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Pierce JE, OHalloran R, Togher L, Nickels L, Copland D, Godecke E, Meinzer M, Rai T, Cadilhac DA, Kim J, Hurley M, Foster A, Carragher M, Wilcox C, Steel G, Rose ML. Acceptability, feasibility and preliminary efficacy of low-moderate intensity Constraint Induced Aphasia Therapy and Multi-Modality Aphasia Therapy in chronic aphasia after stroke. Top Stroke Rehabil 2024; 31:44-56. [PMID: 37036031 DOI: 10.1080/10749357.2023.2196765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/24/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND High-intensity Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) are effective interventions for chronic post-stroke aphasia but challenging to provide in clinical practice. Providing these interventions may be more feasible at lower intensities, but comparative evidence is lacking. We therefore explored feasibility, acceptability, and preliminary efficacy of the treatments at a lower intensity. METHODS A multisite, single-blinded, randomized Phase II trial was conducted within the Phase III COMPARE trial. Groups of participants with chronic aphasia from the usual care arm of the COMPARE trial were randomized to M-MAT or CIAT-Plus, delivered at the same dose as the COMPARE trial but at lower intensity (6 hours/week × 5 weeks rather than 15 hours/week × 2 weeks). Blinded assessors measured aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient), word retrieval, connected speech, multimodal communication, functional communication, and quality of life immediately post interventions and after 12 weeks. Feasibility and acceptability were explored. RESULTS Of 70 eligible participants, 77% consented to the trial; 78% of randomized participants completed intervention and 98% of assessment visits were conducted. Fatigue and distress ratings were low with no related withdrawals. Adverse events related to the trial (n = 4) were mild in severity. Statistically significant treatment effects were demonstrated on word retrieval and functional communication and both interventions were equally effective. CONCLUSIONS Low-moderateintensity CIAT-Plus and M-MAT were feasible and acceptable. Both interventions show preliminary efficacy at a low-moderate intensity. These results support a powered trial investigating these interventions at a low-moderate intensity.
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Affiliation(s)
- John E Pierce
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Robyn OHalloran
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyndsey Nickels
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - David Copland
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
- Surgical Treatment and Rehabilitation Service Education and Research Allience, Metro North Health, Herston, Queensland, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Western, Australia
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tapan Rai
- Graduate Research School, University of Technology Sydney, New South Wales, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
| | - Melanie Hurley
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Abby Foster
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
- School of Allied Health, Human Service & Sport, La Trobe University, Victoria, Australia
- School of Primary & Allied Health Care, Monash University, Victoria, Australia
| | - Marcella Carragher
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Cassie Wilcox
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Gillian Steel
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Miranda L Rose
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
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Georgiou AM, Kambanaros M. Therapies and Challenges in the Post-Stroke Aphasia Rehabilitation Arena: Current and Future Prospects. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1674. [PMID: 37763793 PMCID: PMC10537631 DOI: 10.3390/medicina59091674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Aphasia is a serious consequence of stroke that results in a breakdown in communication. The course of aphasia recovery differs between afflicted individuals, and responsiveness to treatment cannot be predicted. Aphasiologists continue to investigate numerous behavioral treatment protocols that have shifted their focus to complimentary rehabilitation strategies. The aim of this study is threefold. First, to summarize the different categories of aphasia interventions post-stroke, considering their respective protocols, and present available evidence on the effectiveness of those protocols. Second, to document the challenges regarding the prediction of aphasia treatment response post-stroke in individual patients. Third, to report the challenges faced by researchers in recruiting people with aphasia (PWA) for treatment studies, and provide recommendations on how to increase participant recruitment and retention. This study provides up-to-date information on (i) effective therapies and aphasia recovery processes, and (ii) research recruitment hurdles together with potential strategies for overcoming them.
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Affiliation(s)
- Anastasios M. Georgiou
- The Brain and Neurorehabilitation Lab, Department of Rehabilitation Sciences, Cyprus University of Technology, 3041 Limassol, Cyprus;
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Diedrichs VA, Lundine JP, Blackett DS, Durfee AZ, Pan XJ, Harnish SM. A randomized crossover single-case series comparing blocked versus random treatment for anomia. Neuropsychol Rehabil 2023; 33:821-848. [PMID: 35287561 PMCID: PMC9470780 DOI: 10.1080/09602011.2022.2050411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
The motor learning literature has demonstrated that blocked practice facilitates better acquisition of motor skills, whereas random practice facilitates retention and transfer. The verbal learning and memory literature offers similar evidence. The purpose of this study was to investigate effects of blocked versus random practice in treatment for anomia. The study used a single site, randomized crossover design, with two replicated experimental phases (two blocked and two random) for each of 10 individuals with anomia. Each phase consisted of a cued picture-naming treatment. Individual treatment and maintenance effects, as well as weighted averages and group effects, were calculated using Tau-U based on the proportion of correctly named probes. Nine of 10 participants demonstrated treatment effects during each of the four phases. Acquisition was comparable for blocked and random practice. Maintenance effects were observed following seven blocked phases of treatment and 12 random phases of treatment across participants. For four of 10 participants the random schedule resulted in better maintenance of trained items. Although further research is needed, the present data suggest that for word retrieval treatment with multiple repetitions of the same items, a random presentation may benefit maintenance of treatment gains.
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Affiliation(s)
| | - Jennifer P. Lundine
- Department of Speech and Hearing Science, The Ohio State University, Columbus, USA
| | | | | | | | - Stacy M. Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus, USA
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Nunn K, Vallila-Rohter S. Theory-driven treatment modifications: A discussion on meeting the linguistic, cognitive, and psychosocial needs of individual clients with aphasia. JOURNAL OF COMMUNICATION DISORDERS 2023; 103:106327. [PMID: 37060857 PMCID: PMC10247540 DOI: 10.1016/j.jcomdis.2023.106327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/17/2023] [Accepted: 04/07/2023] [Indexed: 06/03/2023]
Abstract
There is a growing body of literature demonstrating that language rehabilitation can improve naming impairments for individuals with aphasia. However, there are challenges applying evidence-based research to clinical practice. Well-controlled clinical studies often consist of homogenous samples and exclude individuals who may confound group-level results. Consequently, the findings may not generalize to the diverse clients serviced by speech-language therapists. Within evidence-based guidelines, clinicians can leverage their experiences and theoretical rationale to adapt interventions to meet the needs of individual clients. However, modifications to evidence-based interventions should not alter aspects of treatment that are necessary to produce change within the treatment target. The current discussion paper uses errorless learning, errorful learning, and retrieval practice for naming in aphasia to model how treatment theories can guide clinicians in making theory-informed modifications to interventions. First, we briefly describe the learning mechanisms hypothesized to underlie errorless learning, errorful learning, and retrieval practice. Next, we identify ways clinicians can provide targeted supports to optimize learning for individual clients. The paper ends with a reflection on how well-defined treatment theories can facilitate the generation of practice-based evidence and clinically relevant decision making.
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Affiliation(s)
- Kristen Nunn
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA.
| | - Sofia Vallila-Rohter
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
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Nunn K, Vallila-Rohter S, Middleton EL. Errorless, Errorful, and Retrieval Practice for Naming Treatment in Aphasia: A Scoping Review of Learning Mechanisms and Treatment Ingredients. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:668-687. [PMID: 36729701 PMCID: PMC10023178 DOI: 10.1044/2022_jslhr-22-00251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/27/2022] [Accepted: 10/25/2022] [Indexed: 06/03/2023]
Abstract
PURPOSE Increasingly, mechanisms of learning are being considered during aphasia rehabilitation. Well-characterized learning mechanisms can inform "how" interventions should be administered to maximize the acquisition and retention of treatment gains. This systematic scoping review mapped hypothesized mechanisms of action (MoAs) and treatment ingredients in three learning-based approaches targeting naming in aphasia: errorless learning (ELess), errorful learning (EFul), and retrieval practice (RP). The rehabilitation treatment specification system was leveraged to describe available literature and identify knowledge gaps within a unified framework. METHOD PubMed and CINHAL were searched for studies that compared ELess, EFul, and/or RP for naming in aphasia. Independent reviewers extracted data on proposed MoAs, treatment ingredients, and outcomes. RESULTS Twelve studies compared ELess and EFul, six studies compared ELess and RP, and one study compared RP and EFul. Hebbian learning, gated Hebbian learning, effortful retrieval, and models of incremental learning via lexical access were proposed as MoAs. To maximize treatment outcomes within theorized MoAs, researchers manipulated study ingredients including cues, scheduling, and feedback. Outcomes in comparative effectiveness studies were examined to identify ingredients that may influence learning. Individual-level variables, such as cognitive and linguistic abilities, may affect treatment response; however, findings were inconsistent across studies. CONCLUSIONS Significant knowledge gaps were identified and include (a) which MoAs operate during ELess, EFul, and RP; (b) which ingredients are active and engage specific MoAs; and (c) how individual-level variables may drive treatment administration. Theory-driven research can support or refute MoAs and active ingredients enabling clinicians to modify treatments within theoretical frameworks.
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Affiliation(s)
- Kristen Nunn
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Sofia Vallila-Rohter
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Erica L. Middleton
- Research Department, Moss Rehabilitation Research Institute, Elkins Park, PA
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Middleton EL, Duquette KL, Rawson KA, Mirman D. An examination of retrieval practice and production training in the treatment of lexical-semantic comprehension deficits in aphasia. Neuropsychology 2022; 36:730-752. [PMID: 36048069 PMCID: PMC9976587 DOI: 10.1037/neu0000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Little research has addressed the treatment of lexical-semantic comprehension deficits (i.e., difficulty retrieving the meanings of words) in people with aphasia (PWA). Research suggests that practice retrieving names for depicted objects from long-term memory (production-based retrieval practice) more strongly benefits word retrieval for production in PWA compared to errorless learning (i.e., word repetition), which eschews retrieval practice. This study assessed whether production-based and comprehension-based retrieval practice enhance performance on errorful word-comprehension items in PWA measured relative to nonretrieval forms of training and untrained control items. METHOD In a within-participant group study of PWA, errorful comprehension items were assigned to (a) a production-based training module (retrieval practice vs. errorless learning); (b) a comprehension-based training module (a receptive form of retrieval practice vs. restudy). Each module comprised one training session and a 1-day and 1-week comprehension posttest on the module's trained items and an untrained item set. RESULTS The comprehension module conditions produced similar and superior posttest performance relative to untrained items. Both production module conditions improved posttest performance relative to untrained items, with retrieval practice conferring more durable learning and generalization indicative of refinement of semantic representations compared to errorless learning. CONCLUSIONS Results suggest comprehension- and production-based forms of training are both beneficial for improving lexical-semantic deficits in aphasia, with production-based retrieval practice conferring additional benefits to the targeted deficit compared to errorless learning. Future studies should examine these learning factors in schedules of training more commensurate with clinical practice and in other neurological populations (e.g., semantic dementia). (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Quique YM, Cavanaugh R, Lescht E, Evans WS. Applying adaptive distributed practice to self-managed computer-based anomia treatment: A single-case experimental design. JOURNAL OF COMMUNICATION DISORDERS 2022; 99:106249. [PMID: 35882077 DOI: 10.1016/j.jcomdis.2022.106249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 07/09/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION There is a pressing need to improve computer-based treatments for aphasia to increase access to long-term effective evidence-based interventions. The current single case design incorporated two learning principles, adaptive distributed practice and stimuli variability, to promote acquisition, retention, and generalization of words in a self-managed computer-based anomia treatment. METHODS Two participants with post-stroke aphasia completed a 12-week adaptive distributed practice naming intervention in a single-case experimental design. Stimuli variability was manipulated in three experimental conditions: high exemplar variability, low exemplar variability, and verbal description prompt balanced across 120 trained words. Outcomes were assessed at 1-week, 1-month, and 3-months post-treatment. Statistical comparisons and effect sizes measured in the number of words acquired, generalized, and retained were estimated using Bayesian generalized mixed-effect models. RESULTS Participants showed large and robust acquisition, generalization, and retention effects. Out of 120 trained words, participant 1 acquired ∼77 words (trained picture exemplars) and ∼63 generalization words (untrained picture exemplars of treated words). Similarly, participant 2 acquired ∼57 trained words and ∼48 generalization words. There was no reliable change in untrained control words for either participant. Stimuli variability did not show practically meaningful effects. CONCLUSIONS These case studies suggest that adaptive distributed practice is an effective method for re-training more words than typically targeted in anomia treatment research (∼47 words on average per Snell et al., 2010). Generalization across experimental conditions provided evidence for improved lexical access beyond what could be attributed to simple stimulus-response mapping. These effects were obtained using free, open-source flashcard software in a clinically feasible, asynchronous format, thereby minimizing clinical implementation barriers. Larger-scale clinical trials are required to replicate and extend these effects.
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Affiliation(s)
- Yina M Quique
- Center for Education in Health Sciences, Northwestern University, Chicago, IL, United States of America.
| | - Robert Cavanaugh
- Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Erica Lescht
- Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - William S Evans
- Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, United States of America
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Language learning in aphasia: A narrative review and critical analysis of the literature with implications for language therapy. Neurosci Biobehav Rev 2022; 141:104825. [PMID: 35963544 DOI: 10.1016/j.neubiorev.2022.104825] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022]
Abstract
People with aphasia (PWA) present with language deficits including word retrieval difficulties after brain damage. Language learning is an essential life-long human capacity that may support treatment-induced language recovery after brain insult. This prospect has motivated a growing interest in the study of language learning in PWA during the last few decades. Here, we critically review the current literature on language learning ability in aphasia. The existing studies in this area indicate that (i) language learning can remain functional in some PWA, (ii) inter-individual variability in learning performance is large in PWA, (iii) language processing, short-term memory and lesion site are associated with learning ability, (iv) preliminary evidence suggests a relationship between learning ability and treatment outcomes in this population. Based on the reviewed evidence, we propose a potential account for the interplay between language and memory/learning systems to explain spared/impaired language learning and its relationship to language therapy in PWA. Finally, we indicate potential avenues for future research that may promote more cross-talk between cognitive neuroscience and aphasia rehabilitation.
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Patra A, Traut HJ, Stabile M, Middleton EL. Effortful Retrieval Practice Effects in Lexical Access: A Role for Semantic Competition. LANGUAGE, COGNITION AND NEUROSCIENCE 2022; 37:948-963. [PMID: 36419750 PMCID: PMC9678354 DOI: 10.1080/23273798.2022.2027991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 01/04/2022] [Indexed: 06/16/2023]
Abstract
Word retrieval difficulty (lexical access deficit) is prevalent in aphasia. Studies have shown that practice retrieving names from long-term memory (retrieval practice) improves future name retrieval for production in people with aphasia (PWA), particularly when retrieval is effortful. To explicate such effects, this study examined a potential role for semantic competition in the learning mechanism(s) underlying effortful retrieval practice effects in lexical access in 6 PWA. Items were trained in a blocked-cyclic naming task, in which repeating sets of pictures drawn from semantically-related versus unrelated categories underwent retrieval practice with feedback. Naming accuracy was lower for the related items at training, but next-day accuracy did not differ between the conditions. However, greater semantic-relatedness of an item to its set in the related condition was associated with lower accuracy at training but higher accuracy at test. Relevance to theories of lexical access and implications for naming treatment in aphasia are discussed.
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Affiliation(s)
- Abhijeet Patra
- Correspondence concerning this article should be addressed to Abhijeet Patra, Research Department, Moss Rehabilitation Research Institute, 50 Township Line Rd., Elkins Park, PA, 19027, USA.
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Cherney LR, Carpenter J. Behavioral interventions for poststroke aphasia. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:197-220. [PMID: 35078599 DOI: 10.1016/b978-0-12-823384-9.00010-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is a long history of behavioral interventions for poststroke aphasia with hundreds of studies supporting the benefits of aphasia treatment. However, interventions for aphasia are complex with many interacting components, and no one treatment is appropriate for all persons with aphasia. We present a novel, simple framework for classifying aphasia interventions. The framework is incorporated within the overarching International Classification of Functioning, Disability, and Health (ICF) model and is consistent with the commonly-held definition that aphasia is a multimodality disorder that impairs, in varying degrees, the understanding and expression of both oral and written language modalities. Furthermore, within the language impairment level, it distinguishes between the linguistic areas of phonology, semantics, and syntax that may be impaired individually or in combination. We define the terminology of the proposed framework and then categorize some common examples of behavioral interventions for post-stroke aphasia. We describe some of these interventions in greater detail to illustrate the extensive toolbox of evidence-based treatments for aphasia. We address some key issues that clinicians, usually speech-language pathologists, consider when selecting interventions for their specific patients with aphasia, including dose. Finally, we address various models of service delivery for persons with aphasia such as Intensive Comprehensive Aphasia Programs (ICAPs) and Aphasia Centers.
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Affiliation(s)
- Leora R Cherney
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, United States; Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, United States; Department of Communication Sciences & Disorders, Northwestern University, Chicago, IL, United States.
| | - Julia Carpenter
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, United States
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Li Z. Distributed treatment of rural environmental wastewater by artificial ecological geographic information system. ENVIRONMENTAL RESEARCH 2021:112572. [PMID: 34921826 DOI: 10.1016/j.envres.2021.112572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/05/2021] [Accepted: 12/12/2021] [Indexed: 06/14/2023]
Abstract
County rural sewage geographic information system, is the use of geographic information technology and computer graphics, digital storage and management of sewage treatment facilities, the sewage treatment plant equipment management, water purification and sewage network and its surrounding corresponding facilities location information and physical attributes of the two combined, according to the needs of users, the sewage treatment process required data in the form of graphics and text to show to According to the user's needs, the data required in the process of sewage treatment is displayed to the user in a graphic way, so as to meet the needs of government departments for comprehensive control of the operation and maintenance management of sewage treatment facilities. Solve the problem of slow update of basic data in sewage treatment projects and ambiguous presentation of water quality monitoring data caused by paper records. The system uses Web-GIS technology, combined with NET development platform, using MVC model design and implementation. The front-end Bootstrap framework for interface optimization display, the back-end ORM framework to provide persistence classes and database tables between the mapping relationship, convenient to complete the migration of the database. The system function design uses the visualization and analysis function of GIS to manage the wastewater treatment facilities and the wastewater purification process for real-time operation and maintenance supervision, and uses the three-dimensional engine to visualize and display the study of the wastewater pipe network on the Web side. Mainly divided into the following modules: water quality parameters supervision module, mainly real-time monitoring of the sewage treatment process, the parameters are in line with the sewage purification indicators, to play a monitoring and early warning role; equipment operation and maintenance module, mainly for the sewage treatment facilities for fault detection and maintenance of property information; statistical analysis module, the water quality information of different sewage treatment plants for horizontal and vertical comparison and analysis, to improve the sewage treatment The statistical analysis module, which provides data for improving the sewage treatment process; and the 3D pipe network visualization module, which uses virtual reality technology to visualize the sewage pipe network on the Web side to make up for the lack of information on the pipe network in the third dimension.
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Affiliation(s)
- Zihan Li
- Jiangsu Environmental Protection Group Co., LTD., China.
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Schuchard J, Rawson KA, Middleton EL. Effects of distributed practice and criterion level on word retrieval in aphasia. Cognition 2020; 198:104216. [PMID: 32044615 PMCID: PMC7197013 DOI: 10.1016/j.cognition.2020.104216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 11/17/2022]
Abstract
This study examined how the distribution and amount of practice affect word retrieval in aphasia as well as how such factors relate to the efficiency of learning. The central hypothesis was that factors that enhance the learning of new knowledge also enhance persistent access to existing, but inconsistently available, word representations. The study evaluated the impact of learning principles on word retrieval by manipulating the timing and amount of retrievals for items presented for naming. Nine people with chronic aphasia with naming impairment completed the experiment. Training materials involved proper noun entities assigned to six conditions formed by crossing a 2-level factor of spacing of sessions, i.e., intersession interval (1 day versus 7 days between sessions) with a 3-level factor of number of correct retrievals per item per session, i.e., criterion level (Criterion-1, Criterion-2, and Criterion-4). Each intersession interval condition comprised three training sessions and a one-month retention test. Increasing the criterion level enhanced naming performance after short (1 day, 7 days) and long (one month) retention intervals, but these advantages came at the cost of many additional training trials. In most cases, later naming success was superior when the same number of correct retrievals of an item was distributed across multiple sessions rather than administered within one session. The substantial advantages for across-session spacing were gained at little cost in terms of additional training trials. At one-month retention, naming accuracy was numerically but not significantly higher in the 7-day versus 1-day intersession interval condition. Implications for theories of lexical access and naming treatment in aphasia are discussed.
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Affiliation(s)
- Julia Schuchard
- Moss Rehabilitation Research Institute, 50 Township Line Rd., Elkins Park, PA 19027, USA.
| | - Katherine A Rawson
- Department of Psychological Sciences, 332 Kent Hall, Kent State University, Kent, OH 44242, USA.
| | - Erica L Middleton
- Moss Rehabilitation Research Institute, 50 Township Line Rd., Elkins Park, PA 19027, USA.
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