Search Results (55)

Background/Objectives: Executive function (EF) impairments are common in neurodevelopmental disorders but are often examined using group-level approaches that may overlook clinically meaningful cognitive heterogeneity. This study explored EF heterogeneity in children with attention deficit hyperactivity disorder (ADHD), developmental dyslexia, and comorbid presentations using a clinically grounded mixed-method approach. Methods: Standardized neuropsychological data from the NEPSY-II, WISC-IV, and Woodcock–Johnson IV batteries were integrated with a case-based thematic synthesis of 11 clinical evaluations. Semi-inductive analysis was informed by preliminary patterns observed in a larger clinical sample. Results: Three executive function profiles were identified: (1) globally reduced executive functioning, characterized by widespread deficits in inhibition, attention, and working memory; (2) verbal–mnestic executive vulnerability, marked by weaknesses in verbal memory and attention regulation despite relative cognitive strengths; and (3) selective executive control deficit, reflecting impairments in inhibitory control and self-regulation. These profiles revealed clinically meaningful patterns that were not fully captured by categorical diagnostic classifications. Conclusions: The findings support the value of integrated, profile-based approaches for understanding executive function heterogeneity in neurodevelopmental conditions. Such approaches may enhance ecological validity in assessment and contribute to individualized intervention planning. Given the exploratory and case-based nature of the study, the findings should be considered preliminary and hypothesis-generating. Full article

This article examines the Latin construction i nunc et V_imp from the perspective of diachronic analyzability. The expression consists of two imperative forms with identical morphological marking—the first a motion verb (V1), the second a lexical verb—linked by the conjunction et. Rather than encoding a literal directive sequence, the construction conveys a rhetorical exhortative value that systematically guides discourse interpretation in a direction different from that suggested by its surface form. Although attested from the Imperial period onward, the construction is analyzed against the background of serial imperatives with a motion verb in initial position and verbal pseudocoordination, patterns documented not only in Archaic Latin but also in other historical Indo-European languages. On the basis of an exhaustive corpus, the study assesses the contribution of each constituent in order to account for the construction’s global value. The analysis shows that i nunc et V_imp displays an uneven degree of analyzability: while its components remain formally and syntactically transparent, its semantic and pragmatic analyzability is reduced, as the elements do not contribute compositionally to propositional content but function as a pragmatically unitized block. Overall, the article highlights the central role of analyzability in diachronic change, including processes of unitization and constructional de/recategorization. Full article

This paper investigates ongoing phonological changes in Campidanese Sardinian and its morphosyntactic repercussions, focusing on the weakening of word-final codas under increasing pressure from Italian. Sardinian preserves the Latin nominal and verbal endings -s and -t, whose interaction with external sandhi processes traditionally sustains crucial distinctions of person and number. Through a comparison between a conservative variety (Tertenia) and an innovative one (Pula), the study shows that total regressive assimilation of -s and -t is becoming generalized in innovative areas, neutralizing the contrast between second- and third-person singulars. The decline of vowel epenthesis in contexts involving heterosyllabic clusters further destabilizes the system, occasionally generating ambiguity in clitic number and verbal person marking. A Strict CV analysis demonstrates that epenthesis-less outputs are structurally well-formed only if final codas are assumed to be absent at the underlying level, pointing to a deeper restructuring of phonological representations. Overall, the data document a shift from a morphologically transparent system toward one increasingly aligned with Italian phonotactics, with significant consequences for morphosyntactic disambiguation. Full article

Background and Clinical Significance: Modern neuro-oncologists encounter a major challenge when dealing with glioblastomas located in the dominant hemisphere’s temporo-basal area, because their invasive nature disrupts the proximity to eloquent cortical areas (language and speech), as well as skull base venous structures, which can lead to a quick decline in function from the disruptions in these networks and the disconnection of corridor-level pathways. This manuscript illustrates the application of metric-based phenotyping, anatomically defined imaging, and venous-anchored microsurgical techniques that can aid in preserving the remaining functional reserve in patients with dominant hemisphere glioblastomas and demonstrate measurable outcomes through longitudinal follow-up data. Case Presentation: A 48-year-old right-handed male patient presented with a four-week history of progressively worsening symptoms consistent with a dominant hemisphere syndrome, resulting in a significant decrease in his independence (mRS 0 → 4; BI 55/100; IADL 2/8). His symptoms included non-fluent expressive aphasia with a marked inability to generate words and respond to verbal cues (BNT 8/30; SF 4 WPM). Additionally, he experienced prolonged lateralizing hemisensory decompensation and corticospinal tract dysfunction. Imaging studies revealed a large multiloculated cystic lesion located in the left temporo-basal region. The lesion displayed a thick irregular peripheral enhancement pattern with mural nodules and septa, and surrounding T2 hyperintensity extending into the temporal associative white matter, indicating disruption of the lexical–semantic networks and corridor-level tracts. Utilizing continuous SSEPS/MEPs during surgery, a skull base parallel ventral temporal corridor was developed to allow decompression of the cyst first, followed by cyst evacuation, inside-out cytoreduction, subpial dissection, and specific preservation of both superficial and deep temporal veins using selective capsular preservation at venous interface locations where necessary. Postoperative CT scans performed on POD #3 and POD #7 indicated stable decompression without hemorrhage or hydrocephalus complications, followed by rapid quantitative improvement in NIHSS (8 → 2), MoCA (18 → 26), BNT (8 → 26), SF (4 → 12), mRS (2 at discharge, 1 at follow-up), BI (85 at discharge, 95 at follow-up), and IADL (6/8 at discharge, 8/8 at follow-up). Histopathological examination confirmed a diagnosis of glioblastoma. Conclusions: This case study supports a model of a network- and vein-constrained glioblastoma of the dominant hemisphere in the temporo-basal region that can result in substantial restoration of language capabilities and preservation of functional reserves for additional therapies using venous-anchored subpial microsurgical approaches. The use of objective and quantifiable measures of phenotyping and longitudinal follow-up tracking could provide a reproducible method for measuring the degree of recovery of the affected network(s) and establishing safe boundaries for temporal glioma surgery. Full article

Background: In multicultural healthcare systems such as the Italian one, migrant children may experience dental care as particularly stressful because linguistic and cultural barriers can limit communication, emotional expression, and understanding of the clinical setting. Aim: Understanding the emotional experience of migrant children during dental visits is essential for improving clinical management in pediatric dentistry and orthodontics within multicultural contexts. Because linguistic barriers often limit verbal communication, this study aimed to explore children’s mental representations, emotional states, and perceptions of the dental environment through drawing and to evaluate the clinical implications for communication and therapeutic collaboration. Methods: This qualitative study was conducted in Italy between 2016 and 2025 and analyzed 50 drawings produced by 50 foreign-born migrant children aged 6–13 years, recruited through an educational cooperative in Piacenza. Most participants originated from developing countries and had limited proficiency in Italian, frequently showing a marked “experience gap” in drawing ability that interfered with normative developmental stages described by Lowenfeld. The analysis focused on spatial organization, line quality, color use, posture, interpersonal distance, and representation of the clinical environment, integrating graphic competence assessment with emotional interpretation. Results: Younger children commonly depicted rigid lines, essential settings, and oversized dental unit lamps, whereas older children increasingly represented threatening or disproportionate instruments, aggressive dentists, and omission of the patient figure. Around age 10, drawings became more detailed and colorful, although symbols of closure, such as locked doors, persisted. In adolescents, representations polarized between rich, coherent scenes and extremely essential drawings dominated by fear, rigidity, minimal environments, and symbols of constraint. The findings suggest that drawing may represent a valuable non-verbal clinical and communicative resource for exploring migrant children’s emotional experience of dental care and for identifying signs of anxiety and vulnerability that may not emerge through verbal interaction alone. Conclusions: These findings support the value of a culturally sensitive dental approach integrating drawing, visual aids, multilingual educational materials, and play-based strategies to reduce communication barriers and improve cooperation in migrant children receiving pediatric dental and orthodontic care. Full article

Background and Objectives: Minor otologic procedures in adults are often performed under local anesthesia, either via injection or topical application, thereby avoiding general anesthesia-associated risks. This study aims to compare pain levels with the use of a lidocaine spray versus lidocaine injections. Materials and Methods: Fifty adult patients underwent local anesthetic myringotomy and ventilation tube placement, 30 unilaterally, and 20 bilaterally. Lidocaine injections were administered to 29 patients, and 21 received a lidocaine spray. Postoperatively, they were asked to mark their perceived pain level on a visual analogue scale (VAS, 0–100 mm), verbal rating scale (VRS, 0–3), and numeric rating scale (NRS, 0–10). Data normality was assessed using the Shapiro–Wilk test, continuous variables were analyzed using analysis of variance (ANOVA), and VRS outcomes were analyzed using binary logistic regression. A p-value ≤ 0.05 indicated statistical significance. Results: Pain levels were low in both groups, although consistently lower in the topical lidocaine group. The average VAS score was 23.14 mm (±14.69) for injection versus 9.76 mm (±11.41) for topical anesthesia (ANOVA, p = 0.002), while NRS scores averaged at 2.41 (±1.57) and 1.19 (±1.17), respectively (ANOVA, p = 0.009), indicating significantly lower pain with topical lidocaine. Logistic regression of the VRS indicated the same trend, although it did not reach statistical significance (OR = 0.153, 95% CI:0.017–1.389, p = 0.095). Conclusions: Lidocaine spray was associated with lower pain levels compared to lidocaine injections in patients undergoing myringotomy and ventilation tube placement. Our findings suggest that topical anesthesia may represent an effective alternative, offering a less invasive approach and reducing the needle-related psychological distress of patients. Full article

Research on twice-exceptional students, those who simultaneously present intellectual giftedness and dyslexia (G-D), remains limited, particularly with regard to gender differences in reading and writing processes. The present study examines these differences in a sample of 39 Spanish students (21 boys and 18 girls) aged 8 to 12 years, with the aim of determining whether significant differences exist in literacy-related scores within this population. Using a comparative design, the results show that most assessed variables do not reveal significant differences between boys and girls. However, some specific differences in test scores were identified: boys obtained higher scores in syllable dictation, whereas girls outperformed boys in story writing and in tasks related to grammatical structures and punctuation marks. These differences suggest the use of differentiated strategies, with greater reliance on visual and visuospatial resources among boys and more efficient use of verbal and linguistic processing among girls. The interaction inherent in this twice-exceptionality appears to modify the gender differences typically reported in other profiles with respect to literacy performance, highlighting the need for specific approaches to identification, assessment, and educational intervention tailored to this G-D population. Full article

Down syndrome (DS) is associated with persistent language impairments that extend beyond early childhood, yet evidence from agglutinative languages remains limited. While morphosyntactic weaknesses have been well-documented in Indo-European languages, less is known about how such difficulties are manifested in Turkish, a language in which grammatical relations are primarily marked through morphology. In addition, short-term memory (STM) limitations, particularly in verbal domains, are characteristic of DS and may contribute to language outcomes. This study examined the interaction between morphosyntax and STM in Turkish-speaking children and adolescents with DS. A cross-sectional observational design was employed, including 12 monolingual Turkish-speaking participants with DS (aged 6;7–15;11) and 10 TD peers matched on nonverbal mental age. Participants completed standardized assessments of syntax and morphology, spontaneous language sampling, and STM tasks assessing verbal and visual memory. Children with DS performed significantly below controls on syntactic comprehension and production as well as morphological measures, with larger effects observed for syntax. Noun morphology was less accurate than verb morphology, likely reflecting increased morphophonological complexity. Regression analyses indicated that auditory digit span predicted sentence comprehension, whereas nonword repetition predicted morphological production indexed by mean length of utterance in morphemes. Substantial inter-individual variability was observed within the DS group. These findings suggest that morphosyntactic outcomes in Turkish-speaking children with DS are closely linked to verbal STM capacities and vary considerably across individuals, underscoring the importance of integrated assessment and individualized intervention planning. Future research with larger samples is warranted to confirm and extend these preliminary findings. Findings should be interpreted cautiously due to the limited sample size and are presented as preliminary descriptive evidence. This study provides initial data on Turkish-speaking individuals with Down syndrome. Full article

Background/Objectives: Bipolar disorder (BD) is a chronic psychiatric condition characterized by episodes of mania, hypomania, and depression. Due to the cognitive impairments associated with BD, patients frequently experience difficulties in attention, memory, and executive functions, which in turn adversely affect specific aspects of their language abilities, such as word retrieval, verbal fluency, and the organization of coherent speech. The present study aims to determine the extent to which the verbal fluency skills of native Turkish-speaking individuals with BD are impaired compared to healthy controls and to identify whether there are differences in verbal fluency skills and their subcategories between bipolar I disorder (BD I) and bipolar II disorder (BD II) groups. Methods: A cross-sectional comparative design was employed in this study, including 39 euthymic patients diagnosed with BD I or BD II and 39 healthy controls. Verbal fluency was assessed using a standardized task comprising semantic fluency, semantic switching, phonemic fluency, and automatic speech subtests. All assessments were conducted under blinded conditions, and scoring was performed by independent raters. Group comparisons were carried out using ANOVA, Kruskal–Wallis, and ANCOVA analyses; age was controlled for through covariance analysis. Additionally, sensitivity analyses were conducted within the 25–55 age range. Results: The control group demonstrated significantly higher performance than the BD groups across all semantic and phonemic verbal fluency tasks. No statistically significant differences were observed between the groups in automatic speech tasks. When comparing the BD I and BD II groups, a statistically significant difference was found only in the action (verb) category, with the BD II group outperforming the BD I group. Conclusions: The findings indicate that bipolar disorder is associated with marked impairments in semantic and phonemic verbal fluency, while automatic speech abilities appear to be relatively preserved. Moreover, the observed difference between BD subtypes—particularly in the action (verb) category—suggests that the type of the disorder may differentially influence cognitive–linguistic functioning. Full article

Background: The original Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) is a simple assessment tool but does not account for individual differences in hand starting position and fails to provide information on limb asymmetries. The purpose of the study is to evaluate the test–retest reliability of a new single-arm CKCUEST as well as the reliability of the limb symmetry index (LSI). This version normalizes the test based on the participant’s arm length and allows for the assessment of limb symmetry since it is performed one arm at a time. Methods: Twelve healthy young adults provided both verbal and written consent to participate. Participants were excluded if they had sustained an injury in the past three months requiring medical attention and/or resulting in decreased activity for more than three days. Testing was conducted in the push-up position with participants’ thumbs placed parallel and at a distance equal to the length of their dominant arm (measured from the acromion to the tip of the middle finger), and feet positioned shoulder-width apart. Participants were instructed to keep the testing hand stable on the floor while the opposite hand reached across the body to touch the stationary hand and then return to the starting position marked with athletic tape. The goal was to complete as many touches as possible in 15 s, with each touch counted only if the participant touched the stationary hand, returned to the starting position, and maintained the shoulder-width stance. The average number of touches from the three trials was used for analysis. Intraclass Correlation Coefficients (ICC_(3,1)) were computed to determine test–retest reliability. Results: Test–retest reliability of the single-arm CKCUEST individual tests was good to excellent. The ICC_(3,1) was 0.88 (95% CI: 0.74–0.95) for all tests, 0.89 (95% CI: 0.66–0.96) for the dominant arm, and 0.93 (95% CI: 0.78–0.98) for the non-dominant arm. In contrast, the reliability of the Limb Symmetry Index (LSI) was questionable, showing substantial variability with an ICC_(3,1) of 0.53 (95% CI: −0.03–0.83) between Day 1 and Day 2, despite similar mean values (Day 1: 93.6 ± 8.46; Day 2: 94.8 ± 5.77). The Kappa coefficient suggested a substantial level of agreement for the direction of the asymmetry (preferred limb) (Kappa coefficient = 0.62). Conclusions: The new single-arm CKCUEST, which personalizes the hand starting position and measures limb symmetry, demonstrates high reliability among healthy young adults. Full article

Background/Objectives: Children born small for gestational age (SGA) are at increased risk for impaired growth, metabolic disturbances, and neurodevelopmental difficulties. Although previous research has examined cognitive and behavioral outcomes in this population, findings remain inconsistent. Moreover, limited evidence is available regarding the potential effects of recombinant human growth hormone (rhGH) therapy on cognitive development. We aimed to assess cognitive performance, emotional–behavioral functioning, and neonatal predictors of neurocognitive outcomes in term SGA children compared with age- and sex-matched peers born appropriate for gestational age (AGA). We also explored potential differences in cognitive outcomes between rhGH-treated and untreated SGA children. Methods: A total of 18 term SGA children and 23 AGA controls underwent anthropometric measurements, biochemical evaluation, cognitive testing using the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV), and behavioral assessment through the Child Behavior Checklist (CBCL). Birth weight, length, and head circumference were analyzed as potential predictors of cognitive performance. Results: SGA children demonstrated significantly lower Intelligence Quotient (IQ) scores than AGA peers, with marked weaknesses in Perceptual Reasoning index (PRI) and Processing Speed index (PSI), while Verbal Comprehension and Working Memory were preserved. They also exhibited higher internalizing behavioral symptoms, whereas externalizing behaviors did not differ between groups. Birth head circumference emerged as a strong predictor of PRI and a modest predictor of PSI. No associations were found between rhGH treatment parameters and cognitive outcomes. Larger longitudinal studies are needed to clarify how early growth restriction affects brain development and cognition and whether GH therapy influences these processes. Full article

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to evolve, with mutations leading to the emergence of new variants. JN.1, a subvariant of omicron BA.2.86, has demonstrated marked immune escape and is now included in updated vaccine formulations. While reduced sensitivity has been reported for antibody assays using ancestral spike protein subunits to detect omicron-induced responses, the performance of full-length spike-based assays against omicron sublineages remains unclear. We aimed to compare the sensitivity of ELISA and Luminex assays using full-length spike proteins from the ancestral Wuhan strain and the JN.1 variant. Methods: Wuhan and JN.1 full-length spike protein constructs were designed and expressed in Expi293F mammalian cells. In-house ELISAs based on previously validated protocols were used to measure anti-spike IgG levels. Additionally, a Luminex-based assay for anti-spike antibody detection was developed and validated. Both assays were applied to the following sample groups: pre-pandemic samples (designated “gold standard negatives”); PCR confirmed 2020 positives (“gold standard wildtype positives”); PCR confirmed 2024 positives (“gold standard omicron positives”); 2022 vaccinated individuals with verbal confirmed infection (“gold standard hybrid positives”); and 2024 household samples (“unknowns”). Results: Wuhan spike protein showed a sensitivity of 100% (95% CI: 0.88–1.0) in detecting omicron-specific antibodies using gold standard omicron positives with JN.1 spike protein as a reference assay. Overall, across all samples, in ELISA, the Wuhan antigen had a sensitivity of 0.93 (95% CI: 0.89–0.95) and a specificity of 0.98 (95% CI: 0.94–0.99). The JN.1 antigen showed a sensitivity of 0.91 (95% CI: 0.87–0.94) and a specificity of 0.97 (95% CI: 0.93–0.99). In Luminex, sensitivity was 0.95 (95% CI: 0.91–0.97) for Wuhan and 0.94 (95% CI: 0.91–0.96) for JN.1. Specificity for both antigens in Luminex was 0.98 (95% CI: 0.94–0.99). Conclusions: Both ELISA and Luminex assays showed comparable sensitivity and specificity for both Wuhan and JN.1 antigens, indicating that mutations in the JN.1 variant do not significantly impact assay performance. This suggests preserved antigenic recognition across variants. Full article

In this paper, I will discuss a topic concerning part–whole structures in the nominal and verbal domain. Specifically, I will address the question of whether there is a universal mechanism for the individuation of entities and events by exploring parallels between singulatives and semelfactives in Slavic. Singulatives are derived unit nouns, whereas semelfactives are punctual verbs that describe a brief event which culminates by returning to the initial state. Cross-linguistically, singulative morphology often alternates with collective marking, whereas semelfactives alternate with iteratives. Collectives and iteratives describe homogenous groupings of entities and events, respectively. From a conceptual perspective, both singulatives and semelfactives individuate to the effect of singular bounded unit reference and in the literature, the parallel between the mass count/distinction and aspect has often been drawn. In Slavic, singulative and semelfactive morphologies share a component; specifically, both markers involve a nasal -n and a vocalic component, e.g., compare Russian gorox ‘peas (as a mass)’ ∼goroš-in-a ‘a pea’ and prygať ‘to jump (repeatedly)’ ∼ pryg-nu-ť ‘to jump once’. I will argue that the singulative -in and semelfactive -nu are complex and both involve the very same -n, which denotes a declustering atomizer modeled in mereotopological terms. Full article

Verbal nouns in Insular Celtic languages have long been a subject of interest because they are capable of exhibiting both nominal and verbal properties, posing a persistent challenge when it comes to determining their precise categorization. This study therefore seeks to examine the intersective gradience of verbal nouns in Scottish Gaelic from a functional-typological and multidimensional perspective, providing an insight into the interaction between their morphosyntactic, semantic, and pragmatic properties and their lexical categorization, and, consequently, encouraging a broader discussion on linguistic gradience. This hybrid category plays a central role in the clause structure of Scottish Gaelic, as it appears in a wide range of distinct grammatical constructions. Drawing on a range of diagnostic tests revealing the morphosyntactic and semantic properties of verbal nouns across various contexts (e.g., etymology, morphological structure, inflection, case marking, TAM features, syntactic function, types of modification, form and position of objects, distributional patterns, cleft constructions, argument structure, subcategorization, etc.), this line of research identifies two key environments, depending on whether the construction features a verbal noun functioning either as a verb or a noun. This distinction aims to illustrate the way in which these contexts condition the gradience of verbal nouns. By doing so, it provides strong evidence for their function along a continuum ranging from fully verbal to fully nominal depending on their syntactic context and semantic and pragmatic interpretation. In conclusion, the findings of this study suggest that the use of verbal nouns blurs the line between two lexical categories, often displaying mixed properties that challenge a rigid categorization. Full article

Headache represents one of the most prevalent and disabling conditions in the pediatric population, with significant repercussions on mental and psychological well-being, as well as on academic achievement and social functioning, ultimately leading to a marked reduction in quality of life. Currently, the diagnosis of headache is based on the clinical criteria of the third edition of the International Classification of Headache Disorders (ICHD-3). However, the characteristics of headache may differ between adults and children, as well as the ability of children to provide a complete description of the pain and associated symptoms. The immature narrative skills of children can represent a limitation in defining the clinical phenotype of headache, making the diagnosis more complex. This is even more challenging when extracting information about the characteristics of the headache in children whose verbal expression is poorly developed or completely absent. Given these limitations, clinical psychology has long used drawing as an effective diagnostic instrument to bypass verbal communication barriers. This tool provides unique access to children’s psychological and emotional states, as a direct window into their inner world and as an expressive medium that often generates more detailed, accurate, and clinically actionable information, compared to verbal reports alone. For these reasons, drawing has been recognized as a valuable diagnostic tool for decades, with multiple studies demonstrating specificity and accuracy rates comparable to standard clinical assessments. Particularly for young children, drawings may give access to fundamental information that might otherwise remain inaccessible, thereby allowing both accurate diagnosis and individualized treatment planning. Multiple studies have highlighted and confirmed the graphic differences between representations of various types of headaches and the undeniable utility of an “artistic diagnosis” alongside the clinical one. Furthermore, the literature suggests and encourages the use of drawing in clinical practice, both in the diagnostic process and during subsequent follow-up, as an effective, enjoyable, easy-to-use, and low-cost resource. Accordingly, we propose a narrative review accompanied by a curated collection of drawings that may help identify and categorize specific correlations between graphic representations and clinical phenotypes, such as pain location, quality, intensity, association with nausea and vomiting, photophobia and phonophobia, and types of migraine aura. Our goal is to create a visual reference that can aid clinicians in the accurate interpretation of children’s drawings. Additionally, we aim to promote the integration of this method into routine clinical practice to improve diagnostic precision and support a more child-centered model of care. We also hope to propose new iconographic models to further enrich the diagnostic framework. Full article