Piano training enhances the neural processing of pitch and improves speech perception in Mandarin-speaking children.

Musical training confers advantages in speech-sound processing, which could play an important role in early childhood education. To understand the mechanisms of this effect, we used event-related potential and behavioral measures in a longitudinal design. Seventy-four Mandarin-speaking children aged 4-5 y old were pseudorandomly assigned to piano training, reading training, or a no-contact control group. Six months of piano training improved behavioral auditory word discrimination in general as well as word discrimination based on vowels compared with the controls. The reading group yielded similar trends. However, the piano group demonstrated unique advantages over the reading and control groups in consonant-based word discrimination and in enhanced positive mismatch responses (pMMRs) to lexical tone and musical pitch changes. The improved word discrimination based on consonants correlated with the enhancements in musical pitch pMMRs among the children in the piano group. In contrast, all three groups improved equally on general cognitive measures, including tests of IQ, working memory, and attention. The results suggest strengthened common sound processing across domains as an important mechanism underlying the benefits of musical training on language processing. In addition, although we failed to find far-transfer effects of musical training to general cognition, the near-transfer effects to speech perception establish the potential for musical training to help children improve their language skills. Piano training was not inferior to reading training on direct tests of language function, and it even seemed superior to reading training in enhancing consonant discrimination.

Role of dexmedetomidine in the treatment of delirium in critically ill patients: a systematic review and meta-analysis.

INTRODUCTION: Although dexmedetomidine has been found to prevent delirium in critically ill patients, it is uncertain whether it can treat acute delirium. This study aimed to evaluate the efficacy and safety of dexmedetomidine in treating delirium, by analyzing and reviewing data from previous studies. EVIDENCE ACQUISITION: Clinical trial data on the use of dexmedetomidine in adult critically ill patients with delirium were retrieved from four databases (PubMed, Embase, Web of Science, and the Cochrane Library) and clinicaltrials.gov, from inception to May, 2020. EVIDENCE SYNTHESIS: Ten randomized controlled trials (RCTs) and five non-RCTs met the selection criteria and data were obtained from 1017 patients. In one study, dexmedetomidine reduced the duration of delirium to a greater extent than did the placebo. In six studies, it was associated with a lower point-prevalence of delirium after treatment (OR, 0.39; 95% CI, 0.20, 0.76; P=0.006) and a shorter time to resolution of delirium (hours; MD, -23.25; 95% CI, -45.28, -1.21; P=0.04) compared with those of other drugs. In four RCTs, it was superior to haloperidol in reducing the time to resolution of delirium (hours; MD, -30.17; P=0.01). However, in seven studies, it showed a higher risk of bradycardia (OR, 3.48; 95% CI, 1.47, 8.23; P=0.004) than that of comparators. CONCLUSIONS: Dexmedetomidine promotes the resolution of delirium but also increases the incidence of bradycardia during treatment. Furthermore, it may be superior to haloperidol in treating delirium, although more studies are needed to confirm this.