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BACKGROUND: There is limited research exploring the changing clinical practices among healthcare providers (HPs) care for patients with Emergency Department (ED)-initiated Medication for Opioid Use Disorder (MOUD). METHODS: This scoping review followed the methodological framework of Arksey and O'Malley to map relevant evidence and synthesize the findings. We searched PubMed, EMBASE, CINAHL, Web of Science, and Scopus for related studies from inception through October 12, 2022. Following the application of inclusion and exclusion criteria, 16 studies were included. Subsequently, they were charted and analyzed thematically based on ecological systems theory. RESULTS: The main determinants in the four ecological systems were generated as follows: (1) microsystem: willingness and attitude, professional competence, readiness, and preference; (2) mesosystem: ED clinical practices, departmental factors; (3) exosystem: multidisciplinary approaches, discharge planning, and (4) macrosystem: stigma, health insurance, policy. The findings have implications for HPs and researchers, as insufficient adoption, implementation, and retention of MOUD in the ED affect clinical practices. CONCLUSIONS: Across the four ecological systems, ED-initiated MOUD is shaped by multifaceted determinants. The microsystem underscores pivotal patient-HP trust dynamics, while the mesosystem emphasizes interdepartmental synergies. Exosystemically, resource allocation and standardized training remain paramount. The macrosystem reveals profound effects of stigma, insurance disparities, and evolving policies on treatment access and efficacy. Addressing these interconnected barriers is crucial for optimizing patient outcomes in the context of MOUD.
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Buprenorfina , Transtornos Relacionados ao Uso de Opioides , Humanos , Serviço Hospitalar de Emergência , Pessoal de Saúde , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Alta do Paciente , PolíticasRESUMO
BACKGROUND: The number of emergency department (ED) visits has significantly declined since the COVID-19 pandemic. In Taiwan, an aged society, it is unknown whether older adults are accessing emergency care during the COVID-19 epidemic. Therefore, this study aimed to investigate the impact of COVID-19 on the ED visits and triage, admission, and intensive care unit (ICU) hospitalization of the geriatric population in a COVID-19-dedicated medical center throughout various periods of the epidemic. METHODS: A retrospective chart review of ED medical records from April 9 to August 31, 2021 were conducted, and demographic information was obtained from the hospital's computer database. The period was divided into pre-, early-, peak-, late-, and post-epidemic stages. For statistical analysis, one-way analysis of variance followed by multiple comparison tests (Bonferroni correction) were used. RESULTS: A statistically significant decrease in the total number of patients attending the ED was noted during the peak-, late-, and post-epidemic stages. In the post-epidemic stage, the number of older patients visiting ED was nearly to that of the pre-epidemic stage, indicating that older adults tend to seek care at the ED earlier than the general population. Throughout the entire epidemic period, there was no statistically significant reduction in the number of the triage 1& 2 patients seeking medical attention at the emergency department. In the entire duration of the epidemic, there was no observed reduction in the admission of elderly patients to our hospital or ICU through the ED. However, a statistically significant decrease was observed in the admission of the general population during the peak epidemic stage. CONCLUSIONS: During the peak of COVID-19 outbreak, the number of ED visits was significantly affected. However, it is noteworthy that as the epidemic was gradually controlled, the older patients resumed their ED visits earlier that the general population as indicated by the surge in their number. Additionally, in the patient group of triage 1& 2, which represents a true emergency, the number did not show a drastic change.
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COVID-19 , Humanos , Idoso , COVID-19/epidemiologia , COVID-19/terapia , Estudos Retrospectivos , Pandemias , Taiwan/epidemiologia , Serviço Hospitalar de EmergênciaRESUMO
Taiwan's National Health Insurance (NHI) is a widely acclaimed universal healthcare system. In the past few years, particularly following the COVID-19 outbreak, challenges related to maintaining the NHI system have surfaced. Since 2020, NHI has faced a series of challenges, including excessive patient visits to the hospital emergency department, a lack of an effective primary care and referral system, and a high turnover rate of healthcare workers. We review major problems related to Taiwan's NHI, emphasizing input from frontline healthcare workers. We provide recommendations for potential policies addressing the concerns around NHI, for example, strengthening the role of primary care services under the NHI administration, reducing the high turnover rate of healthcare workers, and increase the premium and copayments. We hope that this policy analysis may allow policymakers and scholars to understand both the merits and critical problems related to NHI from the clinical perspective.
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COVID-19 , Humanos , Taiwan/epidemiologia , Programas Nacionais de Saúde , Formulação de Políticas , Serviço Hospitalar de EmergênciaRESUMO
INTRODUCTION: Cognitive impairment (COIM) is a major challenge for healthcare systems and is associated with an increased risk of adverse outcomes in older people visiting emergency departments (EDs). Owing to global aging, both cognitive screening and comprehensive geriatric assessment (CGA) application in ED settings are developing areas of geriatric emergency medicine. Meanwhile, the association between clinical outcomes of COIM; cognitive impairment, no dementia (CIND); and dementia in the ED could be better investigated. Our study aims to identify individuals with COIM from older patients in the ED via CGA and to describe the association of CIND and dementia with prognosis in ED visits. METHODS: A prospective cross-sectional study was conducted in the ED of the Taipei Veterans General Hospital, a medical center located in Taipei, Taiwan, from August 2018 to November 2020. Patients aged ≥75 years with and without COIM were compared using data obtained from the CGAs conducted by trained nurses. RESULTS: A total of 823 older patients were enrolled in the study and underwent CGA. Of these, 463 (56.3%) were diagnosed with COIM, of which 292 (35.5%) were diagnosed with dementia; and 171 (20.8%), CIND. Between the no-COIM and COIM groups, the COIM group had a higher rate of hospital admission (p = 0.002) and mortality at 3 months (p < 0.05). Among the no-COIM, CIND, and dementia groups, ED disposition (p = 0.001) and the rate of revisit/readmission (p < 0.05) showed significant differences. In particular, the dementia group had a significantly higher rate of revisit/readmission as compared to the CIND group among the three groups. DISCUSSION/CONCLUSION: Older patients with COIM had a higher rate of hospital admission and mortality at the 3-month follow-up than older patients without COIM. Among the no-COIM, CIND, and dementia groups, patients with dementia had significantly increased risks of hospital admission and revisit/readmission. The early detection of COIM, and even dementia, could help ED physicians formulate strategies with geriatric specialists to improve mortality outcomes and revisit/readmission.
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Avaliação Geriátrica , Readmissão do Paciente , Idoso , Humanos , Estudos Prospectivos , Seguimentos , Estudos Transversais , Serviço Hospitalar de Emergência , Fatores de Risco , Hospitais , CogniçãoRESUMO
Triplex DNA nanostructures are one of the most emerging and fascinating self-assembled nanostructures due to their unique nanoparticle-like organization and inherit characteristics. They have attracted numerous interests recently because of their versatile and powerful utility in diverse areas of science and technology, such as clinical or disease diagnosis and stimuli-based drug delivery. This review addresses particularly the utilization of DNA triplexes in the development of biosensors for detecting nucleic acid; strategies in sensing pH, protein activity, ions, or molecules. Finally, an outlook for potential applications of triplex DNA nanoswitches is provided.
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Técnicas Biossensoriais , Nanoestruturas , DNA/química , Nanoestruturas/química , Conformação de Ácido NucleicoRESUMO
Convective flow in the mantle and the motions of tectonic plates produce deformation of Earth's interior, and the rock fabric produced by this deformation can be discerned using the anisotropy of the seismic wave speed. This deformation is commonly inferred close to lithospheric boundaries beneath the ocean in the uppermost mantle, including near seafloor-spreading centres as new plates are formed via corner flow, and within a weak asthenosphere that lubricates large-scale plate-driven flow and accommodates smaller scale convection. Seismic models of oceanic upper mantle differ as to the relative importance of these deformation processes: seafloor spreading fabric is very strong just beneath the crust-mantle boundary (the Mohorovicic discontinuity, or Moho) at relatively local scales, but at the global and ocean-basin scales, oceanic lithosphere typically appears weakly anisotropic when compared to the asthenosphere. Here we use Rayleigh waves, recorded across an ocean-bottom seismograph array in the central Pacific Ocean (the NoMelt Experiment), to provide unique localized constraints on seismic anisotropy within the oceanic lithosphere-asthenosphere system in the middle of a plate. We find that azimuthal anisotropy is strongest within the high-seismic-velocity lid, with the fast direction coincident with seafloor spreading. A minimum in the magnitude of azimuthal anisotropy occurs within the middle of the seismic low-velocity zone, and then increases with depth below the weakest portion of the asthenosphere. At no depth does the fast direction correlate with the apparent plate motion. Our results suggest that the highest strain deformation in the shallow oceanic mantle occurs during corner flow at the ridge axis, and via pressure-driven or buoyancy-driven flow within the asthenosphere. Shear associated with motion of the plate over the underlying asthenosphere, if present, is weak compared to these other processes.
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The proliferation of drug-resistant pathogens continues to increase, giving rise to serious public health concerns. Many researchers have formulated metal oxide nanoparticles for use as novel antibacterial agents. In the present study, copper oxide (CuO) was synthesized by simple hydrothermal synthesis, and doping was performed to introduce different polymers onto the NP surface for bacteriostasis optimization. The polymer-modified CuO NPs were analyzed further with XRD, FTIR, TEM, DLS and zeta potential to study their morphology, size, and the charge of the substrate. The results indicate that polymer-modified CuO NPs had a significantly higher bacteriostatic rate than unmodified CuO NPs. In particular, polydopamine (PDA)-modified CuO (CuO-PDA) NPs, which carry a weakly negative surface charge, exhibited excellent antibacterial effects, with a bacteriostatic rate of up to 85.8 ± 0.2% within 3 h. When compared to other polymer-modified CuO NPs, CuO-PDA NPs exhibited superior bacteriostatic activity due to their smaller size, surface charge, and favorable van der Waals interactions. This may be attributed to the fact that the CuO-PDA NPs had relatively lipophilic structures at pH 7.4, which increased their affinity for the lipopolysaccharide-containing outer membrane of the Gram-negative bacterium Escherichia coli.
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Antibacterianos/análise , Cobre/química , Nanopartículas Metálicas/química , Testes de Sensibilidade MicrobianaRESUMO
The growing number of industrial carbon emissions have resulted in a significant increase in the greenhouse gas carbon dioxide (CO2), which, in turn, will have a major impact on climate change. Therefore, the reduction, storage, and reuse of CO2 is an important concern in modern society. Calcium oxide (CaO) is known to be an excellent adsorbent of CO2 in a high-temperature environment. However, since deterioration of the adsorbent is likely to occur after repeated cycles of adsorption under high temperature conditions, it would be desirable to mitigate this phenomenon, in order to maintain the stability of CaO. In the present study, common eggshell waste was used as the starting material. The main component of eggshell waste is calcium carbonate (CaCO3), which was purified to produce CaO. Different surfactants and amino-containing polymers were added to synthesize CaO-based adsorbents with different configurations and pore sizes. The amount of CO2 adsorbed was determined using a thermogravimetric analyzer (TGA). The results showed that the CO2 adsorption capacity of the synthetic CaO recovered from purified eggshell waste could reach 0.6 g-CO2/g-sorbent, indicating a good adsorption capacity. CaO modified with a dopamine-containing polymer was shown to have an adsorption capacity of 0.62 g-CO2/g-sorbent. Moreover, it showed an excellent adsorption capacity of 0.40 g-CO2/g-sorbent, even after 10 cycles of CO2 adsorption. The present study suggests that using eggshell waste to synthesize CaO-based adsorbents for effective CO2 adsorption can not only reduce environmental waste, but also have the potential to capture greenhouse gas CO2 emissions, which conforms to the principles of green chemistry.
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Dióxido de Carbono , Gases de Efeito Estufa , Adsorção , Animais , Compostos de Cálcio , Casca de Ovo , ÓxidosRESUMO
This paper describes the synthesis of a nano-porous multilayered film consisting of Au@SiO2 nanoparticles. This film was used to miniaturize the size of a localized surface plasmon resonance (LSPR)-based capillary gas chromatograph (GC) detector. A layer-by-layer (LbL) approach with proper surface reaction sequences was used to create a multilayer structure that consisted of as many as five layers of Au@SiO2 nanoparticles. The center wavelength of LSPR was shifted from 520 to 634 nm due to the approximation of additional layers of nanoparticles. The vapor response time for this Au@SiO2 multilayer LSPR sensor was identical to that of an Au nanoparticle monolayer, which confirmed that this multilayer structure has a high level of gas permeability. The multilayer was synthesized inside a glass capillary for use as a GC detector. Due to the enhancement of absorbance, the gas chromatographic signal was obtained via a single spotlight that penetrated one side of the glass capillary and was then reflected by a silver mirror coated on the opposite side. The detection limits were ≤20 ng for cyclohexanone and m-xylene.
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Vascularization of engineered tissues remains one of the key problems. Here, we described a novel approach to promote vascularization of engineered tissues using fibronectin (FN) incorporated gold nanoparticles (AuNP) coated onto catheters with mesenchymal stem cells (MSCs) for tissue engineering. We found that the FN-AuNP composite with 43.5 ppm of AuNP exhibited better biomechanical properties and thermal stability than pure FN. FN-AuNP composites promoted MSC proliferation and increased the biocompatibility. Mechanistically, vascular endothelial growth factor (VEGF) promoted MSC migration on FN-AuNP through the endothelial oxide synthase (eNOS)/metalloproteinase (MMP) signaling pathway. Vascular femoral artery tissues isolated from the implanted FN-AuNP-coated catheters with MSCs expressed substantial CD31 and alpha-smooth muscle actin (α-SMA), displayed higher antithrombotic activity, as well as better endothelialization ability than those coated with all other materials. These data suggested that the implantation of FN-AuNP-coated catheter with MSCs could be a novel strategy for vascular biomaterials applications.
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Artéria Femoral/citologia , Fibronectinas/química , Ouro/química , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Nanopartículas Metálicas/administração & dosagem , Engenharia Tecidual/métodos , Catéteres , Adesão Celular , Diferenciação Celular , Movimento Celular , Proliferação de Células , Células Cultivadas , Artéria Femoral/fisiologia , Humanos , Teste de Materiais , Nanopartículas Metálicas/química , Regeneração , Fator A de Crescimento do Endotélio Vascular/metabolismo , CicatrizaçãoRESUMO
Di-(2-ethylhexyl) phthalate (DEHP), the common plasticizer used in the production of polyvinyl chloride, can be converted to the more potent metabolite mono-ethylhexyl phthalate (MEHP). Epidemiological studies have shown an association with elevated induction of rat hepatic cancer and reproductive toxicity in response to MEHP exposure. However, the mechanism of genotoxicity and carcinogenicity induced by MEHP treatment remains unclear. As a means to elucidate the mechanisms of action, lethality and mutagenicity in the adenine phosphoribosyltransferase (aprt+/-) gene induced in several CHO cell types by MEHP were assessed. Dose-response relationships were determined in the parental AA8 cell line, its nucleotide repair-deficient UV5 and base repair-deficient EM9 subclones, and also in AS52 cells harboring the bacterial guanine-hypoxanthine phosphoribosyltransferase (gpt) gene and its derived AS52-XPD-knockdown and AS52-PARP-1-knockdown cells. Treatment of AS52 with MEHP led to intracellular production of reactive oxygen species (ROS) and DNA strand breaks in a dose-dependent manner. Separately, mutations in the gpt gene of AS52 cells were characterized and found to be dominated by G:C to A:T and A:T to G:C transitions. Independent AS52-mutant cell (ASMC) clones were collected for the sequential in vivo xenograft tumorigenic studies, 4 of total 20 clones had aggressive tumor growth. Moreover, microarray analysis indicated miR-let-7a and miR-125b downregulated in ASMC, which might raise oncogenic MYC and RAS level and activate ErbB pathway. Comparative evaluation of the results indicates that the principal mechanism of this mutagenic action is probably to be through generation of ROS, causing base excision damage resulting in carcinogenicity.
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Dietilexilftalato/análogos & derivados , Dietilexilftalato/metabolismo , Mutagênese/genética , Poli(ADP-Ribose) Polimerase-1/genética , Animais , Células CHO , Cricetinae , Cricetulus , Dano ao DNA/efeitos dos fármacos , Humanos , Mutagênese/efeitos dos fármacos , Testes de Mutagenicidade , Mutação/efeitos dos fármacos , Ratos , Espécies Reativas de Oxigênio/metabolismoRESUMO
Can healthy food-choice habits protect people against temptations of consuming large portion sizes and unhealthy foods? In two studies, we show that the answer is yes, good habits serve this protective role, at least in contexts in which people are not deliberating and thus fall back on habitual responses. In the first study, participants trained with unhealthy habits to approach eating chocolate, but not those trained with healthy habits, succumbed to temptation and ate more chocolates when their self-control resources were depleted. Study 2 extended and clarified these findings by demonstrating the role of environmental cues in eliciting healthy habits when self-control resources are depleted. Participants who had been trained to choose carrots habitually to a pictorial stimulus (i.e., habit cue) subsequently resisted choosing M&Ms as long as the cue was present. This effect of habit cues on healthy food choices suggests the usefulness of manipulating such cues as a means of meeting self-regulatory goals such as portion control.
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Comportamento de Escolha , Fissura , Dieta Saudável , Comportamento Alimentar , Preferências Alimentares/psicologia , Tamanho da Porção/psicologia , Autocontrole/psicologia , Controle Comportamental , Chocolate , Sinais (Psicologia) , Daucus carota , Feminino , Humanos , Masculino , Motivação , Meio Social , Inquéritos e QuestionáriosAssuntos
Dor Abdominal/etiologia , Dissecção Aórtica/diagnóstico , Artéria Mesentérica Superior , Dor Abdominal/diagnóstico por imagem , Dissecção Aórtica/complicações , Dissecção Aórtica/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Serviço Hospitalar de Emergência , Humanos , Masculino , Artéria Mesentérica Superior/diagnóstico por imagem , Pessoa de Meia-Idade , UltrassonografiaRESUMO
We report on the fabrication of a surface-enhanced Raman scattering (SERS) platform, comprised of a three-dimensional (3D) porous eggshell membrane (ESM) scaffold decorated with Ag nanoparticles (NPs). Both native and treated ESM were used, where the treated ESM pore size and fiber crossing density was controlled by timed exposure to hydrogen peroxide (H2O2). Ag NPs were synthesized in situ by reduction of silver nitrate with ascorbic acid. Our results demonstrate that H2O2-treated Ag-ESM provides a more densely packed 3D network of active material, which leads to consistently higher SERS enhancement than untreated Ag-ESM substrates.
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Casca de Ovo/fisiologia , Membranas/química , Porosidade , Análise Espectral Raman , Compostos de Anilina/química , Animais , Benzoatos/química , Membranas/fisiologia , Nanopartículas Metálicas/química , Estrutura Molecular , Prata/química , Compostos de Sulfidrila/químicaRESUMO
BACKGROUND: Taiwan has a substantial number of veterans, but knowledge regarding their emergency department (ED) visits during the coronavirus disease 2019 (COVID-19) pandemic remains limited. This study examined the characteristics of veterans' ED visits during Taiwan's COVID-19 epidemic. METHODS: This was a cross-sectional study conducted at the ED of a large veteran medical center located in Taipei, Taiwan, from May 2018 to October 2021. We analyzed the numbers and features of visits in summer and autumn according to the first wave of the COVID-19 epidemic in Taiwan in 2021. RESULTS: Medical institutions were positively associated with veteran status. Emergency department complaints of trauma (adjusted odds ratio [AOR] = 1.15, 95% CI: 1.06-1.25; summer P < .01) and chest pain/tightness (AOR = 1.65, 95% CI: 1.45-1.87; summer P < .01; AOR = 1.4, 95% CI: 1.26-1.55; P < .01) were associated with increased odds of being a veteran. Triage levels above 2 were positively associated with veteran status in the autumn model (AOR = 1.14, 95% CI: 1.07-1.22; P < .01). Patients hospitalized after ED visits were associated with reduced odds of veteran status (P < .01). Those who spent a long time in the ED were more likely to be veterans than those who spent a shorter time in the ED (P < .01). Veterans were less likely to visit the ED regardless of the time frame of the study period (P < .01), except during the COVID-19 outbreak in the autumn (2019-2020). CONCLUSIONS: The distinctions in ED visits highlighted the individuality of veterans' medical needs. Our findings suggest that the veteran medical system can add to the focus on improving senior-friendly care, fall prevention, quality of life of institutionalized veterans, access for homeless veterans, and care for ambulatory care-sensitive conditions.
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COVID-19 , Veteranos , Humanos , Taiwan/epidemiologia , Pandemias , Qualidade de Vida , Estudos Transversais , COVID-19/epidemiologia , Serviço Hospitalar de EmergênciaRESUMO
Background: Frailty epitomizes the most complex consequence of an aging population. This study aimed to evaluate the impact of frailty, measured using the Clinical Frailty Scale (CFS), on outcomes of older people in an emergency department (ED). Methods: We conducted a prospective observational study enrolling patients aged 65 years and older in a medical center of Taiwan between March 8, 2021, and November 30, 2021. The primary outcome was 90-day mortality rate. Individuals were categorized into three groups based on the CFS scores. Logistic regression was employed to examine the influence of frailty on clinical outcomes following covariate adjustment. Survival analysis was conducted using Kaplan-Meier curves and Log rank tests. Results: A total of 473 individuals were included in the study, with a mean age of 82.1 years, and 60.5% of them were males. The 90-day mortality rate was 10.6%. Among these groups, the CFS score 7-9 group had the highest 90-day mortality rate (15.9%), followed by the CFS score 4-6 group (8.0%) and the CFS score 1-3 group (7.1%). The multiple logistic regression analyses demonstrated a significant impact of CFS score on prognosis, with adjusted odd ratios of 1.24 (95% CI 1.06-1.47) for 90-day mortality, 1.18 (95% CI 1.06-1.31) for hospitalization, and 1.30 (95% CI 1.12-1.52) for 180-day mortality. The Kaplan-Meier curves revealed a significantly higher 90-day mortality rate for patients with high CFS scores (Log rank tests, p = 0.019). Conclusion: In the older ED population, the severity of frailty assessed by the CFS emerged as a significant and important prognostic factor for hospitalization, 90-day mortality, and 180-day mortality.
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Serviço Hospitalar de Emergência , Idoso Fragilizado , Fragilidade , Avaliação Geriátrica , Humanos , Masculino , Feminino , Serviço Hospitalar de Emergência/estatística & dados numéricos , Estudos Prospectivos , Idoso , Idoso de 80 Anos ou mais , Taiwan/epidemiologia , Fragilidade/mortalidade , Avaliação Geriátrica/métodos , Idoso Fragilizado/estatística & dados numéricos , Modelos Logísticos , Estimativa de Kaplan-Meier , Prognóstico , Mortalidade Hospitalar , Análise de SobrevidaRESUMO
As a consequence of cirrhosis, portal hypertension causes resistance to blood flow and leads to the formation of varices. However, colonic variceal hemorrhages are rarely reported but could be a lethal cause of lower gastrointestinal hemorrhage. Currently, there is no consensus on the management of colonic variceal hemorrhage. Variceal ligation, injection sclerotherapy, transjugular intrahepatic portosystemic shunt placement, and balloon-occluded retrograde transvenous obliteration or a combination of the above therapies have been reported with inconsistent success rates. We advocate considering colonic variceal bleeding as a crucial differential diagnosis of lower gastrointestinal bleeding in cirrhotic patients and initiating time-sensitive, definite operative treatment or combination therapy as soon as possible in colonic variceal patients with life-threatening bleeding events, which are often refractory to conservative treatment.
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Previous studies on spoken word production have shown that native English speakers used phoneme-sized units (e.g., a word-initial phoneme, C) to produce English words, and native Mandarin Chinese speakers employed syllable-sized units (e.g., a word-initial consonant and vowel, CV) as phonological encoding units in Chinese. With spoken word production, although spoken word recognition is a fundamental language skill of human beings, it is unknown whether a Chinese-English bilingual listener can adjust the phonological unit sizes depending on the language used. Using four mouse-tracking spoken word recognition experiments, participants listened to spoken words (either presented in English or Chinese) while viewing a display of two written words. In Experiment 1, Chinese-English bilinguals experienced a larger phonological competition in the CV condition than the control condition, indicating that they recruited syllables when listening to Chinese monosyllabic words. Experiment 2 extended the results of Experiment 1 with a set of Chinese disyllabic words and further revealed the temporal distribution of syllable overlap of a spoken word constrains phonological competition. In Experiment 3, Chinese-English bilinguals exhibited a greater phonological competition in both CV and C conditions that mirrored those reported with English monolinguals in Experiment 4. Our results across experiments demonstrated that Chinese-English bilinguals employed both phonemes and syllables to recognize English spoken words but exclusively relied on syllables to recognize Chinese words, suggesting that there is flexibility in selecting phonological units when recognizing spoken words in the two languages. Implications for models of monolingual and bilingual spoken recognition are also discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Percepção da Fala , Fala , Humanos , Fonética , Idioma , Percepção AuditivaRESUMO
PURPOSE: To assess the effectiveness of contrast-enhanced ultrasound (CEUS) in guiding biopsies of breast lesions that were detected on contrast-enhanced mammography (CEM) or contrast-enhanced breast MRI (CE-MRI) but were not clearly visible on B-mode ultrasound (B-US). METHODS: In this study, 23 lesions in 16 patients were selected for CEUS-guided biopsy due to poor visualization on B-US despite being detected on CEM (n = 20) or CE-MRI (n = 3). B-US, color Doppler ultrasound (CDUS), and CEUS were used to visualize the suspicious lesions, followed by a CEUS-guided core needle biopsy using Sonazoid as the contrast agent. The accuracy of the biopsy was assessed based on pathology-radiology concordance and 12-month imaging follow-up. The conspicuity scores for lesion visualization were evaluated using a 5-point conspicuity scale agreed upon by two breast radiologists. RESULTS: The enhancing lesions detected on CEM/CE-MRI had an average size of 1.6 ± 1.3 cm and appeared as mass-enhancing (61%) or non-mass-enhancing (39%). The lesions had mean conspicuity scores of 2.30 on B-US, 2.78 on CDUS, and 4.61 on CEUS, with 96% of the lesions showing contrast enhancement on CEUS. CEUS-guided biopsy showed increased visibility in 96% and 91% of the lesions compared to B-US and CDUS, respectively. The overall accuracy of CEUS-guided biopsy was 100% based on concordance with histology and 12-month follow-up. CONCLUSIONS: CEUS enhances the visibility of suspicious CEM/CE-MRI lesions that are poorly visible on B-US during biopsy procedures.
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Meios de Contraste , Imageamento por Ressonância Magnética , Humanos , Mamografia , Biópsia Guiada por Imagem , Biópsia , Ultrassonografia de Intervenção/métodosRESUMO
Herbs containing aristolochic acids (AAs) have already been proven to be highly carcinogenic and nephrotoxic. In this study, a novel surface-enhanced Raman scattering (SERS) identification method was developed. Ag-APS nanoparticles with a particle size of 3.53 ± 0.92 nm were produced by combining silver nitrate and 3-aminopropylsilatrane. The reaction between the carboxylic acid group of aristolochic acid I (AAI) and amine group of Ag-APS NPs was used to form amide bonds, and thus, concentrate AAI, rendering it easy to detect via SERS and amplified to obtain the best SERS enhancement effect. Detection limit was calculated to be approximately 40 nM. Using the SERS method, AAI was successfully detected in the samples of four Chinese herbal medicines containing AAI. Therefore, this method has a high potential to be applied in the future development of AAI analysis and rapid qualitative and quantitative analysis of AAI in dietary supplements and edible herbs.