Awake craniotomy with English and British sign language mapping in a patient with a left temporal glioblastoma reveals discordant speech-sign language maps.

The aim of this case study was to describe differences in English and British Sign Language (BSL) communication caused by a left temporal tumour resulting in discordant presentation of symptoms, intraoperative stimulation mapping during awake craniotomy and post-operative language abilities. We report the first case of a hearing child of deaf adults, who acquired BSL with English as a second language. The patient presented with English word finding difficulty, phonemic paraphasias, and reading and writing challenges, with BSL preserved. Intraoperatively, object naming and semantic fluency tasks were performed in English and BSL, revealing differential language maps for each modality. Post-operative assessment confirmed mild dysphasia for English with BSL preserved. These findings suggest that in hearing people who acquire a signed language as a first language, topographical organisation may differ to that of a second, spoken, language.

Lost in Translation: Multilingual Analysis of Online Breast Cancer Information.

INTRODUCTION: Patients use the internet to learn more about health conditions. Non-English-speaking patients may face additional challenges. The quality of online breast cancer information, the most common cancer in women, is uncertain. This study aims to examine the quality of online breast cancer information for English and non-English-speaking patients. METHODS: Three search engines were queried using the terms: "how to do a breast examination," "when do I need a mammogram," and "what are the treatment options for breast cancer" in English, Spanish, and Chinese. For each language, 60 unique websites were included and classified by type and information source. Two language-fluent reviewers evaluated website quality using the Journal of American Medical Association benchmark criteria (0-4) and the DISCERN tool (1-5), with higher scores representing higher quality. Scores were averaged for each language. Health On the Net code presence was noted. Inter-rater reliability between reviewers was assessed. RESULTS: English and Spanish websites most commonly originated from US sources (92% and 80%, respectively) compared to Chinese websites (33%, P < 0.001). The most common website type was hospital-affiliated for English (43%) and foundation/advocacy for Spanish and Chinese (43% and 45%, respectively). English websites had the highest and Chinese websites the lowest mean the Journal of American Medical Association (2.2 ± 1.4 versus 1.0 ± 0.8, P = 0.002) and DISCERN scores (3.5 ± 0.9 versus 2.3 ± 0.6, P < 0.001). Health On the Net code was present on 16 (8.9%) websites. Inter-rater reliability ranged from moderate to substantial agreement. CONCLUSIONS: The quality of online information on breast cancer across all three languages is poor. Information quality was poorest for Chinese websites. Improvements to enhance the reliability of breast cancer information across languages are needed.

Effects of dual- and single-language exposure on children's word learning: Experimentally testing the role of competition.

This study investigated the role of dual- and single-language input in bilingual children's word learning. In Experiment 1, 26 Spanish-English bilingual children aged 4 and 5 years (9 girls; 73% Latino; 65% White) learned novel words in single- and dual-language conditions. In the single-language condition, children learned English-like labels for novel objects. In the dual-language condition, the same children learned Spanish- and English-like labels for a different set of objects; all labels were produced by the same bilingual speaker, creating competition between the two languages. A second group of bilingual children (N = 25; 14 girls; 72% Latino; 40% White) participated in Experiment 2, which tested whether tagging language by speaker in the dual-language condition (mimicking the one person-one language input strategy) would influence performance. In both experiments, participants learned novel English words above chance (ps < .05) in both conditions, with better performance in the single-language condition. These results indicate an advantage for single-language learning contexts, but the theoretical roots and the practical value of this advantage are unclear.

Protective effect of bilingualism on aging, MCI, and dementia: A community-based study.

INTRODUCTION: Lifelong bilingualism is associated with a delayed age at onset of dementia, but evidence from community-based studies is limited. We investigated the relationship between bilingualism and the prevalence of cognitive impairment in a linguistically diverse community. METHODS: A door-to-door community study was conducted from January to December 2021 in urban Bengaluru, India. 1234 individuals aged ≥60 years participated in the study. Participants were diagnosed with no cognitive impairment (NCI), mild cognitive impairment (MCI), or dementia using established diagnostic criteria. RESULTS: Dementia prevalence was higher in monolinguals (4.9%) than bilinguals (0.4%) (P = .001). The prevalence of MCI was also higher in monolinguals (8.5%) than bilinguals (5.3%) (P = .001). The study also revealed better cognitive function in bilinguals than monolinguals with NCI, after controlling for confounding variables. DISCUSSION: The current study provides significant support for the protective effect of bilingualism on cognitive impairment in an urban community with extensive bilingual interactional contexts in everyday life. HIGHLIGHTS: Bilingualism has been demonstrated to protect against dementia and mild cognitive impairment in a linguistically diverse community with extensive code-switching contexts. Bilingual older individuals had superior baseline cognitive performance compared to monolingual older individuals. Bilingualism was found to have an independent effect on general cognition after adjusting for major social determinants of health in the group without cognitive impairment.

Transformers for extracting breast cancer information from Spanish clinical narratives.

The wide adoption of electronic health records (EHRs) offers immense potential as a source of support for clinical research. However, previous studies focused on extracting only a limited set of medical concepts to support information extraction in the cancer domain for the Spanish language. Building on the success of deep learning for processing natural language texts, this paper proposes a transformer-based approach to extract named entities from breast cancer clinical notes written in Spanish and compares several language models. To facilitate this approach, a schema for annotating clinical notes with breast cancer concepts is presented, and a corpus for breast cancer is developed. Results indicate that both BERT-based and RoBERTa-based language models demonstrate competitive performance in clinical Named Entity Recognition (NER). Specifically, BETO and multilingual BERT achieve F-scores of 93.71% and 94.63%, respectively. Additionally, RoBERTa Biomedical attains an F-score of 95.01%, while RoBERTa BNE achieves an F-score of 94.54%. The findings suggest that transformers can feasibly extract information in the clinical domain in the Spanish language, with the use of models trained on biomedical texts contributing to enhanced results. The proposed approach takes advantage of transfer learning techniques by fine-tuning language models to automatically represent text features and avoiding the time-consuming feature engineering process.

Disparity of Primary and Secondary Language Outcomes in Bilingual Patients Undergoing Resection of Glioma of the Speech-Related Regions.

BACKGROUND: The existing data about language recovery in bilingual patients come from few studies on acute lesional deficits like stroke or traumatic injury. Still, little is known about the neuroplasticity potential of bilingual patients who undergo resection of gliomas affecting language-eloquent brain regions. In this study, we prospectively evaluated the pre- and postoperative language functions among bilinguals with eloquent region gliomas. METHODS: We have prospectively collected the preoperative, 3-month and 6-month postoperative data from patients with tumors infiltrating the dominant hemisphere language areas during a 15-month period. Validated Persian/Turkish version of Western Aphasia Battery test and Addenbrooke Cognitive Examination were assessed for main language (L1) and second acquired languages (L2) in each visit. RESULTS: Twenty-two right-handed bilingual patients were enrolled, and language proficiencies were assessed using mixed model analysis. On baseline and postoperative points, L1 had higher scores in all Addenbrooke Cognitive Examination and Western Aphasia Battery subdomains than L2. Both languages had deterioration at 3-month visit; however, L2 was significantly more deteriorated in all domains. At 6-month visit, both L1 and L2 showed recovery; however, L2 recovered to a less extent than L1. The single most parameter affecting the ultimate language outcome in this study was the preoperative functional level of L1. CONCLUSIONS: This study shows L1 is less vulnerable to operative insults and L2 may be damaged even when L1 is preserved. We would suggest the more sensitive L2 be used as the screening tool and L1 be used for confirmation of positive responses during language mapping.

"Neural dynamics supporting longitudinal plasticity of action naming across languages: MEG evidence from bilingual brain tumor patients".

Previous evidence suggests that distinct ventral and dorsal streams respectively underpin the semantic processing of object and action knowledge. Recently, we found that brain tumor patients with dorsal gliomas in frontoparietal hubs show a selective longitudinal compensation (post-vs. pre-surgery) during the retrieval of lexico-semantic information about actions (but not objects), indexed by power increases in beta rhythms (13-28 Hz). Here, we move one-step further and ask whether a similar organizational principle also stands across the different languages a bilingual speaks. To test this hypothesis, we combined a picture-naming task with MEG recordings and evaluated highly proficient Spanish-Basque bilinguals undergoing surgery for tumor resection in left frontoparietal regions. We assessed patients before and three months after surgery. At the behavioral level, we observed a similar performance across sessions irrespectively of the language at use, suggesting overall successful function preservation. At the oscillatory level, we found longitudinal selective power increases in beta for action naming in Spanish and Basque. Nevertheless, tumor resection triggered a differential reorganization of the L1 and the L2, with the latter one additionally recruiting the right hemisphere. Overall, our results provide evidence for (i) the specific involvement of frontoparietal regions in the semantic retrieval/representation of action knowledge across languages; (ii) a key role of beta oscillations as a signature of language compensation and (iii) the existence of divergent plasticity trajectories in L1 and L2 after surgery. By doing so, they provide new insights into the spectro-temporal dynamics supporting postoperative recovery in the bilingual brain.

Cortical mapping in multilinguals undergoing awake brain surgery for brain tumors: Illustrative cases and systematic review.

BACKGROUND: Awake brain mapping in multilingual patients with brain tumors presents unique challenges to the neurosurgeon. Knowledge of potential eloquent sites is vital to preserve language function. METHODS: We present two cases of pars opercularis glioma and perform a systematic review in accordance with PRISMA guidelines. RESULTS: Our review yielded 7 studies, with a total of 25 multilingual brain tumor patients who underwent awake brain mapping. The age ranged from 25 to 62 years. Majority were female (56.5%). Most (52%) were trilingual, while 20% were quadrilingual and 28% were pentalingual. All tumors were left-sided, mostly in the frontal lobe. These were predominantly gliomas. Extent of resection was gross total in 61%. The brain mapping findings were heterogeneous. Some authors reported a greater number of cortical sites for the first language compared to others. Others found that the first and second languages shared cortical sites whereas the third and subsequent languages were located in distant sites. The peri-Sylvian area was also found to be involved in language that was learned at an earlier age. Subsequent languages thus involved more distant sites. A larger number of cortical areas were also activated for languages that were learned later in life. In terms of language disturbance and recovery, there were mixed results. CONCLUSION: Cortical mapping in multilingual brain tumor patients showed heterogeneity in terms of the location and number of language areas in the face of pathology. These findings may influence neurosurgical and oncological management of tumors in the speech area but emphasize the need to tailor surgical approaches and intraoperative testing to the patient.

Characteristics of Cancer Hospitals with Written Language Access Policies.

Patients with limited English proficiency receive worse care due to communication barriers. Little is known about which cancer hospitals have written language access policies addressing bilingual clinicians. We conducted a cross-sectional survey of healthcare organizations, matching survey data to American Hospital Association Survey and American Community Survey data. We analyzed characteristics associated with hospitals having bilingual clinician policies. The response rate was 71% (127/178). Many hospitals (53 [42%]) did not have written policies on bilingual clinicians. Having bilingual clinicians available at the hospital was associated with having a written policy on bilingual clinicians, while being an NCORP site was associated with not having a written policy on bilingual clinicians. Patient demographic characteristics were not associated with hospitals having written policies on bilingual clinicians. A substantial proportion of cancer hospitals do not have policies that cover language use by bilingual clinicians, particularly at NCORP sites. Having written policies on bilingual clinicians has the potential to mitigate cancer disparities by facilitating accountability, improving communication, and reducing errors.

La educación bilingüe en la enseñanza médica superior, actualidad y necesidades / Bilingual education in higher medical education, current affairs and needs

La educación médica superior se enfrenta a un proceso de constantes transformaciones dada por los adelantos científico-técnicos que vienen sucediendo en el campo de la salud. Estos adelantos concluyen en un volumen gigantesco de información en forma de publicaciones científicas que reúnen información valiosa sobre nuevos avances, esquemas terapéuticos y otros elementos relacionados con la enfermedad. La academia y práctica de la medicina se orienta al uso de la medicina basada en evidencia, por lo que los docentes y estudiantes tendrán una preparación y formación con elevado rigor científico, según las exigencias del contexto médico actual. Sin embargo, uno de los mayores problemas a los que se enfrenta la docencia médica universitaria se relaciona directamente con el dominio del idioma inglés, ya que una parte importante de estos documentos se publica en ese idioma. La educación bilingüe, a pesar de estar incluida dentro del proceso docente educativo como uno de los requisitos a vencer por los estudiantes, continúa siendo un desafío para poder lograr una mayor actualización científica que resulte en una mejor preparación profesional. El objetivo de esta investigación es exponer la situación actual de la educación bilingüe en la educación médica superior y cuáles son las necesidades actuales en este sentido(AU)

Higher medical education faces a process of constant transformations given by the scientific-technical advances that have been taking place in the field of health. These advances conclude in a gigantic volume of information that is expressed in the form of scientific publications that gather valuable information on new advances, therapeutic schemes and other elements related to the disease. The academy and practice of medicine is oriented towards the use of Evidence-Based Medicine; Therefore, teachers and students will have preparation and training with a high level of scientific rigor, according to the demands of the current medical context. However, one of the biggest problems faced by university medical teaching is directly related to the command of the English language, since a significant part of these documents are published in English. Bilingual education, despite being included within the educational teaching process as one of the requirements to be met by students, is presented as a current need in order to achieve a greater scientific update that results in better professional preparation. The objective of this research is to expose the current situation of bilingual education in higher medical education and what are the current needs in this regard(AU)

Improving Keyword-Based Topic Classification in Cancer Patient Forums with Multilingual Transformers.

Online forums play an important role in connecting people who have crossed paths with cancer. These communities create networks of mutual support that cover different cancer-related topics, containing an extensive amount of heterogeneous information that can be mined to get useful insights. This work presents a case study where users' posts from an Italian cancer patient community have been classified combining both count-based and prediction-based representations to identify discussion topics, with the aim of improving message reviewing and filtering. We demonstrate that pairing simple bag-of-words representations based on keywords matching with pre-trained contextual embeddings significantly improves the overall quality of the predictions and allows the model to handle ambiguities and misspellings. By using non-English real-world data, we also investigated the reusability of pretrained multilingual models like BERT in lower data regimes like many local medical institutions.

Enabling the space and conditions for co-leadership in co-design: an evaluation of co-facilitator training for culturally and linguistically diverse consumers.

Objectives and importance of study: We report the evaluative findings from the first stage of a project designed to co-produce strategies which improve the safety of culturally and linguistically diverse (CALD) patients in cancer care. Co-leadership is developed via training and supporting consumers, multilingual fieldworkers and researchers to co-facilitate co-design. Our aim was to evaluate the training undertaken with CALD co-facilitators to prepare for co-leadership of the co-design process within the CanEngage project. Study type and methods: A qualitative evaluation was conducted, consisting of semi-structured interviews with co-facilitators. Data were thematically analysed. Results: Analysis of interviews with 12 co-facilitators generated three themes: creating the conditions for co-leadership; developing the space for connections during training; and readiness for co-design. Conclusions: Providing opportunities for informal, social interactions during the training aided relationship-building among co-facilitators. The co-creation of terms of reference for the project encouraged a process of shared ownership and generated a path forward from the training to the upcoming co-design activities. We found that the recruitment process offered an initial forum to discuss the alignment of the motivations and expectations of those interested in becoming involved with the aims of the project and goals of the co-design.

Processamento fonológico e leitura em crianças com dificuldade de aprendizagem em escolas bilíngues português-inglês: relatos de casos / Phonological processing and reading in children with learning difficulties in Portuguese-English bilingual schools: case reports / Procesamiento y lectura fonológica en niños con dificultades de aprendizaje en escuelas bilingües portugués-inglés: reporte de casos

Introdução: Há influência positiva no desenvolvimento da linguagem, quando ocorre a exposição a um novo idioma. No entanto, quando se considera esse contexto em crianças com dificuldade de aprendizagem, o deficit apresentado na primeira língua pode ser transferido para o aprendizado da segunda. Objetivo: O objetivo do presente estudo é caracterizar o desempenho em processamento fonológico e leitura em três crianças com dificuldade de aprendizagem em escolas bilíngues português-inglês. Método: Os dados gerais sobre o desenvolvimento e desempenho nas habilidades de consciência fonológica, memória de trabalho fonológica, acesso ao léxico mental e leitura em três crianças de 8 a 9 anos de idade, cursando 2º e 3º ano do ensino fundamental foram descritos; todos com, ao menos, dois anos de exposição à escola bilíngue, especialmente na alfabetização. Na avaliação, foram aplicados os protocolos CONFIAS, Memória de Trabalho Fonológica, TENA, RAN e Protocolo de Avaliação da Compreensão Leitora de Textos Expositivos. Resultado: as crianças apresentaram desempenho aquém do esperado nas habilidades do processamento fonológico, na fluência da leitura oral, bem como na compreensão leitora. Conclusão: esses resultados podem contribuir tanto para a compreensão de aspectos da linguagem escrita na atuação do fonoaudiólogo com crianças bilíngues, quanto para as implicações clínicas e educacionais, haja vista a escassez de estudos nessa área, no Brasil.

Introduction: There is a positive influence on language development when there is exposure to a new language. However, when considering this context in children with learning difficulties, the deficits presented in the first language can be transferred to the learning of the second. Objective: The aim of the present study was to characterize the performance in phonological processing and reading in three children with learning difficulties from Brazilian-English bilingual schools. Method: General data on the development and performance in phonological awareness skills, phonological working memory, access to mental lexicon and reading in three children aged 8 to 9 years, attending the 2nd and 3rd year of elementary school were described; all with at least two years of exposure to bilingual school, especially in literacy. In the evaluation, the protocols CONFIAS, Phonological Working Memory, TENA, RAN and Protocol for Assessment of Reading Comprehension of Expository Texts were applied. Results: The children performed below expectations in terms of phonological processing skills, difficulties in oral reading fluency, as well as in reading comprehension. Conclusion: These results can contribute to the understanding of aspects of written language in the performance of speech therapists with bilingual children, regarding clinical and educational implications, given the scarcity of studies in this area in Brazil.;Introducción: Existe una influencia positiva en el desarrollo del lenguaje cuando hay exposición a un nuevo idioma. Sin embargo, al considerar este contexto en niños con dificultades de aprendizaje, los déficits presentados en el primer idioma se pueden trasladar al aprendizaje del segundo. Objetivo: El objetivo del presente estudio fue caracterizar el desempeño en procesamiento fonológico y lectura en tres niños con dificultades de aprendizaje de escuelas bilingües brasileño-inglés. Método: Se describieron datos generales sobre el desarrollo y desempeño en las habilidades de conciencia fonológica, memoria de trabajo fonológica, acceso al léxico mental y lectura en tres niños de 8 a 9 años de 2º y 3º de primaria; todos con al menos dos años de exposición a la escuela bilingüe, especialmente en alfabetización. En la evaluación se aplicaron los protocolos CONFIAS, Memoria Fonológica de Trabajo, TENA, RAN y Protocolo de Evaluación de la Comprensión Lectora de Textos Expositivos. Resultados: Los niños se desempeñaron por debajo de las expectativas en términos de habilidades de procesamiento fonológico, dificultades en la fluidez de la lectura oral, así como en la comprensión lectora. Conclusión: Estos resultados pueden contribuir a la comprensión de aspectos del lenguaje escrito en el desempeño de logopedas con niños bilingües, en cuanto a implicaciones clínicas y educativas, dada la escasez de estudios en esta área en Brasil.

Introduction: There is a positive influence on language development when there is exposure to a new language. However, when considering this context in children with learning difficulties, the deficits presented in the first language can be transferred to the learning of the second. Objective: The aim of the present study was to characterize the performance in phonological processing and reading in three children with learning difficulties from Brazilian-English bilingual schools. Method: General data on the development and performance in phonological awareness skills, phonological working memory, access to mental lexicon and reading in three children aged 8 to 9 years, attending the 2nd and 3rd year of elementary school were described; all with at least two years of exposure to bilingual school, especially in literacy. In the evaluation, the protocols CONFIAS, Phonological Working Memory, TENA, RAN and Protocol for Assessment of Reading Comprehension of Expository Texts were applied. Results: The children performed below expectations in terms of phonological processing skills, difficulties in oral reading fluency, as well as in reading comprehension. Conclusion: These results can contribute to the understanding of aspects of written language in the performance of speech therapists with bilingual children, regarding clinical and educational implications, given the scarcity of studies in this area in Brazil.;Introducción: Existe una influencia positiva en el desarrollo del lenguaje cuando hay exposición a un nuevo idioma. Sin embargo, al considerar este contexto en niños con dificultades de aprendizaje, los déficits presentados en el primer idioma se pueden trasladar al aprendizaje del segundo. Objetivo: El objetivo del presente estudio fue caracterizar el desempeño en procesamiento fonológico y lectura en tres niños con dificultades de aprendizaje de escuelas bilingües brasileño-inglés. Método: Se describieron datos generales sobre el desarrollo y desempeño en las habilidades de conciencia fonológica, memoria de trabajo fonológica, acceso al léxico mental y lectura en tres niños de 8 a 9 años de 2º y 3º de primaria; todos con al menos dos años de exposición a la escuela bilingüe, especialmente en alfabetización. En la evaluación se aplicaron los protocolos CONFIAS, Memoria Fonológica de Trabajo, TENA, RAN y Protocolo de Evaluación de la Comprensión Lectora de Textos Expositivos. Resultados: Los niños se desempeñaron por debajo de las expectativas en términos de habilidades de procesamiento fonológico, dificultades en la fluidez de la lectura oral, así como en la comprensión lectora. Conclusión: Estos resultados pueden contribuir a la comprensión de aspectos del lenguaje escrito en el desempeño de logopedas con niños bilingües, en cuanto a implicaciones clínicas y educativas, dada la escasez de estudios en esta área en Brasil.

Enhancing patient-centred communication across barriers: The case of intersubjectivity management in medical interpreting.

OBJECTIVE: This study introduces the concept of intersubjectivity management in medical interpreting and identifies relevant interactional strategies employed by the interpreter, also explores their effectiveness in facilitating positive clinician-patient communication. METHODS: We used conversation analysis (CA) to analyse 27 video recordings of interpreter-mediated dental visits, participants involve English-speaking dentists, Cantonese as the first language (L1) patients and bilingual dental surgery assistants (DSA) who also play the role of ad hoc interpreters. RESULTS: The DSA-as-interpreter manages intersubjectivity for the dentist and patient through interactional strategies, such as reformulating action types, redesigning contents and information capacity, summarising and concentrating turns, constantly monitoring the situation and eliciting spoken or unspoken expressions that are medically relevant from both sides to validate them. The strategies effectively enabled and enhanced the mutual understanding and interpersonal alignment between the dentist and patient. More importantly, the DSA constantly orients to patient-centred communication. CONCLUSION: Although not professionally trained for interpreting, the DSA-as-interpreters demonstrated discursive strategies. The strategies evidently facilitated positive dentist-patient communication and relationships. PRACTICE IMPLICATIONS: The conceptualisation and significant strategies demonstrated by the DSA-as-interpreters could potentially inform the solution of enhancing multilingual health communication in clinical staff training.

Intra-operative mapping and language protection in glioma.

ABSTRACT: The demand for acquiring different languages has increased with increasing globalization. However, knowledge of the modification of the new language in the neural language network remains insufficient. Although many details of language function have been detected based on the awake intra-operative mapping results, the language neural network of the bilingual or multilingual remains unclear, which raises difficulties in clinical practice to preserve patients' full language ability in neurosurgery. In this review, we present a summary of the current findings regarding the structure of the language network and its evolution as the number of acquired languages increased in glioma patients. We then discuss a new insight into the awake intra-operative mapping protocol to reduce surgical risks during the preservation of language function in multilingual patients with glioma.

Screening for Depression in Adolescents with Developmental Disabilities: Brief Report.

Objectives: (1) To examine adherence of universal screening for adolescent depression at initial visits by using an established screening instrument (Patient Health Questionnaire 9 [PHQ-9]) in a university-affiliated urban developmental center that serves children with developmental disabilities (DDs); (2) to study the frequency of positive screening for depression in adolescents with DD. Methods: Review of all adolescents referred for multidisciplinary evaluation in a developmental center in 2019. Data included demographics, DD diagnoses, and use of and scores on the PHQ-9 at initial visit. Statistics included chi-square and non-parametrics. Results: Of all the children evaluated in 2019 (n = 240), 52 were adolescents, 35 boys (63%)/17 girls (37%), age 14 ± 2 years old, and 27 (54%) belonging to a bilingual English-Spanish household. DD: Developmental Language Disorder (88%), Learning Disabilities (54%), attention-deficit/hyperactivity disorder (44%), Autism Spectrum Disorder (25%), Intellectual Disabilities (12%), and Phonological Disorder (8%). The PHQ-9 was administered to 30 (58%) individuals. Scores varied from minimal depression for 17 (57%), mild for 10 (33%), and moderate and severe for 3 (10%); 3 patients endorsed suicidality. Females were more likely to obtain higher scores on the PHQ-9 than males. Adolescents diagnosed with Autism Spectrum Disorder, Intellectual Disabilities, and Phonological Disorder were less likely to be screened. Conclusion: More than half of the sample of urban adolescents with DD were screened for depression at initial visit, and 10% screened positive for moderate to severe depression. Efforts to follow the U.S. Preventive Services Task Force recommendation of universal screening of adolescent depression should continue. However, given challenges with reading and verbal abilities, screening modifications (reading to them) should be considered.

General principles governing the amount of neuroanatomical overlap between languages in bilinguals.

The literature has identified many important factors affecting the extent to which languages in bilinguals rely on the same neural populations in the specific brain region. The factors include the age of acquisition of the second language (L2), proficiency level of the first language (L1) and L2, and the amount of language exposure, among others. What is lacking is a set of global principles that explain how the many factors relate to the degree to which languages overlap neuroanatomically in bilinguals. We are offering a set of such principles that together account for the numerous sources of data that have been examined individually but not collectively: (1) the principle of acquisition similarity between L1 and L2, (2) the principle of linguistic similarity between L1 and L2, and (3) the principle of cognitive control and effort. Referencing the broad characteristics of language organization in bilinguals, as presented by the principles, can provide a roadmap for future clinical and basic science research.

[Electrical Stimulation Mapping of Multilingualism].

Language mapping is commonly practiced in brain tumors and epilepsy surgeries. It is done by direct electrical stimulation of the brain during awake craniotomy or by placing subdural electrodes on the brain's surface, or both. Studies of the language mapping in bi- or multi-lingual patients have concluded that they have both "language-specific areas," in which symptoms are evoked upon stimulation in one specific language and not in the other languages, and "common areas" or "overlapping areas," in which positive findings are evoked in all languages evaluated. The distribution of the pattern of language areas associated with each language, however, varies widely from patient to patient due to multiple factors such as the age of language acquisition, the language proficiency level, the amount of exposure to each language, the location of the lesions, the duration of the diseases, and other factors. Language mapping in bi- or multi-lingual patients should be done by screening all languages the patient speaks.

MULTIMAP: Multilingual picture naming test for mapping eloquent areas during awake surgeries.

Picture naming tasks are currently the gold standard for identifying and preserving language-related areas during awake brain surgery. With multilingual populations increasing worldwide, patients frequently need to be tested in more than one language. There is still no reliable testing instrument, as the available batteries have been developed for specific languages. Heterogeneity in the selection criteria for stimuli leads to differences, for example, in the size, color, image quality, and even names associated with pictures, making direct cross-linguistic comparisons difficult. Here we present MULTIMAP, a new multilingual picture naming test for mapping eloquent areas during awake brain surgery. Recognizing that the distinction between nouns and verbs is necessary for detailed and precise language mapping, MULTIMAP consists of a database of 218 standardized color pictures representing both objects and actions. These images have been tested for name agreement with speakers of Spanish, Basque, Catalan, Italian, French, English, German, Mandarin Chinese, and Arabic, and have been controlled for relevant linguistic features in cross-language combinations. The MULTIMAP test for objects and verbs represents an alternative to the Oral Denomination 80 (DO 80) monolingual pictorial set currently used in language mapping, providing an open-source, standardized set of up-to-date pictures, where relevant linguistic variables across several languages have been taken into account in picture creation and selection.