How does a video feedback intervention work for people with dementia and distress behaviour living in a nursing home, for whom and under which circumstances? A realist interview study.

In verbal communication, speakers must encode meanings into signs such as words. Within a given language community, the correspondence between word forms and meanings can become conventionalized. However, speakers from different language communities cannot rely on these shared conventions. Here, we investigate whether purely verbal communication using single words is still possible in such a context, enabled by generalized form-meaning mappings. In a pre-registered experiment, we presented Italian speakers with words and instructed them to come up with corresponding German translations. The resulting German-like pseudowords were then shown to German speakers, who were asked to guess the original words. Supporting our hypotheses, results showed that the German participants' guesses were semantically closer to the original words than to randomly selected control words. These findings highlight the remarkable human ability to spontaneously create and interpret meaningful signals, even across language boundaries and without relying on an established mutually-known lexicon.

Ensuring Continuity of Emergency Care During Patient Handover.

Virtual reality for verbal communication development in English as second language learning: Advantages and optimisation strategies

The phenotypic spectrum associated with pathogenic ARID1B variants is remarkably broad, ranging from classic Coffin-Siris syndrome to non-syndromic intellectual disability and autism spectrum disorders. While speech delay, motor impairments and learning difficulties are well documented, brain imaging investigations remain scarce in this population. We combined multimodal neuroimaging and neuropsychological assessments in 12 patients carrying pathogenic ARID1B variants (age = 13.8 ± 4.7 years) and 34 age-matched healthy controls. Whole-brain voxel-wise analyses included arterial spin labelling to measure cerebral blood flow (CBF) at rest and voxel-based morphometry to assess grey matter density. To investigate white matter abnormalities, we performed fixel-based analysis in a subgroup of 7 patients and 17 age-matched controls. While patients showed pronounced language, motor and social impairments, their memory performance ( + 5 SD) largely exceeded other cognitive and motor skills. Whole-brain voxel-wise analyses showed a significant bilateral increase of CBF at rest in several limbic structures, including hippocampi and visual areas. They also showed significant decrease in grey matter density and fibre density in the same limbic structures, language, motor and social circuits. This paradoxical coexistence of hyperperfusion and structural deficits within memory networks suggests functional resilience or compensatory mechanisms. These preserved visual and memory functions strongly contrasted with their impaired language, motor, and social abilities. Patients appeared to rely on visual cues and memory to compensate for deficits in verbal communication. These findings support the development of individualized and innovative interventions that build on preserved visual and memory abilities in children with pathogenic ARID1B variants.

laryngectomees depend on an electromechanical device to generate electrolaryngeal (EL) speech for verbal communication. Compared with normal speech, EL speech suffers from severe distortion, limited phonetic variation, unnatural prosody, and temporal shifts, degrading naturalness and intelligibility. Although sequence-to-sequence (seq2seq) voice conversion (VC) based EL-speech-to-normal-speech conversion (EL2SP) is promising, substantial mismatches between EL and normal speech inevitably cause cumulative mapping errors that limit performance. To address this, we describe a novel representation learning framework integrating speech and text representations to improve mapping and reconstruction quality within a seq2seq VC model. our methodology comprises two main stages: 1) representation integration and learning, and 2) reconstruction training. A network capable of incorporating auxiliary text information is first constructed with pretrained modules to learn speech-text-based integrated representations. Then, an autoencoder-style reconstruction strategy finalizes EL2SP model to inherit these representations without increasing model complexity. Additional optimization designs are performed across these stages. We introduce three fusion strategies including middle-, input-, and hybrid-level fusion strategies that progressively enhance learning. Moreover, besides standard seq2seq VC objectives, an additional reconstruction loss on the integrated representation is introduced to refine representation transfer. experiments under different EL2SP datasets consistently demonstrate that our methods, combined with data augmentations, outperform baselines relying solely on speech representations regarding both conversion quality and intelligibility. Furthermore, progressive improvements with system design depth validate the effectiveness of our methods. the proposed methods provide an extensible and practical methodology for EL speech enhancement and assistive communication technologies.

Verbal communication transmits information across diverse linguistic levels, with neural synchronization (NS) between speakers and listeners emerging as a putative mechanism underlying successful speech exchange. However, the specific speech features that drive this synchronization, and how language-specific versus universal characteristics facilitate information transfer, remain poorly understood. We developed a novel feature-based interbrain encoding modeling approach to disentangle the contributions of acoustic and linguistic features to speaker-listener NS during Mandarin storytelling and listening, as measured via magnetoencephalography (MEG). A female speaker and 22 listeners (12 females and 10 males) were recruited and analyzed. We observed strong NS across frontotemporal-parietal networks, with systematic time lags between the speaker and listeners. Crucially, suprasegmental lexical tone features (i.e., tone categories, pitch height, and pitch change), which are essential for lexical meaning in Mandarin, contributed more significantly to NS than either acoustic elements or universal segmental units (i.e., consonants and vowels). These tonal features produced unique spatiotemporal NS patterns, forming language-specific interbrain neural connections that enabled effective transmission of representations between the speaker and listeners. The strength and patterns of NS, driven by these speech features, further predicted listeners' understanding of the speaker's storytelling. These findings demonstrate the interbrain neural mechanisms underlying shared representations during verbal exchange and highlight how language-specific speech features shape neural alignment between speakers and listeners, supporting information transfer.Significance Statement Human communication depends on shared neural representations between speakers and listeners, but the specific features that promote this alignment remain unclear. Using MEG and a feature-based interbrain analysis approach, we show that speaker-listener neural synchronization is driven more by linguistic content than by acoustics alone. Language-specific lexical tones and pitch cues have a stronger influence than segmental features and can predict how effectively listeners comprehend the speaker's stories. These findings highlight the importance of language-specific tonal information in driving interbrain alignment and introduce a new method to distinguish the roles of different speech features. The study provides insights into how production and perception systems are coordinated across brains in space and time, depending on linguistic features during the transfer of verbal information.

To describe the characteristics of paediatric postoperative patients with cognitive dysfunction and assess the prevalence of pain and associated factors. A descriptive observational study. Cross-sectional study in children and adolescents who had undergone surgery in the previous 72 h with cognitive dysfunction impeding verbal communication of pain. The Spanish-language version of the revised Face, Legs, Activity, Cry and Consolability scale was used to assess pain intensity. The 51 included patients underwent 1072 pain assessments. Moderate to severe pain was detected in 12.1% of the evaluations (n = 130). Girls showed more intense pain after analgesia than boys. Higher pain intensity before analgesia was associated with neurodegenerative disease and autism spectrum disorder. In children with cognitive dysfunction, female sex and baseline cognitive conditions seem to be associated with more intense postsurgical pain. Hospital pain management protocols should differentiate between patients with cognitive dysfunction and patients with neurotypical development. - This study addresses the prevalence of postsurgical pain in paediatric patients with cognitive dysfunction and associated factors - 12.1% of postsurgical evaluations showed moderate to severe pain. Female sex and baseline cognitive conditions seem to be associated with more intense postsurgical pain. - This research will have an impact on the care of paediatric patients with cognitive dysfunction in postsurgical hospitalization units. This study was performed according to EQUATOR GUIDELINES and the STROBE statement. No Patient or Public Contribution.

ABSTRACT One important factor for preschool children’s well-being and development is the relationship with their teachers. The International Child Development Programme (ICDP) is a health promotion and prevention programme for caregivers of children. There is research about ICDP as a parenting programme but almost none about its usefulness for professional caregivers. This study aims to explore perceived changes in preschool educators and children after participating in ICDP. Written evaluations by educators were analysed using qualitative content analysis. The educators reported strengthened and improved professional role, changed perception and improved approach towards the children. The educators also reported positive changes in the children, e.g., improved social behaviour, emotional balance and verbal communication, as well as increased self-agency. Our study suggests that ICDP is a plausible intervention for professional development in relational work, which educators experience as beneficial for both themselves and the children. More research is necessary to strengthen these tentative conclusions.

ABSTRACT Background Conducting research with people living with dementia presents unique methodological and ethical challenges, particularly when attempting to access subjective experiences and uphold participant voice. Traditional research tools often fail to accommodate the progressive cognitive changes of dementia, raising questions about inclusion, agency, and meaningful participation. Purpose This reflective article examines the complexities of dementia research through the lens of music therapy, exploring how musical engagement may serve as both a therapeutic intervention and a mode of inquiry. Method Drawing on three decades of clinical and research experience, this practice-based reflection presents vignettes that illustrate key challenges in dementia research: the limitations of verbal communication, consent as an evolving process, and the recognition of non-verbal expression as meaningful data. Results Three insights are offered: (1) Music-based recognition tasks can substitute cognitively demanding direct questions, allowing participants to demonstrate familiarity through engagement; (2) Consent in dementia research requires ongoing attunement to verbal and non-verbal cues of assent or dissent; (3) Spontaneous comments within music therapy sessions may offer authentic insights into participants’ subjective experiences without relying on formal interviews. Conclusions Music therapy invites a reconsideration of how data are understood within qualitative dementia research. When musical interaction is recognized as a site of knowledge generation, intervention and inquiry become intertwined. This perspective highlights how experience, agency, and participation may be expressed and recognized within the therapeutic encounter itself. Future research may benefit from designing qualitative studies that attend to these interactional processes as integral to data generation.

Effectiveness of high-fidelity simulation interventions in enhancing interpersonal skills in nurse-patient relationships among undergraduate nursing students: A systematic review.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with problems in social interactions, verbal and non-verbal communication, repetitive behaviors, and limited interests in a person. Considering the challenges in diagnosing ASD based on behavioral symptoms-such as subjectivity, variability among individuals, and overlap with other developmental conditions-it seems necessary to propose computer-aided diagnosis systems (CADS) for ASD. We proposed an age-dependent CADS based on functional connectivity (FC) in the frequency domain for ASD using resting-state functional magnetic resonance imaging (rs-fMRI). Also, the features and classification accuracy obtained in the frequency and time domains were compared. First, preprocessing was performed on the rs-fMRI data. Then, group-independent component analysis (GICA) was used to obtain resting state networks (RSNs). This was followed by obtaining separate components of RSNs for each individual using dual regression. Then, coherence analysis was used to extract the features of FC in the frequency domain between RSNs. To consider the role of age in the classification process, three age groups of children, adolescents, and adults were considered, and feature selection for each age group was applied separately using an embedded approach, in which all classifiers in the Waikato Environment for Knowledge Analysis (WEKA) machine learning platform were used simultaneously. Finally, classification accuracy was obtained for each age group. The proposed CADS was able to classify 95.23% in the children group, 88.1% in the adolescent group, and 92.8% in the adult group. In addition, the frequency bands whose features obtained the most distinction in each age group were identified, highlighting their potential relevance for supporting ASD diagnosis and monitoring rehabilitation.

This Community Service (PkM) activity will implement an experiential learning-based Master of Ceremony (MC) training model. This PkM is conducted through the stages of needs analysis, practical simulation implementation, and evaluation using pretest-posttest instruments. There were 33 students in attendance. The results of this PkM activity found a significant increase in self-confidence, verbal and nonverbal communication, improvisation, and audience management. The results of this PkM also prove that the experiential learning approach is effective in improving master of ceremonies skills through direct practice and structured reflection

Feasibility and initial outcomes of the social ABCs parent-mediated intervention for autistic toddlers in Israel: A pilot single-arm study

This paper presents the design and implementation of a Society Complaint Management System, a web-based application developed using the MERN stack (MongoDB, Express.js, React.js, Node.js) to improve the efficiency and transparency of residential community management. Traditional housing societies rely heavily on manual methods such as registers, notice boards, and verbal communication, leading to delays, mismanagement, and lack of accountability. The proposed system introduces a centralized digital platform that enables residents to raise complaints, track their status in real-time, and receive updates through an interactive dashboard. Administrators are provided with role-based access to manage complaints, update their progress, publish notices, and handle permission requests. The system uses JWT-based authentication for secure login and ensures data integrity through structured database management. The results demonstrate improved communication, reduced response time, and efficient handling of society operations. The system offers a scalable and user-friendly solution that supports the digital transformation of residential societies.

ABSTRACT Background Adolescents with social anxiety often experience significant challenges in participating in group-based therapies, particularly those relying heavily on verbal communication. Hybrid models may reduce barriers and enhance engagement. Aims This pilot study examined the feasibility and acceptability of a hybrid group art therapy and cognitive–behavioural therapy (CBT) intervention, adapted from the Role of Emotional Processing in Art Therapy (REPAT) protocol, for adolescents with social anxiety. Methods Four adolescent girls participated in an 8-week intervention combining 4 online sessions and 4 in-person sessions. Each session included structured art-making, psychoeducation and gradual social exposure. Feasibility was assessed through recruitment, retention and adherence rates, along with participant feedback. Social anxiety, general anxiety and emotional awareness were measured pre-, mid-, and post-intervention. Qualitative observations were also recorded. Results Recruitment and retention rates indicated good feasibility, and participants valued starting online to ease the transition to in-person sessions. Qualitative data revealed increased comfort in group settings, enhanced peer connection and active participation in collaborative art-making. Quantitative trends suggested potential reductions in social and general anxiety, alongside mixed changes in emotional awareness. Conclusions The hybrid format supported engagement and offered a safe, creative environment for socially anxious adolescents. Implications for practice/policy/future research Integrating art therapy with CBT in a hybrid delivery model may help reduce barriers to participation for adolescents with social anxiety. Future research should include larger controlled studies to establish efficacy and examine how the model can be adapted to different contexts. Plain-language summary Social anxiety can make it difficult for teenagers to take part in group therapy, especially when sessions focus mainly on talking. This pilot project tested a new intervention that combined art therapy and cognitive–behavioural therapy (CBT) to help adolescents feel more comfortable in group settings, express themselves and face social challenges gradually. The intervention lasted 8 weeks: the first 4 sessions were held online, followed by 4 in-person sessions . Each session included creative art-making, learning about emotions and gentle steps to practice social skills in a safe way. The aim was to give participants time to adjust before meeting face-to-face, while using art to support emotional expression and connection. A total of 4 girls aged 13–16 took part. All attended most of the sessions, and said starting online helped reduce the stress of meeting new people in person. Once they met in the same room, participants were more willing to share their artwork, talk to each other and work together on creative projects. The art activities offered different ways to communicate, without having to rely only on words. Overall, the results suggest that combining art therapy with CBT in a hybrid (online and in-person) format may be a helpful way to help teenagers with social anxiety. It can lower the barriers to joining a group, give them time to feel safe, and encourage positive social interaction. More research with larger samples and a control group is needed to understand how effective this approach is and how it might work in other settings.

This study explores, in a clear and accessible way, the effectiveness of folinic acid (leucovorin) in modulating symptoms in individuals with Autism Spectrum Disorder (ASD), particularly those who present autoantibodies against the folate receptor alpha. It is based on the understanding that disruptions in folate metabolism may directly affect neurological development and brain function, influencing language, behavior, and cognition. The presence of these autoantibodies can impair the transport of folate into the central nervous system, leading to significant functional deficits. In this context, folinic acid emerges as a therapeutic alternative due to its ability to bypass this blockage and improve folate availability in the brain. Recent studies suggest improvements in verbal communication, social interaction, and a reduction in repetitive behaviors in some treated patients. However, results are not uniform, highlighting the importance of individualized assessment and careful clinical monitoring. It is concluded that leucovorin may represent a promising strategy, particularly for specific subgroups within the spectrum, reinforcing the relevance of personalized approaches in ASD management.

As the educational landscape changes with the widespread use of generative artificial intelligence (AI), we have made the deliberate choice to adapt with intention through the constructive integration of this tool within the curriculum. Writing assignments are often vulnerable to AI shortcuts, and therefore, we reimagined the project in our online microbiology lab to incorporate AI in a structured and pedagogically sound way that prioritizes both the writing process and the final product. Students must work with AI to create a script for a 5-minute video which they then illustrate and record on the differences between Staphylococcus aureus and methicillin-resistant S. aureus. The drafting process is highly structured and provides a scaffold for students to reflect on their own knowledge, think critically about AI outputs, develop AI literacy skills, and engage in self-reflection. Students are graded based on their involvement in this modified writing process rather than the final product. Subsequently, students create illustrations and record their 5-minute video; engaging in this verbal and visual communication helps reinforce student learning. Surveys conducted in the Fall 2025 semester suggest that the assignment reinforced student content understanding and reiterated the importance of responsible AI use. Additionally, students self-reported increased confidence in their prompt engineering skills. This assignment achieves student engagement and fosters the growth of AI literacy without compromising critical thinking or scholarly diligence. It can be adapted to different fields and topics and showcases a purposeful, strategic, and thoughtful incorporation of AI in undergraduate education.

Chronic pain in older adults with mild cognitive impairment represents a clinical and ethical challenge for nursing, as it often manifests silently and remains underreported. The absence of clear verbal communication compromises diagnostic accuracy and hinders the implementation of appropriate therapeutic strategies. In this context, the validation of pain assessment scales becomes essential to ensure quality of care and humanization of assistance. This literature review aimed to analyze recent evidence on instruments applied by nursing professionals in clinical and community settings, focusing on the reliability and validity of these tools. International and national databases were consulted, prioritizing publications from the last five years. The analysis revealed that observational scales, such as PAINAD and Doloplus-2, show greater applicability in older adults with mild cognitive impairment, although limitations remain related to the subjectivity of interpretation and the need for continuous staff training. The literature indicates that systematic use of these scales helps reduce pain underassessment, improves therapeutic adherence, and promotes greater clinical safety. However, methodological gaps require further studies to consolidate cross-cultural validity parameters and adaptation to the specificities of the Brazilian population. The review highlights the importance of nursing training and the integration of standardized protocols to ensure that silent pain is recognized and treated with scientific rigor and ethical sensitivity.

Voice disorders severely limit verbal communication, creating a need for intuitive assistive technologies. To meet this need, we present epidermal strain sensors that capture strain signals during silent speech and hand gesture. A thin electrospun nanofiber layer integrated onto commercial polyurethane films guides uniform, controlled microcrack formation in screen-printed carbon conductive paths, achieving a gauge factor up to 243 over 0-40% strain. Signals from the seven-channel strain sensor array are recognized by a hybrid neural network that combines convolutional and Transformer architectures, reaching over 98% accuracy. The recognized outputs are rendered in virtual reality (VR), enabling intuitive, real-time communication. Moreover, the approach simplifies fabrication by enabling crack-based strain sensing with only a thin electrospun surface layer on commercial polyurethane films, eliminating the need for thick freestanding electrospun substrates. This cost-effective approach addresses limitations of conventional electrospun substrates by minimizing the thickness of the electrospun layer, thereby shortening the electrospinning time. Overall, the work demonstrates a method for translating natural non-verbal expressions into speech and text in VR, with promising applications in healthcare and assistive communication.