles. This mismatch increases cognitive and physical burden, reducing adoption rates. We developed the Human-inspired Actuator Modeling and Reconstruction (HAMR) process, a user-centered framework informed by individual morphology and functional needs, to generate customized agonist/antagonist tendon-actuated end effectors. Using HAMR, we created the Tendon Actuated Prosthetic Hand (TAPH), which integrates human-derived geometry with adaptive force distribution to promote natural object interaction. In a study with 12 participants without limb difference, TAPH was compared to a structurally similar tendon-actuated hand with generalized anthropomorphic geometry across three ADL tasks of varying complexity. TAPH significantly improved task performance and reduced physical effort, mental workload, and frustration, particularly during gross motor tasks. For fine motor tasks, performance improved under stable conditions but not during tasks requiring dynamic precision and continuous coordination. These findings highlight the functional benefits of biologically informed prosthesis design and support biomimetic principles in enhancing performance and user experience.

Dystonia treatment evaluation in cerebral palsy (CP) is limited by the lack of clinician-assessed scales linking dystonia severity to functional impact. We asked 7 pediatric movement disorder specialists to review videos of 27 children with CP while performing an upper extremity task and while walking. Experts rated arm and leg dystonia severity using the Global Dystonia Severity Rating Scale (GDRS) and task-specific functional impact on a five-point scale adapted from the Dyskinetic Cerebral Palsy Functional Impact Scale. Arm GDRS scores correlated with functional impact on the upper extremity task (linear regression R^2=0.48, p=0.0005). Leg GDRS scores correlated with gait impact (R^2=0.43, p=0.001). A four-point increase in total GDRS corresponded to a one-point worsening in combined functional impact. By demonstrating how expert-rated limb dystonia severity correlates with task-specific functional impact in children with CP, these results could help clinically identify functionally-meaningful differences in dystonia severity.

Introduction: Adults with spinal cord injury (SCI) often experience reduced or lost sensation and movement, impairing the ability of the brain to locate paralyzed body parts, which, in turn, compromises sensorimotor recovery. This disruption of the internal body map of the brain, or mental body representations (MBR), also contributes to neuropathic pain in about 69% of adults with SCI. Medications for neuropathic pain are often ineffective and can cause adverse reactions. Our previous pilot clinical trial showed that Cognitive Multisensory Rehabilitation (CMR), a physical therapy that restores MBR, produced significant, lasting reductions in neuropathic pain, improved sensorimotor function, and enhanced brain function. Building on these results, we examined whether 8 weeks of CMR or adaptive fitness (1) improved sensorimotor function and reduced pain; (2) greater brain activity and connectivity related to sensorimotor function and MBR in adults with SCI. Methods: Sixteen participants (52+/-8 years old, 13+/-10 years post-SCI) were randomized to 8 weeks of CMR or adaptive fitness (45 min, 3x/week). Ten participants had neuropathic pain of 3/10 or greater. Pain and sensorimotor function were assessed at baseline, post-intervention, and 3-month follow-up using the Numeric Pain Rating Scale (NPRS), ASIA Impairment Scale (AIS), and Neuromuscular Recovery Scale (NRS). Functional MRI included resting-state and 4 tasks: imagining feeling the left leg, imagining moving the left leg, whole-body movement imagery, and a sensation task. Results: After CMR, participants improved on AIS with large effect sizes (touch: d=1.54; pinprick: d=1.83; lower limb motor function: d=1.32), while adaptive fitness had small/moderate effects (touch: d=0.49; pinprick: d=0.53; lower limb motor function: d=0.74). CMR also showed larger effect sizes for NRS (core: d=2.19; upper limb: d=0.69; lower limb: d=0.74) than fitness (core: d=0.73; upper limb: d=0.34; lower limb: d=0.00). Benefits persisted at follow-up. Highest neuropathic pain intensity reduced post-CMR and at 3-month follow-up (d=0.48; d=0.63). Pain increased slightly after fitness (n=6; d=-0.19; d=-0.41). CMR increased brain connectivity and activation during the leg imagery task. Increased activation during whole-body imagery was greater after CMR than fitness. Discussion: These preliminary results support the potential of CMR to improve function and reduce neuropathic pain in adults with SCI, warranting larger confirmatory trials. Clinicaltrial.gov: NCT05167032

Background: Lumbar spinal stenosis (LSS) can cause pain and severe walking limitation. Although surgery aims to improve walking, many patients do not achieve clinically meaningful gains. Rehabilitation can improve outcomes, yet existing programmes lack robust evidence and theoretical underpinning. This study aimed to (1) co-design a theory-informed rehabilitation programme to improve walking after LSS surgery, and (2) evaluate feasibility of conducting a future trial and acceptability of the intervention. Methods: A multi-methods study included intervention co-design followed by a single-arm feasibility study. Co-design used an adapted Experience-Based Co-Design approach with patients, carers, and healthcare professionals (n=39), integrating the Behaviour Change Wheel. This resulted in STructured Rehabilitation and InDividualised Exercise and Education (STRIDE), delivered over 12-week pre- and 12-weeks post-surgery, targeting knowledge, expectations, perceived control, physical capability, and fears. Adults aged [&ge;]50 years awaiting LSS surgery were recruited to a before-after feasibility study. Feasibility outcomes included recruitment and retention. Acceptability was assessed using the Theoretical Framework of Acceptability questionnaire (0-5 (high acceptability)) and focus groups. Clinical outcomes measured at baseline, post-prehabilitation, and post-rehabilitation included 6-minute walk distance (6MWD) and mean daily step count over 7 days. Results: Fifteen of 31 eligible participants were recruited (48%; mean age 70 years), with 80% retained to study end (2 decided against surgery, 1 unable to complete final assessment). Acceptability was high (median 5/5, IQR 0). Participants valued the personalised, supportive approach and reported improved motivation and preparation for surgery, though travel was burdensome. Small pre-operative and moderate-to-large post-operative improvements were observed in 6MWD (+49.9 m and +81.6 m) and daily step count (+868 and +1405 steps/day). Conclusions: This co-designed, physiotherapy-led, behaviour-change rehabilitation programme was acceptable to participants, with encouraging recruitment, retention, and signals of improved walking following LSS surgery. The findings support progression to a future trial.

BackgroundPhysical activity has been associated with better reading comprehension and reduces cognitive load (CL), but the role of brain volume in modulating this relationship remains unclear. Therefore, this study aims to determine whether the gray matter volume in key regions modulates the effects of different physical activity modalities on reading comprehension and associated CL. MethodsThirteen male adolescents (12-13 years). Adolescents with MRI data participated in a randomized cross-over trial comparing three conditions: 1) sedentary behavior (SC, emulating a school class), 2) moderate-intensity continuous training (MICT), and 3) cooperative high-intensity interval training (C-HIIT), with physical activity conditions duration adjusted to match SC energy expenditure. Gray matter volumes were measured in the bilateral hippocampus, left pars opercularis, and the brainstem. CL was assessed via pupil dilation during reading using eye-tracking. Reading comprehension was measured through seven-question multiple-choice tests with expert-validated items. ResultsC-HIIT demonstrated superior effects on both CL and reading comprehension compared to MICT and SC, with significant brain volume modulation effects across all examined regions. Brain volume interactions with physical activity modalities systematically modified the pattern of cognitive responses, with C-HIIT consistently benefiting from these modulations, whereas the effects of MICT were generally attenuated. ConclusionThis study suggests that selecting the appropriate physical activity modality may be relevant for cognitive outcomes during reading in adolescents. C-HIIT yielded lower CL and better reading comprehension, and these effects were not explained by brain volume alone but by its interaction with exercise modality.

Objectives: To determine the impact of discharge home on physical activity and sedentary behaviour following orthopaedic trauma. Design: Observational study. Setting: Acute hospital. Participants: Between October 2022 and January 2024, 31 adult orthopaedic trauma patients were recruited during hospital admission. Participants had either an isolated hip fracture or multi-trauma (i.e., a lower limb fracture, with an upper limb and/or spinal fracture). Interventions: Participants wore two activity monitors (activPAL3 and ActiGraphGT3x) during the final days of an acute hospital admission and the first five days at home. An interrupted time series analysis evaluated changes physical activity variables during the hospital to home transition. Participants were analysed individually using mixed-effects linear regression allowing the intercept to vary by participant. Main outcome measures: Primary outcome was daily steps; secondary outcomes included sedentary time and other activity measures. Results: Daily steps (mean +- SD) were higher at home (4552.4 +- 2639.5) compared to hospital (2597.8 +- 1450.8). Modelled results indicated a 27% increase in daily steps following hospital discharge (exp(beta946;): 1.27, 95% CI: 1.01,1.59, p=0.039) and a sustained improvement at home. No significant differences were observed between hip fracture and multi-trauma participants. Conclusion: Participants recovering from orthopaedic trauma showed a significant increase in daily step count upon discharge home from hospital, highlighting the positive impact of the home environment on activity levels. Further research is warranted to assess the effectiveness of interventions to improve activity levels in hospital (e.g., early intensive therapy) and at home (e.g., immediate home-based physiotherapy) in individuals following orthopaedic trauma.

Both episodic memory and word retrieval have been linked to power decreases in the alpha and beta oscillatory bands, but these patterns have rarely been related to each other, partly due to a lack of methodological approaches available. In this explorative study, we investigate the similarities and dissimilarities in the oscillatory fingerprints of the retrieval of words and episodes by directly comparing the activity patterns across time, frequency, and space. We acquired electroencephalography (EEG) data of participants performing a language and an episodic memory task based on the same stimulus material. With a newly developed approach, we directly compared the source-reconstructed oscillatory activity using mutual information and a feature-impact analysis. While left temporal and frontal regions showed dissimilarities between the tasks, right-hemispheric parietal regions exhibited similarities. We speculate that this could indicate a homologous function of these regions, potentially sharing less-specific representations between the tasks. We further uncovered a dissociation of the alpha and beta bands regarding the similarity across tasks. While the beta band was dissimilar between word and episodic memory retrieval, the alpha band seemed to contribute to the similarity we observed in right parietal regions. Whether this points to a task-unspecific function of the alpha band or a functional role in the retrieval process of the presumed representations, remains to be determined. In summary, we present an approach to study similarity across tasks using the temporal, spectral, and spatial dimensions of EEG data, and present results of exploring the shared oscillatory fingerprints between episodic memory and word retrieval.

BackgroundOlder adulthood is often accompanied by declines in auditory processing and cognitive functioning, increasing the risk of reduced autonomy and quality of life. Multidomain lifestyle interventions have shown potential to counteract these changes, and choir-based activities represent a promising approach by simultaneously engaging auditory, cognitive, physical, and social domains. However, evidence regarding their feasibility and neurophysiological impact in community-dwelling older adults, particularly those without formal musical training, remains scarce. MethodsThis 9-month quasi-experimental feasibility study involved 54 community-dwelling older adults (mean age = 72.9 years) with no formal musical background. Participants self-selected into a choir-based intervention group, an active control group engaging in non-musical leisure activities, or a passive control group; however, some participants in the control groups were selected from the waiting list for the choir. Assessments were conducted at baseline and follow-up and included measures of global cognition, cognitive reserve, psychological well-being (Flourishing Scale), multidimensional frailty (Selfy-MPI), music perception, pure-tone audiometry, and auditory evoked potentials recorded using a standardized clinical oddball paradigm. ResultsThe choir-based intervention was feasible in a community setting. At the neurophysiological level, choir participation was associated with a bilateral, significant shortening of the N2-P3 inter-peak latency, indicating faster auditory-cortical processing. Additionally, through explorative analyses multidimensional frailty, as assessed by the Selfy-MPI, showed a significant reduction in individuals engaging in a higher number of activities, irrespective of group allocation. Similarly, psychological well-being revealed a decrease in flourishing scores in the passive control group relative to the choir group. No changes were observed in audiometric thresholds or music perception measures. ConclusionChoir-based multidomain participation is a feasible intervention for community-dwelling older adults without formal musical training and is associated with selective benefits in cognitive reserve, psychological well-being, auditory-cortical processing speed, and multidimensional frailty. These findings provide a foundation for a larger randomized controlled trial aimed at clarifying the cognitive, psychosocial, and neural mechanisms underlying choir-based interventions in ageing. Trial RegistrationThe upcoming trial has been prospectively registered on ClinicalTrials.gov (ID: NCT06767410; registration date: January 9, 2025).

Global healthcare is targeting patient-centred care, as it leads to better health outcomes and higher level of patient satisfaction. Patient-centred communication, is an important part of patient-centred care because it focuses on involving patients in their care. Recent surveys both nationally and globally have shown that patients are not involved enough in their own healthcare decisions. This problem is especially common among the elderly with chronic conditions. This study aimed to describe patient-healthcare professional interactions, expectations, and satisfaction in physiotherapy within an understudied context, thereby providing important, specific data on ICE dynamics and satisfaction in the specific setting. Cross-sectional study of participants in scheduled consultations was conducted. Two government physiotherapy centres, seven private physiotherapy centres and two trust centres with physiotherapy facilities in Gujarat, India. 232 patients (from various public and private physiotherapy clinics) participated in the study. Patients' ideas, concerns, expectations (ICE) and satisfaction were explored. Almost 88% of patients reported their thoughts and explanations about their symptoms during the consultation. Most patients described not having any concerns about the diagnosis/treatment, and more than two-third of patients consulting PTs expected explanation for their symptoms. Almost 90% patients were satisfied with the consultation. The study revealed that while most patients conveyed their thoughts during consultations, very few expressed their concerns. Overall, patients were satisfied with their consultations.

Prolonged esports play induces cognitive fatigue that is not fully captured by subjective awareness, motivating practical, non-stimulant nutritional strategies supported by objective physiological markers. We here tested whether acute milk protein intake attenuates fatigue-related physiological responses during prolonged esports play and supports subjective state, executive control, and in-game performance. In a randomized, single-blind (assessor-blind), energy-matched controlled crossover study, 15 healthy young adults with esports experience completed two sessions in which they consumed either a milk protein drink or an energy-matched apple juice control before a 3-h virtual soccer task. Physiological measures included pupillometry during gameplay, salivary cortisol, continuous interstitial glucose monitoring, and heart rate. Subjective ratings (VAS) and executive function (flanker task) were assessed across post-ingestion time points, and in-game performance metrics were aggregated within hourly gameplay blocks. Milk protein intake was associated with a coherent pattern of physiological advantages, including larger pupil diameter during gameplay, smoother interstitial glucose dynamics, and lower salivary cortisol, while heart rate showed time-dependent changes without a clear condition effect. These physiological changes co-occurred with higher enjoyment and lower hunger, improved flanker performance, and condition-dependent improvements in in-game performance, most notably higher shot success rate. Additionally, pupil diameter during gameplay was associated with inhibitory-control efficiency on the flanker task. These findings suggest that acute milk protein intake may serve as a practical, non-stimulant nutritional strategy to sustain physiological state and cognitive-behavioral performance during prolonged esports (virtual soccer) play. Highlights- Prolonged esports play models modern digital cognitive activity and cognitive fatigue. - Acute milk protein intake increases pupil diameter during prolonged esports play. - Interstitial glucose dynamics are smoother and salivary cortisol is lower with milk protein. - Enjoyment increases and hunger decreases during 3 h of virtual soccer play. - Executive function and in-game performance improve, most notably shot success rate.

BackgroundAutonomous sensory meridian response (ASMR) and music-induced frisson are sensory-affective phenomena characterized by tingling, chills, and pronounced emotional responses. Previous research has mainly focused on physiological changes during these experiences, whereas much less is known about whether baseline physiological state is associated with subsequent susceptibility. ObjectiveTo examine whether baseline autonomic flexibility, indexed primarily by heart rate variability (HRV), is associated with later ASMR/frisson responsiveness. Resting EEG measures were included as secondary exploratory markers. MethodsFifteen participants were recruited by convenience sampling; after artifact-based exclusion, 10 participants were included in the analyses. A 5-minute resting baseline EEG and ECG was recorded prior to stimulus presentation. Participants were then exposed to auditory and audiovisual ASMR stimuli, classical music excerpts, and a control stimulus, and reported whether they had experienced ASMR-typical sensations or frisson. Main analyses examined associations between baseline physiological parameters and a combined response-positive outcome. Exploratory analyses included participant-level correlations, comparisons between susceptible and non-susceptible participants, and stimulus-specific effect sizes. ResultsHRV-related measures showed the clearest and most consistent pattern of association with responsiveness. Higher baseline total HRV power was associated with a greater number of response-positive stimuli (r = 0.756, p = 0.011), with similar positive associations for high-frequency HRV (HF; r = 0.672, p = 0.033) and baseline heart rate slope (r = 0.751, p = 0.012). Stimulus-specific analyses likewise showed the most consistent positive baseline effects for total HRV power, with HF and heart rate slope pointing in the same direction. Frontal alpha asymmetry (FAA) was negatively associated with responsiveness ({rho} = -0.862, p = 0.001), but EEG findings overall were less consistent than the HRV-related pattern and are best interpreted as secondary exploratory observations. ConclusionsIn this exploratory pilot sample, baseline HRV, particularly total HRV power, showed the most coherent physiological association with susceptibility to ASMR and music-induced frisson. The findings are consistent with the possibility that these experiences depend not only on stimulus properties, but also on pre-existing physiological state. Given the small sample and exploratory design, the results should be interpreted as hypothesis-generating and require replication in larger confirmatory studies.

Background/Objective: Common measures of physical activity (PA) based on duration and intensity do not fully capture its complexity. Adding additional PA components of muscle strength, mechanical strain, and turning actions, can provide a more complete view of activity behavior. Furthermore, PA behaviors differ between men and women. Therefore, the goal of this study is to identify and cluster similar long-term PA patterns over time for each PA component, examined separately for men and women. Methods: We used data from 4963 participants (52% women; mean age 66 years, SD = 8.6) of the Longitudinal Aging Study Amsterdam (1992 to 2019). PA component scores were assigned to self-reported activities, and Sequence Analysis with Optimal Matching was used to identify and cluster similar activity patterns over a period of 10 years, separately for each component and stratified by sex. Results: PA components varied by sex and displayed a unique mix of trajectories, including predominately low, medium, or high activity, increasing or decreasing patterns, and trajectories characterized by early or late mortality. Importantly, trajectories remained independent, indicating that changes in one PA component were not linked to changes in others. Conclusion: Older men and women follow distinct and independent long term PA trajectories across components, underscoring that PA behaviour cannot be described by a single dimension. Significance/Implications: The observed independence and heterogeneity of trajectories suggest that muscle strength, mechanical strain, and turning actions capture meaningful and distinct aspects of PA that are not reflected by traditional measures alone. Future PA-strategies could incorporate these dimensions and acknowledge sex-specific patterns to better reflect natural movement. The independence of components suggests that future interventions should target multiple dimensions, as changes in one component may not translate to others. Such an approach may support more tailored and sustainable PA interventions in later life.

BACKGROUND: Cranioplasty is an essential procedure to restore cranial integrity, protect neural structures, and improve cosmetic outcomes. However, commercially available implants are often costly, limiting their accessibility in public healthcare systems. Three dimensional (3D) printing offers a low cost alternative for producing patient-specific solutions. METHODS: A retrospective case series of eight patients undergoing cranioplasty using customized polymethylmethacrylate (PMMA) implants fabricated with 3D printed molds was conducted. Computed tomography (CT) scans were used for segmentation and digital modeling. Patient specific molds were designed and printed preoperatively. Variables analyzed included design time, printing time, intraoperative workflow, and clinical outcomes. RESULTS: Design time ranged from approximately 1 hour for small defects to 3 hours for larger defects. Printing time ranged from 2 3 hours for smaller defects and up to 8 10 hours for larger reconstructions. Satisfactory aesthetic outcomes were achieved in 7 of 8 patients (87.5%). No major implant related complications were observed. CONCLUSION: Low cost 3D printing for PMMA cranioplasty is a feasible, accessible, and effective technique for cranial reconstruction, particularly in resource limited settings. Keywords: Cranioplasty; 3D printing; Cranial defect reconstruction; Low cost surgery; Patient specific implants; Polymethylmethacrylate; Skull reconstruction

Post-traumatic stress disorder (PTSD) is a debilitating condition that affects millions of veterans. A recent observational study in 30 veterans showed that a single dose of the atypical psychedelic ibogaine can be highly effective at treating PTSD up to twelve months later. Although a prior study demonstrated that ibogaine transiently alters electroencephalography (EEG) power in various frequency bands, the long-term, network-level neural mechanisms targeted by ibogaine are unclear. Here, we investigated whether ibogaine-related clinical improvements are associated with the reorganization of certain brain networks. We applied a novel framework, FREQuency-resolved brain Network Estimation via Source Separation (FREQ-NESS), to identify frequency-specific brain networks in resting-state EEG data acquired at baseline, three to four days after treatment (immediate-post), and one month after ibogaine. At both the immediate-post and one month-post timepoints, high-beta (24 and 25 Hz) networks shifted away from frontal areas and towards posterior regions, an effect that was replicated in an independent EEG dataset on ibogaine treatment for opioid use disorder. This posterior shift was significantly correlated with improvements in PTSD symptoms at both timepoints. Neural field modeling demonstrated that these posterior high-beta shifts are associated with increases in corticocortical, but not corticothalamic, connectivity. Our results are consistent with prior evidence implicating aberrant frontal beta-band activity in PTSD. Overall, we demonstrate that the reconfiguration of high-beta brain networks could be a robust biomarker for ibogaines therapeutic effects.

The early development of the prefrontal cortex is crucial for higher cognitive functions. However, current research presents inconsistent findings regarding whether intra-prefrontal connectivity increases or decreases in infants younger than six months. Do dynamic changes in connection strength across different states over time carry information about prefrontal maturation? This study used functional near-infrared spectroscopy (fNIRS) to record prefrontal brain activity in 48 healthy infants aged 1-8 months during natural sleep and auditory stimulation. By analyzing the fluctuations in frequency-domain characteristics of functional connectivity (FC) and various brain network properties, we found that: under auditory stimulation, the intensity of FC fluctuations in the ultra-low frequency range was positively correlated with age; while in the resting state, the fluctuation intensity of network properties in relatively higher frequency bands decreased with age. Furthermore, auditory stimulation reconfigured the energy distribution of network fluctuations, shifting it towards higher frequency bands. These results suggest that the early development of the infant prefrontal internal network is characterized by state-dependent optimization of its dynamic fluctuation properties, shedding light on the developmental tuning of functional network dynamics in infancy.