Annals of the New York Academy of Sciences

Sensorimotor synchronization, the ability to align motor behaviour with the temporal structure of external stimuli, is thought to emerge gradually during development, but its origins remain unclear. Here, we investigated whether newborns can adapt their sucking behaviour and synchronise it to the temporal structure of auditory stimuli within the first days of life. Forty-one healthy full-term newborns (24-72 hours old) were exposed to two three-minute auditory streams differing in temporal structure: a highly structured stream with a stable temporal pattern and a highly variant stream with greater temporal variability, while their non-nutritive sucking (NNS) was continuously recorded. We assessed changes in NNS frequency and pressure and quantified NNS-sound coupling using magnitude-squared coherence at frequencies distinctive to each auditory stream. Structured stimulation promoted a more organised NNS, with more suck bursts than the variant stream, and increased sucking vigour, with a transiently higher suck peak rate during the first minute relative to the variant stream and greater suck pressure relative to silence. Coherence analyses revealed that coherence was selectively higher at the frequencies distinctive to each auditory stream, both for the structured and the highly variant stimulus. These findings show that, within hours of birth, NNS behaviour can selectively align with stimulus-specific temporal regularities, even when these are weakly predictable and lack a dominant periodicity. This early capacity to extract temporal structure and coordinate motor behaviour may provide a foundation for the subsequent development of sensorimotor synchronisation.

Humans coordinate their actions while their bodies and brains synchronize in social interactions, yet how behavioral, physiological, and neural dynamics interact during interpersonal coordination remains largely unknown. We investigated how respiration and individual differences influence behavioral and inter-brain synchrony in a musical synchronization task, which requires precise temporal alignment. Eighty-eight individuals first produced a familiar melody at their most comfortable rate to measure their spontaneous production rate (SPR). They then synchronized the melody with a randomly assigned unfamiliar partner under natural (unpaced), instructed in-phase, and instructed anti-phase breathing conditions, while hyperscanning 64-channel electroencephalography (EEG), respiration, auditory-motor timing, and perceived social connectedness were recorded. Relative to natural respiration, both in-phase and anti-phase breathing increased inter-brain phase-locking and perceived social closeness but reduced behavioral synchrony; the instructed respiratory phase relationship was mirrored in their inter-brain relative phase. Differences in phase of respiratory cycles (inhalation and exhalation) also influenced coordination: Inhalation was associated with stronger inter-brain synchronization but less precise and stable behavioral coordination than was exhalation. Moreover, Individual differences influenced coordination: Partners with the faster SPR consistently preceded the slower partners and exhibited an alpha-band inter-brain phase advance in synchronization, whereas dyads with similar SPR showed greater behavioral synchrony and smaller inter-brain phase difference. Our findings identify respiration as a previously overlooked factor that organizes behavioral and neural synchronization, while individual intrinsic rhythms constrain how interacting partners align in time. Together, these findings reveal a dynamic interplay between the rhythms of the body and brain during human social interactions.

Interpersonal physiological synchrony (IPS) between interaction partners has been studied as a marker of social connectedness and coordination. However, little is known about how such interpersonal synchrony relates to the intrapersonal coordination of individuals' own autonomic systems during team interaction. The present study examined whether IPS and intrapersonal physiological synchrony (IAPS), defined as the within-person coordination of heart rate (HR), respiration, and electrodermal activity (EDA), function as competing or complementary regulatory processes. It also examined whether IAPS is state- or trait-like and whether teams high or low in both IPS and IAPS had better outcomes. Fifty five newly formed triads (N = 165; Mage = 23.87, 77% female) participated in a laboratory interaction including passive shared experiences and active collaborative tasks while continuous physiological activity was recorded. Synchrony within individuals and between team members was quantified using multidimensional recurrence quantification analysis. Across interaction segments, IAPS was positively associated with IPS in both HR and EDA, with stronger and more consistent associations during active teamwork versus during passive social contexts. These findings contradict a trade-off hypothesis and instead support a synergistic relationship between IAPS and IPS. IAPS exhibited state-like dynamics and sensitivity to features of the context, i.e., consistency within similar interaction contexts and higher in passive versus active social segments. Further, IAPS had limited associations with individual difference measures. Exploratory analyses indicated that teams characterized by both high IAPS and high IPS demonstrated more favorable outcomes, reflected in either higher objective task performance or greater perceived team efficacy depending on physiological modality. Together, these results suggest that effective team coordination is supported not only by IPS but also by the capacity to maintain coherent internal autonomic organization. They further highlight IAPS as a dynamic component of social functioning that merits exploration alongside interpersonal processes.

Semi-occluded vocal tract (SOVT) exercises are widely used in voice training and therapy, but their immediate electroglottographic (EGG) effects remain incompletely characterized. In this pilot methodological study, six female community singers completed a no-straw baseline recording and then 1-min straw-phonation exercises with four straws (Household metal, Metal VoiceStraw, plastic, and paper), each followed by a no-straw EGG recording. Thirty 1s recordings were analyzed with a standardized pipeline including contact quotient (CQ), waveform skewness, contact-phase rise/fall timing, temporal skewness (s_t), a normalized derivative asymmetry index (NDAI), average-cycle morphology, and EGG spectral descriptors. Relative to baseline, group-mean CQ was higher after all four straws (by 0.027-0.058), waveform skewness and NDAI were lower, and the EGG spectral centroid was lower (by 9.6-15.3%). Contact-phase timing asymmetry did not change consistently: s_t exceeded baseline after three straws and fell below it after one, and the rise/fall ratio decreased in three to five of six participants depending on the straw. Four participants ranked the Metal VoiceStraw first and two ranked paper first. Because every straw condition followed the baseline, warm-up and order effects cannot be separated from straw effects. These hypothesis-generating results identify CQ, waveform skewness, and EGG spectral centroid as candidate endpoints for a larger controlled study

Discourse analysis can reliably predict real-world communicative success, yet is rarely implemented clinically, due to challenges in manually generating stimulus-specific main concept inventories (MCIs) and scoring patient narratives. We evaluated whether automatically derived macrolinguistic (main concept, sentiment) and microlinguistic (fluency, lexical, syntactic) features extracted from movie clip narrations can augment the clinical assessment of discourse in aphasia. The MCIs generated directly from each clip's video, audio and subtitles using a vision-language model approximated the main concepts healthy controls produced. Group classification (control: n=51; aphasia: n=54) based on the discourse features was excellent (AUC=0.95, 95% CI [0.90, 0.99]), with macrolinguistic features showing the largest group differences (main concept completeness: d=-1.84, 95% CI [-2.30, -1.38]) and strongest associations with aphasia severity (semantic distance to inventory: r=-0.79, 95% CI [-0.87, -0.66]). Findings support the feasibility and scalability of automated criterion-based discourse assessment using ecological stimuli, and highlight its potential for clinical implementation.

Humans coordinate in groups, yet much of what we know about coordination comes from dyadic interaction. In groups, however, how much people synchronize may not be enough. Pairwise synchrony can be distributed across teammates: who synchronizes with whom, and how these connections are distributed, may carry distinct social information. Here, we tested whether physiological group synchrony can be understood as a network topology of interpersonal coordination rather than as an aggregate of dyadic alignments. A total of 33 groups (N = 161 participants) completed cooperative and competitive joint drumming tasks while cardiac inter-beat intervals (IBI) and electrodermal activity (EDA) were recorded simultaneously. Pairwise physiological synchrony was estimated using lagged cross-correlation and used to construct synchrony-based networks. IBI-based networks showed stronger and broader cardiac connectivity during cooperation, with cardiac coupling also increasing during competitive drumming relative to baseline. EDA-based networks also showed task-sensitive changes in node-level connectivity and captured social and behavioral dimensions of group interaction, linking trust and cohesion to node-level connectivity, and collective behavioral synchrony to lower clustering and higher local efficiency. Together, these findings show that the social meaning of physiological group synchrony lies not only in how much individuals align, but in how physiological alignment is distributed across people, relationships, and biological systems. By preserving this configuration, synchrony-based network analysis captures information about group experience that is lost when synchrony is reduced to an average dyadic score, providing a route toward understanding group synchrony as a flexible, selective, and distributed property of social coordination.

Purpose: Impaired balance and fall risk in individuals with respiratory conditions highlight the importance of respiratory-postural integration during upright activity. However, breathing and postural control are often studied separately, limiting understanding of their interaction. Singing imposes concurrent ventilatory and trunk control demands, yet respiratory-postural responses during standing singing remain unclear. We examined the effects of vocalisation and tempo on respiratory-postural responses during standing, and whether age and singing experience moderated these responses. Methods: Eighty healthy younger (18-35yr; n=35) and older ([&ge;]60yr; n= 45) adults completed rhythmically paced speaking and singing tasks at slow, normal, and fast tempos while standing on a force platform. Respiratory rate (RR), mediolateral and anteroposterior sway, peripheral oxygen saturation, and perceived breathlessness were measured. Generalised estimating equations assessed vocalisation, tempo, and their interaction, with moderation by age and singing experience. Results: RR showed a vocalisation x tempo interaction (p<.001), with higher RR during slow speaking and greatest increases during fast singing. Singing increased postural sway relative to speaking, particularly mediolaterally (p<.001), with tempo-related increases in anteroposterior sway (p<.001). Older adults exhibited greater postural sway overall (p values[&le;].040) but similar task-dependent modulation to younger adults. Singing experience attenuated RR increases during fast singing (p=.033) and was associated with greater mediolateral sway (p=.004). Perceived breathlessness increased with tempo but was not associated with vocalisation; SpO2 was unchanged. Conclusions: Standing singing was associated with tempo-dependent respiratory and postural responses. Age and singing experience showed distinct associations with these responses. Task-dependent respiratory-postural coordination appeared preserved among participants.

Aim. To evaluate the accuracy, run-to-run consistency, and agreement of large language models on the Ukrainian Integrated Licensing Examination Krok 2 for the Specialty of Physical Therapy. Materials and Methods. Five cloud-based LLMs (ChatGPT-5.5, Claude 5 Sonnet, Gemini 3.5 Flash, Grok 4, DeepSeek-V3) were evaluated using 150 Ukrainian-language multiple-choice questions from the official Krok 2 database. Each model completed two independent runs with identical inputs. Accuracy (with 95% confidence intervals, Wilson method), run-to-run consistency, and agreement were assessed. Statistical analysis included Cohen's {kappa}, Cochran's Q and pairwise McNemar tests with Holm-Bonferroni correction. Results. All models achieved >80% accuracy in both runs, exceeding the passing threshold of [&ge;]64%. In the first run, accuracy ranged from 80.00% (DeepSeek-V3) to 93.33% (Gemini 3.5 Flash); in the second run, from 82.67% (Claude 5 Sonnet) to 88.67% (Gemini 3.5 Flash). In the first run significant differences were observed between Gemini 3.5 Flash and Grok 4 (93.33% vs 84.00%; p=0.0022) and DeepSeek-V3 (93.33% vs 80.00%; p=0.0001). There were no statistically significant differences between models in the second run. R2R consistency exceeded 90% for all models with the highest in ChatGPT-5.5 (98.67%) and lowest in DeepSeek-V3 (90.00%). Cohen's {kappa} ranged from 0.64 to 0.94, indicating substantial to almost perfect agreement. The stability of LLMs' response correctness across two runs ranged from 77.33% (DeepSeek-V3) to 88.00% (Gemini 3.5 Flash). Conclusions. All LLMs demonstrated high performance on Ukrainian-language Krok 2 examination tasks. Gemini 3.5 Flash showed the highest accuracy in both runs and response correctness stability while ChatGPT-5.5 exhibited the greatest response consistency and agreement. Although the accuracy and stability of LLM responses may be interrelated, they represent distinct aspects of model performance. This highlights the need for a comprehensive approach to evaluating LLMs. The findings indicate the potential of LLMs as an auxiliary tool in the professional practice of physical therapy specialists.

To characterise temporal changes in antimicrobial resistance (AMR) among clinically important bacterial pathogens in Iraq during 2021-2024 and examine their implications for empirical antimicrobial therapy and stewardship. We conducted a retrospective longitudinal analysis of aggregated national AMR surveillance data for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. Annual resistance proportions were evaluated across clinically relevant antimicrobials. Temporal change was characterised using absolute percentage-point changes and exploratory linear regression. Resistance trajectories were interpreted in relation to empirical treatment options and antimicrobial stewardship. The analysis included 92,338 organism records: 40,496 (43.9%) E. coli, 24,621 (26.7%) S. aureus, 18,223 (19.7%) K. pneumoniae and 8,998 (9.7%) P. aeruginosa. In 2024, ceftriaxone resistance reached 82.9% in E. coli and 65.2% in K. pneumoniae, while ciprofloxacin resistance was 55.4% and 57.9%, respectively. Meropenem resistance reached 37.4% in K. pneumoniae and 62.3% in P. aeruginosa. Conversely, resistance declined for amoxicillin-clavulanate in E. coli (83.5% in 2021 to 57.2% in 2024) and piperacillin-tazobactam in P. aeruginosa (46.4% to 32.9%). Several pathogen-antimicrobial combinations showed marked year-to-year variation, and no temporal trend remained statistically significant after false discovery rate correction. Resistance to several agents central to empirical therapy remains high in Iraq, while substantial carbapenem resistance constrains reliance on carbapenem escalation when resistance to other {beta}-lactams is suspected. Heterogeneous trajectories indicate that empirical recommendations should not rely on single-year national antibiograms alone and support regular integration of national and local resistance surveillance into empirical treatment and antimicrobial stewardship strategies.

Dance is increasingly delivered as an intervention for social and affective functioning, but a live dyadic encounter confounds several distinct ingredients - social attention, verbal engagement, coordinated movement, and in-the-moment generation - so its neural effects cannot be assigned to any one of them. We recorded dual-brain mobile EEG from adult human participants of both sexes (16 female, 2 male) and a dance instructor across six five-minute conditions that vary these ingredients independently: solitary rest, direct eye gaze, conversation, teacher-led and participant-led mirroring, and free improvisation, with concurrent head-mounted accelerometry. Referencing each condition to eye gaze - socially engaging but nearly motionless - rather than to solitary rest partitioned the response. The components proved dissociable. Nonverbal social attention alone reorganized the power spectrum, flattening the aperiodic exponent (g = -0.97) and desynchronizing alpha-band oscillations (g = -0.90), while leaving inter-regional connectivity unchanged (amplitude g = +0.15; phase g = +0.11). Verbal engagement added high-frequency amplitude coupling (g = +2.61) without further spectral change. Coordinated movement added a decrease in theta/alpha coupling involving the frontoparietal-control network (g = -0.59), the signature of an externally directed state, alongside a further spectral shift (g = -0.61). Movement-vigor covariates, corticokinematic coherence, and aperiodic-adjusted power indicated that the spectral effects were cortical rather than myogenic. Four weeks of improvisational dance training increased empathic responsiveness to others' distress relative to a movie control (g = 0.82). Coordinated social movement thus acts on the brain componentially, with mutual attention rather than motor load establishing the engaged state.

Categorical rhythmic patterns are fundamental features found in language and music across cultures. In humans, these rhythmic patterns occur in both vocal production and perceptual preference, highlighting a link between rhythmic production and preference. Categorical rhythmic patterns have recently been identified in animal vocalisations too, but whether rhythm production is linked with rhythmic preferences in non-human animals remains unclear. Within this context, zebra finches (Taeniopygia castanotis) are of particular interest, as both sexes develop a song preference, and their song has been suggested to exhibit an isochronous temporal structure. Here, we tested for the first time whether zebra finches prefer songs containing discrete rhythmic patterns, using operant preference tests with either two or four rhythmic patterns. Our results show that no categorical rhythmic pattern was consistently preferred across the population, although responses varied among individuals. These findings indicate that categorical rhythmic patterns are unlikely to be a primary driver of song preference in zebra finches. Together with previous work in other vocal-learning birds, our results suggest that preferences for categorical rhythmic patterns may not be universal and could instead reflect species-specific features of vocal displays rather than the rhythmic categories characteristic of human music.

Musical aesthetic experience can reveal students' cognitive, aesthetic, and emotional responses to music. However, how professional vocal training alters brain functions in female college students with varying levels of musicianship to promote these is unknown. Here we applied fMRI, psychological measures and Goldsmiths musical sophistication index (Gold-MSI) assessments to study 27 non-music major female college students consisting of instrument group (normal pitch accuracy with instrumental training), general group (normal pitch accuracy without instrumental training) and poor-pitch group (poor pitch accuracy and without instrumental training). After 1 year of one-on-one instructional practice, we found that professional vocal training enhanced information processing related to musical cognition and pleasure during musical aesthetic experiences across all three groups, involving improvements in motor control of vocalization, auditory feedback processing, musical memory and attention together with musical pleasure. Specifically, instrument group showed activation of reward circuits, general group exhibited activation of laryngeal motor control circuits, and poor-pitch group displayed activation of sensory/sensorimotor/motor control circuits. Both pre- and post-training, the instrument group exhibited higher connectivity than the other two groups in the left amygdala-dorsal anterior cingulate cortex (dACC) and the right posterior superior temporal gyrus (pSTG)-left insula pathway. After professional vocal training, the general group showed higher connectivity in the left amygdala-dACC, whereas the poor-pitch group demonstrated increased connectivity in the right pSTG-left insula and dACC-nucleus accumbens pathways. Surprisingly, professional vocal training activated the bed nucleus of the stria terminalis (BNST), a subcortical emotion center, and connectivity with the medial prefrontal cortex associated with musical information processing. Thus, vocal training can significantly improve musical cognition and aesthetic pleasure, and facilitates neural modulation in the brain's emotional centers.

Background Wearable heart rate (HR) monitors collect minute-level HR continuously across days, yet these data are commonly reduced to scalars such as resting HR (RHR) and heart rate reserve (HRR), defined as the difference between maximum HR and RHR. This discards two dimensions of within-day HR dynamics: how HR range varies across the day and the magnitude and duration of individual HR rises and declines. We introduce diurnal heart rate range (dHRR), a time-of-day-specific measure of HR range across repeated days, and heart rate excursions (HREs), individual HR rises and declines characterized by amplitude and duration. Methods We analyzed minute-level HR from 750 participants in the Baltimore Longitudinal Study of Aging (mean [SD] age, 66 [12] years). We estimated the 5th, 50th, and 95th HR percentiles at each minute of the 24-hour cycle across repeated days, defining diurnal HR (dHR) as the median curve and dHRR as the 95th minus 5th percentile curve. A moving-average algorithm segmented HR into HREs. Function-on-scalar regression modeled dHR and dHRR by age, sex,and BMI across the day; local polynomial regression examined age and sex differences in HRR and HREs. Results Conventional HRR decreased with age, indicating a smaller overall observed HR range. Age-related differences in dHR varied substantially across the day: between ages 40 and 80, fitted dHR was approximately 2 bpm lower at 3:00 AM but 8 bpm lower at 6:00 PM. dHRR showed that this contraction was not uniform across the day: the evening peak near 6:00 PM at younger ages was largely absent by age 70, while the morning peak shifted from approximately 9:00 AM toward noon. At the event level, HREs showed two parallel age-related changes: between ages 40 and 80, mean excursion amplitude decreased from approximately 40 to 32 bpm, while mean excursion duration increased from approximately 90 to 104 minutes. Conclusions Aging was characterized by a smaller global HR range, compression and reorganization of HR range across the day, and smaller, longer-lasting HREs. dHRR and HREs provide complementary views of the diurnal organization and event-level dynamics of wearable HR and are implemented in the open-source ihr R package.

Purpose: Stimulability testing involves the evaluation of multiple aspects of a patient's behavior, but the results are most frequently consolidated into a single domain (i.e., "stimulable"). The current study performs preliminary content, construct, concurrent, and predictive validation for the Multidimensional Stimulability Profile for Voice (MSP-V), a rating scale designed to measure multiple domains during stimulability testing (Degree of Change, Rapidity of Change, Generalization, Patient-rated Voice Quality, Patient-rated Voice Feel, and an overall rating of Stimulability Level). Methods: 78 patients with voice disorders (24 functional, 15 structural, 39 neurological) were administered the MSP-V by five speech-language pathologists (SLPs). Content validity was evaluated via the Content Validity Index (CVI) completed by nine voice-specialized SLPs. Construct validity was evaluated via exploratory factor analysis. Concurrent validity was assessed by determining whether MSP-V domains scaled in the expected direction compared to categorical stimulability ratings (e.g., "Highly stimulable" vs. "Stimulable"). Predictive validity was assessed by examining the relationship between MSP-V domains and voice disorder diagnosis, return to voice therapy, and patient-reported practice outside of therapy. Results: The CVI reached the critical value for clinician-rated and patient-rated domains. Two distinct factors were identified during EFA, one consisting of clinician-rated domains and the other of patient-rated domains. All MSP-V domains showed the expected directional relationships as categorical stimulability ratings. No domains differed significantly between disorder etiologies. The Rapidity of Change and Stimulability Level domains both significantly predicted return for voice therapy, where participants who rated lower on each domain were more likely to return to for voice therapy. No domains were predictive of patient-reported practice. Conclusions: The MSP-V is a clinically feasible tool with emerging content, construct, concurrent, and predictive validity that could be used to provide increased clarity and precision in stimulability testing documentation for research and practice.

Rhythmic auditory stimulation in early life rarely occurs in isolation. Caregivers naturally combine singing and speech with rhythmic touch, rocking, and visual cues. Newborns are sensitive to auditory rhythm from birth, yet little is known about how temporally aligned information across sensory modalities shapes the neural encoding of auditory rhythmic structure. Here, we tested whether rhythmic touch can alter how the newborn brain tracks an ongoing auditory signal beyond the period of tactile stimulation. We recorded high-density electroencephalography from full-term newborns (N = 40), 1-3 days after birth, while they were exposed to recorded French lullabies presented either alone or accompanied by gentle patting synchronized with the metrically strong beat. Patting was delivered intermittently, allowing us to compare neural responses to lullabies across conditions, notably during periods without concurrent tactile stimulation. We quantified neural tracking of the lullabies using brain-stimulus coherence and temporal response function modeling. Newborns' neural activity synchronized with the rhythmic structure of the lullabies at frequencies corresponding to both the beat and the metrically accented strong beat. Critically, neural tracking was stronger when the lullabies had been accompanied by synchronized touch than when they were presented alone, and this enhancement persisted during subsequent periods in which no touch was delivered. Although rhythmic touch enhanced tracking in newborns with both weaker and stronger auditory-only tracking, there was a larger gain in those who initially showed weaker auditory tracking. Together, our findings reveal that the newborn brain exploits rhythmic touch to strengthen its encoding of auditory rhythm, and that this benefit outlasts the touch itself. This provides neural evidence that patting an infant in time with a song, a caregiving practice shared across cultures, does more than simply provide a tactile stimulation. It shapes how the newborn brain encodes the song's rhythm.

Background: Safely walking through complex environments requires the use of visual information to plan and regulate steps, while managing competing cognitive demands. Age-related changes in visual control of gait and executive function may contribute to unsafe stepping behaviour, particularly under cognitive load. Route previewing may support visual motor planning, but its effects under dual task conditions in older adults are not well understood. Research Question: Does cognitive dual tasking influence gait and gaze behaviour during adaptive walking in older adults, and does previewing the walking route before gait initiation mitigate these effects? Methods: Thirty nine community dwelling older adults (Mage=73.4 years, SD=8.1; 14 male) completed four adaptive walking conditions, combining single and dual-task walking with and without previewing. Per condition, participants completed six trials across different 8-m long coloured walking routes. Gait characteristics were assessed using an instrumented walkway and video-analysis, while gaze behaviour was recorded using mobile eye tracking. Cognitive load was manipulated using a serial subtraction task. Gait and gaze outcomes were evaluated using linear mixed effects models. Results: Dual task performance significantly increased stepping errors, cross-steps, and double limb support, while reducing stride length (p < .001). It also significantly increased the number and duration of task irrelevant fixations (p < .001). After previewing, participants exhibited more efficient gaze behaviour, as evidenced by looking further ahead (larger forward gaze transitions) and fewer irrelevant gaze fixations (p < .002). Significant Task-by-Preview interactions revealed that previewing mitigated the negative effects of dual-tasking on stepping errors and cross steps (p < .001). Significance: Route previewing prior to gait initiation attenuates negative effects of cognitive load on adaptive gait in older adults, likely by supporting visual motor planning. These findings highlight the potential value of simple visual planning interventions for improving adaptive gait in older adults.

Vocal communication depends on the biomechanical integrity of the vocal folds, yet how impairment alters vocal behavior remains poorly understood. We used the California mouse (Peromyscus californicus), a highly vocal species that produces songs through airflow-induced vocal fold vibration, to experimentally examine how defined vocal fold injury alters vocal production. Longitudinal recordings were combined with histological assessment to track changes in vocal function after impairment. Injury produced acute edema of the lamina propria and thyroarytenoid muscle. Despite stable levels of vocal activity, the vocal phenotype shifted characteristically following injury. Thus, vocal behavior can persist despite substantial alteration of the biomechanical tissues underlying sound production, demonstrating that maintenance of behavioral output does not necessarily indicate preservation of the physiological system that generates it. More broadly, these findings establish an experimental link between vocal fold injury and vocal phenotype and provide a framework for understanding how tissue damage and remodeling can reshape acoustic communication even when vocal behavior is maintained. Because repeated vocalization can impose substantial mechanical demands on vocal folds, this framework may have broad relevance for understanding how vocal use, injury, and tissue remodeling interact to shape vocal communication.

Efficient motion perception requires integrating immediate sensory evidence with internal representations shaped by experience. This influence of recent history can produce serial dependence effects (SDEs), in which current judgments are biased toward or away from the source of previous information. We examined SDEs in auditory, visual, and cued audiovisual motion-direction discrimination using aggregate psychometric measures and trial-level generalized linear mixed-effects models (GLMMs), which estimated the independent contributions of the previous stimulus direction and the participant's previous response. Participants completed unisensory (n=57) and cued audiovisual (n=48) motion-discrimination tasks. Aggregate analyses indicated attractive SDEs in auditory conditions, repulsive SDEs in visual conditions, and no net SDE in the audiovisual-cued condition. Trial-level modeling revealed a more nuanced structure: previous stimulus direction produced repulsive effects in both unisensory conditions, with previous visual direction influencing judgments across all conditions containing visual motion, whereas previous response produced attractive effects only when visual information was task-relevant. In the audiovisual-cued condition, the absence of a net psychometric shift was consistent with the opposing influences of an attractive response-history effect and a repulsive visual stimulus-history effect rather than an absence of serial dependence. These findings suggest that serial dependence in motion perception reflects dissociable and concurrently operating processes, including a predominantly visual, adaptation-like stimulus-history effect and a task-dependent, decision-related response-history effect.

Frailty assessment is important while awaiting lung transplantation (LTx), as frailty is associated with disability and death before and after LTx. We assessed known risk factors and/or frailty indicators in frail, pre-frail, and non-frail patients according to the Short Physical Performance Battery (SPPB) and the Frailty Instrument for primary care of the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), and evaluated the value of SHARE-FI as a proxy to detect frail patients. Frailty was assessed using SPPB and SHARE-FI in 82 patients on a waiting list for LTx. Demographic, anthropomorphic, and clinical variables were collected, and patients underwent respiratory/cardiorespiratory, biochemical, and quadriceps muscle performance assessments. The mean age was 57.3 {+/-} 9.4 years. Chronic obstructive pulmonary disease (COPD) (41.5%) and interstitial lung disease (ILD) (30.6%) were the most common indications for LTx. Four (4.9%), 13 (15.9%), and 65 (79.3%) patients were classified as frail, pre-frail, and non-frail by SPPB, respectively. These figures were 26 (31.7%), 41 (50%), and 15 (18.3%) with SHARE-FI. SPPB found differences between frail/pre-frail and non-frail patients in physical performance (6-minute walking distance) and muscular assessment, while SHARE-FI found differences in age, 6-minute walking distance, and oxygen saturation, and a trend in muscular strength. For COPD and ILD, frailty discrimination was better with SPPB. Concordance between the two measurements was weak, although all SPPB-frail ILD patients were detected by SHARE-FI. In patients awaiting LTx, SPPB showed better discrimination than SHARE-FI for COPD and ILD. SHARE-FI seems appropriate as a preliminary screening instrument for patients with ILD.

Background: Task challenge is recognized as a core principle of neurorehabilitation and is frequently mentioned within stroke rehabilitation guidelines. However, guidance for operationalizing challenge in clinical practice remains limited. Examining how therapists and people with stroke currently use challenge in practice may help address this gap. Objective: To examine how challenge is operationalized in routine stroke rehabilitation practice. Methods: This study used focused video analysis to examine eight video-recorded stroke rehabilitation sessions across physiotherapy, occupational therapy, and speech-language therapy contexts. Video data were supplemented by observational memos. Analysis was conducted iteratively through four stages: immersion, detailed transcription, in-depth episode analysis, and comparative analysis. These stages enabled examination of material, embodied, social, and contextual aspects of challenge-related interactions as they unfolded during rehabilitation. Results: Twenty individuals, comprising four patient-therapist dyads and four triads participated. Challenge was operationalized through three intersecting practices: (i) Structuring challenge-related work through temporal phases determined when challenge was introduced, experienced, and consolidated across the session and within tasks; (ii) Establishing the macro-architecture of challenge guided what and how it was operationalized by constructing a challenge plan, shaping an optimal bandwidth by tailoring challenge to the persons abilities and/or experiences, and facilitating its transfer beyond the session; (iii) Modulating challenge through micro-calibrations involved moment-to-moment adjustments (e.g., adapting physical assistance, communication style, environmental setup) to modulate active practice, navigate differing perspectives, and cultivate an atmosphere conducive to engaging with challenge. These overarching practices were dynamically enacted through a range of explicit and implicit practices. Conclusion: Challenge in stroke rehabilitation is not merely a task parameter; it is operationalized through an interplay of explicit and implicit practices that structure and enable its responsive implementation. Considering challenge through these practices may help therapists and people with stroke co-construct meaningful experiences of challenge, both within and beyond formal stroke rehabilitation sessions.