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Background: Cognitive impairment occurs in up to 65% of people with multiple sclerosis (PwMS), negatively affecting daily functioning and health-related quality of life. In general, neuropsychological testing is not part of standard MS-care due to insufficient time and trained personnel. Consequently, a baseline assessment of cognitive functioning is often lacking, hampering early identification of cognitive decline and change within a person over time. To assess cognitive functioning in PwMS in a time-efficient manner, a BICAMS-based self-explanatory digital screening tool called the Multiple Screener©, has recently been developed. The aim of the current study is to validate the Multiple Screener© in a representative sample of PwMS in the Netherlands. Additionally, we aim to investigate how cognitive functioning is related to psychological factors, and both work and societal participation. Methods: In this cross-sectional multicentre study, 750 PwMS (aged 18–67 years) are included. To obtain a representative sample, PwMS are recruited via 12 hospitals across the Netherlands. They undergo assessment with the Minimal Assessment of Cognitive Functioning in MS (MACFIMS; reference-standard) and the Multiple Screener©. Sensitivity, specificity, and predictive values for identifying (mild) cognitive impairment are determined in a subset of 300 participants. In a second step, the identified cut-off values are tested in an independent subset of at least 150 PwMS. Moreover, test–retest reliability for the Multiple Screener© is determined in 30 PwMS. Information on psychological and work-related factors is assessed with questionnaires. Discussion: Validating the Multiple Screener© in PwMS and investigating cognition and its determinants will further facilitate early identification and adequate monitoring of cognitive decline in PwMS. [ABSTRACT FROM AUTHOR]

The wavelet analysis is used to examine the wavelet coherence and phase variation in circular economy and emissions in the presence of technological innovation. The findings reveal a time and spectral correlation between them in the short term but an inverse link in the long and medium term. Similarly, the circular economy leads technology innovation in the short term and vice versa in the medium to short term, caused by infrastructure development and business models. The carbon emissions lead technology innovation in the short term and vice versa in the medium run. Furthermore, the existence of technological innovation alters the connection between the circular economy and carbon emissions. The study suggests that upgrading existing infrastructure will enable sectors to produce minimal waste that affects emissions. Technology innovation assists in developing appropriate strategies to solve environmental concerns. The circular economy may be accomplished relatively swiftly and offer greater environmental and economic benefits if businesses and technological developers work together. [ABSTRACT FROM AUTHOR]