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Advanced beyond-silicon electronic technology requires both channel materials and also ultralow-resistance contacts to be discovered1,2. Atomically thin two-dimensional semiconductors have great potential for realizing high-performance electronic devices1,3. However, owing to metal-induced gap states (MIGS)4-7, energy barriers at the metal-semiconductor interface-which fundamentally lead to high contact resistance and poor current-delivery capability-have constrained the improvement of two-dimensional semiconductor transistors so far2,8,9. Here we report ohmic contact between semimetallic bismuth and semiconducting monolayer transition metal dichalcogenides (TMDs) where the MIGS are sufficiently suppressed and degenerate states in the TMD are spontaneously formed in contact with bismuth. Through this approach, we achieve zero Schottky barrier height, a contact resistance of 123 ohm micrometres and an on-state current density of 1,135 microamps per micrometre on monolayer MoS2; these two values are, to the best of our knowledge, the lowest and highest yet recorded, respectively. We also demonstrate that excellent ohmic contacts can be formed on various monolayer semiconductors, including MoS2, WS2 and WSe2. Our reported contact resistances are a substantial improvement for two-dimensional semiconductors, and approach the quantum limit. This technology unveils the potential of high-performance monolayer transistors that are on par with state-of-the-art three-dimensional semiconductors, enabling further device downscaling and extending Moore's law.
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Strain engineering is a powerful tool with which to enhance semiconductor device performance1,2. Halide perovskites have shown great promise in device applications owing to their remarkable electronic and optoelectronic properties3-5. Although applying strain to halide perovskites has been frequently attempted, including using hydrostatic pressurization6-8, electrostriction9, annealing10-12, van der Waals force13, thermal expansion mismatch14, and heat-induced substrate phase transition15, the controllable and device-compatible strain engineering of halide perovskites by chemical epitaxy remains a challenge, owing to the absence of suitable lattice-mismatched epitaxial substrates. Here we report the strained epitaxial growth of halide perovskite single-crystal thin films on lattice-mismatched halide perovskite substrates. We investigated strain engineering of α-formamidinium lead iodide (α-FAPbI3) using both experimental techniques and theoretical calculations. By tailoring the substrate composition-and therefore its lattice parameter-a compressive strain as high as 2.4 per cent is applied to the epitaxial α-FAPbI3 thin film. We demonstrate that this strain effectively changes the crystal structure, reduces the bandgap and increases the hole mobility of α-FAPbI3. Strained epitaxy is also shown to have a substantial stabilization effect on the α-FAPbI3 phase owing to the synergistic effects of epitaxial stabilization and strain neutralization. As an example, strain engineering is applied to enhance the performance of an α-FAPbI3-based photodetector.
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The lack of systematic approaches and analyses to identify, quantify, and manage the biotic transport of microplastics (MPs) along cross-ecosystem landscapes prevents the current goals of sustainable environmental development from being met. This Perspective proposes a meta-ecosystem framework, which considers organismal and resource flows among ecosystems to shed light on the research and management challenges related to both abiotic and biotic MP transport at landscape levels. We discuss MP transport pathways through species movements and trophic transfers among ecosystems and sub-ecosystems, and highlight these pathways in the mitigation of MP pollution. The integration of biotic pathways across landscapes prioritizes management actions for MP transport using diverse approaches such as wastewater treatment and plastic removal policies to mitigate contamination. In addition, our framework emphasizes the potential sink enhancement of MPs through habitat conservation and enhancement of riparian vegetation. By considering the mechanisms of meta-ecosystem dynamics through the processes of biotic dispersal, accumulation, and the ultimate fate of MPs, advances in the environmental impact assessment and management of MP production can proceed more effectively.
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Ecossistema , Microplásticos , Monitoramento Ambiental , PlásticosRESUMO
This work uses density functional theory (DFT) calculations and kinetic Monte Carlo (kMC) simulations to compare the diffusion of S-vacancies on defective MoS2 and WS2, two structures that are often discussed as catalysts. Similar to what has been discussed for MoS2, the vacancy diffusion barriers on WS2 also follow Brønsted-Evans-Polanyi (BEP) type linear scaling relations. The vacancy diffusion kinetics is discussed at the example of a large vacancy cluster consisting of 37 unoccupied sites in direct vicinity and how its structure changes with time. Using barriers estimated via linear scaling relations as input for the kMC simulations yields results that qualitatively agree with results calculated self-consistently at DFT level. As the diffusion barriers for WS2 are significantly higher than those for MoS2, the vacancy diffusion on WS2 is poorly described by the linear scaling relations derived from MoS2 and vice versa. This work further shows that one needs DFT level barriers of about 40% of all S-vacancy diffusion processes on a material to derive sufficiently reliable linear scaling relations. This means that computational costs for future studies may be reduced by only explicitly computing one fraction of the diffusion barriers while estimating the remaining ones via linear scaling. However, in this case, one would lack information about the partition function of the transition states, which are needed for calculating the rate constants. Thus, we have also proposed a scheme to estimate the contribution of the partition functions based only on the initial state's vibrational modes.
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OBJECTIVES: Pharmacological and non-pharmacological interventions are mostly designed for patients with early Alzheimer's disease (AD) dementia. Long-term case management and planning for the remainder of life with disability require an estimation of the survival duration. METHODS: This cohort study utilized data from the National Health Insurance Research Database, Taiwan, to identify incident cases of mild-to-moderate AD dementia diagnosed from 2000 to 2002, followed through December 31, 2017. A multivariate Cox proportional hazards regression model was constructed to compare the independent effects of age, sex, and comorbidities on all-cause mortality risk. Cumulative survival rates and survival times were estimated. RESULTS: A total of 5258 incident cases were identified, all treated with cholinesterase inhibitors after diagnosis confirmation by an expert committee. During the 15-year follow-up period, 4331 deaths occurred. The 1-, 3-, 5-, 10-, and 15-year cumulative survival rates were 95, 92, 67, 37, and 18, respectively. The median (95% CI) survival time after diagnosis was 7.69 (7.46-7.90) years overall, 6.37 (6.06-6.65) years in men, and 8.81 (8.49-9.12) years in women. After stratification by age and number of comorbidities, the median survival time ranged from 13.72 (ages 40-64) to 5.29 (ages ≥ 80) years among those without comorbidities. For those with ≥ 3 comorbidities, the median survival times decreased to 6.43 for individuals diagnosed at ages 40-64 and to 2.98 years for those diagnosed at age 80 or older. CONCLUSIONS: This nationwide, large, long-term cohort study provided survival rates and durations from diagnosis to death, varying by sex, age group, and presence/number of comorbidities. This information can serve as a foundation for further cost-effectiveness studies on new treatments, and may aid clinicians, patients, and families in shared decision-making and advance personalized care planning for early dementia cases.
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Doença de Alzheimer , Modelos de Riscos Proporcionais , Humanos , Masculino , Feminino , Doença de Alzheimer/mortalidade , Doença de Alzheimer/diagnóstico , Taiwan/epidemiologia , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Estudos de Coortes , Taxa de Sobrevida , Comorbidade , Inibidores da Colinesterase/uso terapêutico , Bases de Dados FactuaisRESUMO
Blood-based biomarkers (BBM) are potentially powerful tools that assist in the biological diagnosis of Alzheimer's disease (AD) in vivo with minimal invasiveness, relatively low cost, and good accessibility. This review summarizes current evidence for using BBMs in AD, focusing on amyloid, tau, and biomarkers for neurodegeneration. Blood-based phosphorylated tau and the Aß42/Aß40 ratio showed consistent concordance with brain pathology measured by CSF or PET in the research setting. In addition, glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) are neurodegenerative biomarkers that show the potential to assist in the differential diagnosis of AD. Other pathology-specific biomarkers, such as α-synuclein and TAR DNA-binding protein 43 (TDP-43), can potentially detect AD concurrent pathology. Based on current evidence, the working group from the Taiwan Dementia Society (TDS) achieved consensus recommendations on the appropriate use of BBMs for AD in clinical practice. BBMs may assist clinical diagnosis and prognosis in AD subjects with cognitive symptoms; however, the results should be interpreted by dementia specialists and combining biochemical, neuropsychological, and neuroimaging information. Further studies are needed to evaluate BBMs' real-world performance and potential impact on clinical decision-making.
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Wafer-scale monolayer two-dimensional (2D) materials have been realized by epitaxial chemical vapor deposition (CVD) in recent years. To scale up the synthesis of 2D materials, a systematic analysis of how the growth dynamics depend on the growth parameters is essential to unravel its mechanisms. However, the studies of CVD-grown 2D materials mostly adopted the control variate method and considered each parameter as an independent variable, which is not comprehensive for 2D materials growth optimization. Herein, we synthesized a representative 2D material, monolayer hexagonal boron nitride (hBN), on single-crystalline Cu (111) by epitaxial chemical vapor deposition and varied the growth parameters to regulate the hBN domain sizes. Furthermore, we explored the correlation between two growth parameters and provided the growth windows for large flake sizes by the Gaussian process. This new analysis approach based on machine learning provides a more comprehensive understanding of the growth mechanism for 2D materials.
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INTRODUCTION: Clinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown. METHODS: We included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier. RESULTS: Both semantic variant (sv) PPA and logopenic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices. DISCUSSION: This study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers. HIGHLIGHTS: Noun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and logopenic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices. In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA. Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages.
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Afasia Primária Progressiva , Humanos , Afasia Primária Progressiva/diagnóstico , Idioma , Substância Cinzenta , Córtex CerebralRESUMO
Background: The scarcity of medical resources and personnel has worsened due to COVID-19. Telemedicine faces challenges in assessing wounds without physical examination. Evaluating pressure injuries is time consuming, energy intensive, and inconsistent. Most of today's telemedicine platforms utilize graphical user interfaces with complex operational procedures and limited channels for information dissemination. The study aims to establish a smart telemedicine diagnosis system based on YOLOv7 and large language model. Methods: The YOLOv7 model is trained using a clinical data set, with data augmentation techniques employed to enhance the data set to identify six types of pressure injury images. The established system features a front-end interface that includes responsive web design and a chatbot with ChatGPT, and it is integrated with a database for personal information management. Results: This research provides a practical pressure injury staging classification model with an average F1 score of 0.9238. The system remotely provides real-time accurate diagnoses and prescriptions, guiding patients to seek various medical help levels based on symptom severity. Conclusions: This study establishes a smart telemedicine auxiliary diagnosis system based on the YOLOv7 model, which possesses capabilities for classification and real-time detection. During teleconsultations, it provides immediate and accurate diagnostic information and prescription recommendations and seeks various medical assistance based on the severity of symptoms. Through the setup of a chatbot with ChatGPT, different users can quickly achieve their respective objectives.
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COVID-19 , Úlcera por Pressão , Telemedicina , Humanos , Úlcera por Pressão/diagnóstico , COVID-19/diagnóstico , SARS-CoV-2RESUMO
Global ecosystems are facing anthropogenic threats that affect their ecological functions and biodiversity. However, we still lack an understanding of how biodiversity can mediate the responses of ecosystems or communities to human disturbance across spatial gradients. Here, we examined how existing, spatial patterns of biodiversity influence the ecological effects of small hydropower plants (SHPs) on macroinvertebrates in river ecosystems. This study found that levels of biodiversity (e.g., number of species) can influence the degrees of its alterations by SHPs occurring along elevational gradients. The results of the study reveal that the construction of SHPs has various effects on biodiversity. For example, low-altitude areas with low biodiversity (species richness less than 12) showed a small increase in biodiversity compared to high-altitude areas (species richness more than 12) under SHP disturbances. The increases in the effective habitat area of the river segment could be a driver of the enhanced biodiversity in response to SHP effects. Changes in the numerically dominant species contributed to the overall level of community variation from disturbances. Location-specific strategies may mitigate the effects of SHPs and perhaps other disturbances.
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Ecossistema , Rios , Humanos , Biodiversidade , AltitudeRESUMO
Surveys often add reverse-coded questions to monitor respondents with insufficient effort responses (IERs) but often wrongly assume that all respondents consistently answer all questions with full effort. By contrast, this study expanded the mixture model for IERs and ran a simulation via LatentGOLD to show the harmful consequences of ignoring IERs to positively and negatively worded questions: less test reliability, bias and less accuracy in slope and intercept parameters. We showed its practical application to two public data sets: Machiavellianism (five-point scale) and self-reported depression (four-point scale).
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Reprodutibilidade dos Testes , Humanos , Inquéritos e Questionários , Autorrelato , ViésRESUMO
The bacterial communities that colonize the cadaver environment of insects infected and killed by parasitic fungi can be selected by the sympatric fungi and provide novel impacts. In this study, we found that Bacillus cereus/thuringiensis predominate the bacterial community in Dolichoderus thoracicus ant cadavers colonized by O. pseudolloydii. The most predominant bacterial strains in these ant cadavers were hemolytic and able to produce hydrolytic enzymes for digesting the ant tissue. A relatively intense lethal effect on the co-cultured nematode was displayed by a hemolytic strain. Moreover, the antagonistic effect against pathogenic fungi detected in the bacteria sympatric with O. pseudolloydii was reported here. Naphthoquinones have been shown to confer antibacterial activities and produced by the ant-pathogenic Ophiocordyceps fungi. However, our results did not show the naphthoquinone tolerance we expected to be detected in the bacteria from the ant infected by O. pseudolloydii. The bacterial diversity in the samples associated with O. pseudolloydii infected ants as revealed in this study will be a step forward to the understanding of the roles playing by the microbial community in the native habitats of O. pseudolloydii.
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Formigas , Bacillus thuringiensis , Bacillus , Animais , Formigas/microbiologia , InsetosRESUMO
OBJECTIVE: To investigate the association between Alzheimer's disease (AD) and periodontitis in the aspects of periodontal status, serological markers, and oral microbiome. MATERIALS AND METHODS: Twenty AD and 20 healthy subjects were enrolled in this age- and gender-matched case-control study. Clinical periodontal parameters and serum biomarkers, including amyloid ß42 (Aß42 ), Tau, phosphorylated Tau (pTau), triglyceride, pro-inflammatory cytokines, and anti-Porphyromonas gingivalis lipopolysaccharide (LPS) antibody were examined. The saliva samples were analyzed for oral microbiome composition. RESULTS: Alzheimer's disease patients with Clinical Dementia Rating (CDR) ≥1 exhibited significantly more clinical attachment loss (CAL) than those with lower CDR. The levels of serum Tau protein, hsCRP and anti-P. gingivalis LPS antibody were markedly elevated in the AD group compared with the control group. Serum pTau protein level was positively correlated with anti-P. gingivalis LPS antibody titer. Moreover, the increased abundances of Capnocytophaga sp ora clone DZ074, Eubacterium infirmum, Prevotella buccae, and Selenomonas artemidis were detected in the AD group. Interestingly, serum levels of Aß42, pTau, and anti-P. gingivalis LPS antibody were strongly related to the gene upregulation in human pathogen septicemia. CONCLUSIONS: Our study suggested the association of periodontal infection and oral microbiome with AD. Further large-scale studies with longitudinal follow-up are warranted.
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Doença de Alzheimer , Periodontite , Humanos , Peptídeos beta-Amiloides , Estudos de Casos e Controles , Lipopolissacarídeos , Periodontite/complicações , Periodontite/microbiologiaRESUMO
Grafted tomato (Solanum lycopersicum L.) is widely used to manage soil-borne diseases (Lee et.al 2010). In Taiwan, grafting on eggplant (S. melongena L.) rootstock have been extensively used to reduce bacterial wilt in tomato production. In July 2019, wilting plants were found at a cherry tomato farm (~ 0.5 ha) located at Miaoli County. About 10% tomatoes of cv. 'Mint Shine' grafted onto the eggplant rootstock displayed wilt symptoms. Numerous leaflets with chlorosis, inter-vein yellowing, V-shaped necrotic lesions and withered leaves were observed on the affected plants. Some plants eventually wilted and died. A cut at the grafting site revealed the vascular discolorations on both scion (tomato) and rootstock (eggplant). A fungus with a compact whitish colony was consistently isolated from the symptomatic vascular tissue by using acidified potato dextrose agar (PDA) plates. Two isolates, Ve2 from eggplant and Ve4 from tomato, grown on PDA plates were characterized. Both Ve2 and Ve4 grow slowly (ca. 2.6 mm/day at 28 oC) and shared almost identical cultural and morphological characteristics. They first showed whitish mycelium and cream color in reverse within 1 week. Later, numerous microsclerotia developed evenly over the colony and the reverse color turned dark black. Microscopic observations revealed hyaline hyphae with black, elongated, irregularly spherical microsclerotia measuring 31.3 to 71.5 × 16.8 to 49.0 µm (average 50.4 × 28.5 µm) on a 3-week-old PDA culture. Abundant hyaline, single-celled, ellipsoida conidia measuring 2.7 to 4.7 × 0.9 to 3.2 µm (average 3.7 × 1.9 µm) and verticillate conidiophores were observed. The fungus was identified as Verticilium dahliae based on the consistent morphological characteristics (Hawksworth et. al 1970). To confirm the identity, the internal transcribed spacer regions of ribosomal DNA, amplified by PCR with universal primers ITS4/ITS5 (White et.al 1990), were sequenced. Both strains shared the same sequences (GenBank MZ734460; MZ736637), and BLASTn searching was 100% identical to many records of V. dahliae including an ex-epitype CBS130341. Pathogenicity was tested on 3-week-old seedlings of tomato cv. 'Bonny best' and eggplant cv. 'Longship' by a root dip method (Bhat & Subbarao 2007). Eighteen plants arranged into three replications were inoculated for each host-isolate combination, and incubated in the greenhouse at 25±3â. The pathogenicity test was repeated two times, with the result that both isolates were pathogenic to tomato and eggplant. Both isolates induced wilt symptoms in all inoculated plants within 14 days post-inoculation (DPI). Severe leaf drop, wilting and vascular discoloration in all inoculated eggplant whereas slight yellowing and mildly stunt growth in tomato were observed at 21 DPI. Koch's postulates were fulfilled by re-isolating the same fungus from both infected tomato and eggplant. All uninoculated plants remained health and no V. dahliae was isolated from them. To our knowledge, this is the first report of V. dahliae and Verticilium wilt of grafted tomato caused by this pathogen in Taiwan. This pathogen affects over 400 plant species and has resulted in significant economic losses in many regions of world (Subbarao 2020). It is important to investigate the distribution and extent of damage caused by this emerging pathogen on Solanaceous or other crops.
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BACKGROUND: Face-to-face class suspensions during the coronavirus disease (COVID-19) pandemic in 2019 increased telepractice in speech and language therapy. However, little is known about speech and language therapists' (SLTs) perceived effectiveness of telepractice and its antecedents. AIMS: To examine the use of telepractice and the factors affecting its perceived effectiveness in Hong Kong mainstream schools during COVID-19. METHODS & PROCEDURES: Seventy-two school-based Hong Kong SLTs completed a 110-item online survey with six structural components: (1) concerns, (2) adoption, (3) student selection criteria, (4) perceived effectiveness, (5) continuous professional development and (6) attitudes/beliefs. OUTCOMES & RESULTS: Over 90% of respondents adopted telepractice during the pandemic. Confirmatory factor analysis identified reliable constructs from their component measures. These participants reported great telepractice difficulties (especially in therapy preparation and managing students' attention and/or communication). Mixed-response analysis revealed that psychosocial factors (i.e., students' engagement and SLTs' attitudes towards telepractice) but not professional practice skill factors (i.e., student client selection criteria and SLTs' years of experience in school settings) contributed to SLTs' self-perceived effectiveness of telepractice. CONCLUSIONS & IMPLICATIONS: Our findings suggest that psychosocial factors play a more important role than professional practice skill factors in the self-perceived effectiveness of telepractice. WHAT THIS PAPER ADDS: What is already known on the subject Previous surveys reported that although SLTs were interested in using telepractice before the COVID-19 pandemic, they showed concern about its effectiveness, resulting in a low adoption rate. One critical question naturally arises: What factors may affect the perceived effectiveness of telepractice by SLTs? What this paper adds to existing knowledge This study demonstrates for the first time that despite the high adoption rate of telepractice during the COVID-19 pandemic, school-based SLTs exhibited great difficulties, and the SLTs' self-perceived effectiveness of telepractice was related to psychosocial factors instead of professional practice skill factors. What are the potential or actual clinical implications of this work Professional support is needed to alter the attitudes of SLTs towards telepractice for enhancing their self-perceived effectiveness and positive clinical practice experience.
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COVID-19 , Terapia da Linguagem , Humanos , Terapia da Linguagem/métodos , Pandemias , Fala , Fonoterapia/métodosRESUMO
Studies of how positive and negative coping styles affect social anxiety show mixed results. Hence, our two meta-analyses determined the overall effect sizes of problem solving-focused coping (PSC) styles and emotion-focused coping (EFC) styles on social anxiety in mainland China (PSC: k = 49 studies, N = 34,669; EFC: k = 52, N = 36,531). PSC was negatively linked to social anxiety (- .198), and EFC was positively linked to social anxiety (.223). In years with more national income, PSC's and EFC's effect sizes were larger. PSC's effect sizes were smaller among rural students (vs. urban students), larger among older students (university, high school, middle school), and larger in cross-sectional (vs. longitudinal) studies. When using SAD (vs. others) social anxiety measures, PSC effect sizes were larger, but EFC effect sizes were smaller. EFC effect sizes were larger in studies with convenience (vs. representative) samples. Gender, single child status, and coping style measurement showed no moderation effects. These findings suggest that using problem solving-focused coping styles rather than emotion-focused may reduce social anxiety, so future experimental studies can test this idea more rigorously.
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OBJECTIVES: Patients with terminal cancer often experience physical and mental distress. Signing a do-not-resuscitate order (DNR) is crucial to protect against invalid treatment. This study aims to explore the effect of hospice shared care intervention by medical staff on the completion of a DNR-S (DNR order signed by surrogates) for patients with terminal cancer. METHOD: The cross-sectional study in this research involved secondary analysis of data from the 2011-2015 clinical cancer case management database of a medical center in central Taiwan. Those with a DNR order signed by patients (DNR-P) or DNR-S before the hospice shared care consultation were excluded from this study; a total of 1,306 patients with terminal cancer were selected. RESULTS: This study demonstrated that the percentage of DNR-S after consultation involving both nurse and physician was 75.4%. With other variables controlled, the number of DNR-Ss after consultation with a nurse was significantly lower [odds ratio (OR) = 0.57, 95% confidence interval (CI) = 0.42-0.75] and that of DNR-Ss after consultation involving both nurse and physician was significantly higher (OR = 1.35, 95% CI = 1.01-1.79), than that of DNR-Ss after consultation with only the physician. SIGNIFICANCE OF RESULTS: Joint involvement of the nurse and physician in hospice care provides sufficient information to patients and family with terminal cancer about their condition and enhances doctor-patient communication. This effectively assists patients with terminal cancer and their family members in making the major decision of signing a DNR, alleviates the concerns of patients and family members about signing a DNR, and reduces terminal cancer patients' pain at the end of life to ensure that they die in peace and dignity.
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Cuidados Paliativos na Terminalidade da Vida , Hospitais para Doentes Terminais , Neoplasias , Médicos , Assistência Terminal , Humanos , Ordens quanto à Conduta (Ética Médica) , Estudos Transversais , Neoplasias/complicações , Neoplasias/terapia , Morte , Estudos RetrospectivosRESUMO
IMPORTANCE: Limited evidence exists to support cognitive intervention improving the daily function of adults with subjective cognitive decline (SCD). OBJECTIVE: To examine the preliminary efficacy of a group-based multicomponent cognitive intervention that integrates Lifestyle Redesign® (LR) techniques. DESIGN: Single-arm two-period crossover trial; 16-wk waiting period, 16-wk intervention, and 16-wk follow-up. SETTING: Memory clinic in a medical center, Taiwan. PARTICIPANTS: Purposive sample of adults ages >55 yr with SCD. INTERVENTION: Sixteen 1.5-hr weekly multicomponent sessions of cognitive training, cognitive rehabilitation, psychological intervention, and lifestyle intervention. OUTCOMES AND MEASURES: Primary outcomes were (1) self-reported daily function, measured with the Activities of Daily Living Questionnaire (ADLQ) and Cognitive Failure Questionnaire; (2) performance-based daily function, measured with the Brief University of California San Diego Performance-Based Skills Assessment-Traditional Chinese Version; and (3) functional cognition, measured with the Contextual Memory Test (CMT) and Miami Prospective Memory Test. Secondary outcomes included cognitive functions, anxiety, and depression. RESULTS: Seventeen participants completed the intervention; 4 missed the follow-up. The generalized estimating equations model showed significant changes from baseline to pretest (control) and pretest to posttest (intervention) on the ADLQ (p = .014) and CMT-delayed (p = .003). Effects remained at the 16-wk follow-up. After adjusting for the effects of covariates, the self-reported daily function of participants ages ≤ 63 yr improved more than that of other participants (p = .003). CONCLUSIONS AND RELEVANCE: Multicomponent cognitive interventions integrating LR techniques may improve self-reported daily function and context-dependent memory function of adults with SCD, with efficacy sustained at follow-up. What This Article Adds: A group-based multicomponent cognitive intervention consisting of cognitive training, cognitive rehabilitation, psychoeducation, and lifestyle intervention may provide benefits for the daily function and cognitive function of adults with SCD.
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Atividades Cotidianas , Cognição , Disfunção Cognitiva , Humanos , Ansiedade , Disfunção Cognitiva/terapia , Autorrelato , Estudos Cross-Over , Taiwan , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Aggression is an evolutionarily conserved behavior critical for animal survival. In the fish Betta splendens, across different stages of fighting interactions, fighting opponents suffer from various stressors, especially from the great demand for oxygen. Using RNA sequencing, we profiled differential alternative splicing (DAS) events in the brains of fish collected before fighting, during fighting, and after fighting to study the involvement of alternative splicing (AS) in the response to stress during the fight. RESULTS: We found that fighting interactions induced the greatest increase in AS in the 'during-fighting' fish, followed by that of the 'after-fighting' fish. Intron retention (IR) was the most enriched type among all the basic AS events. DAS genes were mainly associated with synapse assembly, ion transport, and regulation of protein secretion. We further observed that IR events significantly differentiated between winners and losers for 19 genes, which were associated with messenger RNA biogenesis, DNA repair, and transcription machinery. These genes share many common features, including shorter intron length and higher GC content. CONCLUSIONS: This study is the first comprehensive view of AS induced by fighting interactions in a fish species across different stages of those interactions, especially with respect to IR events in winners and losers. Together, these findings facilitate future investigations into transcriptome complexity and AS regulation in response to stress under the context of aggression in vertebrates.
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Processamento Alternativo , Peixes , Animais , Composição de Bases , Peixes/genética , Análise de Sequência de RNA , TranscriptomaRESUMO
BACKGROUND: Screening or diagnosis for the elderly with dementia in rural regions might be delayed and underestimated due to limited utilization of healthcare resources. This study aimed to evaluate the disparities of prevalence and risk factors of mild cognitive impairment (MCI) and dementia between urban and rural residence. METHODS: In this nationwide door-to-door survey, 10,432 participants aged 65 years and more were selected through computerized random sampling from all administrative districts in Taiwan and were assessed using an in-person interview. We calculated the prevalence of MCI and dementia, with their risk factors examined using multivariable logistic regression. RESULTS: The prevalence of dementia in rural, suburban, and urban areas among the elderly was 8.69% (95% CI, 8.68-8.69), 6.63% (95% CI, 6.62-6.63), and 4.46% (95% CI, 4.46-4.47), respectively. A similar rural-suburban-urban gradient relationship on the dementia prevalence was observed in any age and sex group. The rural:urban ratio was higher in women than in men for both MCI and dementia. Urbanization remained to be an independent factor for both MCI and dementia after adjustment for age, gender, education, lifestyle, and health status. The beneficial effects of exercise on dementia were more evident in rural areas than in urban ones. CONCLUSION: Significantly higher prevalence of MCI and dementia were found in rural areas than in urban ones, especially for women. The odds of risk factors for MCI and dementia varied by urbanization status. Focus on the rural-urban inequality and the modification of associated factors specifically for different urbanization levels are needed.