Monitoring cognitive load is critical in diverse, demanding environments, yet conventional assessment methods face limitations in real-time applicability. While machine learning approaches using physiological signals show promise, they often require long data segments, exhibit high computational complexity, or neglect underlying causal dynamics. This paper proposes an efficient framework for cognitive load decoding using causal spatiotemporal patterns derived from multimodal peripheral biosignals. We introduce a novel feature engineering pipeline that transforms short signal segments into image-like representations capturing temporal dynamics via Gramian Angular Difference Fields and Motif Difference Fields, alongside causal interdependencies assessed using forward-backward copula Granger causality networks. These fused multimodal features are classified using a lightweight capsule neural network employing a self-attention routing mechanism. To evaluate the proposed solution, we conducted experiments on two widely used benchmark datasets, WESAD and CLAS. Our model achieved up to 94% accuracy using only 5-second signal segments, and maintained robust performance (84% accuracy) even with 1-second windows, a configuration rarely addressed in prior research. The proposed architecture includes only 323K trainable parameters, offering a favorable balance between model complexity and classification performance. The results confirm the framework's potential for computationally efficient, real-time cognitive load assessment suitable for resource-constrained environments and biofeedback applications.

• Keywords
• Capsule network, Cognitive load, Electrocardiogram, Electrodermal activity, Machine learning, Pattern recognition, Physiology,
• MeSH
• Cognition * physiology   MeSH
• Humans MeSH
• Neural Networks, Computer * MeSH
• Signal Processing, Computer-Assisted * MeSH
• Machine Learning MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH

Sleep spindles, an oscillatory brain activity occurring during light non-rapid eye movement (NREM) sleep, are important for memory consolidation and cognitive functions. Accurate detection is important for understanding the role of spindles in sleep state physiology and brain health and for better understanding sleep and neurological disorders. However, manual spindle labeling of electroencephalography (EEG) data is time-consuming and impractical for most clinical and research settings and intracranial EEG (iEEG) presents additional challenges for spindle identification due to its unique signal characteristics and recording environment. This study introduces a novel, precise, and automatic spindle detection method for iEEG using a dual-head architecture to enhance performance, robustness, and ease of use. Our approach achieves a detection F1 score of 0.67 on a challenging iEEG dataset and 0.69 on the publicly available scalp EEG DREAMS dataset. Compared to existing methods such as SUMO, A7, and YASA, our model demonstrates superior performance in detecting, segmenting, and characterizing sleep spindles. This model contributes to open science and advances automated sleep spindle classification in iEEG. This will advance the development of more precise diagnostic and research tools and facilitate a deeper understanding of the role of sleep spindles in cognitive processes and neurological health.

• Keywords
• Dual-head architecture, Intracranial EEG (iEEG), Machine Learning, Signal segmentation, Sleep spindle detection,
• MeSH
• Deep Learning * MeSH
• Electroencephalography * methods   MeSH
• Electrocorticography * methods   MeSH
• Humans MeSH
• Brain * physiology   MeSH
• Signal Processing, Computer-Assisted * MeSH
• Scalp physiology   MeSH
• Sleep * physiology   MeSH
• Sleep Stages * physiology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Karate is one of the most popular martial arts. This study investigates the cognitive profiles of top-level Para Karate athletes with intellectual disability (ID), aiming to assess the extent to which cognitive abilities are related to athletic performance. Cognitive and executive functions, including decision-making, processing speed, working memory, cognitive flexibility, and inhibitory control, are critical in high-level sports but are often understudied in athletes with ID. We conducted cognitive assessments and executive function tests on a cohort of elite Para Karate athletes (n = 42) aged 27.0 (±6.5) years competing in two separate classes. The K21 class (n = 21) is the traditional class for athletes diagnosed with ID and the K22 (n = 23) is a class for ID-athletes with a significant additional impairment such as a genetic syndrome (e.g., Down syndrome) or functional limitation (e.g., reduced joint mobility). The MANOVA revealed that K21 Para Karate athletes perform significantly better than K22 athletes in the areas related to cognitive processing speed (i.e., simple reaction time), visuospatial processing (block design) and inductive reasoning (matrix reasoning task) with large effect sizes. No significant differences between the classes were found for the executive function measures working memory and inhibitory control. The kata-performance during competition was judged by a panel of seven referees. K21 athletes performed better than K22 athletes and a significant correlation was apparent between kata-performance and one parameter of executive function (i.e., inhibitory control). These results highlight the relation between cognitive development and martial arts performance and provide insights for future studies related to the development of sport-specific classification for athletes with ID. More sophisticated measures are necessary to assess the key determinants of kata performance.

• Keywords
• Classification, Down syndrome, Intellectual function, Kata-performance,
• Publication type
• Journal Article MeSH

Cognitive decline is a common feature of neurologic conditions, with language functions often affected. Word finding difficulties are commonly reported to neurologists in clinic. Receptive language dysfunction (i.e., comprehension) tends to be more difficult to recognize for both the patient and the clinician. Subtle yet pervasive decrements in language may be a key feature (and potential driver) of pathological cognitive decline inherent to neurologic diseases involving a primary or secondary neurodegenerative process. While severe language impairment such as aphasia presenting in the context of stroke or dementia has been studied in detail, mild or insidious presentations remain relatively understudied. In this review, we evaluate neural substrates and clinical manifestations of language deficits noted in four neurologic populations: Alzheimer's disease (AD), stroke, multiple sclerosis (MS), and Parkinson's disease (PD). Despite differences in etiology and pathophysiology, these four neurologic populations each present with prominent language dysfunction. For each, we describe neuroanatomical substrates and networks underlying language dysfunction. We then describe current observations of language dysfunction in each population. We incorporate a discussion of emerging speech measurement tools employing machine learning (ML) and artificial intelligence (AI). Overall, we provide evidence to support a nascent hypothesis of language dysfunction as a potential driver of cognitive decline across neurologic populations with the aim of motivating novel research insights and informing clinical care.

• Keywords
• Cognition, Cognitive impairment, Language, Neurodegenerative, Neurological,
• Publication type
• Journal Article MeSH
• Review MeSH

Auditory cognitive control is crucial for filtering relevant information from irrelevant distractions, a frequent challenge in noisy everyday environments. This study investigates the association between vagally mediated heart rate variability (HRV) and auditory cognitive control, employing the Bergen Dichotic Listening (BDL) task. We hypothesized that higher HRV would be associated with enhanced performance in the cognitively demanding forced-left (FL) condition of the BDL, which is a validated measure of auditory cognitive control. Our sample consisted of 63 healthy individuals (N = 35 women), who performed the BDL task in a laboratory setting, with resting HRV measurements taken, followed by real-life cognitive assessments with simultaneous ambulatory HRV monitoring conducted three times across different times of the day. The results confirmed a significant positive relationship between HRV and performance in the FL condition but not in the less demanding forced-right condition (FR). Furthermore, ambulatory measurements revealed that this relationship was influenced by circadian rhythms, showing stronger positive correlations during the night and morning. These findings highlight HRV as a promising biomarker for auditory cognitive control and underscore the impact of time of day on cognitive performance. This study broadens our understanding of the autonomic nervous system's role in cognitive functions and affirms the extension of laboratory findings to daily life settings.

• Keywords
• auditory cognitive control, autonomic nervous system, dichotic listening, heart rate variability,
• MeSH
• Autonomic Nervous System * physiology   MeSH
• Circadian Rhythm * physiology   MeSH
• Dichotic Listening Tests MeSH
• Adult MeSH
• Executive Function * physiology   MeSH
• Cognition * physiology   MeSH
• Humans MeSH
• Young Adult MeSH
• Vagus Nerve * physiology   MeSH
• Auditory Perception * physiology   MeSH
• Heart Rate * physiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: In phase 3 trials, ozanimod reduced brain atrophy and improved cognitive processing speed compared with interferon β-1a (IFN) in participants with relapsing multiple sclerosis (RMS). OBJECTIVES: To assess long-term brain volume changes and associations with clinical/cognitive outcomes during an open-label extension ([OLE] DAYBREAK [NCT02576717]). METHODS: Completers of phase 3 "parent" trials were eligible to receive ozanimod 0.92 mg in DAYBREAK. Whole brain, thalamic, and cortical gray matter volumes (WBV, TV, and CGMV, respectively) were analyzed annually. RESULTS: Participants receiving continuous ozanimod had sustained, low rates of WBV loss through OLE month (M)60 (annualized least-squares mean percent change from parent baseline: RADIANCE, -0.27; SUNBEAM, -0.35). Compared with participants switched from IFN, these participants had lower reductions in WBV (parent baseline through OLE M48 [RADIANCE] and OLE M60 [SUNBEAM]). Larger baseline brain volumes were associated with numerically better Symbol Digit Modalities Test scores and lower 3-month confirmed disability progression (CDP) incidence. Annualized TV atrophy ⩽1.0% was associated with lower 3-month CDP. CONCLUSION: This study confirms the sustained efficacy of ozanimod in reducing brain atrophy rates for up to 7 years. Brain volume preservation was associated with faster cognitive processing speed and slower physical disability progression.

• Keywords
• MRI, Multiple sclerosis, Symbol Digit Modalities Test, confirmed disability progression, sphingosine 1-phosphate receptor modulators, thalamus,
• MeSH
• Atrophy pathology   drug therapy   MeSH
• Adult MeSH
• Indans * therapeutic use   MeSH
• Cognition drug effects   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Sphingosine 1 Phosphate Receptor Modulators * pharmacology   MeSH
• Brain * pathology   drug effects   diagnostic imaging   MeSH
• Oxadiazoles * therapeutic use   MeSH
• Multiple Sclerosis, Relapsing-Remitting * diagnostic imaging   drug therapy   pathology   MeSH
• Gray Matter pathology   drug effects   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial, Phase III MeSH
• Names of Substances
• Indans * MeSH
• Sphingosine 1 Phosphate Receptor Modulators * MeSH
• Oxadiazoles * MeSH
• ozanimod MeSH Browser

Despite growing interest in sustainability, the adoption of circular economy (CE) practices in hospitality remains largely symbolic and limited to low-effort actions. This paper explores why hotels, despite expressing genuine interest and facing external pressures, often avoid deeper CE strategies. First, a systematic literature review and bibliometric mapping identify key behavioural, structural, social and market-related barriers that constrain CE action. These barriers shape managerial thinking and contribute to disengagement from ambitious practices. Building on this, an explanatory analysis draws on psychological mechanisms, particularly cognitive dissonance and moral licensing, to explain why external limitations become internally justified. This rationalisation process fosters a 'So What?' mindset, where minimal actions are viewed as sufficient in light of perceived barriers. As a result, the gap between sustainability intentions and behaviour and further action widens. The study helps us understand how hotel managers' beliefs and thinking patterns influence whether and how they apply CE principles.

• Keywords
• Behaviour, Circular economy, Cognitive dissonance, Decision-makers, Hospitality, Sustainability,
• MeSH
• Humans MeSH
• Morals MeSH
• Organizational Culture * MeSH
• Private Facilities MeSH
• Intention * MeSH
• Conservation of Natural Resources * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Systematic Review MeSH

BACKGROUND: Sense of agency (SoA) is the subjective experience of causing and controlling one's actions. Recent studies have linked SoA to gamma-band oscillations in the right inferior parietal lobule (IPL) and suggest that it can be modulated through external interventions using neurostimulation techniques. OBJECTIVE: This study aims to provide evidence for a causal role of the right IPL in SoA using multiple noninvasive brain stimulation methods (NIBS), electroencephalography (EEG), and a feedback manipulation task. METHODS: In two experiments, we investigated the effect of gamma band (60 Hz) transcranial alternating current stimulation (tACS), transcranial random noise stimulation (tRNS), low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS), and high-frequency (10 Hz, 20 Hz) rTMS over the right IPL. RESULTS: As anticipated, gamma band tACS and high-frequency rTMS had distinct effects on SoA. Gamma band tACS enhanced the detection of non-self agency, while high-frequency rTMS impaired this capacity and reduced the overall SoA. EEG spectral analysis confirmed the impact of stimulation on the right IPL and highlighted the role of beta band oscillations. CONCLUSION: Using the largest subject pool to date, our study provides causal evidence for the crucial role of the right IPL in processing SoA, particularly in detecting non-self agency arising from real-time sensorimotor mismatch comparison. Our findings suggest that external stimulation affects the comparator mechanism, rather than introducing prediction errors as previously proposed, and support the view that the right IPL is more closely associated with the implicit feeling of agency rather than with higher cognitive processes.

• Keywords
• EEG, Gamma oscillations, Inferior parietal lobule, Sense of agency, Temporo-parietal junction, rTMS, tACS,
• MeSH
• Adult MeSH
• Electroencephalography * methods   MeSH
• Deep Brain Stimulation methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Transcranial Direct Current Stimulation * methods   MeSH
• Sense of Agency * MeSH
• Parietal Lobe * physiology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH

BACKGROUND: Although exercises and physical activities are beneficial for overall health, it can unfortunately result in a musculoskeletal injury that requires a surgical intervention in physically active youth. One of the major injures young athletes sustain is anterior cruciate ligament (ACL) tear, which often requires a surgical intervention. Following the ACL reconstruction (ACLR) surgery, athletes need to participate in rehabilitation and often perform return-to-sport (RTS) testing. During this process, the RTS decision requires the contributions of multidisciplinary sports medicine healthcare providers. PURPOSE: To discuss how to optimize a safe RTS from the perspective of multidisciplinary sports medicine healthcare practitioners and synthesize them with research-based evidence using a clinical scenario involving a female athlete following ACL injury. METHODS: A clinical scenario of a young female basketball player with an ACL tear is presented. In this particular case, the patient had a previous ACL tear history in her contralateral limb. Thigh circumference, knee range of motion, quadriceps and hamstrings strength, hop tests, and psychological readiness measures at 9 months post-operatively is also presented. RESULTS: An orthopaedic surgeon, academic-physiotherapist, sports psychiatrist, clinical physical therapy, and performance and sport scientist provided their RTS perspectives based on the given scenario. Because of her previous history and low psychological readiness, several emerging concepts were discussed including neurocognitive-based rehabilitation, cognitive-behavioral therapy, and step-by-step RTS progression (return to participation, sport, and performance). CONCLUSION: The current article synthesized clinical insights from various sports medicine healthcare with practitioners and research evidence based on an ACL clinical scenario. The approaches discussed in this paper may be beneficial to facilitate safe RTS.

• Keywords
• ACL, female athletes, knee injury, pediatrics, rehabilitation,
• Publication type
• Journal Article MeSH

Schizophrenia is increasingly recognized as a disorder with a prominent neuroimmune component. Researchers have observed elevated markers of inflammation (e.g., cytokines, CRP, and NLR) not only during first-episode psychosis but also in chronic stages, suggesting that immune dysregulation may play a key role in the illness's pathophysiology. Yet, current pharmacological treatment mainly targets dopaminergic dysregulation, which is effective in reducing positive symptoms but is ineffective in managing negative symptoms and cognitive decline associated with schizophrenia. Antipsychotics (APs) may exert anti-inflammatory effects, possibly through attenuating glial activation and modulation of the immune pathways, though these effects remain still underexplored. That is why, in this narrative review, we synthesize evidence from in vitro, animal, and human studies to examine whether APs influence inflammatory processes and assess their potential in mitigating the refractory symptoms of schizophrenia through the immune modulation. Despite promising findings, several key uncertainties persist: inflammatory markers exhibit inconsistent patterns across studies, methodological approaches differ considerably, and antipsychotic-induced metabolic alterations further complicate interpretation. To fully understand the anti-inflammatory potential of APs, future research should identify the most effective compounds, determine optimal treatment timing, and rigorously control for confounding factors. Crucially, a paradigm shift is needed: clinical trials must adopt biomarker-guided stratification, and drug development should focus on agents that modulate the innate immunity. These steps are essential for developing more effective treatments for the refractory symptoms of schizophrenia.

• Keywords
• Anti-inflammatory effect, Antipsychotic medication, Cytokines, First-episode psychosis, Markers of inflammation, Neuroinflammation, Schizophrenia,
• MeSH
• Anti-Inflammatory Agents * pharmacology   therapeutic use   MeSH
• Antipsychotic Agents * pharmacology   therapeutic use   MeSH
• Dopamine * metabolism   MeSH
• Humans MeSH
• Schizophrenia * drug therapy   immunology   metabolism   MeSH
• Inflammation * drug therapy   metabolism   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Anti-Inflammatory Agents * MeSH
• Antipsychotic Agents * MeSH
• Dopamine * MeSH