Annals of the New York Academy of Sciences

PurposeHuman anatomy remains foundational to clinical practice, yet reduced instructional hours raise concerns about graduate competence and preparedness for patient care. Although trainees often report confidence, supervisors may perceive deficiencies, creating a gap between self-assessment and external evaluation. This study examined stakeholder perspectives on anatomical competence within physical therapy education to identify areas of discordance in perceived capability. MethodsA cross-sectional web-based survey collected responses from 165 stakeholders associated with an entry-level Doctor of Physical Therapy program featuring a 16-week dissection curriculum. Participants rated four domains of anatomical competence using a 5-point ordinal scale. Group differences were analyzed with the Kruskal-Wallis test appropriate for ordinal data. This methodology ensured robust assessment of stakeholder perceptions and comparative analysis. ResultsMedian ratings of preparedness and capability were 4 of 5 (quite prepared). Significant discordance emerged in three domains: recent graduates rated their foundational knowledge and ability to explain complex concepts to lay audiences higher than faculty or clinical instructors, whereas faculty expressed lower confidence in graduates ability to explain patient symptoms using anatomical principles. No significant differences were observed in the ability to describe structures by location, suggesting shared perceptions of basic anatomical understanding despite variation in applied reasoning. ConclusionsStakeholders generally viewed graduates as well prepared, yet disagreement persisted regarding clinical application of anatomical knowledge. Faculty skepticism about symptom explanation indicates that mastery of anatomy alone does not guarantee clinical reasoning. Curricular strategies emphasizing vertical integration and explicit connections between anatomical science and patient-centered reasoning may help bridge perception gaps and enhance professional competence.

AimTo determine the mechanistic relationship between segmental trunk control in the neutral vertical posture (NVP), assessed using the Segmental Assessment of Trunk Control (SATCo), and the Gross Motor Function Classification System (GMFCS); and hence to identify the means to enhance function in children with cerebral palsy (CP). MethodThis cross-sectional study included 101 children with CP (34 female, 10y(3y8m), 1.32(0.27)m, 33.4(18.4)kg) classified across GMFCS Levels I-V and tested with SATCo. Association and variation between GMFCS Levels and SATCo results were examined. ResultsSATCo results differed significantly (p<.05) between GMFCS Levels in static, active and reactive tests of trunk control. As neuro-ability increases through GMFCS Levels V-I, ability to control the head and trunk in NVP increases ({rho}(99)=-0.61 to -1,p<.0001) and variation in head and trunk control increases ({rho}(3)=-0.9 to -1,p<.05). InterpretationSATCo provides mechanistic insights supporting its use following GMFCS. In severe CP, NVP control is minimal across all children. In mild CP, large variation in results shows that SATCo discriminates between the use of full trunk control from compensatory strategies to achieve function. For each GMFCS Level, SATCo identifies the training required to improve trunk control in NVP, thus improving functional performance and reducing long-term risk of deformity. What this paper addsO_LISATCo results are related to GMFCS Levels, and complements GMFCS C_LIO_LISATCo provides the mechanistic explanation for what is observed in GMFCS C_LIO_LISATCo-GMFCS reveals if function is attained with trunk control or compensatory strategies C_LIO_LICompensatory strategies often used in mild CP are not captured by GMFCS C_LIO_LISATCo identifies the training required to improve function and reduce deformity risk C_LI Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=115 SRC="FIGDIR/small/26344472v2_ufig1.gif" ALT="Figure 1"> View larger version (19K): org.highwire.dtl.DTLVardef@3ba4f1org.highwire.dtl.DTLVardef@1c9ce70org.highwire.dtl.DTLVardef@101d01org.highwire.dtl.DTLVardef@1e04861_HPS_FORMAT_FIGEXP M_FIG C_FIG O_LIExample above: GMFCS Level I child leaning backwards when tested for lower thoracic NVP trunk control. Same child showing compensatory lordotic lumbar posture while standing. C_LIO_LISATCo can be used in combination with GMFCS to identify specific training targets to improve postural control, enhance function, and reduce deformity risk. C_LI

BackgroundThoracic spine mobilization (TSM) has been proposed to influence autonomic nervous system (ANS) activity, yet evidence remains inconsistent and feasibility of standardised protocols is unclear. This study aimed to evaluate whether a randomized TSM protocol can be implemented successfully in healthy participants and to provide preliminary estimates of its effects on heart rate variability (HRV) and heart rate (HR). MethodsA randomized feasibility trial was conducted with healthy young adults receiving six manual therapy sessions consisting of rotational mobilizations above Th5 over 14 days. Feasibility outcomes included adherence, absence of unexpected adverse events (UAE), and practicality of autonomic data acquisition. Physiological outcomes comprised HRV parameters, high-frequency (HF), low-frequency/high-frequency ratio (LF/HF) and HR, analyzed using autoregressive (AR) and fast Fourier transform (FFT) methods. ResultsProcedural safety and methodological integrity were confirmed (no UAE; complete datasets), but feasibility was only partially achieved due to adherence shortfalls, higher attrition, and device-related delays. Physiologically, large effect sizes were observed in the intervention group: at evening assessment, HF_AR showed ES = 0.80 (p = .008); at morning assessment, HF_FFT ES = 0.72 (p = .016), HF_AR ES = 0.78 (p = .010), and LF/HF_AR ES = 0.70 (p = .021). HR remained unchanged. These findings suggest repeated TSM may modulate HRV, primarily through HF-related changes associated with vagal activity, while LF/HF interpretation remains controversial. ConclusionA randomized TSM protocol is safe and methodologically viable with logistical refinements. Preliminary evidence indicates potential vagal modulation, warranting larger trials with respiratory control, ECG-based HRV, multimodal ANS measures, and clinical populations to confirm efficacy and translational relevance.

AimWe investigated the heterogeneity of treatment effects in transcranial direct current stimulation (tDCS) with mindfulness-based meditation (MBM) and within each individual study group (tDCS alone, MBM alone, and sham) among individuals with symptomatic knee osteoarthritis. We also explored participant characteristics underlying this heterogeneity. MethodsThis secondary analysis drew on a double-blind, randomized, sham-controlled, phase II, parallel-group trial in which 200 participants were assigned to one of four groups: (1) active tDCS + active MBM, (2) active tDCS + sham MBM, (3) sham tDCS + active MBM, or (4) sham tDCS + sham MBM. Participants received ten 20-minute tDCS sessions (active or sham) administered concurrently with MBM (active or sham). Latent class growth analysis was used to identify subgroups with distinct treatment response trajectories (responders vs. non-responders) based on changes in clinical pain (Numeric Rating Scale) from baseline to post-intervention. Generalized linear models were then applied to determine baseline factors associated with participants response classification, including demographic, clinical, and psychological characteristics; quantitative sensory testing battery; and pain-related cortical hemodynamic activity measured using functional near-infrared spectroscopy (fNIRS) in response to punctate and thermal stimuli. ResultsResponders in the active tDCS + active MBM and active tDCS + sham MBM groups demonstrated greater improvements in clinical pain from baseline to post-intervention than non-responders (p < 0.001). In the active tDCS + active MBM group, greater cortical activation in the fNIRS channel S06-D06 of the left somatosensory cortex in response to punctate stimuli, identifying as white, and lower conditioned pain modulation (reflecting less efficient endogenous pain modulation), were significantly associated with being responders (p < 0.05). In the active tDCS + sham MBM group, younger age and lower heat pain tolerance at the knee were significantly associated with being responders (p < 0.05). No clear response patterns were observed in the remaining groups. ConclusionFactors underlying heterogeneity of treatment effects, including somatosensory cortical activation and pain modulatory profiles, may provide preliminary insights to inform the development of personalized neuromodulation (stimulation) protocols.

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.

BackgroundLong Covid, also referred to as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by symptoms that persist or emerge weeks to months following acute COVID-19 illness. Cognitive impairments affecting attention, memory, and executive functioning--commonly described as "brain fog"--are frequently reported. Currently, limited evidence-based cognitive rehabilitation interventions specifically target these impairments. ObjectivesThis pilot randomized controlled trial aims to evaluate the feasibility and acceptability, and to develop preliminary data regarding efficacy of Attention Process Training-3 (APT-3), a computerized attention training program, for individuals with Long Covid-related brain fog. MethodsThis study uses a three-arm randomized controlled design. Participants are randomized to (1) Immediate Attention Training, (2) Delayed Attention Training, or (3) Music Activity. Participants complete comprehensive cognitive assessments at baseline, post-intervention, and one-month follow-up. The Immediate Attention Training group completes a 4-week APT-3 intervention, while the Music Activity group engages in a 4-week music-based listening activity. The Delayed Attention Training group dont receive any intervention for 4 weeks. Following completion of the final assessment, participants in the Music Activity and Delayed Attention Training groups are offered the APT-3 intervention. Feasibility and acceptability outcomes include recruitment, retention, and adherence numbers, and participant satisfaction. Preliminary data regarding efficacy will be determined using objective cognitive tests and subjective self-report measures. ConclusionsThis pilot trial will inform the feasibility and acceptability of APT-3 and generate preliminary efficacy data to guide the design of a future fully powered randomized controlled trial targeting brain fog associated with Long Covid.

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.

BackgroundMirroring is a foundational method used in Dance Movement Therapy (DMT), assumed to foster empathy and therapeutic attunement, yet its embodied dynamics remain insufficiently studied. In this paper, we provide the first quantitative exploration of client-therapist mirroring across dyadic and triadic formats, examining how synchrony unfolded during a structured mirroring exercise in which participants alternated between leading and following roles. MethodologyUsing optical motion capture and time-series modelling, we quantified movement coordination in dyadic (female client-therapist; male client-therapist) and triadic (therapist with both clients) interactions. ResultsIn dyadic tasks, the female client-therapist interaction was marked by tight temporal alignment, significant synchrony, robust predictive accuracy, and clear client-to-therapist influence, consistent with kinaesthetic empathy and affect-sensitive entrainment. By contrast, the male client-therapist dyad exhibited weaker and more delayed temporal coupling, alongside reduced phase synchronisation and fewer directional dependencies, despite comparable levels of interpersonal proximity. In the triadic task, temporal entrainment attenuated: therapist movement had few matching qualities to clients movement, yet recurrent synchrony with both clients persisted, suggesting a strategic shift from fine-grained entrainment to stable postural scaffolding under divided attention. DiscussionThese findings demonstrated that mirroring is not a uniform technique, but a family of embodied coordination modes flexibly recruited according to relational context and client expressivity. They align with theories of embodied simulation and affect attunement, implicating rapid motor resonance in dyadic entrainment and interoceptive-affective scaffolding in triadic stability. Clinically, the results underscore the need for training in flexible embodied strategies, split attention, and equitable allocation of attunement in group work. More broadly, they open a translational agenda linking kinematic synchrony to neural, interoceptive, and autonomic mechanisms, positioning mirroring as both an experiential hallmark and a measurable mechanism of change in embodied psychotherapy.

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.

Creativity is one of the unique cognitive constructs in human beings and its neurobiological correlates are one of the current hot topics in neuroscience. The "Different Hearing" program (DHP) is an educational activity aimed at stimulating musical creativity by means of group composing in the classroom, alternative to the mainstream model of music education in Czechia. In our previous study, the data from task-related functional MRI with passive listening was analyzed. The results suggested that DHP training modified the response to diverse sound samples, differentially changing the engagement of functional networks known to be related to creative thinking, namely, increasing default mode network activation and decreasing activation of executive and salience networks. In the present study, we hypothesized that the DHP short-term (2 days) intense workshop would also induce changes in the resting-state networks that were significantly modified during task. To investigate it, seed-based, ROI-to-ROI resting-state functional connectivity and degree centrality analysis were performed on the acquired resting-state fMRI data. The results showed no significant group-by-time interaction.

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.

Motor rehabilitation requiring sustained physical exercise faces poor adherence in neurological populations due to insufficient supervision and monotony. While virtual reality and musical biofeedback independently improve engagement and motivation, their comparative and combined impact on intensity control strategies during high-intensity interval training (HIIT) remains unexplored. Thirty healthy adults (16 males, 14 females; mean age 27.5 {+/-} 7.2 years) were sequentially assigned to three feedback modalities (n=10 each) during intensity-guided stationary cycling: visual-only (position-based), musical-only (speed-based), and combined audiovisual (position-based). Participants completed two 9-minute moderate-to-high intensity sessions (Set 1 and Set 2) maintaining pedaling speed within a target speed zone. Performance distinguished control strategy from effectiveness: stability via target zone exits, correction capacity via recovery time and sustained deviations, and overall effectiveness via time in zone. Heart rate (HR) assessed physiological intensity; usability and cognitive workload were evaluated via e-Rubric and NASA-TLX. Distinct regulation strategies emerged. Musical-only showed significantly lower stability (Set 1: 14.52 exits/min vs. 1.48 visual and 1.79 combined; corrected p < 0.0167) but superior correction (0.21s recovery vs. 2.48s and 1.06s; p < 0.0001) with minimal sustained deviations. Combined feedback achieved highest Set 2 effectiveness (98.13% vs. 95.17% time in zone; corrected p < 0.0167) but elevated physical demand (corrected p < 0.0167). HR variability was comparable (p = 0.85), confirming consistent cardiovascular workload despite differing strategies. Satisfaction was high, with slight preference for musical feedback; cognitive workload did not differ. Musical biofeedback promotes reactive control with frequent but rapidly corrected oscillations, maintaining physiological safety and engagement. Visual feedback ensures stable target adherence at the cost of compensatory physical effort. Combined modality offered no synergy, increasing demand without improving effectiveness. Findings reveal a trade-off between stability and correction agility, supporting tailored modality selection: musical feedback suits unsupervised rehabilitation prioritizing engagement, rapid error correction, and sustainable effort, while visual feedback suits supervised protocols requiring stable preventive control and precise adherence quantification. Author summaryMany people undergoing neurological rehabilitation struggle to maintain adherence to high-intensity exercise programs, particularly without direct supervision. While virtual reality and musical feedback have shown promise for improving engagement and motivation, we didnt know which type works best for controlling exercise intensity, or whether combining them would be better. We tested three feedback systems with 30 healthy adults performing stationary cycling: visual-only, musical-only, and both combined. We measured how well participants stayed within target speed and assessed their experience. Musical feedback prompted frequent but instant adjustments--a reactive strategy that was less physically demanding and most enjoyable. Visual feedback kept participants more precisely in the target zone but required significantly more effort. Surprisingly, combining both didnt improve performance and instead increased physical demand. Our results show that different feedback types suit different rehabilitation contexts. Musical feedback may be ideal for unsupervised home-based exercise because it keeps people engaged without requiring exhausting effort. Visual feedback works better when precise control is essential in supervised clinical settings, despite being more demanding. Combining both offers no advantage. These findings help clinicians choose the right feedback approach based on their specific rehabilitation goals.

AIMExecutive functions (EF) are advanced cognitive processes that play an essential role in daily functioning and may be of increased importance in cerebral palsy (CP), given the complexity of primary and associated impairments. This study aims to synthesize existing evidence on the relation between EF and domains of the International Classification of Functioning, Disability and Health (ICF) in individuals with CP, and to quantify the magnitude of these associations through meta-analysis. METHODA systematic literature search was conducted in eight electronic databases up to 14 July 2025, examining associations between EF and ICF domains in CP. EF outcomes were classified into inhibitory control, working memory, cognitive flexibility, higher-order EF, and EF composite scores. Outcome measures were mapped onto ICF domains: Body Functions and Structures, Activity, Participation, and Contextual factors, using the CP Core Sets. Correlation coefficients were transformed to Fishers z and entered into three-level meta-analyses to estimate pooled effect sizes. Single moderator analyses examined CP subtype, EF domain, EF assessment type, and mean age. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. RESULTSFrom 4637 identified records, 38 studies were included, comprising a total sample of 1633 participants with CP. There was substantial heterogeneity in CP subtype, participant age, and EF conceptualization, while the ICF Contextual factors domain was underrepresented. A medium-to-large association was found between EF and functioning across all ICF domains combined (r=0.26, p<0.001). Domain-specific analyses showed a medium association of EF with Body Functions and Structures (r=0.21, p<0.01), a medium-to-large association with Activity (r=0.38, p<0.001) and Participation (r=0.26, p<0.01). CP subtype and mean age significantly moderated the overall EF-functioning association, with mixed CP and younger age associated with stronger effects. INTERPRETATIONEF are meaningfully associated with multiple domains of functioning in individuals with CP. These findings support the relevance of routine EF assessment and suggest that EF are an important cognitive correlate to consider when addressing broader aspects of daily functioning. WHAT THIS PAPER ADDSO_LIExecutive functions (EF) showed medium-to-large associations with all ICF domains in people with cerebral palsy (CP) C_LIO_LIThe strongest and most consistent associations were found between EF and ICF Activity C_LIO_LIOverall associations highlight the relevance of EF as a meaningful intervention target in CP C_LI

The study of contemplative practices has evolved into a mature field, yet current taxonomies tend to classify all mantra-based meditation approaches as a single category, overlooking potentially different neural states induced by different mantras or different instructions. To address this gap, we conducted a study of 50 novice subjects practicing two types of mantra-based meditation over a six week period to evaluate changes in Electroencephalography (EEG) during and after meditation. Participants were randomly assigned to meditating with the Hare Krishna (HK) and Sa-Ta-Na-Ma (SA) mantras. Using spectral parameterization, we assessed the effects of each type of meditation on individual alpha power (IAP), individual alpha frequency (IAF) and center of gravity (CoG). The results revealed marked differences in alpha dynamics between the two practices. On the one hand, the HK group exhibited widespread IAP decrease and an IAF/CoG increase during mantra meditation that was maintained during rest after the meditation, which became more pronounced after training in the HK meditation. On the other hand, the SA group showed a localized IAP reduction during meditation and significant reduction of IAF during meditation after training. We suggest that the higher cognitive demands of HK induce a more activating, attentionally focused state, whereas SA promotes a more relaxed state. Additional psychological data show that both meditation groups had reduction in stress. Thus, these findings challenge the monolithic classification of mantra meditation and highlight the importance of differentiating practices according to their mechanisms, particularly for their targeted application in mental health contexts.

Motivational music has been shown to improve running performance through delaying fatigue and increasing run duration. Previous studies have highlighted the effect of music tempo, that matching tempo to the runners cadence delays running fatigue. It remains unclear whether the motivational content in music lyrics is also responsible for delaying running fatigue. We designed a cross-sectional study and investigated the effect of tempo and motivational content on running biomechanics, and had participants run at a moderate intensity for up to ten minutes, or until exhaustion. Fifteen adults (age=20.9{+/-}1.3 years, weight=71.2{+/-}12.1 kg, height=174.7{+/-}11.0 cm) participated. Participants finished three trials, starting with running without any stimulus as a baseline trial, and ran with a visual metronome that flashed at a rate that matched their running cadence in the visual stimulus trial (VST). In the visual-auditory stimulus trial (VAST), participants ran with the visual metronome (as described in VST) while listening to a non-rhythmic motivational speech. We recorded run duration, perceived exertion, center of pressure sway during standing before and after each trial, and measured trunk acceleration to obtain root-mean-square (RMS) of acceleration during each minute of the run. Compared to baseline, participants reduced perceived exertion by 0.87 and 0.85 rating during the VST and VAST, respectively, though these changes did not reach significance (p=0.05). Stimulus affected the RMS of acceleration in anterior-posterior (p=0.011), vertical (p=0.008), and resultant directions (p=0.006). Our linear mixed effect model suggested that compared VST, VAST further lowered RMS of acceleration by 0.026g (anterior-posterior), 0.028g (vertical), and 0.036g (resultant). Our results showed that motivational content played an important role in lowering RMS of trunk acceleration, with the potential to delay running-induced fatigue. To maximize the effect of music on running performance, runners should listen to music that they find motivational and that is close to their natural running cadence.

INTRODUCTIONConnected speech analyses can help characterize linguistic impairments in primary progressive aphasia (PPA) and classify variants, however, manual transcription of speech samples is time-consuming and expensive. Automated speech recognition (ASR) may be efficacious for transcribing PPA speech. METHODSTranscripts of picture descriptions (109 PPA, 32 healthy controls (HC)) were generated using a manual, automated (Whisper) or semi-automated approach including a quality control (QC) step. We evaluated transcript accuracy, the reliability of ASR-derived linguistic features, and classification performance. RESULTSWhisper demonstrated lowest error rates for HC, followed by semantic, logopenic and non-fluent PPA variants. Errors correlated with overall disease severity for semantic and logopenic variants. QC of Whisper outputs reduced errors and improved the reliability of linguistic features. Overall, ASR-derived features achieved better classification performance than manual transcription features. DISCUSSIONResults support the use of off-the-shelf ASR for scalable, cost-efficient transcription of PPA speech and classification.

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.

Individuals with post-stroke aphasia live with long-term disabilities, yet they do not know whether they will improve their communication and cognitive skills over time. We propose a "Therapy Calculator" to provide patients with a better understanding of likely recovery as they engage with therapy. Using a large dataset of rehabilitation outcomes from a digital therapeutic called Constant Therapy (3.5 million therapy sessions of 18,000+ users), we developed a machine learning algorithm that estimates the probability of improvement from one functional landmark (i.e., a given skill level) to the next in a functional domain (e.g., reading) while accounting for age, etiology, starting performance, and frequency and duration of therapy. This logistic regression model performed a binary classification task, i.e., whether patients can improve to the next landmark, with an average F1 score of all models at 0.84, suggesting reliable prediction of moving to the next landmark. Then, we created an online "Therapy Calculator" to assess a new users current functional level and demographic information, and make predictions by passing these features into models trained on relevant subsets of historical data. The findings indicate that our model can provide reliable predictions for patients beginning self-managed SLT, and therapy calculator is publicly available.

Phasic increase of frontal midline theta (Fm theta) has been described as a key indicator of cognitive processing, while relatively lower task-related Fm theta is associated with reduced cognitive strain, reflecting less intensive cognitive processing. In a previous investigation, reduced task-related Fm theta in relation to higher expertise, as well as higher setting anticipation performance in the domain of volleyball was identified. In the present study a single-session sham-controlled neurofeedback training (NFT) intervention was conducted to investigate the feasibility of Fm theta downregulation for the improvement of volleyball setting anticipation. A total of 24 volleyball novices was allocated to "Real" (n = 12) and "Sham" (n = 12) Fm theta downregulation NFT groups. NFT-related Fm theta, pre-/post-NFT setting anticipation task performance and task-related Fm theta, as well as resting EEG activity were analyzed. Incongruous with our expectations, the Real NFT group showed a tendency toward stronger Fm theta synchronization compared with the Sham group during NFT. Anticipation task performance did not change significantly from before to after NFT in both groups, yet a significant reduction of task-related Fm theta was observed in the Real NFT group following NFT. A post-NFT rebound of Fm theta could be responsible for this result. With our findings we provide further evidence for the existence of an apparent paradox of Fm theta downregulation, in which cognitive control mechanisms, associated with oscillatory Fm theta activity, appear to hinder explicit downregulation of Fm theta through classical neurofeedback learning mechanisms.