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Most current climate models predict that the equatorial Pacific will evolve under greenhouse gas-induced warming to a more El Niño-like state over the next several decades, with a reduced zonal sea surface temperature gradient and weakened atmospheric Walker circulation. Yet, observations over the last 50 y show the opposite trend, toward a more La Niña-like state. Recent research provides evidence that the discrepancy cannot be dismissed as due to internal variability but rather that the models are incorrectly simulating the equatorial Pacific response to greenhouse gas warming. This implies that projections of regional tropical cyclone activity may be incorrect as well, perhaps even in the direction of change, in ways that can be understood by analogy to historical El Niño and La Niña events: North Pacific tropical cyclone projections will be too active, North Atlantic ones not active enough, for example. Other perils, including severe convective storms and droughts, will also be projected erroneously. While it can be argued that these errors are transient, such that the models' responses to greenhouse gases may be correct in equilibrium, the transient response is relevant for climate adaptation in the next several decades. Given the urgency of understanding regional patterns of climate risk in the near term, it would be desirable to develop projections that represent a broader range of possible future tropical Pacific warming scenarios-including some in which recent historical trends continue-even if such projections cannot currently be produced using existing coupled earth system models.
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Salmonella infections are a serious global health concern, particularly in developing countries, and are further exacerbated by the emergence of antibiotic resistance. San-Huang-Xie-Xin-Tang (SHXXT), a traditional herbal medicine with potent anti-inflammatory properties, has recently gained attention as an alternative treatment. Our study emphasizes on the importance of precise timing in accordance with traditional Chinese medicine principles. A mouse infection model was established while different administration times of SHXXT were recorded for the body weight, clinical scores, bacterial counts in blood, and organs. Additionally, cytokine levels, fatty acids, and amino acids in the serum were also monitored. We found that administering SHXXT 1 day after Salmonella enterica subsp. enterica serovar Typhimurium (S. Typhimurium) infection (T1 group) leads to positive outcomes. This includes restoration of body weight, improved clinical scores, and reduced bacterial counts in blood and vital organs. Interferon-gamma levels remained consistently high across all treatment groups 6 days post-infection. However, the T1 group showed exclusive suppression of serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1ß). The timing of administration significantly influenced serum fatty acid concentrations, countering Salmonella-induced disruptions, aligning with TNF-α and IL-1ß levels. SHXXT had also restored amino acid profiles disrupted by the infection, with notable effects when administered at the correct timing. Our research highlights SHXXT's potential in treating S. Typhimurium infection, emphasizing the importance of precise timing in line with traditional Chinese medicine principles for effective treatment at different disease stages.
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Medicamentos de Ervas Chinesas , Salmonella typhimurium , Animais , Salmonella typhimurium/efeitos dos fármacos , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/farmacologia , Camundongos , Infecções por Salmonella/tratamento farmacológico , Infecções por Salmonella/microbiologia , Citocinas/sangue , Citocinas/metabolismo , Feminino , Masculino , Camundongos Endogâmicos BALB CRESUMO
BACKGROUND: Full-thickness macular hole (FTMH) is a rare complication in retinitis pigmentosa (RP) patients and may increase intraoperative challenges. Furthermore, lens capsular flap transplantation and inverted internal limiting membrane (ILM) flap were reported to close complicated FTMH successfully. Here, we present a case of bilateral advanced RP complicated by a FTMH treated with a novel lens capsular flap transplantation and inverted internal limiting membrane flap. CASE PRESENTATION: A 46-year-old presented to our hospital with a complaint of progressively blurred vision and metamorphopsia in both eyes. Spectral-domain optical coherence tomography revealed a FTMH with retinoschisis in the right eye and another FTMH in the left eye. ILM peeling with inverted ILM flap technique was performed on the right eye and ILM peeling with anterior lens capsular flap technique was performed on the left eye. Post-operative follow-up showed successful closure of the FTMH and improved vision in both eyes. CONCLUSIONS: In our present case, flap-assisted techniques for retinitis pigmentosa with macular hole result in excellent visual and anatomic outcomes.
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Perfurações Retinianas , Retinose Pigmentar , Membrana Basal , Humanos , Pessoa de Meia-Idade , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Perfurações Retinianas/cirurgia , Retinose Pigmentar/complicações , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual , VitrectomiaRESUMO
Studies conducted in developed nations have shown that increase in life expectancy has brought with it a rise in the incidence and treatment of degenerative aortic and mitral heart valve diseases. Current standards recommend valve replacement among even some asymptomatic patients. In this research, we examine the epidemiology of valvular heart disease and rate of valve replacement in Taiwan, where life expectancy now stands at 80.69 years. Patients were enrolled based on claims from a widely used national database and categorized into cohorts defined by type of valve disease and, further, by valve replacements and type of valve (mechanical, porcine, or bovine). Data, including disease type, age, and gender, were analyzed to determine annual and cumulative incidence rates and prosthetic usage from 2000 to 2017. Results showed that across the cohorts, the cumulative incidence rate in 2017 was 3.59%, and in the aortic valve cohort, the percentage of surgical valve replacement for those ≥60 years was 6.99%. Compared with other developed nations, this demonstrates that incidence rates are slightly higher, yet surgical replacements are less than half that of other developed nations. This under-treatment of patients with valvular heart disease presents an important public health challenge in Taiwan.
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Valva Aórtica/cirurgia , Doenças das Valvas Cardíacas/epidemiologia , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Valva Mitral/cirurgia , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/patologia , Bioprótese/estatística & dados numéricos , Bioprótese/tendências , Estudos de Coortes , Bases de Dados Factuais , Feminino , Próteses Valvulares Cardíacas/estatística & dados numéricos , Humanos , Incidência , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Valva Mitral/patologia , Saúde Pública/legislação & jurisprudência , Estudos Retrospectivos , Taiwan/epidemiologiaRESUMO
Mismatch negativity (MMN) is an event-related potential component used to index automatic auditory change detection. Thus, MMN provides an excellent tool to assess the speech sensitivity of infants and children. Although MMN is well established in adults, the polarity and latency of mismatch responses (MMRs) in infants are highly inconsistent across studies. This paper aims to provide a comprehensive review of MMN studies of speech perception in early infancy. In particular, data from a series of MMN studies of Mandarin lexical tone, vowels, and initial consonants will be presented to demonstrate how phonological saliency, size of deviance, and neural maturation modulate MMRs in early infancy. These data suggest that MMN and positive MMRs index different functional characteristics and may provide information on when and how children's speech perception becomes automatic at different developmental stages. By using MMN to index sensitivity to speech discrimination, dyslexic children usually show reduced or absent MMN, which supports the relationship between phonological sensitivity and literacy. However, children with attention deficit/hyperactivity disorder showed the typical MMN, but attenuated P3a and enhanced late discriminative negativity. Taken together, the MMR characteristics, including amplitude, peak latency, and the transition of polarity, may be used to index the maturation of speech development and for the early identification of children with atypical language development.
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Potenciais Evocados Auditivos , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Pré-Escolar , Eletroencefalografia , Humanos , Lactente , Desenvolvimento da Linguagem , Alfabetização , Fonética , Percepção da Altura Sonora/fisiologia , Percepção da Fala/fisiologiaRESUMO
Tetraspanins play important roles in normal (e.g. cell adhesion, motility, activation, and proliferation) and pathological conditions (e.g. metastasis and viral infection). Tetraspanins interact with integrins and regulate integrin functions, but the specifics of tetraspanin-integrin interactions are unclear. Using co-immunoprecipitation with integrins as a sole method to detect interaction between integrins and full-length tetraspanins, it has been proposed that the variable region (helices D and E) of the extracellular-2 (EC2) domain of tetraspanins laterally associates with a non-ligand-binding site of integrins. We describe that, using adhesion assays, the EC2 domain of CD81, CD9, and CD151 bound to integrin αvß3, and this binding was suppressed by cRGDfV, a specific inhibitor of αvß3, and antibody 7E3, which is mapped to the ligand-binding site of ß3. We also present evidence that the specificity loop of ß3 directly bound to the EC2 domains. This suggests that the EC2 domains specifically bind to the classical ligand-binding site of αvß3. αvß3 was a more effective receptor for the EC2 domains than the previously known tetraspanin receptors α3ß1, α4ß1, and α6ß1. Docking simulation predicted that the helices A and B of CD81 EC2 bind to the RGD-binding site of αvß3. Substituting Lys residues at positions 116 and 144/148 of CD81 EC2 in the predicted integrin-binding interface reduced the binding of CD81 EC2 to αvß3, consistent with the docking model. These findings suggest that, in contrast with previous models, the ligand-binding site of integrin αvß3, a new tetraspanin receptor, binds to the constant region (helices A and B) of the EC2 domain.
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Integrina alfaVbeta3/química , Tetraspanina 24/química , Tetraspanina 28/química , Tetraspanina 29/química , Sequência de Aminoácidos , Animais , Anticorpos Monoclonais/química , Sítios de Ligação , Células CHO , Clonagem Molecular , Cricetulus , Escherichia coli/genética , Escherichia coli/metabolismo , Expressão Gênica , Integrina alfaVbeta3/genética , Integrina alfaVbeta3/imunologia , Cinética , Simulação de Acoplamento Molecular , Ligação Proteica , Conformação Proteica em alfa-Hélice , Conformação Proteica em Folha beta , Domínios e Motivos de Interação entre Proteínas , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Tetraspanina 24/genética , Tetraspanina 24/imunologia , Tetraspanina 28/genética , Tetraspanina 28/imunologia , Tetraspanina 29/genética , Tetraspanina 29/imunologiaRESUMO
Words are considered semantically ambiguous if they have more than one meaning and can be used in multiple contexts. A number of recent studies have provided objective ambiguity measures by using a corpus-based approach and have demonstrated ambiguity advantages in both naming and lexical decision tasks. Although the predictive power of objective ambiguity measures has been examined in several alphabetic language systems, the effects in logographic languages remain unclear. Moreover, most ambiguity measures do not explicitly address how the various contexts associated with a given word relate to each other. To explore these issues, we computed the contextual diversity (Adelman, Brown, & Quesada, Psychological Science, 17; 814-823, 2006) and semantic ambiguity (Hoffman, Lambon Ralph, & Rogers, Behavior Research Methods, 45; 718-730, 2013) of traditional Chinese single-character words based on the Academia Sinica Balanced Corpus, where contextual diversity was used to evaluate the present semantic space. We then derived a novel ambiguity measure, namely semantic variability, by computing the distance properties of the distinct clusters grouped by the contexts that contained a given word. We demonstrated that semantic variability was superior to semantic diversity in accounting for the variance in naming response times, suggesting that considering the substructure of the various contexts associated with a given word can provide a relatively fine scale of ambiguity information for a word. All of the context and ambiguity measures for 2,418 Chinese single-character words are provided as supplementary materials.
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Povo Asiático , Semântica , Incerteza , Tomada de Decisões , Humanos , Idioma , Tempo de ReaçãoRESUMO
Using the Chinese writing system, which is unique with respect to the composition of each character in terms of its graphic shape, as an example, this chapter addresses the neurobiological underpinnings of reading and writing and how these brain circuits are used in different languages.
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Encéfalo/fisiologia , Dislexia , Aprendizagem/fisiologia , Psicolinguística , Leitura , Redação , Dislexia/genética , Dislexia/fisiopatologia , HumanosRESUMO
Orthographic neighborhood (N) size effects have been extensively studied in English consistently producing a facilitatory effect in word naming tasks. In contrast, several recent studies on Chinese character naming have demonstrated an inhibitory effect of neighborhood size. Response latencies tend to be inhibited by inconsistent characters with large neighborhoods relative to small neighborhoods. These differences in neighborhood effects between languages may depend on the characteristics (depth) of the mapping between orthography and phonology. To explore this, we first conducted a behavioral experiment to investigate the relationship between neighborhood size, consistency and reading response. The results showed an inhibitory effect of neighborhood size for inconsistent characters but a facilitatory effect for consistent characters. We then developed two computational models based on parallel distributed processing principles to try and capture the nature of the processing that leads to these results in Chinese character naming. Simulations using models based on the triangle model of reading indicated that consistency and neighborhood size interact with the division of labor between semantics and phonology to produce these effects.
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Modelos Psicológicos , Fonética , Leitura , Semântica , Simulação por Computador , Feminino , Humanos , Masculino , Tempo de ReaçãoRESUMO
In this study, we aimed to provide a large-scale set of psycholinguistic norms for 3,314 traditional Chinese characters, along with their naming reaction times (RTs), collected from 140 Chinese speakers. The lexical and semantic variables in the database include frequency, regularity, familiarity, consistency, number of strokes, homophone density, semantic ambiguity rating, phonetic combinability, semantic combinability, and the number of disyllabic compound words formed by a character. Multiple regression analyses were conducted to examine the predictive powers of these variables for the naming RTs. The results demonstrated that these variables could account for a significant portion of variance (55.8%) in the naming RTs. An additional multiple regression analysis was conducted to demonstrate the effects of consistency and character frequency. Overall, the regression results were consistent with the findings of previous studies on Chinese character naming. This database should be useful for research into Chinese language processing, Chinese education, or cross-linguistic comparisons. The database can be accessed via an online inquiry system (http://ball.ling.sinica.edu.tw/namingdatabase/index.html).
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Bases de Dados Factuais , Idioma , Nomes , Redação , Adolescente , Adulto , Feminino , Humanos , Masculino , Fonética , Psicolinguística , Tempo de Reação , Reconhecimento Psicológico , Semântica , Adulto JovemRESUMO
This study demonstrated that semantic transparency as a linguistic property modulates the recognition memory for two-character Chinese words, with opaque words (i.e., words whose meanings cannot be derived from constituent characters-e.g., "[/guang/, light][/gun/, stick]", bachelor) remembered better than transparent words (i.e., words whose meanings can be derived from constituent characters-e.g., "[/cha/, tea][/bei/, cup]", teacup). In Experiment 1, the participants made lexical decisions on transparent words, opaque words, and nonwords in the study and then engaged in an old/new recognition test. Experiment 2 employed a concreteness judgment as the encoding task to ensure equivalent semantic processing for opaque and transparent words. In Experiment 3, the neighborhood size of the two-character words was manipulated together with their semantic transparency. In all three experiments, opaque words were found to be better remembered than transparent words. We concluded that the conceptual incongruence between the meanings of a whole word and its constituent characters made opaque words more distinctive and, hence, better remembered than transparent words.
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Rememoração Mental/fisiologia , Reconhecimento Visual de Modelos/fisiologia , Leitura , Reconhecimento Psicológico/fisiologia , Semântica , Adolescente , Adulto , China , Humanos , Adulto JovemRESUMO
Individuals with autism spectrum disorder (ASD) have difficulties in understanding emotional language, but little research has discussed the developmental course of the processing of emotional words in the clinical population. Previous studies have revealed distinct processing for emotion-label (e.g., happiness) and emotion-laden (e.g., birthday) words in typically developing (TD) children and adolescents. Extending these findings, the study used event-related potentials (ERPs) to explore the processing of these two types of emotional words in children and adolescents with ASD. The stimuli included two-character Chinese words with factors of word type (emotion-label versus emotion-laden) and valence (positive versus negative). The participants were 11 to 14-year-old children and adolescents with ASD (N = 23) and age-matched TD peers (N = 23). They categorized emotion valence for words while their brain responses were recorded. Both the TD and the ASD groups exhibited emotional processing for all emotional words across the N400 and late positivity component (LPC). The emotional processing was modulated by word type but varied with group and valence. A trend for group differences was observed in processing positive words at 500-600 ms. In particular, the emotion effects of positive emotion-label words were positively correlated with social dysfunction across all participants. These findings suggested that children and adolescents with ASD have a selective impairment in understanding emotional concepts from language. The ERP measurements may reflect atypical emotional word processing for individuals with higher autistic severity in positive valence contexts.
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To enhance the cellular uptake of liposomes, we prepared conventional liposomes with targeting molecules and surface-charged liposomes and evaluated their potential as nano-carriers and vaccine adjuvants by comparing their endocytosis efficiencies using immune cells. Surface-charged liposomes were synthesized via a one-step microfluidic method, which provided a novel, simple, fast, and highly reproducible method for preparing liposomes. Flow cytometry revealed that cationic polyelectrolyte-coated liposomes exhibited higher endocytosis efficiencies (of up to a factor of 100) in A774A.1 cells and JAWs II cells compared with uncoated liposomes or those coated with anionic polyelectrolytes. Positively charged liposomes exhibited some cytotoxicity at quaternary-chitosan coating concentrations higher than 6â¯mg/mL; however, significantly lower cytotoxicities (by a factor of almost ten) were obtained by protein mixing. Furthermore, BALB/c mice vaccinated with a mixture of Anthrax vaccine adsorbed (AVA) and quaternary chitosan-coated liposomes showed faster and stronger anti-PA IgG inductions compared to those vaccinated with AVA alone, with titers positively correlating with the amount of cationic liposome used. This finding clearly reveals that quaternary chitosan-coated liposomes act as both nano-carriers and vaccine adjuvants that significantly enhance in-vivo immune responses to vaccines with low immunogenicities.
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Endocitose , Lipossomos , Camundongos Endogâmicos BALB C , Lipossomos/química , Animais , Endocitose/efeitos dos fármacos , Camundongos , Polieletrólitos/química , Quitosana/química , Microfluídica/métodos , FemininoRESUMO
Introduction: Research has shown that speech analysis demonstrates sensitivity in detecting early Alzheimer's disease (AD), but the relation between linguistic features and cognitive tests or biomarkers remains unclear. This study aimed to investigate how linguistic features help identify cognitive impairments in patients in the early stages of AD. Method: This study analyzed connected speech from 80 participants and categorized the participants into early-AD and normal control (NC) groups. The participants underwent amyloid-ß positron emission tomography scans, brain magnetic resonance imaging, and comprehensive neuropsychological testing. Participants' speech data from a picture description task were examined. A total of 15 linguistic features were analyzed to classify groups and predict cognitive performance. Results: We found notable linguistic differences between the early-AD and NC groups in lexical diversity, syntactic complexity, and language disfluency. Using machine learning classifiers (SVM, KNN, and RF), we achieved up to 88% accuracy in distinguishing early-AD patients from normal controls, with mean length of utterance (MLU) and long pauses ratio (LPR) serving as core linguistic indicators. Moreover, the integration of linguistic indicators with biomarkers significantly improved predictive accuracy for AD. Regression analysis also highlighted crucial linguistic features, such as MLU, LPR, Type-to-Token ratio (TTR), and passive construction ratio (PCR), which were sensitive to changes in cognitive function. Conclusion: Findings support the efficacy of linguistic analysis as a screening tool for the early detection of AD and the assessment of subtle cognitive decline. Integrating linguistic features with biomarkers significantly improved diagnostic accuracy.
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Many medical centers in Taiwan have started to provide Traditional Chinese Medicine (TCM) services for hospitalized patients. Due to the complexity of TCM modality and the increasing need for providing TCM services for patients in different wards at distantly separate locations within the hospital, it is getting difficult to manage the situation in the traditional way. A computerized system with mobile ability can therefore provide a practical solution to the challenge presented. The study tries to develop a cloud system equipped with mobile devices to integrate electronic medical records, facilitate communication between medical workers, and improve the quality of TCM services for the hospitalized patients in a medical center. The system developed in the study includes mobile devices carrying Android operation system and a PC as a cloud server. All the devices use the same TCM management system developed by the study. A website of database is set up for information sharing. The cloud system allows users to access and update patients' medical information, which is of great help to medical workers for verifying patients' identification and giving proper treatments to patients. The information then can be wirelessly transmitted between medical personnel through the cloud system. Several quantitative and qualitative evaluation indexes are developed to measure the effectiveness of the cloud system on the quality of the TCM service. The cloud system is tested and verified based on a sample of hospitalized patients receiving the acupuncture treatment at the Lukang Branch of Changhua Christian Hospital (CCH) in Taiwan. The result shows a great improvement in operating efficiency of the TCM service in that a significant saving in labor time can be attributable to the cloud system. In addition, the cloud system makes it easy to confirm patients' identity through taking a picture of the patient upon receiving any medical treatment. The result also shows that the cloud system achieves significant improvement in the acupuncture treatment. All the acupuncture needles now can be removed at the time they are expected to be removed. Furthermore, through the cloud system, medical workers can access and update patients' medical information on-site, which provides a means of effective communication between medical workers. These functions allow us to make the most use of the portability feature of the acupuncture service. The result shows that the contribution made by the cloud system to the TCM service is multi-dimensional: cost-effective, environment-protective, performance-enhancing etc. Developing and implementing such a cloud system for the TCM service in Taiwan symbolizes a pioneering effort. We believe that the work we have done here can serve as a stepping-stone toward advancing the TCM service quality in the future.
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Registros Eletrônicos de Saúde/organização & administração , Administração Hospitalar , Internet , Medicina Tradicional Chinesa , Qualidade da Assistência à Saúde/organização & administração , Terapia por Acupuntura/métodos , Comunicação , Hospitalização , Humanos , Taiwan , Fatores de TempoRESUMO
Most studies on word repetition have demonstrated that repeated stimuli yield reductions in brain activity. Despite the well-known repetition reduction effect, some literature reports repetition enhancements in electroencephalogram (EEG) activities. However, although studies of object and face recognition have consistently demonstrated both repetition reduction and enhancement effects, the results of repetition enhancement effects were not consistent in studies of visual word recognition. Therefore, the present study aimed to further investigate the repetition effect on the P200, an early event-related potential (ERP) component that indexes the coactivation of lexical candidates during visual word recognition. To achieve a high signal-to-noise ratio, EEG signals were decomposed into various modes by using the Hilbert-Huang transform. Results demonstrated a repetition enhancement effect on P200 activity in alpha-band oscillation and that lexicality and orthographic neighborhood size would influence the magnitude of the repetition enhancement effect on P200. These findings suggest that alpha activity during visual word recognition might reflect the coactivation of orthographically similar words in the early stages of lexical processing. Meantime, there were repetition reduction effects on ERP activities in theta-delta band oscillation, which might index that the lateral inhibition between lexical candidates would be omitted in repetition.
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INTRODUCTION: Mitral regurgitation (MR) is characterized by systolic blood flow reversal from the left ventricle to the left atrium. A 2019 study indicated that in the USA, clinically significant MR (sMR) is associated with a substantial healthcare cost burden. In Taiwan, few data are available to describe the clinical characteristics, treatment patterns, and economic burden of patients with sMR. METHODS: Using the National Health Insurance Research Database (NHIRD), a national, detailed claims database of all 23 million residents of Taiwan, we conducted a retrospective cohort study to identify patients with sMR and quantify the impact of the disease on Taiwan's healthcare system. We classified patients with sMR into three cohorts based on disease etiology: functional MR (sFMR), degenerative MR (sDMR), and uncharacterized MR (sUMR). RESULTS: We compared patient characteristics across cohorts and estimated attributable healthcare utilization and costs during the 12-month follow-up period. Our research shows that in Taiwan, patients with sFMR were older, sicker, and presented at casualty (emergency department) more frequently than those with sDMR and sUMR. Meanwhile, patients with sDMR had the highest 12-month healthcare expenditures across the cohorts. CONCLUSION: These findings are inconsistent with what has been shown in the USA, which warrants further investigation.
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Introduction: Speech comprehension involves context-based lexical predictions for efficient semantic integration. This study investigated how noise affects the predictability effect on event-related potentials (ERPs) such as the N400 and late positive component (LPC) in speech comprehension. Methods: Twenty-seven listeners were asked to comprehend sentences in clear and noisy conditions (hereinafter referred to as "clear speech" and "noisy speech," respectively) that ended with a high-or low-predictability word during electroencephalogram (EEG) recordings. Results: The study results regarding clear speech showed the predictability effect on the N400, wherein low-predictability words elicited a larger N400 amplitude than did high-predictability words in the centroparietal and frontocentral regions. Noisy speech showed a reduced and delayed predictability effect on the N400 in the centroparietal regions. Additionally, noisy speech showed a predictability effect on the LPC in the centroparietal regions. Discussion: These findings suggest that listeners achieve comprehension outcomes through different neural mechanisms according to listening conditions. Noisy speech may be comprehended with a second-pass process that possibly functions to recover the phonological form of degraded speech through phonetic reanalysis or repair, thus compensating for decreased predictive efficiency.
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OBJECTIVE: Aortic stenosis (AS) is a heart valve disease characterized by left ventricular outflow fixed obstruction. It can be managed by surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). However, real-world evidence for TAVI or SAVR outcomes is lacking in Taiwan. This study aimed to compare the clinical outcomes of TAVI and SAVR for treating of AS in Taiwan. MATERIALS AND METHODS: The National Health Insurance Research Database is a nationally representative cohort that contains detailed registry and claims data from all 23 million residents of Taiwan. This retrospective cohort study used this database to compare patients who underwent SAVR (bioprosthetic valves) or TAVI from 2017 to 2019. Survival outcomes and length of hospital stay (LOS) and intensive care unit (ICU) stay between TAVI and SAVR in the matched cohort. A Cox proportional hazards model was performed to identify the effect of treatment type on survival rates while controlling variables including age, gender, and comorbidities. RESULTS: We identified 475 and 1605 patients who underwent TAVI and SAVR with a bioprosthetic valve, respectively. Patients who underwent TAVI were older (82.19 vs. 68.75 y/o) and more likely to be female (55.79% vs. 42.31%) compared with patients who underwent SAVR. Propensity score matching (PSM) on age, gender, and Elixhauser Comorbidity Index (ECI) score revealed that 375 patients who underwent TAVI were matched with patients who underwent SAVR. A significant difference was found in survival rates between TAVI and SAVR. The 1-year mortality rate was 11.44% with TAVI and 17.55% with SAVR. Both the mean total LOS (19.86 vs. 28.24 days) and mean ICU stay (6.47 vs. 11.12 days) for patients who underwent TAVI were shorter than those who underwent SAVR. CONCLUSION: Patients who had undergone TAVI had better survival outcomes and shorter LOS compared with patients who had undergone SAVR in Taiwan.
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Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Substituição da Valva Aórtica Transcateter , Humanos , Feminino , Masculino , Valva Aórtica/cirurgia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Estudos de Coortes , Estudos Retrospectivos , Taiwan/epidemiologia , Fatores de Risco , Implante de Prótese de Valva Cardíaca/efeitos adversos , Resultado do TratamentoRESUMO
Prior studies involving adults have shown that words can elicit emotional processing, with emotion-label (e.g., happiness) and emotion-laden words (e.g., gift) having distinct processes. However, limited studies have explored the developmental changes in these processes in relation to emotional valence. To address this question, this exploratory study measured event-related potentials (ERPs) in 11-14-year-old children/adolescents (N = 25) and adults (N = 23) while performing an emotional categorization task. The stimuli used were two-character Chinese words, with factors for word type (emotion-label versus emotion-laden) and valence (positive versus negative). To confirm word emotionality, neutral words were also included and compared with all emotional words. The results showed that adults exhibited reduced N400 amplitudes to emotion-label words compared to emotion-laden ones in both positive and negative valence contexts. The differentiation was only sustained for negative valence in the late positive component (LPC). Similar scalp distributions of the effects of word type were found in children/adolescents; however, they exhibited a more prolonged processing of all emotional words than adults. These results suggest that the processing of emotion-label and emotion-laden words are distinct in late childhood, and this discrepancy varies with emotional valence and increasing age.