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In recent advancements in spoken question answering (QA), end-to-end models have made significant strides. However, previous research has primarily focused on extractive span selection. While this extractive-based approach is effective when answers are present directly within the input, it falls short in addressing abstractive questions, where answers are not directly extracted but inferred from the given information. To bridge this gap, we introduce the first end-to-end Generative Spoken Question Answering (GSQA) model that empowers the system to engage in abstractive reasoning. The challenge in training our GSQA model lies in the absence of a spoken abstractive QA dataset. We propose using text models for initialization and leveraging the extractive QA dataset to transfer knowledge from the text generative model to the spoken generative model. Experimental results indicate that our model surpasses the previous extractive model by 3% on extractive QA datasets. Furthermore, the GSQA model has only been fine-tuned on the spoken extractive QA dataset. Despite not having seen any spoken abstractive QA data, it can still closely match the performance of the cascade model. In conclusion, our GSQA model shows the potential to generalize to a broad spectrum of questions, thus further expanding the spoken question answering capabilities of abstractive QA. Our code is available at https://voidful.github.io/GSQA

The sound codec's dual roles in minimizing data transmission latency and serving as tokenizers underscore its critical importance. Recent years have witnessed significant developments in codec models. The ideal sound codec should preserve content, paralinguistics, speakers, and audio information. However, the question of which codec achieves optimal sound information preservation remains unanswered, as in different papers, models are evaluated on their selected experimental settings. This study introduces Codec-SUPERB, an acronym for Codec sound processing Universal PERformance Benchmark. It is an ecosystem designed to assess codec models across representative sound applications and signal-level metrics rooted in sound domain knowledge.Codec-SUPERB simplifies result sharing through an online leaderboard, promoting collaboration within a community-driven benchmark database, thereby stimulating new development cycles for codecs. Furthermore, we undertake an in-depth analysis to offer insights into codec models from both application and signal perspectives, diverging from previous codec papers mainly concentrating on signal-level comparisons. Finally, we will release codes, the leaderboard, and data to accelerate progress within the community.

The combined effects of low-molecular-weight fucoidan (LMF) and fucoxanthin (Fx) in terms of antihyperglycemic, antihyperlipidemic, and hepatoprotective activities were investigated in a mouse model of type II diabetes. The intake of LMF, Fx, and LMF + Fx lowered the blood sugar and fasting blood sugar levels, and increased serum adiponectin levels. The significant decrease in urinary sugar was only observed in LMF + Fx supplementation. LMF and Fx had ameliorating effects on the hepatic tissue of db/db mice by increasing hepatic glycogen and antioxidative enzymes, and LMF was more effective than Fx at improving hepatic glucose metabolism. As for glucose and lipid metabolism in the adipose tissue, the expression of insulin receptor substrate (IRS)-1, glucose transporter (GLUT), peroxisome proliferator-activated receptor gamma (PPARγ), and uncoupling protein (UCP)-1 mRNAs in the adipose tissue of diabetic mice was significantly upregulated by Fx and LMF + Fx, and levels of inflammatory adipocytokines, such as adiponectin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6), were significantly modulated only by LMF + Fx supplementation. The efficacy of LMF + Fx supplementation on the decrease in urinary sugar and on glucose and lipid metabolism in the white adipose tissue of db/db mice was better than that of Fx or LMF alone, indicating the occurrence of a synergistic effect of LMF and Fx.

Background The early detection of dementia depends on efficient methods for the assessment of cognitive capacity. Existing cognitive screening tools are ill-suited to the differentiation of cognitive status, particularly when dealing with early-stage impairment. Methods The study included 8,979 individuals (> 50 years) with unimpaired cognitive functions, mild cognitive impairment (MCI), or dementia. This study sought to determine optimal cutoffs values for the Cognitive Abilities Screening Instrument (CASI) aimed at differentiating between individuals with or without dementia as well as between individuals with or without mild cognitive impairment. Cox proportional hazards models were used to evaluate the value of CASI tasks in predicting conversion from MCI to all-cause dementia, dementia of Alzheimer’s type (DAT), or to vascular dementia (VaD). Results Our optimized cutoff scores achieved high accuracy in differentiating between individuals with or without dementia (AUC = 0.87—0.93) and moderate accuracy in differentiating between CU and MCI individuals (AUC = 0.67 – 0.74). Among individuals without cognitive impairment, scores that were at least 1.5 × the standard deviation below the mean scores on CASI memory tasks were predictive of conversion to dementia within roughly 2 years after the first assessment (all-cause dementia: hazard ratio [HR] = 2.81 – 3.53; DAT: 1.28 – 1.49; VaD: 1.58). Note that the cutoff scores derived in this study were lower than those reported in previous studies. Conclusion Our results in this study underline the importance of establishing optimal cutoff scores for individuals with specific demographic characteristics and establishing profiles by which to guide CASI analysis.

Pollution in human-made fishing ports caused by petroleum from boats, dead fish, toxic chemicals, and effluent poses a challenge to the organisms in seawater. To decipher the impact of pollution on the microbiome, we collected surface water from a fishing port and a nearby offshore island in northern Taiwan facing the Northwestern Pacific Ocean. By employing 16S rRNA gene amplicon sequencing and whole-genome shotgun sequencing, we discovered that Rhodobacteraceae, Vibrionaceae, and Oceanospirillaceae emerged as the dominant species in the fishing port, where we found many genes harboring the functions of antibiotic resistance (ansamycin, nitroimidazole, and aminocoumarin), metal tolerance (copper, chromium, iron and multimetal), virulence factors (chemotaxis, flagella, T3SS1), carbohydrate metabolism (biofilm formation and remodeling of bacterial cell walls), nitrogen metabolism (denitrification, N2 fixation, and ammonium assimilation), and ABC transporters (phosphate, lipopolysaccharide, and branched-chain amino acids). The dominant bacteria at the nearby offshore island (Alteromonadaceae, Cryomorphaceae, Flavobacteriaceae, Litoricolaceae, and Rhodobacteraceae) were partly similar to those in the South China Sea and the East China Sea. Furthermore, we inferred that the microbial community network of the cooccurrence of dominant bacteria on the offshore island was connected to dominant bacteria in the fishing port by mutual exclusion. By examining the assembled microbial genomes collected from the coastal seawater of the fishing port, we revealed four genomic islands containing large gene-containing sequences, including phage integrase, DNA invertase, restriction enzyme, DNA gyrase inhibitor, and antitoxin HigA-1. In this study, we provided clues for the possibility of genomic islands as the units of horizontal transfer and as the tools of microbes for facilitating adaptation in a human-made port environment.

Background Atrial substrate remodeling (ASR) was emerged as a critical determinant of very late recurrence (VLR) in paroxysmal atrial fibrillation (PaAF). However, the multifaceted risk factors driving ASR progression and their interplay with clinical outcomes remain incompletely characterized. This study aimed to identify clinical, electrophysiological, and structural risk factors associated with ASR in PaAF patients experiencing VLR after catheter ablation (CA). Methods A total of 1786 consecutive patients with PaAF who underwent catheter ablation at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between May 2006 and July 2023 were screened. Patients with normal atrial substrate at baseline who subsequently experienced recurrent AF were enrolled and categorized into two cohorts: the ASR group (with ASR) and the NASR group (without ASR). A comparative assessment was performed to identify risk factors, encompassing the recurrent type of arrhythmia, CHA2DS2-VASc score, comorbidities, and pulmonary veins-left atrial (PVs-LA) reconnection, between two groups. Results Of 1,786 screened patients, 102 met inclusion criteria (mean age: 61.0 ± 10.0 years; 54% male), with 49 (48%) patients in the ASR group (mean age: 62.1 ± 9.0 years; 45% male) and 53 (52%) in the NASR group (mean age: 61.0 ± 10.0 years; 62% male). The ASR group had a higher CHA2DS2-VASc score, longer recurrence intervals, and a greater prevalence of recurrent persistent AF (PsAF). Notably, recurrent PsAF emerged as an independent risk factor for ASR (HR = 2.66, 95%CI = 1.05–6.73, P = 0.04). Despite the presence of ASR, cardiac function remained preserved in both groups. Conclusions In PaAF patients with VLR, recurrent persistent AF is an independent risk factor for atrial substrate remodeling. These findings highlight the role of arrhythmia progression in driving structural-electrical remodeling, even in initially normal atrial substrates. Key Messages 1. Atrial substrate remodeling significantly contributes to very late PaAF recurrence. 2. The transition from PaAF to PsAF, as a standalone risk factor, accelerates atrial substrate remodeling.

Catheter ablation is effective in restoring sinus rhythm and left atrial appendage closure (LAAC) is increasingly used for stroke prevention in patients with atrial fibrillation (AF). We aimed to observe the feasibility and safety of performing AF ablation and LAAC in a single (one-stop) procedure. Consecutive AF patients who underwent the combined procedure of AF ablation and LAAC with WATCHMAN device between March 2017 and September 2018 were prospectively enrolled. Baseline and intra-procedural parameters were evaluated. Three-month and subsequent 1-year follow-up were performed in all and earlier-enrolled subjects, respectively. A total of 178 AF patients (94 males, 68.9 ± 8.1 years) underwent the one-stop procedure with CHA2DS2-VASc score 3.3 ± 1.5 and HAS-BLED score 1.6 ± 1.0, respectively. Pulmonary vein isolation was achieved in all patients while additional linear ablation was applied if the operator deemed necessary, yielding immediate ablation success rate of 98.9% (176/178). In the subsequent LAAC, satisfactory seal (residual leak <5 mm) was achieved in all patients. One stroke and four cardiac perforations occurred peri-operatively. At 3-month follow-up, sinus rhythm and satisfactory seal were maintained in 153/178 (86.0%) and 178/178 (100%) patients, respectively. One stroke and one delayed cardiac tamponade occurred, while no device-related thrombus or device migration was observed. During the 1-year follow-up for the earlier enrolled subjects, 52/72 (72.2%) of the patients maintained sinus rhythm. There was no stroke or systemic embolism observed. Combining catheter ablation and LAAC in a single procedure can be successfully and safely performed in non-valvular AF patients of Chinese population.

Objective: Early management of modifiable dementia-related factors is seen as a novel approach to preventing dementia onset; however, these efforts are often hindered by the complexity of interactions among these factors. In addition, different modifiable dementia-related factors may contribute to different etiologies of dementia. Design: The current study investigated the effects of common modifiable dementia-related factors on prediction of incident dementia, dementia of the Alzheimer’s type (DAT), and vascular dementia (VaD). Methods: Vascular- and lifestyle-related factors were used as predictors of incident dementia, DAT, and VaD among 1,285 elderly individuals without obvious signs of dementia or mild cognitive impairment. Cox proportional hazard models were used to evaluate the risks associated with each modifiable factor. Results: After controlling for factors other than stroke-related factors, hypercholesterolemia was correlated with a relatively low risk of all-cause incident dementia and DAT, whereas a vegetarian diet was correlated with an elevated risk of all-cause incident dementia and VaD. Hypertension was correlated with incident VaD. After controlling for stroke-related factors, a vegetarian diet was correlated with an elevated risk of all-cause dementia. A history of myocardiac infarction and the use of anti-platelet medication were, respectively, associated with a reduced risk of DAT and elevated risk of VaD. The use of anti-hypertensives was associated with a reduced risk of all-cause dementia, whereas the use of anti-lipid agents was associated with slow progression DAT (i.e. exceeding the average conversion time). Hypercholesterolemia was associated with an elevated risk for slow progression DAT. Conclusion: These findings could perhaps be used as clinical markers in predicting and preventing incident dementia, DAT, and VaD.

Catheter ablation (CA) combined with left atrial appendage occlusion (LAAO) is a feasible approach for atrial fibrillation (AF) patients. Its role in octogenarians with AF is unclear. In AF patients over 80 years, CA combined with LAAO is a feasible way in restoring sinus rhythm and preventing stroke. This is a single-center retrospective study. Patients who underwent CA and LAAO in a single procedure between March 2018 and December 2020 were included. Efficacy endpoints included procedural success rate, AF recurrence rate, and thromboembolic events. Safety endpoints included pericardial effusion/cardiac tamponade, device-related thrombus (DRT), all-cause death, and major bleeding. Five hundred and five patients (mean age 69.5 ± 7.7 years; 230 [45.5%] female) were included, with 46 (9.1%) patients aged ≥80 years old (octogenarian group). Prevalence of paroxysmal AF (25 [54.3%] vs. 207 [45.1%], p < 0.001) and CHA2DS2VASc score (4.1 ± 1.3 vs. 3.1 ± 1.4, p < 0.0001) were higher in octogenarian patients. There were six cases (1.2%) of pericardial effusion (all in nonoctogenarian patients). At 3 months postprocedure, 437 patients underwent TEE/CT. Thirty-two (80%) octogenarian patients and 308 (77.6%) nonoctogenarian patients had no peri-device leak. After a mean follow-up of 26.9 ± 9.1 months, AF was documented in 10 (21.7%) patients in octogenarian group and in 103 (22.4%) patients in nonoctogenarian group (p = 0.99). The annual thromboembolic risk was 2.1% and 0.8% in the octogenarian group and nonoctogenarian group, respectively. Death occurred in 16 nonoctogenarian patients. One major bleeding was recorded in the octogenarian group. The combination of CA and LAAO in a single procedure is a feasible treatment option in octogenarians with comparable efficacy and safety profile.

The demand for mobile epidemic prevention medical stations originated from the rapid spread of the COVID-19 pandemic. In order to reduce the infection risk of medical practitioners and provide flexible medical facilities in response to the variable needs of the pandemic, this research aimed to design mobile medical stations for COVID-19 epidemic prevention, the emergence of which began in February 2020. The mobile medical stations include a negative pressure isolation ward, a positive pressure swabbing station, a fever clinic and a laboratory. In Taiwan, many medical institutions used the mobile swabbing station design of this study to practice COVID-19 screening pre-tests. Internationally, this study assisted Palau in setting up medical stations to provide anti-epidemic goods and materials. The design of this study not only provides a highly flexible and safe medical environment but the benefits of screening can also be used as resources for medical research, forming an economic circulation for operation sustainability. In addition, the design of this study can also be used during the non-epidemic period as a healthcare station for rural areas or as a long-term community medical station.