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Remote forensic interviews may restrict access to children's nonverbal cues, potentially constraining affective assessment. This exploratory study examined whether children's emotional states during forensic interviews could be identified using an artificial intelligence (AI)-assisted system that analyzes vocal emotional biomarkers, and whether AI-derived affective indices differ between an AI-assisted interview condition featuring real-time monitoring of children's emotion and a traditional face-to-face interview condition. Fifty-nine children aged 4-8 years participated in simulated forensic interviews, yielding 2,084 utterances. Acoustic features were analyzed post hoc on recorded interview audio using a pretrained speech emotion model to estimate probabilities for happiness, anger, sadness, and neutral emotion. Regression analyses with participant-level clustering were conducted to account for the repeated-measures structure. Results indicated that anger probabilities, as well as anger-to-sadness and neutral-to-sadness ratios, were significantly higher in the AI-assisted condition. However, overall emotional distributions did not indicate increased distress associated with the AI-assisted modality, and dominant happiness did not differ significantly between groups. These findings suggest that AI-based vocal affect analysis may serve as a supplementary observational tool in forensic interviews while supporting the emotional validity of AI-assisted interview conditions. Particularly in contexts where visual cues are limited, AI-assisted approaches may offer a structured means of monitoring children's affective changes without replacing professional judgment.

Head and neck cancers (HNCs) represent a heterogeneous group of malignancies with high morbidity and complex functional impairment. Despite advances in multimodal therapy, many patients present with advanced or incurable disease, demanding early integration of palliative care. To review the epidemiology, symptom burden, and best practices in palliative care for patients with advanced HNC, highlighting strategies for symptom management, communication, and end-of-life decision-making. A narrative review of current literature, clinical guidelines (National Comprehensive Cancer Network (NCCN), American Society of Clinical Oncology (ASCO), UK National Multidisciplinary Guidelines), and key studies on palliative interventions in HNC was conducted. Emphasis was placed on early integration of palliative care, multidisciplinary management, and evidence-based approaches to symptom control. HNC patients experience high symptom burden, including pain, dysphagia, airway compromise, hemorrhage, and psychological distress. Early palliative care integration improves symptom control, quality of life, and alignment of treatment with patient goals. Multidisciplinary approaches involving surgeons, oncologists, palliative specialists, speech therapists, dietitians, and psychosocial support are essential. Sentinel clinical events should trigger structured discussions on prognosis, treatment objectives, and end-of-life preferences. Advance care planning, including documentation of "do not resuscitate" (DNR) orders and preferred location of death, is critical in the terminal phase. Effective palliative care in HNC requires early, proactive, and multidisciplinary strategies that balance disease-directed therapy with patient-centered goals. Standardization of care pathways and ongoing evaluation of emerging evidence are essential to optimize symptom management, facilitate informed decision-making, and enhance quality of life for patients with advanced diseases.

Inspired by the auditory system's capacity to process spatiotemporal sound patterns, voiceprint recognition plays a vital role in identity authentication and security. However, current platforms often face challenges of speech frequency and amplitude variability, hindering accurate feature extraction in noisy environments. To address these issues, a large-scale hybrid metal-halide dynamic memristor (MHDM) featuring an engineered gradient-distributed architecture is developed for adaptive voiceprint recognition. The spontaneously graded metal-halide functional layer allows for precise modulation of Schottky barriers and redistribution of interface charges. This design achieves µs-scale response, enhances noise tolerance (over 20% improvement in signal-to-noise ratio), and enables kHz-scale dynamic signal processing. Experimental results demonstrate that the MHDM achieves a voiceprint recognition accuracy of 99.3%, maintaining high performance at 93.2% even in realistic background noise. These findings demonstrate the system's potential for secure and efficient voiceprint recognition, combining scalability with robust performance in noisy environments.

One of the challenges in accessing cross-border clinical trials involving international participants in Europe is language diversity, with 32 official languages in the European continent. Some patients have reported being excluded from trials owing to their native language, and in certain studies, language has been used as an eligibility criterion for participation. Considering that pediatric studies in Europe are not conducted in all countries, cross-border access to clinical trials may represent the only therapeutic opportunity for children living with rare diseases for which no approved treatment exists. This study aimed to assess the use of language as an eligibility criterion in pediatric clinical trial protocols conducted in Europe (2007-2024) and published in the Clinicaltrials.gov database. It evaluated the frequency and context of language requirements and whether these were scientifically justified. The overall objective was to identify potential sources of language-based discrimination that may prevent cross-border access to pediatric clinical trials. The 32 official languages of the European continent were used as keywords to search the eligibility criteria of 1,754 pediatric clinical trial protocols for studies conducted in Europe between 2007 and 2024 and registered in the largest clinical trial registry, ClinicalTrials.gov, via an Application Programming Interface. Acceptable scientific justifications to use language as an eligibility criterion were defined as being (1) related to specific therapeutic areas that required language or cognitive assessments in communication with the health professionals, who do not speak the patient's language or (2) related to the use of patient- or caregiver-reported outcome measures that had only been validated in specific languages. The majority of the study protocols (95.2%) did not include any reference to European official languages in the eligibility criteria. Of the 85 study protocols that did include language requirements, only 23 (27.1%) had a scientific justification for the use of this criterion. The most frequent European languages required as eligibility criteria were English (20%) and French (16.5%). A minority of European paediatric studies (4.8%) included language in eligibility criteria in the study protocols, but of those that did, most offered no reasonable explanation for the restriction. To prevent language-based discrimination within the European regulatory framework, we recommend that ethics committees should require justification for any language-based eligibility criteria. Additionally, including dedicated sections on cross-border access in clinical trial protocols will help ensure the provision of appropriate resources such as translations, interpreters, travel, and accommodation when recruiting international participants. Pediatric clinical trials are needed to find safe and effective treatments for children. However, language requirements that are not scientifically necessary may prevent some children from taking part. In Europe, some families have reported that their child could not join a clinical trial because they did not speak a required language. This study examined 1,754 pediatric clinical trial studies conducted in Europe between 2007 and 2024, using data from a large database termed ClinicalTrials.gov. The researchers looked for any mention of language in the study entry rules (the criteria used to decide who can participate). They found that only a small number of trials (4.8%) mentioned language. However, when a language requirement was included, it was often not clearly justified. In only 27% of studies it was a scientific reason, for example, when tests required a specific language or relied on speech or understanding. English and French were the most commonly required languages. The study also identified other requirements that could limit participation, such as needing access to a mobile phone, Internet, or enrollment in a specific national health system. These factors may make it harder for international families or those with fewer resources to participate. The authors recommend that ethics committees carefully review language requirements and require a clear scientific reason before approving them. They also suggest that study plans include a section explaining how children from different language backgrounds and countries can be included.

Corticobulbar symptoms, including dysarthria and dysphagia, are frequent manifestations of Huntington's disease, yet evidence on speech and swallowing rehabilitation remains limited. This study explored the potential effects of a home-based corticobulbar rehabilitation program on selected speech and swallowing-related clinical outcomes in Huntington's disease. This prospective, non-randomized, observational controlled study included 40 adults with genetically confirmed Huntington's disease. Twenty-five patients entered a 6-month home-based corticobulbar rehabilitation program, while 15 received standard care without structured speech or swallowing rehabilitation. Six patients in the rehabilitation group discontinued the program because of rapid progression of corticobulbar symptoms; therefore, complete-case outcome analyses included 34 patients: 19 rehabilitation completers and 15 controls. Speech and swallowing outcomes were assessed at baseline and month 6 by blinded speech-language pathologists using an exploratory clinical rating scale. Secondary outcomes included body mass index and Unified Huntington's Disease Rating Scale Total Motor Score. No intervention-related adverse events were reported among completers. Breathy voice worsened in 6 control patients but in none of the rehabilitation completers (p = 0.004). Speech rate normalization was more frequent in the rehabilitation group than in controls (p = 0.003). Oral residue decreased more frequently in the rehabilitation group, whereas it increased more frequently in controls (p = 0.039). Body mass index was relatively preserved in the rehabilitation group overall (p = 0.025). UHDRS Total Motor Score changes favored rehabilitation but were considered exploratory because motor assessment was not blinded. Home-based corticobulbar rehabilitation may be feasible and associated with favorable exploratory changes in selected speech and swallowing parameters in Huntington's disease.

Deciduous teeth play a crucial role in mastication, speech, esthetics, and space maintenance. Full-coverage restorations such as stainless steel crowns (SSCs) ensure a hermetic seal but fall short in esthetics, prompting the development of alternatives such as Bioflx crowns. To compare the clinical success of SSCs and Bioflx crowns in children. Twenty children (ages 4-8) requiring crowns postpulpectomy for mandibular second primary molars were divided into two groups: group A (stainless steel crown) and group B (Bioflx crown). Child satisfaction was assessed via the children's acceptance scale, and clinician satisfaction was assessed with a 5-point Likert scale. Discomfort and anxiety were evaluated using the emoji and FLACC scales. Clinical success (retention, wear, stain resistance, plaque, and gingival index) was recorded at 3, 6, and 12 months. Children preferred Bioflx crowns for their esthetics (p < 0.05), while clinicians favored the morphology of SSCs (p < 0.05). Bioflx required less chair time (p < 0.05). Discomfort levels were comparable across groups. SSCs showed superior retention, gingival health, and plaque control (p < 0.05). No significant difference in wear or stain resistance was noted. Bioflx crowns are esthetically pleasing and efficient for pediatric restorations. However, SSCs remain superior in durability and clinical performance. Long-term studies are recommended for Bioflx crowns. The Clinical Trials Registry of India (CTRI) has prospectively registered the study under the CTRI number CTRI/2024/12/077894. Shaji NE, Vundela RR, Setty JV, et al. Comparative Evaluation of Clinical Success with Preformed Stainless Steel Crowns and Bioflx Crowns: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2026;19(3):368-374.

With the growing use of AI-powered conversational technology, people with dementia may benefit from these tools. Finetuning and adapting such systems require an understanding of the language use of people with dementia and communication patterns. Daily conversations with 120 Korean older adults at various stages of dementia were collected over a two-year period and transcribed. Text mining techniques were applied to identify language patterns and latent meanings, including Term Frequency (TF), Term Frequency-Inverse Document Frequency (TF-IDF), co-occurrence network and concordance analyses, and topic modeling using both Latent Dirichlet Allocation (LDA) and BERTopic. TF/TF-IDF analyses of 6,989 speech segments by people with dementia revealed frequent use of pronouns and vague demonstratives. Word pairs and in-context usage of frequently used words were closely tied to their lived experiences. Topic modeling identified five themes via LDA and nine key topics from 29 BERTopic subcategories, covering hardship, family and relationships, emotions, reminiscence, and daily pleasures. BERTopic also captured health-related needs, identity, and agency, offering insight into the inner world of people with dementia. Despite declining cognitive abilities, people with dementia experience a wide range of life events and emotions. This study highlights the need for language-based support to help them retain agency, rather than be viewed solely as dependent or in need of care. Furthermore, the words and themes from this study could serve as valuable input for developing AI-powered communication algorithms, enabling more dementia-friendly and engaging conversations with people with dementia.

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Swallowing involves the precise coordination of muscles and brain areas and can be disrupted in a variety of neurological conditions. Current methods to visualize swallowing cannot examine both the biomechanics and brain activity associated with specific swallowing events. An updated version of a pulse sequence that simultaneously samples BOLD-based fMRI and dynamic imaging (called SimulScan) is introduced that provides higher quality and faster dynamic imaging, enabling data-driven analysis of swallowing function through a partial least squares (PLS) analysis. Integrating updated dynamic imaging approaches, SimulScan achieved dynamic MRI at 23.75 frames per second with a 30&#x2009;cm field of view with BOLD fMRI at a 1.6&#x2009;s TR. Five subjects were scanned with SimulScan twice and with videofluoroscopy to compare the preliminary reliability of measuring swallowing biomechanics using computational analysis of swallowing mechanics (CASM) and the test-retest relationship in correlated functional and dynamic components of PLS. High reliability of biomechanical measures of swallowing was achieved across the two SimulScan runs with CASM (r&#x2009;=&#x2009;0.891; p&#x2009;<&#x2009;0.0001) and between SimulScan and videofluoroscopy (r&#x2009;=&#x2009;0.686; p&#x2009;<&#x2009;0.0001). Correlations between dynamic and functional imaging across runs also showed high reliability (mean correlation of first 3 latent variable timeseries was 0.49 (p&#x2009;<&#x2009;0.001) within a run and 0.17 (p&#x2009;<&#x2009;0.001) across runs), indicating that SimulScan with PLS can extract reliable maps of linked correlations between the brain and the oropharyngeal dynamics. The updated SimulScan with PLS analysis enables the study of central control of swallowing, providing simultaneous biomechanical visualization of the swallow along with brain functional signals.

Due to the spread of misinformation that some vaccines cause autism spectrum disorder (ASD), many parents report changes in their vaccination behavior following a diagnosis of ASD, putting their children at increased risk for preventable diseases. Our study aimed to determine the rate of vaccination-related concerns and refusal behaviors in parents of children with ASD and non-autistic developmental delays (non-ASD-DD) and to examine factors potentially associated with vaccine hesitancy and refusal. In our study, a questionnaire was distributed to all parents of children diagnosed with ASD and non-ASD-DD who attended outpatient check-ups over 3&#xa0;months at the Child Psychiatry Clinic of the two large hospitals. Participants completed a structured questionnaire assessing self-reported vaccination behaviors before and after diagnosis, as well as separate Likert-scale items evaluating vaccine-related beliefs and attitudes. No parents declined participation, and all 154 eligible parents were included in the study. Among the respondents, 87.7% were mothers. The most common diagnoses were intellectual disability (41.6%) and ASD (31.2%). Reported vaccine refusal increased from 3.9% before diagnosis to 9.7% after diagnosis (p&#x2009;=&#x2009;0.012). The main reason cited for hesitancy or refusal was the belief that vaccines had caused their child's neurodevelopmental condition. No independent associations were found between post-diagnosis vaccine hesitancy/refusal and parental education, income, source of vaccine information, or depression/anxiety scores. However, 88.3% of participants disagreed or strongly disagreed with the statement that vaccines cause ASD or developmental disorders. &#xa0;Parental concerns about vaccines persist after a diagnosis of neurodevelopmental disorders. Tailored education and communication strategies are essential to support informed vaccine decision-making in these families and to prevent refusal for both diagnosed children and their siblings. &#x2022; Persistent misinformation linking childhood vaccines-particularly the MMR vaccine-to autism spectrum disorder continues to influence parental attitudes toward vaccination. &#x2022; Parents of children with ASD have been shown to exhibit higher rates of vaccine hesitancy, especially regarding vaccination of younger siblings. &#x2022;&#xa0;Vaccine hesitancy and refusal were more frequently reported after the diagnosis of not only autism spectrum disorder but also other developmental delays, including intellectual disability and speech delay. &#x2022;&#xa0;Although concerns about vaccines causing developmental disorders were common, vaccine refusal remained relatively uncommon and no independent predictors of post-diagnosis hesitancy or refusal were identified, highlighting the complex nature of parental vaccination decisions.

Policy recommendations (PRs) now play a crucial role in tackling the climate crisis, underscoring the need for evidence-based, objective and transparent communication. Scientific studies often put forward PRs, but their quality has not yet been evaluated. Here, we systematically appraised the quality of PRs in areas of green energy and transportation for tackling climate change. Four databases were searched from 2019. Over three thousand papers were considered, and 23 studies are included. Quality rating, based on the Evidence Communication Rules for Policy (ECR-P) critical appraisal tool, indicated poor quality in PRs across all studies. There was a clear trend towards advocacy as opposed to providing neutral information, further exacerbated by inadequate disclosure of uncertainties. Communication quality was markedly better regarding study findings and conclusions compared to PRs. Researchers should use the same scientific rigour and reporting standards in PRs as in any other aspect of their research. A reporting guideline for scientific-based PRs could greatly assist in this area, elevating the standards of communication for both academic publishing and global policymaking while reducing potential criticism that scientists simply put forward their own opinions.

Gestures and silent pauses are fundamental in comprehension and communication of emotional speech. While previous research has examined gesture inhibition primarily in neutral or fictional speech tasks with mixed findings, an empirical study on the effect of gesture inhibition on silent pause behaviour during personal emotional autobiographical narratives is yet not examined. The present study addresses this gap. Thirty participants (15 gesture-restricted, 15 non-restricted; aged 18-23) narrated personal negative emotional memories and neutral daily routine in Hindi-English bilingual speech. Silent pauses were categorized by duration into short (250-500&#xa0;ms), medium (500-1000&#xa0;ms) and long (more than 1000&#xa0;ms) pauses, based on distinct cognitive and affective functions. Pause count, duration, and proportion were analysed using linear and generalized linear mixed-effects models on 4242 individual pauses. Emotional narratives consistently produced more frequent, longer, and proportionately larger long pauses than neutral narratives across both gesture conditions, with no comparable effects on shorter pauses. Gesture-restriction selectively increased long-pause counts in both narrative contexts, with directionally consistent but smaller effects on long-pause duration and proportion. Short and medium pauses showed no significant contrast effects across groups and narratives. The findings indicate that emotional content and gesture restriction selectively modulate the long-pause range associated with higher-order cognitive and affective processing, while leaving shorter segmenting pauses unaffected. Results are discussed within gesture-for-conceptualization and embodied emotion frameworks.

The present study aims to develop and evaluate the feasibility of automatic categorical differentiation of pathological voice disorders (organic, functional, and neurologic) using machine learning (ML) models based on multidomain acoustic features from connected speech. A total of 584 pathological recordings obtained from the Advanced Voice Function Assessment Databases&#xa0;were analyzed. Twenty-nine prespecified acoustic features covering multiple domains including prosodic, perturbation, harmonicity, and cepstral-spectral domains, were extracted. Three classifiers, including Random Forest, Extreme Gradient Boosting (XGBoost), and CatBoost, plus a soft-voting ensemble, were trained with stratified 5-fold cross-validation on an 80% development split and evaluated on a 20% external hold-out set. Performance metrics including accuracy, precision (positive predictive value [PPV]), recall/sensitivity, specificity, F1, per-class indices, and confusion matrices, were assessed. Feature importance (XGBoost) was summarized via Weight, Gain, and Cover to support physiologic interpretability. Results indicated that XGBoost yielded the best overall performance (accuracy = 0.82, PPV = 0.80, sensitivity = 0.70, specificity = 0.91, F1 = 0.73), followed by CatBoost (accuracy = 0.79, F1 = 0.66) and the ensemble (accuracy = 0.79, F1 = 0.66); random forest showed lower sensitivity (0.55) and F1 (0.60). Across models, organic dysphonia achieved the highest F1 (0.86-0.87), neurologic was moderate (F1 &#x2248; 0.70-0.72), and functional was most challenging (F1 = 0.42-0.60). Feature importance was dominated by cepstral-spectral measures, particularly cepstral peak prominence smoothed, cepstral spectral index of dysphonia, and harmonics-to-noise ratio, indicating that indices related to signal periodicity and glottal closure-related structure help were influential in the etiologic classification task. Gradient-boosting ML, XGBoost in particular, enables clinically meaningful multiclass differentiation of voice disorder etiologies from sentence-level acoustics. The prominence of cepstral-spectral predictors provides physiologically plausible markers for objective assessment. ML-assisted acoustics can complement perceptual and laryngoscopic evaluation for triage and longitudinal monitoring; improving sensitivity for functional dysphonia will likely require task diversity, multimodal features, and larger, multilingual validation cohorts.

Brain magnetic resonance imaging (MRI) abnormalities are an important finding in the evaluation of patients with suspected autoimmune encephalitis (AE). There have been few studies evaluating the frequency and prognostic significance of MRI abnormalities, especially hippocampal swelling, in anti-N-methyl-D-aspartate receptor (NMDAR) and anti-leucine-rich glioma-inactivated 1 (LGI1) Ab-mediated encephalitides. We conducted a multi-centre, retrospective study involving adult patients with confirmed antibody-mediated encephalitis and at least one MRI scan from 10 Australian hospitals (n = 139). MRI scans were evaluated by a neuroradiologist blinded to the specific autoimmune encephalitis diagnosis. We evaluated associations between acute MRI abnormalities (e.g. hippocampal swelling) with 12-month function (modified Rankin scale, mRS &#x2265;2 = worse outcome) and radiological findings. In patients with anti-LGI1 Ab-mediated encephalitis, we identified hippocampal swelling on initial MRI to be associated with worse function at 12 months (OR 0.03; 95% CI 0.003, 0.34; P = 0.005). We found initial AE-associated T2/fluid attenuated inversion recovery (FLAIR) hyperintensities were not associated with 12-month mRS in either the anti-NMDAR (OR 0.39; 95% CI 0.04, 3.97; P = 0.42) or anti-LGI1 Ab-mediated encephalitis groups (OR 0.34; 95% CI 0.07, 1.57; P = 0.17). In anti-LGI1 Ab-mediated encephalitis, both hippocampal swelling (OR 5.76; 95% CI 1.14, 29.02; P = 0.03) and T2/FLAIR hyperintensity (OR 6.81; 95% CI 1.28, 36.22; P = 0.03) were related to the development of mesial temporal atrophy and hippocampal sclerosis. Acute hippocampal swelling is associated with worse outcomes in anti-LGI1 Ab-mediated encephalitis and, alongside initial T2/FLAIR hyperintensity, is associated with the development of both mesial temporal atrophy and hippocampal sclerosis.

SET is a member of the inhibitor of histone acetyltransferases (INHAT) complex, involved in transcriptional silencing and gene regulation. Pathogenic variants in SET are postulated to cause neurodevelopmental disorder (NDD) phenotypes, but as only few individuals are described, detailed clinical information is scarce. Hence, currently counseling on phenotype and prognosis of this condition remains challenging. Here we describe the clinical phenotype and mutational spectrum of 23 unreported individuals harboring (likely) pathogenic variants in SET. Phenotypes include global developmental delay with often pronounced hypotonia, delayed motor development and speech and language delay, ultimately evolving into (mild) intellectual disability. Comorbidities include behavioral concerns, sleeping disturbance and variable unspecific ocular problems. Next generation computer-assisted phenotyping using GestaltMatcher showed limited overlapping facial features between affected individuals and differences compared to disorders caused by related chromatin modifying genes. In addition, we generated a DNA methylation signature, able to distinguish individuals carrying pathogenic variants in SET from individuals with other NDDs and healthy controls. We used this DNA methylation signature to assess pathogenicity of two variants of uncertain significance in SET found in two additional individuals. Together, this expands the knowledge on the SET-related disorder and provides novel approaches for its diagnosis.

Adjuvant therapies in aphasia rehabilitation may help reduce the cost and clinical resources required for intensive speech-language interventions. We conducted a proof-of-principle pilot study to evaluate whether transcranial direct current stimulation (tDCS) paired with a shortened course of phonomotor treatment (sPMT)-targeting sounds and nonwords but not real words-enhances phonological production in chronic post-stroke aphasia, and to examine the neural mechanisms underlying this approach. Using a double-blind, parallel-group design, participants received 30&#x202f;h of sPMT combined with 1&#x202f;mA tDCS (anode/cathode over left/right inferior frontal gyrus) delivered at the start of each intervention session. Here, we report data from six older male participants matched on aphasia severity (active: n&#x202f;=&#x202f;3; sham: n&#x202f;=&#x202f;3). Phonological production and confrontation naming were assessed at baseline, immediately post-intervention, and at 3-month follow-up. Structural and resting-state functional MRI (rs-fMRI) were acquired at baseline and post-intervention. Repeated-measures ANOVA revealed a significant group-by-time interaction for phonological production, with the active tDCS&#xa0;+&#xa0;sPMT group showing gains from baseline to post-intervention that were maintained at 3 months, whereas the sham group showed no significant improvement. Confrontation naming showed no significant effects of time or group. MRI-based estimates of current density (J) indicated that J varied systematically with lesion volume and inter-electrode distance, underscoring the importance of individualized electrode placement. rs-fMRI analyses demonstrated significant group-by-time interactions, with greater connectivity increases in the active versus sham group across domain-specific and domain-general networks. These preliminary findings suggest that active tDCS may enhance the effects of sPMT on phonological production and provide mechanistic support for individualized, network-informed neuromodulatory approaches in post-stroke aphasia rehabilitation.

Crossed aphasia is a rare form of aphasia in right-handed individuals with right-hemisphere lesions. We report a man aged 67 years who developed crossed aphasia after a right posterior cerebral artery infarction involving the occipital lobe, thalamus, and medial parietal lobe. Neurological and neuropsychological examinations revealed mild anomic aphasia with preserved repetition and comprehension, left homonymous hemianopia, unilateral spatial neglect, prosopagnosia, and no apraxia. Writing showed a marked script-specific dissociation: kana writing was intact, whereas kanji writing was severely impaired and dominated by recall-failure errors (>90%), with few orthographic or component errors. One-year follow-up using the same language and writing tasks demonstrated partial improvement in accuracy but a stable error profile dominated by recall failures. This rare case indicates that selective kanji agraphia can occur in crossed aphasia due to right-hemisphere lesions and suggests impaired access to the visual orthographic lexicon with atypical hemispheric lateralization of writing functions in Japanese. A afasia cruzada &#xe9; uma forma rara de afasia em indiv&#xed;duos destros com les&#xf5;es no hemisf&#xe9;rio direito. Relatamos um homem de 67 anos que desenvolveu afasia cruzada ap&#xf3;s infarto da art&#xe9;ria cerebral posterior direita envolvendo o lobo occipital, o t&#xe1;lamo e a regi&#xe3;o parietal medial. Os exames neurol&#xf3;gico e neuropsicol&#xf3;gico mostraram afasia an&#xf4;mica leve com repeti&#xe7;&#xe3;o e compreens&#xe3;o preservadas, hemianopsia hom&#xf4;nima esquerda, neglig&#xea;ncia espacial unilateral e prosopagnosia, sem apraxia. A escrita evidenciou dissocia&#xe7;&#xe3;o clara entre sistemas: kana preservado, enquanto kanji estava gravemente prejudicado e dominado por erros de falha de evoca&#xe7;&#xe3;o (>90%). A reavalia&#xe7;&#xe3;o ap&#xf3;s um ano com as mesmas tarefas demonstrou melhora parcial, mas manuten&#xe7;&#xe3;o do perfil de erros dominado por falhas de evoca&#xe7;&#xe3;o. Este caso sugere agrafia seletiva para kanji na afasia cruzada por les&#xe3;o do hemisf&#xe9;rio direito, associada a acesso prejudicado ao l&#xe9;xico ortogr&#xe1;fico visual.

Documenting change is fundamental to understanding the process of intervention among individuals with communication disorders. This technical report demonstrates the clinical applicability of wearable fNIRS systems and the NeuroDOT processing pipelines for examining within-person cortical dynamics of learning. Using a microgenetic research design and a dense sampling approach, we examined changes in the prefrontal cortical hemodynamic response in an adult female participant who completed the same spoken sentence repetition and auditory fixation tasks across eight sessions. In addition to behavioral accuracy, hemodynamic data were collected with a continuous-wave, multi-channel fNIRS system (NIRSport2) using a prefrontal 20-channel optode montage. Data were processed using NeuroDOT ( https://www.nitrc.org/projects/neurodot ) (Eggebrecht & Culver, 2019) to: (i) standardize signal quality across the sessions to quantify motion levels and to ensure standardized brain map specificity, (ii) to examine both channel space fluctuations in the hemodynamic response and map changes in cortical activation patterns over the sessions. The signal quality met the predefined criteria for only the first five sessions. Participant's repetition accuracy did not improve over the five sessions. Channel-wise analysis revealed that HbO concentration differs significantly over right and left hemisphere channels over the course of the five sessions for the Sentence Repetition task, but not for the Auditory Fixation condition. Brain maps revealed qualitative differences in the pattern of prefrontal cortical activation across the five sessions. Behavioral assessments do not fully capture what occurs during speech repetition tasks, and leveraging neuroimaging can help identify and discriminate between disordered and neurotypical populations.

Validated prognostic tools are essential to advance drug development and clinical care in Alzheimer's disease, particularly as the field shifts toward the prevention of cognitive decline. While progress has been made in developing blood-based biomarkers for the early detection of amyloid pathology, amyloid positivity alone does not reliably predict progression to symptomatic disease. Digital markers can serve as complementary prognostic tools to inform early intervention strategies. Among digital markers, speech-based markers offer a scalable, non-invasive, and cost-effective approach to predicting and monitoring cognitive decline. However, the development of validated speech-based tools has been constrained by the lack of large, multilingual datasets with longitudinal sampling, deep phenotyping, harmonized clinical and biomarker data, and adequate representation of preclinical populations. SpeechDx is a 3-year, multinational, multilingual observational study (n&#xa0;=&#xa0;2006) designed to address these gaps and accelerate the development of speech-based tools to inform early risk assessment, enable timely intervention, and guide personalized care.