Processing Difficulties Research Articles

Syntactic processing skills in elderly people with mild cognitive impairment and mild Alzheimer’s disease

AbstractBackgroundCommunication and language impairments may be found in individuals with CCL. Thus, a better understanding language processing in this group and in healthy aging is necessary. Most studies in CCL and AD have focused on naming and semantic processes, and few studies have focused on syntactic processing skills, especially in the Brazilian population.MethodA total of 114 elderly people of both sexes, aged at least 60 years, living in the city of São Paulo, were evaluated. The subjects were divided into 32 healthy elderly, 22 with aminestic mild cognitive impairment, 43 with non‐aminestic mild cognitive impairment and 17 with mild Alzheimer’s disease. For language assessment, the Grammar Reception Test – TROG2 was used as the main instrument, as well as the tests Northwestern Anagram Test, Token Test and the Object and Verb Naming Battery. For cognitive evaluation using the tests and functionality, the following tests were used: MoCA, Rivermead Behavioral Memory Test, Tracks A and B Test, Rey‐Osterrieth Complex Figure Test, Stroop Test, Digit Extension Test, Learning Test Verbal de Rey FAS, Three Words Three Shapes Test. The functionality of the was assessed using the Lawton & Brody scale for Activities of Daily Living.ResultOur results showed differences in performance among the control, CCL, and AD groups in the total number and the profile of correct answers according to the type of sentence tested (p<0.05). Sentences with zero anaphora structure discriminated the control group from CCLa and AD, as well as CCLna from AD; pronoun gender/number sentences discriminated controls from CCLa (p<0.05). These sentence types bring to evidence the effect of increased demand on working memory and executive functions on syntactic processing.ConclusionThe use of the Grammar Reception Test ‐ TROG ‐ 2 instrument can be useful in the assessment of the elderly, serving as a reference to differentiate healthy aging from cognitive and language impairments. Patients with MCI already have difficulties in syntactic processing when syntactic complexity is increased, overloading working memory and executive functions. These difficulties are intensified in patients with AD.

Visual scanning of faces with neutral expression in patients with Alzheimer’s disease and amnestic mild cognitive impairment

AbstractBackgroundDeficits in face perception and face processing have been reported in Alzheimer’s disease (AD) (Kawagoe et al., 2017). However, conflicting findings were presented in these functions in amnestic mild cognitive impairment (aMCI) compared to older adults (Lim et al., 2011). This study aimed to examine eye movement patterns during visual scanning of faces with neutral expressions in AD, aMCI, and healthy controls (HC).MethodNinety‐five participants, including 29 patients with AD (mean age 72.5±7.9), 34 patients with aMCI (mean age 70.6±6.7 years), and 32 HC (mean age 68.5±6.2 years) were participated in the study. Eye movements were recorded from the right eye with the EyeLink 1000 Plus video‐based eye tracker. In the face scanning task, neutral face images without emotional expressions produced by artificial intelligence were used. In this task, which consists of a practical trial and 20 trials, each stimulus was shown for 3000 ms. Participants were instructed to examine the neutral face images presented. Number of saccade, fixation counts, mean fixation duration, and first fixation duration were analysed separately on the regions of eyes, mouth, nose, and face.ResultThe mean number of fixation, the number of saccades, and mean fixation duration across the face were significantly reduced in AD patients compared to HC. The mean number of fixation and fixation durations in the eye were significantly reduced in AD compared to HC. No significant difference was observed in all groups in eye movements in the nose and mouth. In addition, aMCI and HC exhibited similar eye movement patterns in the face‐scanning task.ConclusionStudies with healthy individuals have reported typical eye movement patterns focusing primarily on the eyes, but also on the nose and mouth regions. It is stated that the decrease in the gaze towards the face and eye region in AD patients may be related to face processing difficulties. To our knowledge, this is the first study to examine eye movement patterns during neutral face scanning in AD and aMCI.This work was supported by the TUBITAK project number 119S560.

Bilingual problem size effect: an ERP study of multiplication verification and production in two languages.

The problem size effect (PSE) is defined by better performance solving small problems (e.g., 2x4) than large problems (e.g., 8x9). For monolinguals, the PSE is larger when problems are presented in unfamiliar formats (e.g., written words), reflecting increased processing difficulty. Bilinguals are typically faster and more accurate at retrieving multiplication facts in the language of learning (LA+) than in their other language (LA-). We hypothesized that the less familiar arithmetic language (i.e., LA-) would elicit larger PSEs than LA+. Here, fluent Spanish-English bilingual adults verified spoken multiplication problems presented in LA+ and LA- while event-related potentials (ERPs) were recorded (Experiment 1A). To further promote language differences, we increased task difficulty by presenting problems at a faster pace (Experiment 1B) and requiring bilinguals to verbally produce solutions (Experiment 2). Language differences in performance were only observed for Experiment 2, where solutions were produced more slowly in LA- than LA+. In the ERPs, a PSE was driven by larger P300s for small than large solutions. A language effect was only observed under time pressure where LA- elicited a PSE at the 2nd operand. Additionally, the PSE was smaller for LA- at the solution. This suggests that categorizing multiplication facts is more effortful in LA-. In sum, very subtle language differences arise in fluent bilinguals when problems are more difficult, such as larger problems presented under time pressure in a weaker language. Critically, the effect of LA+ is at the level of response production and not access to the facts from memory.

Statistical Methods for Visualizing Healthcare Big Data

With the advancement and acceleration of digital technology, the demand and supply of healthcare big data are increasing. In Korea, the government and companies have made various efforts to utilize healthcare big data, such as deregulation data-related legal regulations and data linkage between different institutions. As a result, many researchers have been able to access a variety of healthcare big data. Although healthcare big data has a vast amount and high value, many researchers are unable to fully access healthcare big data because there are difficulties in processing, analysis, and interpretation for data. The data visualization is recognized as an important tool that can solve these limitations. Using data visualization, researchers can intuitively understand complex data and receive support for decision-making. Additionally, these visualizations promote effective communication between experts in different fields and between experts and non-experts. Visualization is used in a variety of research fields and processes, including data summarization, data exploration, and evaluation and interpretation of predictive models. Various types of visualization have different meanings depending on how they are expressed. Therefore, it is important to express the meaning of visualization appropriately. This study provides representative examples of visual representations for data summarization, data exploration, and predictive model evaluation. This study aimed to improve easier access and utilization of healthcare big data by providing R code and visualization results.

Design and Experimental Validation of an Optical Autofocusing System with Improved Accuracy

This study proposes a modified optical design to improve the issue of autofocus accuracy in existing optical systems. The proposed system uses lens offset to convert incident light into non-parallel light, achieving a focus shift and avoiding severe deformation of the light spot near the focal point of the objective lens. Based on triangulation theory and optical focusing theories such as the centroid method, the proposed optical design improves the shortcomings of existing technology. Experimental results demonstrate that the proposed optical autofocusing system has better autofocus accuracy than traditional systems while also reducing the difficulty of image processing. In summary, the proposed optical system is not only an effective autofocusing technology but also a highly valuable optical inspection and industrial application technology. This system has broader application and development opportunities for future research and practice.

Additive manufacturing of functionally gradient refractory coatings using substrate dilution and in-situ carbide formation

Enabling operations in extreme environments remains a top priority for the space, defense, and energy sectors, driving the demand for ultra-high-temperature materials. Traditional materials employed in these sectors have limited operating temperatures and thus novel alternatives are of interest. Refractory metals and carbides have excellent high-temperature properties, however, their high melting points and susceptibility to cracking during solidification make them challenging to process, especially through additive manufacturing (AM) technologies. In this work, Directed Energy Deposition (DED) was used to create a functionally graded refractory coating (W-WC-Nb system on a titanium substrate) by integrating titanium into the refractory matrix through substrate dilution. By developing a new W-based alloy then adding titanium from the substrate along the build direction, a crack-free microstructure was formed within layers closer to the substrate. Additionally, an in-situ carbide formation strategy was explored, creating titanium carbide and niobium carbide phases that could improve the high-temperature and corrosion properties without the need to overcome processing difficulties associated with these high-melting carbides. These strategies allow for the development of new material systems with tailored properties and improved processibility of refractory material systems.

Theoretical simulation research on the hygroscopicity, stability, sensitivity, and mechanical properties of the cocrystals of ammonium nitrate with typical high energetic molecules

Ammonium nitrate (AN) is a classical ionic salt that possesses thriving prospects in civil and military fields. Nevertheless, the problems of multiple-phase transition and difficulty in processing (easy agglomeration and hygroscopicity) limit its practical application. Cocrystallization technology is one of the most emerging and effective strategies that can tune the physical and chemical properties of materials without changing the pristine molecular structure. In this paper, we employed the molecular simulation method for designing the AN cocrystals by pairing AN with three different types of energetic molecules (nitramine energetic molecule (RDX, HMX, and CL-20), nitro energetic molecule (TATB), and nitrate energetic molecule (PETN)) with a ratio of 1:1. Then, the hygroscopicity, stability, sensitivity, and mechanical properties of the five cocrystals were investigated from the perspective of adsorption heat, binding energy, cohesive energy density, and mechanical parameters. From the results of adsorption heat and binding energy, the AN/CL-20 cocrystal is the desirable cocrystal with the minimum hygroscopicity and strong stability. On the other hand, it is noteworthy that the AN/TATB cocrystal is a charming cocrystal with excellent machinability and lower sensitivity from the results of cohesive energy density and mechanical parameters. This work may provide substantial insights into the design of AN cocrystals.

Assessing Phonological Processing in Children With Speech Sound Disorders

Purpose: Phonological processing skills, or using phoneme knowledge to process language, in preschool- and kindergarten-age children are an important indicator of children's future reading abilities. However, assessing phonological processing skills can be difficult in children with speech sound disorders because scoring often requires that children produce speech sound accurately. This tutorial presents assessment tasks that are appropriate for children with speech sound disorders to better identify children with phonological processing difficulties. Conclusions: The following phonological processing assessment tasks are recommended for children with speech sound disorders: receptive tasks for phonological awareness, the Syllable Repetition Task for phonological memory, and limited letter choices for rapid automatized naming in phonological retrieval tasks. These tasks can be modified for multilingual children. Appropriate assessment of phonological processing skills will help speech-language pathologists in differential diagnosis of children with true phonological processing difficulties and children whose speech sound errors may mask phonological processing abilities. Assessment of phonological processing skills is particularly important for children with speech sound disorders, whose speech errors may be evidence of phonological processing difficulties.

Synthesis and modification of poly (p‐phenylene terephthalamide) for production of light‐weight hybrid composite armors reinforced with polymer composite nanofiber mats

AbstractPoly (p‐phenylene terephthalamide) (PPTA) polymer was synthesized and then modified to eliminate the processing difficulties arising from its insolubility in organic solvents. The chemical structures of the synthesized PPTA and N‐butyl PPTA (BPPTA) were confirmed by elemental analysis, x‐ray diffraction, Fourier transform infrared (FTIR), and 13C‐NMR spectroscopy studies. As a result of modification, an aramid derivative that is soluble in some common solvents was obtained and added into polyacrylonitrile (PAN) matrix in solution. PAN/BPPTA composite nanofiber mats (CNMs) were fabricated by electrospinning. Mechanical tests showed that tensile strength increased by 119% with 3% BPPTA content. The fabricated CNMs were combined with aramid fabrics to produce laminated hybrid armors and ballistic tests were performed following the NATO Stanag 2920 standard. This is the first report about the integration of CNMs into multilayer armor configurations and resulted in improved ballistic limit velocity (V50) with a relatively very small weight gain and emergence of new energy absorption mechanisms.Highlights Alkylation of the para‐aramid yielded an organo‐soluble aramid derivative. Tensile strength of PAN nanofiber mat increased by 119% with 3% N‐butyl PPTA. Integration of the CNMs resulted in new ballistic impact absorption mechanisms. CNMs contribute to V50 with a very low mass gain due to their high surface area/mass.

Facile fabrication of low-content surface-assembled MXene in silicone rubber foam materials with lightweight, wide-temperature mechanical flexibility, improved flame resistance and exceptional smoke suppression

Silicone rubber foam (SiRF) is a promising porous material that is widely applied in various fields. However, its intrinsic flammability nature remains a significant challenge. One of the simplest and the most economical solutions is to incorporate high content flame-retardant fillers. Unfortunately, such approach is limited by several drawbacks, including poor filler dispersion, difficulty in processing and negative effect on mechanical flexibility. Herein, we report a green and facile strategy for surface-assembling ultralow content of MXene sheets bonded onto the pore surface of SiRF via the effective foaming reaction process. The as-prepared MSiRF-0.2 composite at 0.2 wt% MXene exhibited lightweight characteristic, wide-temperature mechanical flexibility, UL94-V0 grade, limited oxygen index of > 27 %, and exceptional smoke suppression (reduction by 88.24 %). Furthermore, flame-retardant mechanism was discussed based on the char structure observation. This study provides a novel approach for fabricating mechanically flexible and flame-retardant SiRF via in-situ reactive assembly of low content MXene sheets.

Effects of carbon-based nanofillers on mechanical, electrical, and thermal properties of bast fiber reinforced polymer composites

Bast fiber-reinforced polymer composites (BFRPs) are grabbing considerable research attention due to their assertive impact on the environment and excellence in biodegradability. Though BFRPs have excellent ecological performance factors, they also lack in some cases, such as lower mechanical, electrical, and thermal properties, due to the significant moisture absorption, minimal thermal stability, and inherent nature of bast fibers. BFRPs exhibit weaker fiber/matrix interfacial adhesion as compared to synthetic fiber-reinforced polymer composites, resulting in lower mechanical properties. Nowadays, a wide variety of fiber and matrix modification techniques are practiced improving the fiber-matrix interaction, which ultimately improves the mechanical properties. Among the fiber and matrix modification techniques, nanofiller integration is the most promising one. This study reviews the impacts of introducing carbon-based nanofillers, particularly graphene and carbon nanotubes (CNT), in diversified BFRPs. The influence of carbon-based nanofillers on the mechanical, electrical, and thermal behavior of BFRPs and their potential prospects are comprehensively reviewed. The paper concludes with the challenges and difficulties in composite processing, along with the techniques for overcoming them.

Visual-motor involvement in autism spectrum disorder: could the stereopsis deficit affect motor coordination?

PurposeGiven the known difficulty in sensory processing and in motor skills in patients with Autism Spectrum Disorder (ASD), and since visual impairment could interfere with children’s behaviour, early detection and management of visual-motor difficulties are crucial. This exploratory study aims to evaluate the visual-motor status in a cohort of children affected by ASD.MethodsThe records of patients affected by ASD and admitted between 2018 and 2022 to the Pediatric University Hospital of Verona were reviewed. Best Corrected Visual Acuity, cycloplegic refraction, stereopsis, convergence, complete ocular motility, strabismus examination, slit-lamp anterior segment examination and fundus ophthalmoscopy were collected and reviewed.ResultsA total of 253 patients (203 ASD and 50 healthy controls) were included in the study. A higher number of total orthoptic defects were detected in the ASD group, in comparison with the control group. Specifically, a higher percentage of stereopsis deficit and convergence insufficiency was observed.ConclusionIn our cohort of children with ASD stereopsis deficit, convergence insufficiency and refractive errors are the most observed ocular conditions. These findings are consistent with the known alterations of motor skills and sensory processing in ASD. Moreover, our study supports the hypothesis that visual acuity is not compromised in children with ASD. As a result, a complete ophthalmic evaluation is highly recommended in children with ASD, to guarantee early detection and treatment of possible visual-motor defects.

Reconfigurable Amplitude-Phase-Coding Metasurface with Flexible Beamforming Capability

Recently, reconfigurable coding metasurfaces have attracted extensive attention due to their dynamic and flexible manipulation of electromagnetic (EM) waves, making them an effective solution to connect physical reality and information science. Nevertheless, most previously reported reconfigurable metasurfaces suffer from limited applications, as they solely possess either phase or amplitude modulation. In this article, we propose a reconfigurable coding metasurface that can regulate both phase and amplitude response independently. In the field of the metasurface, the phase response can tailor the wavefronts, and the amplitude response can adjust the redistribution of the energy of the EM waves. Specifically, by integrating a PIN diode into the meta-atom and controlling its bias voltage, the reflection phase can be switched between two opposite phases with a phase difference of about 180°, and the reflection amplitude can be manipulated from 0.02 to 0.98 continuously at 11 GHz. The unit element consists of simple multi-layer structures, reducing its production cost and processing difficulty. By loading 1-bit phase code and multi-bit amplitude code to each unit element severally, this metasurface can modulate the distribution of reflected EM waves in two-dimensional (2-D) space while simultaneously suppressing the sidelobes for any quantity of scattered beams over a wide operating band ranging from 10.5 to 11.5 GHz. This metasurface exhibits promising potential for manipulating the distribution of EM wave energy and shaping of EM beams, which can be expected to facilitate wireless communication technology.

Deep Learning Enriched Automation in Damage Detection for Sustainable Operation in Pipelines with Welding Defects under Varying Embedment Conditions

Welded joints in metallic pipelines and other structures are used to connect metallic structures. Welding defects, such as cracks and lack of fusion, are vulnerable to initiating early-age cracking and corrosion. The present damage identification techniques use ultrasonic-guided wave procedures, which depend on the change in the physical characteristics of waveforms as they propagate to determine damage states. However, the complexity of geometry and material discontinuity (e.g., the roughness of a weldment with or without defects) could lead to complicated wave reflection and scatters, thus increasing the difficulty in the signal processing. Artificial intelligence and machine learning exhibit their capability for data fusion, including processing signals originally from ultrasonic-guided waves. This study aims to utilize deep learning approaches, including a convolutional neural network (CNN), Long-short term memory network (LSTM), or hybrid CNN-LSTM model, to demonstrate the capability in automation for damage detection for pipes with welded joints embedded in soil. The damage features in terms of welding defect types and severity as well as multiple defects are used to understand the effectiveness of the hybrid CNN-LSTM model, which is further compared to the two commonly used deep learning approaches, CNN and LSTM. The results showed the hybrid CNN-LSTM model has much higher classification accuracy for damage states under all scenarios in comparison with the CNN and LSTM models. Furthermore, the impacts of the pipelines embedded in different types of materials, ranging from loose sand to stiff soil, on signal processing and data classification were further calibrated. The results demonstrated these deep learning approaches can still perform well to detect various pipeline damage under varying embedment conditions. However, the results demonstrate when concrete is used as an embedding material, high attention to absorbing the signal energy of concrete could pose a challenge for the signal processing, particularly under high noise levels.

Convenient-assembled, open-ended solid-state electrochromic devices enabled by electrolyte glue

Electrochromic (EC) technology has a tremendous development over the past few decades and attracts wide attention due to its promising applications in smart windows, smart displays and wearable electronics. However, strict sealed requirements of EC devices increase the difficulty of manufacturing processing and production cost, limiting their practical application in common life. Moreover, the disassembly and replacement of EC devices are still enormous challenges in practical application. Here, open-ended solid-state EC devices were prepared by directly sticking the EC electrode and counter electrode with photocurable electrolyte glue which did not require additional encapsulation and could be conveniently assembled and replaced by ourselves in common life. The poly(butyl acrylate-co-methoxypolyethylene glycol acrylate) (P(BA-co-mPEGDA))-based solid-state electrolyte formed after UV curing of electrolyte glue exhibited excellent adhesion to electrodes through the construction of intimate contact interface, which improved the ion transport efficiency at the interface and interface stability of EC devices. The Open-ended solid-state EC devices exhibited excellent electrochemical, environmental and mechanical stability, and show promising applications in exchangeable smart windows and designable wearable displays.

Fabrication of high‐performance poly(vinyl alcohol) tubes via stable melt extrusion by reversible crosslinking of boric acid

AbstractThe unique intermolecular interactions of poly(vinyl alcohol) (PVA) endow it with excellent barrier properties to oxygen and nonpolar hydrocarbon organic solvents, thus having potential applications in the fields of oil and gas transmission. In view of the difficulties in thermal processing of PVA and based on the molecular complexation technology established by our research group, the melt extrusion of PVA tubes was achieved. To improve the extrusion stability of PVA tubes, boric acid (BA), which could form reversible crosslinking with PVA, was further introduced, and the influences of BA content on the interactions between BA and PVA, the thermal processability of PVA, as well as the mechanical properties and gasoline barrier properties of PVA tubes were systematically studied. The results showed that BA could form both chemical and physical crosslinking with PVA, so controlled the violent evaporation of water, one of plasticizers with low boiling point, and at the same time ensured the good thermal processing of PVA, lastly realizing the stable melt extrusion of PVA tubes. With the increase of BA content, the crystallinity of PVA decreased, but the glass transition temperature, mechanical properties, thermal dimensional stability, as well as water resistance of PVA tubes increased. The gasoline barrier of PVA tubes reached the best at the BA content of 0.10 wt%, that is, 0.97 g mm/m2 day.

39 Neurodevelopmental Complexity of a Patient with Perinatal Right Middle Cerebral Artery Stroke and Infantile Spasms

Objective:A rich literature exists on cognitive changes related to focal injury in the adult brain. In contrast, the developing brains of children are less understood. In contrast to adult cases, 20% to 25% of perinatal strokes result in language disorder regardless of lesion lateralization. Existing literature suggests children with perinatal stroke may present with a range of executive functioning and visuospatial processing difficulties. Gross and fine motor challenges are also likely to occur. Furthermore, these children have an increased prevalence of autism spectrum disorder (ASD) and carry the highest risk for epilepsy. Despite growing research on neurodevelopmental profiles in patients with perinatal stroke, published literature is limited.Participants and Methods:Our study examines neurodevelopment of a 2-year-old, right-handed male with a history of perinatal ischemic right middle cerebral artery (MCA) stroke, infantile spasms, and left hemiparesis following right hemispherectomy for seizure management who underwent two neurodevelopmental evaluations at our medical center over approximately 3 years.Results:Findings from the patient’s evaluation with the Mullen Scales of Early Learning revealed overall cognitive ability in the low average range (SS = 89, 23rd percentile); however, notable variability was seen in his performance. His receptive language was average (SS = 98, 45th %tile) and consistent with previous evaluation results, and he has made gains in visual reception (from SS = 75, 5th %tile to SS = 91, 27th %tile) and expressive language (from SS = 55, 0.1st %tile to SS = 70, 2nd %tile). In addition, his gross motor was exceptionally low (SS = 55, 0.1st %tile) and consistent with previous evaluation results. Fine motor was low average (SS = 84, 14th %tile).Conclusions:Our patient showed cognitive gains in language and visual reception since his prior evaluation despite history of right MCA stroke and right hemispherectomy. Improvements are likely due to a combination of early brain plasticity and intensive therapies he has received. Consistent with published findings in this population, he experienced seizures associated with his stroke. Our results add to the limited literature on neurodevelopmental challenges associated with perinatal stroke and progress that can be made when appropriate supports are provided early and consistently.

Impact of Prematurity on Auditory Processing in Children.

Prematurity is one of the most crucial risk factors negatively affecting the maturation of the auditory system. Children born preterm demonstrate high rates of hearing impairments. Auditory processing difficulties in preterm children might be a result of disturbances in the central auditory system development and/or sensory deprivation due to peripheral hearing loss. To investigate auditory processing in preterm children, we utilized a set of psychoacoustic tests to assess temporal processing and speech intelligibility. A total of 241 children aged 6-11 years old (136 born preterm and 105 healthy full-term children forming the control group) were assessed. The preterm children were divided into three groups based on their peripheral hearing status: 74 normal hearing (NH group); 30 children with bilateral permanent sensorineural hearing loss (SNHL group) and 32 children with bilateral auditory neuropathy spectrum disorder (ANSD group). The results showed significantly worse performance in all tests in premature children compared with full-term children. NH and SNHL groups showed significant age-related improvement in speech recognition thresholds in noise that might signify a "bottom-up" auditory processing maturation effect. Overall, all premature children had signs of auditory processing disorders of varying degrees. Analyzing and understanding the auditory processing specificity in preterm children can positively contribute to the more effective implementation of rehabilitation programs.

Past and future time reference processing teased apart in Paiwan, an endangered Formosan language

AbstractHow the time reference of a sentence is processed based on the grammatical marking of the verb has already been explored in several languages with grammatical tense and aspect. It can also be grammatically expressed according to the reality status of the event (whether the event exists in time,realismood, or not,irrealis). This study reports results from an acceptability judgment experiment in Paiwan, a Formosan language which exhibits a realis-perfective/irrealis distinction. By placing realis-perfective and irrealis markers after deictic past or future time adverbs and manipulating the grammaticality of the sentences, we asked which temporal concord violation (i.e., realis-perfective or irrealis) was harder to detect. The temporal concord violation of the realis-perfective marker induced greater processing difficulties (interactions between time reference and mood marking revealed lower accuracy rates and longer reaction time), but not the irrealis marker, in line with previous hypotheses. These processing difficulties may be partly due to the Paiwan realis mood marker which also encodes perfective aspect meaning. The reanalysis of the design of previous studies indicates that the interaction with perfective aspect also led to additional processing cost, suggesting that perfective aspect marking plays a crucial role in the processing of time reference.

Effectiveness of sensory adaptive dental environments to reduce psychophysiology responses of dental anxiety and support positive behaviours in children and young adults with intellectual and developmental disabilities: a systematic review and meta-analyses

Background People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing difficulties, maladaptive behaviours and dental anxiety contribute to difficulties in receiving preventive and routine dental treatments. This study aimed to systematically review the evidence on the effectiveness of sensory adaptive dental environments (SADE) for children and young adults (up to the ages 24 years) with IDD to address cooperation and dental anxiety.MethodsThis review was reported according to The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE (Ovid), The Cochrane Library, Embase, Google Scholar, Web of Science and OT Seeker were searched using appropriate terms to identify Randomised Control Trails (RCTs) that matched inclusion criteria. Screening was conducted by two reviewers after de-duplication based on titles and abstracts followed by full text retrieval. Quality of the included studies was assessed using Cochrane Risk of Bias (ROB)-2 for crossover trials and data extracted by two reviewers. The details of the interventions and effectiveness were compared and discussed narratively, and comparable outcomes were included to meta-analyses using R software.ResultsA total of 622 articles were identified and five articles met eligibility for inclusion. Three studies used multi-sensory adaptations and one used single sensory adaptation of music. Narrative synthesis showed some evidence of SADE reducing magnitude and duration, although, questionable for reducing the number of maladaptive behaviours. Two studies demonstrated conflicting evidence of the effect of SADE on cooperation. Three studies demonstrated significant positive impact of SADE on psychophysiological outcomes. Despite an overall tendency to favour SADE, no statistically significant difference of maladaptive behaviours was found between SADE and regular dental environment (RDE) (Standardised mean change (SMC) = 0.51; 95% Confidence Interval (CI) -0.20 to 1.22; p = 0.161). SADE was superior to RDE (SMC -0.66; 95% CI -1.01 to -0.30; p = < 0.001) in reducing psychophysiological responses of dental anxiety.ConclusionCurrent evidence suggests that adapting visual, tactile, and auditory aspects of the dental environment in a single or multi-sensory approach demonstrates small positive effects on psychophysiological responses and maladaptive behaviours of dental anxiety for people with IDD.Trial registrationThe title of this review was registered with PROSPERO (CRD42022322083).