MELD-SCH: A megastudy of lexical decision in simplified Chinese.

Here we report on MELD-SCH (MEgastudy of Lexical Decision in Simplified CHinese), a dataset that contains the lexical decision data of 1,020 one-character, 10,022 two-character, 949 three-character, and 587 four-character simplified Chinese words obtained from 504 native Chinese users. It also includes a number of word-level and character-level variables. Analyses showed that the reliability of the dataset is satisfactory, as indicated by split-half correlations and comparisons with other datasets. Item-based regression showed that both word-level and character-level variables contributed significantly to the reaction times and error rates of lexical decision. Moreover, we discovered a U-shape relationship between word-length and reaction times, which has not been reported in Chinese before. MELD-SCH can facilitate research in Chinese word recognition by providing high quality normative data and information of different linguistic variables. It also encourages researchers to extend their empirical findings, which are mostly based on one-character and two-character words, to words of different lengths.

Dynamic brain architectures in local brain activity and functional network efficiency associate with efficient reading in bilinguals.

The human brain is organized as a dynamic network, in which both regional brain activity and inter-regional connectivity support high-level cognitive processes, such as reading. However, it is still largely unknown how the functional brain network organizes to enable fast and effortless reading processing in the native language (L1) but not in a non-proficient second language (L2), and whether the mechanisms underlying local activity are associated with connectivity dynamics in large-scale brain networks. In the present study, we combined activation-based and multivariate graph-theory analysis with functional magnetic resonance imaging data to address these questions. Chinese-English unbalanced bilinguals read narratives for comprehension in Chinese (L1) and in English (L2). Compared with L2, reading in L1 evoked greater brain activation and recruited a more globally efficient but less clustered network organization. Regions with both increased network efficiency and enhanced brain activation in L1 reading were mostly located in the fronto-temporal reading-related network (RN), whereas regions with decreased global network efficiency, increased clustering, and more deactivation in L2 reading were identified in the default mode network (DMN). Moreover, functional network efficiency was closely associated with local brain activation, and such associations were also modulated by reading efficiency in the two languages. Our results demonstrate that an economical and integrative brain network topology is associated with efficient reading, and further reveal a dynamic association between network efficiency and local activation for both RN and DMN. These findings underscore the importance of considering interregional connectivity when interpreting local BOLD signal changes in bilingual reading.

Use of the Free Endometriosis Risk Advisor App as a Non-Invasive Screening Test for Endometriosis in Patients with Chronic Pelvic Pain and/or Unexplained Infertility.

Endometriosis is a prevalent condition that affects millions of individuals globally, leading to various symptoms and significant disruptions to their quality of life. However, the diagnosis of endometriosis often encounters delays, emphasizing the pressing need for non-invasive screening. This retrospective cross-sectional study aimed to evaluate the utility of the Endometriosis Risk Advisor (EndoRA) mobile application in screening for endometriosis in patients with chronic pelvic pain and/or unexplained infertility. The study consisted of 293 patients who met specific criteria: they were English-speaking individuals with chronic pelvic pain and/or unexplained infertility, owned smartphones, and had no prior diagnosis of endometriosis. The results demonstrated that the EndoRA score exhibited a high sensitivity of 93.1% but a low specificity of 5.9% in detecting endometriosis. The positive predictive value was 94.1%, while the negative predictive value was 5.0%. Although the study had limitations and potential selection bias, its findings suggest that EndoRA can serve as a valuable screening tool for high-risk individuals, enabling them to identify themselves as being at an increased risk for endometriosis. EndoRA's non-invasive nature, free access, and easy accessibility have the potential to streamline evaluation and treatment processes, thereby empowering individuals to seek timely care and ultimately improving patient outcomes and overall well-being.

Tonal and syllabic encoding in overt Cantonese Chinese speech production: An ERP study.

This study was conducted to investigate how syllables and lexical tones are processed in Cantonese speech production using the picture-word interference task with concurrent recording of event-related brain potentials (ERPs). Cantonese-speaking participants were asked to name aloud individually presented pictures and ignore an accompanying auditory word distractor. The target and distractor either shared the same word-initial syllable with the same tone (Tonal-Syllable related), the same word-initial syllable without the same tone (Atonal-Syllable related), the same tone only (Tone alone related), or were phonologically unrelated. Participants' naming responses were faster, relative to an unrelated control, when the target and distractor shared the same tonal- or atonal-syllable but null effect was found in the Tone alone related condition. The mean ERP amplitudes (per each 100-ms time window) were subjected to stimulus-locked (i.e., time-locked to stimulus onset) and response-locked (i.e., time-locked to response onset) analyses. Significant differences between related and unrelated ERP waves were similarly observed in both Tonal-Syllable related and Atonal-Syllable related conditions in the time window of 400-500 ms post-stimulus. However, distinct ERP effects were observed in these two phonological conditions within the 500-ms pre-response period. In addition, null effects were found in the Tone alone related condition in both stimulus-locked and response-locked analyses. These results suggest that in Cantonese spoken word production, the atonal syllable of the target is retrieved first and then associated with the target lexical tone, consistent with the view that tone has an important role to play at a late stage of phonological encoding in tonal language production.

The anterior left inferior frontal gyrus contributes to semantic unification.

Semantic unification, the process by which small blocks of semantic information are combined into a coherent utterance, has been studied with various types of tasks. However, whether the brain activations reported in these studies are attributed to semantic unification per se or to other task-induced concomitant processes still remains unclear. The neural basis for semantic unification in sentence comprehension was examined using event-related potentials (ERP) and functional Magnetic Resonance Imaging (fMRI). The semantic unification load was manipulated by varying the goodness of fit between a critical word and its preceding context (in high cloze, low cloze and violation sentences). The sentences were presented in a serial visual presentation mode. The participants were asked to perform one of three tasks: semantic congruency judgment (SEM), silent reading for comprehension (READ), or font size judgment (FONT), in separate sessions. The ERP results showed a similar N400 amplitude modulation by the semantic unification load across all of the three tasks. The brain activations associated with the semantic unification load were found in the anterior left inferior frontal gyrus (aLIFG) in the FONT task and in a widespread set of regions in the other two tasks. These results suggest that the aLIFG activation reflects a semantic unification, which is different from other brain activations that may reflect task-specific strategic processing.

What and where is the word?

Examples from Chinese, Thai, and Finnish illustrate why researchers cannot always be confident about the precise nature of the word unit. Understanding ambiguities regarding where a word begins and ends, and how to model word recognition when many derivations of a word are possible, is essential for universal theories of reading applied to both developing and expert readers.

Cost-effectiveness of the add-on exenatide to conventional treatment in patients with Parkinson's disease when considering the coexisting effects of diabetes mellitus.

OBJECTIVE: This study aims to investigate the cost-effectiveness of the add-on exenatide to conventional pharmacotherapy in patients with Parkinson's disease (PD) when considering the coexistence of diabetes mellitus (DM). METHODS: We used the Keelung and Community-based Integrated Screening databases to understand the medical utilisation in the Hoehn and Yahr stages of patients with PD. A Markov model with 1-year cycle length and 50-year time horizon was used to assess the cost-effectiveness of add-on exenatide to conventional pharmacotherapy compared to conventional pharmacotherapy alone. All costs were adjusted to the value of the new Taiwanese dollar (NT$) as of the year 2020. One-way sensitivity and probability analyses were performed to test the robustness of the results. RESULTS: From a societal perspective, the add-on exenatide brought an average of 0.39 quality-adjusted life years (QALYs) gained, and a cost increment of NT$104,744 per person in a 50-year horizon compared to conventional pharmacotherapy. The incremental cost-effectiveness ratio (ICER) was NT$268,333 per QALY gained. As the ICER was less than the gross domestic product per capita (NT$839,558), the add-on exenatide was considered to be very cost-effective in the two models, according to the World Health Organization recommendation. Add-on exenatide had a 96.9% probability of being cost-effective in patients with PD, and a 100% probability of being cost-effective in patients with PD and DM. CONCLUSION: Add-on exenatide is cost-effective in PD combined with DM. Considering that DM may be a risk factor for neurodegenerative diseases, exenatide provides both clinical benefits and cost-effectiveness when considering both PD and DM.

Impact of COVID-19 pandemic on accessibility of Taiwanese medical care.

OBJECTIVES: Whether and how the COVID-19 pandemic affected utilization of routine medical care in areas with low infection risk, such as Taiwan, has not been widely addressed. We aimed to evaluate the impact of the COVID-19 pandemic on access to medical care. STUDY DESIGN: Before and after exposure (COVID-19 pandemic) design with a historical control group for comparison of clinical visits based on a retrospective cohort of 6722 customary patients of a community hospital in Zhunan, Taiwan. METHODS: Repeated measurements of medical utilization in 4-month periods (January to April) of 2019 and 2020 in light of the emerging COVID-19 pandemic were collected. Access to medical care was defined as the mean frequencies of clinical visits. The impacts of the COVID-19 pandemic on access in the overall and specific groups were quantified with a multivariable Poisson regression model. RESULTS: The overall outpatient visits per month declined by 39% (rate ratio [RR], 0.61; P < .0001) after adjusting for demographics. A notable reduction in visits was observed in foreign patients (RR, 0.50; P < .0001). The visits of the elderly (≥ 80 years) were the most frequent before the COVID-19 pandemic but were reduced by 44% (RR, 0.56; P < .0001) after it began. Most disease categories revealed a declining trend, but the size of reduction varied by International Classification of Diseases codes. CONCLUSIONS: The COVID-19 pandemic prevented some individuals from keeping regular medical appointments even in an area with a low infection risk. Our findings imply that more research is required to mitigate the effects of delayed medical care for patients who infrequently utilized medical care during and after the long-lasting pandemic period.

Stroke Encoding Processes of Chinese Character During Sentence Reading.

The present study was conducted to examine whether traditional and simplified Chinese readers (TCRs and SCRs) differed in stroke encoding in character processing by an eye-tracking experiment. We recruited 66 participants (32 TCRs and 34 SCRs) to read sentences comprising characters with different proportions and types of strokes removed in order to explore whether any visual complexity effect existed in their processing of simplified and traditional Chinese characters. The present study found a cross-script visual complexity effect and that SCRs were more influenced by visual complexity change in lexical access than were TCRs. In addition, the stroke-order effect appeared to be more salient for TCRs than for SCRs.

Involvement of left inferior frontal gyrus in sentence-level semantic integration.

Using event-related functional MRI, we examined the involvement of the left inferior frontal gyrus (LIFG) in semantic integration in reading Chinese sentences. During scanning, Chinese readers read individually presented sentences and judged whether or not a sentence was semantically acceptable. Behaviorally, those sentences with a small degree of semantic violation were found to be more difficult to reject relative to sentences with a large degree of semantic violation, indicating that more semantic integration occurred in the former than in the latter condition. Direct contrast revealed significantly greater brain activity in the LIFG for sentences with a small violation, relative to those with a large violation, but no differences in any anterior temporal cortical areas between the two types of anomalous sentences. The results are in line with the idea that the LIFG plays a critical role in integrating individual word meanings to coherent sentence-level messages, but not with the idea that semantic integration depends on anterior temporal cortex in language comprehension.

Forward and backward repetition blindness in speed and accuracy.

Repetition blindness (RB) was investigated in a new paradigm in which effects could stem from items preceding or following a target. Speeded-response tasks were used in which 3 critical items (C1, C2, and C3) were sequentially presented on each trial. In Experiments 1 and 2, participants were asked to judge whether C2 (the target) was present on each trial. Forward RB was examined in Experiment 1 via manipulation of whether C1 and C2 were repeated and backward RB was probed in Experiment 2 via manipulation of whether C2 and C3 were repeated. RB was successfully demonstrated in both experiments: Target presence judgments were slower and less accurate with repeated conditions than with unrepeated conditions. Experiment 3 involved a semantic categorization task in which participants had to judge whether C2 was a letter or a digit. Manipulating forward and backward repetition produced reliable effects on both reaction times and accuracy. The results are consistent with the idea that RB is due to failure in token individualization rather than type refractory problems or failure in memory retrieval.

Relations between mental verb and false belief understanding in Cantonese-speaking children.

Previous research has shown that linguistic forms that codify mental contents bear a specific relation with children's false belief understanding. These forms include mental verbs and their following complements, yet the two have not been considered separately. The current study examined the roles of mental verb semantics and the complement syntax in children's false belief understanding. Independent tasks were used to measure verb meaning, complements, and false belief understanding such that the verbs in question were present only in the verb meaning test, and no linguistic devices biased toward false belief were used in the false belief test. We focused on (a) some mental verbs that obligatorily affirm or negate what follows and (b) sentential complements, the content of which is to be evaluated against the mind of another person, not reality. Results showed that only (a) predicted false belief understanding in a group of Cantonese-speaking 4-year-olds, controlling for nonverbal intelligence and general language ability. In particular, children's understanding of the strong nonfactive semantics of the Cantonese verbs /ji5-wai4/ ("falsely think") predicted false belief understanding most strongly. The current findings suggest that false belief understanding is specifically related to the comprehension of mental verbs that entail false thought in their semantics.

The time course of semantic and syntactic processing in Chinese sentence comprehension: evidence from eye movements.

In the present study, we examined the time course of semantic and syntactic processing when Chinese is read. Readers' eye movements were monitored, and the relation between a single-character critical word and the sentence context was manipulated such that three kinds of sentences were developed: (1) congruent, (2) those with a semantic violation, and (3) those with both a semantic and a syntactic violation. The eye movement data showed that the first-pass reading times were significantly longer for the target region in the two violation conditions than in the congruent condition. Moreover, the semantic+syntactic violation caused more severe disruption than did the pure semantic violation, as reflected by longer first-pass reading times for the target region and by longer go-past times for the target region and posttarget region in the former than in the latter condition. These results suggest that the effects of, at least, a semantic violation can be detected immediately by Chinese readers and that the processing of syntactic and semantic information is distinct in both first-pass and second-pass reading.

Independent effects of orthographic and phonological facilitation on spoken word production in Mandarin.

A picture-word interference paradigm with visually presented distractors was used to investigate the independent effects of orthographic and phonological facilitation on Mandarin monosyllabic word production. Both the stimulus-onset asynchrony (SOA) and the picture-word relationship along different lexical dimensions were varied. We observed a pure orthographic facilitation effect and a pure phonological facilitation effect, and found that the patterns of orthographic and phonological facilitation were different. Of most interest, the additive effects of orthographic and phonological facilitation at -150-ms and 0-ms SOAs indicated that the orthographic effect was largely independent of the phonological effect on spoken picture naming. We argue that the present findings are useful for constraining theoretical models of language production and contend that theoretical models of word production need to consider independent effects of orthography and phonology on picture naming, at least in Chinese.

Behavioural evidence for segments as subordinate units in Chinese spoken word production: The form-preparation paradigm revisited.

It is widely acknowledged that phonemic segments are primary phonological units, processed serially, in spoken word production of Germanic languages. However, evidence for a behavioural effect of single-segment overlap on Chinese spoken word production is lacking. The current study adopted the form-preparation paradigm to investigate the effects of segment predictability and segment repetition separately, which were mixed in previous studies. Native Mandarin Chinese speakers named pictures in the following conditions: predictable, unpredictable, and no segment repetition. Different positions in words (i.e., the onset and the rhyme) were examined at the same time. Results revealed a facilitation effect of onset predictability masked by an inhibition tendency of onset repetition, indicating Chinese speakers' ability to prepare the predictable onset. In contrast, rhyme predictability showed a non-significant effect. This pattern of results did not change no matter whether the conditions of unpredictable onset repetition and unpredictable rhyme repetition were mixed in the same context (Experiment 1) or extracted from different blocked contexts (Experiment 2). The finding provides essential support to the claim that phonemic segments are functionally engaged in Chinese spoken word production, and thus adds original evidence to the universal aspect of spoken word production.

Molecular studies of pH-dependent ligand interactions with the low-density lipoprotein receptor.

The release of ligand from the low-density lipoprotein receptor (LDLR) has been postulated to involve a "histidine switch"-induced intramolecular rearrangement that discharges bound ligand. A recombinant soluble low-density lipoprotein receptor (sLDLR) was employed in ligand binding experiments with a fluorescently tagged variant apolipoprotein E N-terminal domain (apoE-NT). Binding was monitored as a function of fluorescence resonance energy transfer (FRET) from excited Trp residues in sLDLR to an extrinsic fluorophore covalently attached to Trp-null apoE3-NT. In binding experiments with wild-type (WT) sLDLR, FRET-dependent AEDANS fluorescence decreased as the pH was lowered. To investigate the role of His190, His562, and His586 in sLDLR in pH-dependent ligand binding and discharge, site-directed mutagenesis studies were performed. Compared to WT sLDLR, triple His --> Ala mutant sLDLR displayed attenuated pH-dependent ligand binding and a decreased level of ligand release as a function of low pH. When these His residues were substituted for Lys, the positively charged side chain of which does not ionize over this pH range, ligand binding was nearly abolished at all pH values. When sequential His to Lys mutants were examined, the evidence suggested that His562 and His586 function cooperatively. Whereas the sedimentation coefficient for WT sLDLR increased when the pH was reduced from 7 to 5, no such change occurred in the case of the triple Lys mutant receptor or a His562Lys/His586Lys double mutant receptor. The data support the existence of a cryptic, histidine side chain ionization-dependent alternative ligand that modulates ligand discharge via conformational reorganization.

Broca's area plays a role in syntactic processing during Chinese reading comprehension.

Event-related functional magnetic resonance imaging (ER-fMRI) was adopted to examine brain activation of syntactic processing in reading logographic Chinese. While fMRI data were obtained, 15 readers of Chinese read individually presented sentences and performed semantic congruency judgments on three kinds of sentences: Congruous sentences (CON), sentences with a semantic violation (SEM), and sentences with both semantic and syntactic violations (SEM+SYN). The two types of incongruous sentences were matched in the degree of semantic plausibility. Three brain regions were identified showing significantly different levels of percent signal change across the three conditions, including BA44 in the left inferior frontal gyrus (IFG) and both BA9 and BA10/46 in the left middle frontal gyrus (MFG). Furthermore, the mean percent signal change in the left BA44 observed in the SEM+SYN condition was significantly stronger than that in either the SEM or the CON condition, while the latter two conditions were at a similar level, implying an important role of this area in Chinese syntactic processing. These results, in conjunction with those found in alphabetic scripts, suggest that there are some common neural substrates underlie syntactic processing across distinctive writing systems such as the logographic Chinese and the alphabetic English.

Processing segmental and prosodic information in Cantonese word production.

Five experiments were conducted to investigate how subsyllabic, syllabic, and prosodic information is processed in Cantonese monosyllabic word production. A picture-word interference task was used in which a target picture and a distractor word were presented simultaneously or sequentially. In the first 3 experiments with visually presented distractors, null effects on naming latencies were found when the distractor and the picture name shared the onset, the rhyme, the tone, or both the onset and tone. However, significant facilitation effects were obtained when the target and the distractor shared the rhyme + tone (Experiment 2), the segmental syllable (Experiment 3), or the syllable + tone (Experiment 3). Similar results were found in Experiments 4 and 5 with spoken rather than visual distractors. Moreover, a significant facilitation effect was observed in the rhyme-related condition in Experiment 5, and this effect was not affected by the degree of phonological overlap between the target and the distractor. These results are interpreted in an interactive model, which allows feedback sending from the subsyllabic to the lexical level during the phonological encoding stage in Cantonese word production.

Time course of syllabic and sub-syllabic processing in Mandarin word production: Evidence from the picture-word interference paradigm.

The time course of phonological encoding in Mandarin monosyllabic word production was investigated by using the picture-word interference paradigm. Participants were asked to name pictures in Mandarin while visual distractor words were presented before, at, or after picture onset (i.e., stimulus-onset asynchrony/SOA = -100, 0, or +100 ms, respectively). Compared with the unrelated control, the distractors sharing atonal syllables with the picture names significantly facilitated the naming responses at -100- and 0-ms SOAs. In addition, the facilitation effect of sharing word-initial segments only appeared at 0-ms SOA, and null effects were found for sharing word-final segments. These results indicate that both syllables and subsyllabic units play important roles in Mandarin spoken word production and more critically that syllabic processing precedes subsyllabic processing. The current results lend strong support to the proximate units principle (O'Seaghdha, Chen, & Chen, 2010), which holds that the phonological structure of spoken word production is language-specific and that atonal syllables are the proximate phonological units in Mandarin Chinese. On the other hand, the significance of word-initial segments over word-final segments suggests that serial processing of segmental information seems to be universal across Germanic languages and Chinese, which remains to be verified in future studies.

Syllable retrieval precedes sub-syllabic encoding in Cantonese spoken word production.

Two experiments were conducted to investigate the time course of syllabic and sub-syllabic processing in Cantonese spoken word production by using the picture-word interference task. Cantonese-speaking participants were asked to name individually presented pictures aloud and ignore an auditory word distractor. The targets and distractors were either phonologically related (i.e., sharing two identical word-initial phonemes) or unrelated. In Experiment 1, the target syllables were all consonant-vowel (CV)-structured. The phonological distractor was either a CV syllable (i.e., Full Syllable Overlap) or a CVC (consonant-vowel-consonant) syllable (i.e., Sub-syllable Overlap). Relative to the unrelated control, Full Syllable Overlap distractors facilitated naming in all stimuli onset asynchronies (SOAs) (-175, 0, or +175 ms) whereas Sub-syllable Overlap distractors exhibited facilitation only at 0-ms and +175-ms SOAs. Experiment 2 adopted a similar design to examine the possible influence of syllabic structure similarity on the results of Experiment 1. The target syllables were all CVC-structured. The phonological distractor was either a CVC (i.e., Syllable-structure Consistent) or CV (i.e., Syllable-structure Inconsistent) syllable. Comparable priming was observed between the two distractor conditions across the three SOAs. These results indicated that an earlier priming effect was observed with full syllable overlap than sub-syllabic overlap when the degree of segmental overlap was held constant (Experiment 1). The earlier syllable priming observed in Experiment 1 could not be attributed to the effect of syllabic-structure (Experiment 2), thereby suggesting that the syllable unit is important in Cantonese and is retrieved earlier than sub-syllabic components during phonological encoding.