Efficacy of a gamified digital therapy for speech production in people with chronic aphasia (iTalkBetter): behavioural and imaging outcomes of a phase II item-randomised clinical trial.

Background: Aphasia is among the most debilitating of symptoms affecting stroke survivors. Speech and language therapy (SLT) is effective, but many hours of practice are required to make clinically meaningful gains. One solution to this 'dosage' problem is to automate therapeutic approaches via self-supporting apps so people with aphasia (PWA) can amass practice as it suits them. However, response to therapy is variable and no clinical trial has yet identified the key brain regions required to engage with word-retrieval therapy. Methods: Between Sep 7, 2020 and Mar 1, 2022 at University College London in the UK, we carried out a phase II, item-randomised clinical trial in 27 PWA using a novel, self-led app, 'iTalkBetter', which utilises confrontation naming therapy. Unlike previously reported apps, it has a real-time utterance verification system that drives its adaptive therapy algorithm. Therapy items were individually randomised to provide balanced lists of 'trained' and 'untrained' items matched on key psycholinguistic variables and baseline performance. PWA practised with iTalkBetter over a 6-week therapy block. Structural and functional MRI data were collected to identify therapy-related changes in brain states. A repeated-measures design was employed. The trial was registered at ClinicalTrials.gov (NCT04566081). Findings: iTalkBetter significantly improved naming ability by 13% for trained items compared with no change for untrained items, an average increase of 29 words (SD = 26) per person; beneficial effects persisted at three months. PWA's propositional speech also significantly improved. iTalkBetter use was associated with brain volume increases in right auditory and left anterior prefrontal cortices. Task-based fMRI identified dose-related activity in the right temporoparietal junction. Interpretation: Our findings suggested that iTalkBetter significantly improves PWAs' naming ability on trained items. The effect size is similar to a previous RCT of computerised therapy, but this is the first study to show transfer to a naturalistic speaking task. iTalkBetter usage and dose caused observable changes in brain structure and function to key parts of the surviving language perception, production and control networks. iTalkBetter is being rolled-out as an app for all PWA and anomia: https://www.ucl.ac.uk/icn/research/research-groups/neurotherapeutics/projects/digital-interventions-neuro-rehabilitation-0 so that they can increase their dosage of practice-based SLT. Funding: National Institute for Health and Care Research, Wellcome Centre for Human Neuroimaging.

NUVA: A Naming Utterance Verifier for Aphasia Treatment.

Anomia (word-finding difficulties) is the hallmark of aphasia, an acquired language disorder most commonly caused by stroke. Assessment of speech performance using picture naming tasks is a key method for both diagnosis and monitoring of responses to treatment interventions by people with aphasia (PWA). Currently, this assessment is conducted manually by speech and language therapists (SLT). Surprisingly, despite advancements in automatic speech recognition (ASR) and artificial intelligence with technologies like deep learning, research on developing automated systems for this task has been scarce. Here we present NUVA, an utterance verification system incorporating a deep learning element that classifies 'correct' versus' incorrect' naming attempts from aphasic stroke patients. When tested on eight native British-English speaking PWA the system's performance accuracy ranged between 83.6% to 93.6%, with a 10-fold cross-validation mean of 89.5%. This performance was not only significantly better than a baseline created for this study using one of the leading commercially available ASRs (Google speech-to-text service) but also comparable in some instances with two independent SLT ratings for the same dataset.

CSynth: an interactive modelling and visualization tool for 3D chromatin structure.

MOTIVATION: The 3D structure of chromatin in the nucleus is important for gene expression and regulation. Chromosome conformation capture techniques, such as Hi-C, generate large amounts of data showing interaction points on the genome but these are hard to interpret using standard tools. RESULTS: We have developed CSynth, an interactive 3D genome browser and real-time chromatin restraint-based modeller to visualize models of any chromosome conformation capture (3C) data. Unlike other modelling systems, CSynth allows dynamic interaction with the modelling parameters to allow experimentation and effects on the model. It also allows comparison of models generated from data in different tissues/cell states and the results of third-party 3D modelling outputs. In addition, we include an option to view and manipulate these complicated structures using Virtual Reality (VR) so scientists can immerse themselves in the models for further understanding. This VR component has also proven to be a valuable teaching and a public engagement tool. AVAILABILITYAND IMPLEMENTATION: CSynth is web based and available to use at csynth.org. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

On Writing and Reading Artistic Computational Ecosystems.

We study the use of the generative systems known as computational ecosystems to convey artistic and narrative aims. These are virtual worlds running on computers, composed of agents that trade units of energy and emulate cycles of life and behaviors adapted from biological life forms. In this article we propose a conceptual framework in order to understand these systems, which are involved in processes of authorship and interpretation that this investigation analyzes in order to identify critical instruments for artistic exploration. We formulate a model of narrative that we call system stories (after Mitchell Whitelaw), characterized by the dynamic network of material and conceptual processes that define these artefacts. They account for narrative constellations with multiple agencies from which meaning and messages emerge. Finally, we present three case studies to explore the potential of this model within an artistic and generative domain, arguing that this understanding expands and enriches the palette of the language of these systems.