Cognitive and language deficits are frequently reported sequelae of posterior fossa brain tumors (PFBT). Typically, delayed onset impedes prompt assessment and early intervention. This has devastating implications for quality of life. This study aimed to describe the language profiles of children treated for posterior fossa brain tumors referred to outpatient speech pathology, and to identify early indicators and predictive factors of late effects on language profiles of children treated for posterior fossa brain tumors. A retrospective file audit and cohort study was conducted using medical records, speech pathology, and neuropsychology assessment data of 21 patients (≤18years) diagnosed and treated for a primary PFBT between 2008 and 2021. Standard scores were extracted and categorized into language and neuropsychological domains. General and mixed effects linear models were used to investigate changes in assessment outcomes over time and the influence of child-, tumor-, and treatment-related variables. Of 117 children diagnosed with a PFBT during the study period, 21 met the inclusion criteria. Narrative and pragmatics were the weakest language domains at the first timepoint post-treatment across the cohort. Statistically insignificant declines in assessment performance were noted across all language domains. Significant associations were identified between larger tumor size (p = 0.018) and tumor resection (p = 0.041) with a decline in semantic performance. The lack of overt language deficits at the first timepoint post-treatment, with trends toward increasing deficits over time, highlights the need for ongoing assessment. Evaluation of narrative and pragmatic skills should be prioritized. Prospective studies with larger sample sizes are recommended.

Functional recovery and neuroplasticity post-hemispherectomy in humans.

Micro-multinationals from emerging markets (mEMNEs) face significant challenges in establishing social legitimacy in foreign markets due to resource constraints and limited knowledge of local societal issues. This study examines how mEMNEs leverage partnerships with non-governmental organizations (NGOs) to develop dynamic capabilities for social innovation and, ultimately, to build social legitimacy in other emerging markets. Drawing on survey data from 143 Pakistani mEMNEs operating internationally, we find that NGO coupling positively influences the development of dynamic capabilities. These effects amplify when NGO salience and activism are high. Furthermore, social innovation mediates the relationship between NGO coupling, dynamic capabilities, and social legitimacy. Our findings extend dynamic capabilities theory into the social domain and contribute to understanding how resource-constrained multinationals from emerging markets can overcome legitimacy deficits through strategic stakeholder engagement. We also provide practical insights for managers on leveraging NGO partnerships and offer policy recommendations for facilitating cross-border social innovation initiatives.

Most influential comprehensive geriatric assessment factors on geriatricians' advice for cancer treatment in older adults.

Against the backdrop of global ageing, a growing empirical literature highlights associations between age-friendly environments (AFEs) and older adults' well-being. However, the evidence is difficult to cumulate because AFE measurement is fragmented, characterized by heterogeneous operational approaches and uneven domain coverage. Importantly, this measurement heterogeneity is not merely a methodological limitation; it acts as a structuring force that shapes inference, comparability, and policy learning across studies. This systematic review aims to map how AFEs are operationalized and how they are connected to older adults' well-being. Following PRISMA, four databases were searched to April 2025; 5305 records were screened, and 58 studies were included. We classified AFE measures as subjective (n = 37), objective (n = 11), and mixed (n = 10) and mapped indicators to the WHO Age-Friendly Cities and Communities (AFCC) domains. Our synthesis reveals that AFE measurement is skewed to physical domains, such as transportation, outdoor spaces and buildings, and health services, with social domains underspecified. Associations are often positive for features such as reliable public transport, proximate everyday services, and opportunities for social participation; however, magnitudes and even directions vary by context and by how AFEs are operationalized. We also observe non-linear patterns (for example, in street connectivity or greenness), and occasional negative associations, particularly in disadvantaged settings where higher service density may signal unmet need rather than support. Some of this heterogeneity likely reflects analytic choices, including denominator selection, buffer size and shape, and the omission of micro-scale features and barriers. We recommend a comprehensive AFE assessment that combines subjective and objective approaches, balances physical and social domains, and improves transparency on validity and cross-cultural equivalence. Emerging tools such as street-view imagery and other fine-scale urban data can help capture micro-spatial features with greater precision.

Social vulnerability is likely to be predictive of how well individuals within regions are supported during adverse events such as natural disasters. We aimed to examine the association between social vulnerability and suicide to inform targeted suicide prevention strategies. We obtained region-level data on suicide counts and population estimates from the Australian Institute of Health and Welfare, and the same level of data on social vulnerability to health impacts of climate change. We performed adjusted negative binomial regression analysis to examine the associations of social vulnerability index (and the 14 social domains that comprise the index) with suicide. Greater social vulnerability was marginally associated with lower suicide rates at the population level (Incidence Rate Ratio [IRR] 0.99, 95% Confidence Interval [CI] 0.97-1.00). When social domains were modelled individually, increasing vulnerability related to three domains (income and employment, education and social development, communication and transport infrastructure) was associated with a higher suicide rate. Opposite patterns were observed for increasing vulnerability to the domains of household composition, natural and built environment, emergency services, health services, government services, housing precarity, and livelihood/occupation. Social vulnerability index misses indicators that are associated with suicide. Regions with greater social vulnerability experienced slightly lower suicide rates. However, regions with heightened vulnerability due to unemployment, low labour force participation, poverty, low school participation, low educational attainment, high income inequality, and inadequate access to communication and transport infrastructure had higher suicide rates, highlighting the need to address these population-level factors to reduce suicide.

• FFTGate: a novel activation function that integrates temporal and spectral activation histories. • FFT-based frequency-domain gating modulates neuron activations using spectral features. • Target-adaptive regularization of the activation’s trainable parameters improves generalization. • FFTGate improves generalization on image classification and neural machine translation tasks. • FFTGate outperforms 18 existing activation functions on benchmark datasets. Activation functions are crucial in determining how deep neural networks process information and adapt during training. Although widely adopted activation functions such as ReLU, GELU, and Swish demonstrate strong empirical performance, they rely primarily on pre-activation inputs, ignoring temporal activation histories that capture how neuron activations evolve over time and spectral features that capture frequency-domain patterns in activation histories. This can limit their adaptability, particularly in dynamic or time-varying tasks. To address this, we propose FFTGate , a novel activation function that integrates temporal and spectral activation information from neuron activation histories into the activation process. Specifically, FFTGate first captures per-channel activation histories using a sliding window of a defined length. Next, it applies the Fast Fourier Transform to extract spectral features from the captured activation histories, which are then used to form an FFT-based gating mechanism subsequently used to modulate each neuron’s pre-activation input. This enables networks to adapt more effectively to evolving inputs, thereby improving generalization. FFTGate is evaluated on both vision and language domains. Experimental results show that FFTGate consistently outperforms 18 established and recently proposed activation functions on small-scale image classification tasks (CIFAR-10, CIFAR-100; Top-1 accuracy gain of +0.74 %) and large-scale image classification task (ImageNet-1K; Top-1 accuracy gain of +0.36 %), demonstrating strong generalization on datasets of different scales. Furthermore, FFTGate achieves even greater improvements in neural machine translation, with BLEU score gains of +2.94 on Kaggle German–English, +1.08 on IWSLT’13 French–English, and +0.88 on IWSLT’13 English–French over the best-performing baselines. These results demonstrate that FFTGate enhances generalization and stability in both image-based and time-varying tasks. Code and results are available at: https://github.com/Ndupuechi/FFTGate .

Measurement differences in the Harmonized Cognitive Assessment Protocol across ethnicity and language in the United States.

High-frequency rTMS applied to the right hemisphere promotes aphasia recovery and brain microstructural changes in subacute stroke.

Beyond genetics: A rare case of childhood disintegrative disorder following psychosocial trauma.

Ethics label for digital systems to promote transparency and user awareness

Impact of combined intradialytic exercise on quality of life, functional capacity, and dialysis adequacy in pediatric hemodialysis patients: A pilot study.

Introduction: Incidence of Diabetes Mellitus (DM) is rising in India. Uncontrolled diabetes is a harbinger of potential lifethreatening complications. In recent years, focus has shifted to achieving adequate glycaemic control in order to prevent the complications of Diabetes. Adequate glycaemic control significantly reduces diabetes-related complications. Good glycaemic control should therefore lead to better Quality of Life (QoL) in Diabetes patients. Aim: To assess whether glycaemic control has any relationship with QoL as assessed by the World Health Organisation (WHO) Quality of Life Brief Version (WHOQoL-BREF) Questionnaire. Materials and Methods: This cross-sectional study was conducted at the Department of Medicine, ESI Postgraduate Institute of Medical Sciences and Research, Basaidarapur, New Delhi, India, from July 2022 to December 2023, in which 140 subjects satisfying inclusion and exclusion criteria were recruited. Patients were subjected to Serum HbA1c estimation and based on HbA1c values, the subjects were divided into good glycaemic control group (satisfying ADA glycaemic goal of HbA1c <7%, n=55) and poor glycaemic control group (not satisfying ADA glycaemic goal and HbA1c ≥7%, n=85). The patients were then administered QoL questionnaire devised by WHOQoL-BREF evaluating four key domains of life i.e., physical, psychological, social relationships and environmental and the QoL scores for each domain were calculated for each patient. Thereafter, the QoL scores in all four domains of both good and poor glycaemic control were compared and correlation was assessed using Pearson’s correlation coefficient. Results: A total of 140 patients were enrolled in the study with a mean age of 55.32±5.9 years. The proportion of male patients was slightly less as compared to female patients of Diabetes Mellitus (46.4% vis a vis 53.6%). The QoL of good glycaemic control group was significantly higher in all four domains viz., p-values was <0.001 for physical, and for psychological, social and environmental domain it was p-value ≤0.001 as compared to the poor glycaemic control group. QoL scores in all four domains showed a statistically significant negative correlation with HbA1c (all p-value<0.05), with correlation coefficients ranging from -0.181 to -0.417. Conclusion: In the present study, majority of the diabetic patients had poorly controlled diabetes. The level of glycaemic control has a weak to moderate negative correlation with QoL and good glycaemic control is associated with better QoL as compared to poor glycaemic control group.

The Relevance of Handedness in Cognitive Outcomes After Glioma Surgery in Adults: A Retrospective Study.

This study explains how perceived sustainability-oriented managerial performance is maintained in dynamic and digitalized workplaces by integrating strategic leadership, digital leadership capability, and perceived organizational support with two human-centered mechanisms. Sustainable managerial performance is defined and measured at the individual manager level as managers’ self-reported ability to sustain consistent, resilient, and adaptive performance over time through managerial actions in economic, environmental, and social domains within their area of responsibility. Survey data from 360 managers in Indonesia were analyzed using PLS-SEM to test direct effects and parallel mediation. The results show that strategic leadership, digital leadership capability, and perceived organizational support significantly strengthen manager well-being and managerial engagement, which in turn enhance sustainable managerial performance. In terms of magnitude, manager well-being is the stronger predictor of sustainable managerial performance compared with managerial engagement, indicating that psychological capacity is a more influential pathway than motivational involvement alone. Among the exogenous drivers, strategic leadership shows the largest direct contribution to sustainable managerial performance, followed by digital leadership capability and perceived organizational support. The parallel mediation pattern suggests that leadership and support sustain managerial performance simultaneously by improving well-being and reinforcing engagement rather than through a single sequential mechanism. These findings extend sustainable performance theory at the managerial level and imply that organizations should prioritize leadership development that strengthens strategic direction and digital readiness while implementing support practices that protect well-being and maintain engagement to sustain managerial effectiveness over time.

The use of body part terms in everyday expressions is a well-documented phenomenon across many languages, yet it remains underexplored in Tetun , one of the official languages of Timor-Leste. Body part lexemes in Tetun frequently appear as components in compound words, producing words that go far beyond their literal anatomical references. This research aims to describe the form-meaning relationship in body-part compound words in Tetun and to uncover the cultural values and social concepts reflected within them. A qualitative descriptive approach was employed. Data were collected through observation and note-taking of natural speech, supplemented by dictionary consultation and interviews. The corpus consists of Tetun compound words containing body-part elements, classified and analyzed using Bauer's typology of compounding and Lieber's morphosemantic framework, alongside conceptual metaphor and metonymy theory. The analysis identifies three main categories of body-part compounds: compositional, metonymic, and metaphorical. Compositional compounds retain transparent semantic links between their elements, while metonymic compounds use a body part to refer to related functions or states. Metaphorical compounds, the most dominant category, map physical bodily experience onto abstract psychological and social domains. From an anthropolinguistic perspective, the body functions as a cultural symbol system through which Tetun speakers evaluate behavior, express emotions, and understand social roles. This study contributes to Tetun morphology documentation and enriches Austronesian linguistic studies by demonstrating how language, cognition, and culture intersect through bodily experience. The findings also have practical value for Tetun lexicography and language education

Purpose The purpose is to examine engineering students’ perceptions of soft skills, focussing on the gap between their self-perceived acquisition and the importance attributed to these skills by employers. Particular attention is given to leadership, innovation, ethical and social responsibility, and adaptability as key skills. Design/methodology/approach The study is based on a cross-sectional survey of 344 first-year engineering students (70 females; M age = 18) from two Spanish universities. A newly validated instrument (HABEI) measured perceived importance, self-reported acquisition and employer relevance of nine core soft skills. Findings Results reveal a consistent gap between the value students attribute to soft skills and their self-perceived acquisition. Ethical and social responsibility, in particular, is undervalued despite being recognised as highly relevant by employers. Research limitations/implications The study is limited to first-year engineering students in Spain and relies on self-report measures, which may introduce bias. Future research could include longitudinal designs and cross-cultural comparisons. Practical implications The findings highlight the need to integrate soft skills training, especially in ethical and social domains, more explicitly into engineering curricula. Universities should design learning experiences that bridge the gap between academic formation and workplace expectations. Originality/value It provides empirical evidence using a novel instrument, offering both conceptual and practical contributions to understanding and addressing the soft skills gap in engineering education.

Creating language-specific and domain-specific large language models presents substantial challenges, including computational demands and limited data availability. While it is commonly believed that the benefits of specialized models justify these challenges, we dispute this notion with a comparative evaluation in a low-resourced language and medical-specific domain. In our study, we analyze the performance of various LLMs applied to the Italian healthcare domain using novel unpublished datasets, consisting of five-choice questions from national pre-university and post-university medical exams, covering clinical and preclinical fields. As part of this work, we release these datasets to the research community. We evaluated multilingual and Italian-specific models, along with general-purpose and healthcare-specific models, spanning both open-source and proprietary architectures of varying sizes. Our results demonstrate that multilingual, general-purpose large models consistently exceed the pass threshold across all tests, with the best models achieving over 90% accuracy on postgraduate-level exams. Model size emerged as the most critical factor influencing performance, whereas domain specialization and single-language localization offered no evidence of specialization superiority. These findings challenge the traditional pretrain-then-finetune paradigm for domain and language localization in language models, suggesting that advancements in generic-purpose multilingual models may render domain-specific pretraining unnecessary in many specialized cases.

Acromegaly is a chronic multisystem disorder in which growth hormone and insulin-like growth factor 1 excess cause progressive somatic, metabolic, psychological, and functional morbidity. Although biochemical control improves outcomes, many patients continue to experience persistent symptoms, impaired health-related quality of life (HRQoL), and substantial treatment burden. This review synthesizes data from clinical trials, longitudinal cohorts, registry studies, and patient-reported outcome (PRO) research evaluating physical symptoms, HRQoL, mood, interpersonal functioning, work productivity, and financial burden in acromegaly. We examine validated PRO instruments and the impact of medical, surgical, and radiation therapies on the patient experience. Fatigue, musculoskeletal pain, arthropathy, sleep disturbance, and body-image concerns are highly prevalent and frequently persist despite biochemical remission. HRQoL remains impaired in physical, psychological, and social domains, with depression and anxiety affecting a substantial proportion of patients. Treatment-related factors, including injection burden, breakthrough symptoms, gastrointestinal effects, and financial and surveillance demands further reduce well-being and productivity. PRO tools, including the Acromegaly Quality of Life Questionnaire, Patient-Assessed Acromegaly Symptom Questionnaire, Acromegaly Treatment Satisfaction Questionnaire, and the Acromegaly Symptom Diary, reveal discordance between biochemical control and PROs, highlighting the need for standardized PRO assessment and validated minimal important difference thresholds. New oral therapies and long-acting formulations may reduce treatment burden, but comparative PRO data are limited. Despite therapeutic advances, acromegaly remains associated with considerable symptom burden and impaired HRQoL. Patient-centered care requires systematic PRO incorporation, multidisciplinary management of comorbidities, attention to treatment burden, and shared decision-making.

This study aims to investigate the association between the perceived functional impact of hearing loss, assessed using the evaluation of the impact of hearing loss in adults (Évaluation du Retentissement de la Surdité chez l'Adulte; ERSA), and depressive symptoms quantified by the Beck Depression Inventory (BDI) in adults with hearing impairment. This cross-sectional study comprised adult individuals exhibiting hearing loss of at least 25 dB in 1 ear for a minimum period of 6 months. The ERSA scale assessed hearing-related quality of life (QOL) in functional and psychosocial domains, whereas depression symptoms were measured using the BDI. Demographic and clinical attributes were documented. Correlations between ERSA scores and BDI scores were analyzed in various aspects. A total of 103 adults with hearing loss were included in this study. Higher BDI scores were significantly correlated with lower ERSA scores in the QOL, personal life, and social life domains. Strong negative correlations were observed between BDI scores and ERSA total scores (ERSA 150 and ERSA 200). Participants exhibiting more severe, bilateral, and mixed-type hearing loss showed higher depressive symptom scores and lower ERSA outcomes. Hearing aid users exhibited higher BDI scores and lower ERSA scores compared with non-users. A higher socioeconomic status correlated with reduced depression symptoms and improved hearing-related QOL. The perceived functional and psychosocial impact of hearing loss, as evaluated by ERSA, is strongly associated with the severity of depressive symptoms measured by the BDI. These findings highlight the necessity of incorporating patient-reported outcome measures and mental health screening into routine audiological assessment. A multidisciplinary, patient-centered approach addressing both auditory and psychological requirements may improve overall outcomes in adults with hearing loss.