The involvement of decomposition and composition processes in restructuring during problem solving.

Decomposition of chunks has been widely accepted as a critical proxy of restructuring, but the role of composition in forming new representations has been largely neglected. This study aims to investigate the roles of both decomposition and composition processes in chunk restructuring, as well as their relationships with "aha" experiences during problem-solving. Participants were asked to move a part of a character to another character to create two new characters. Across three experiments, the characters to be decomposed or composed were varied in terms of tight or loose chunks. The results showed that decomposition or composition of tight chunks led to lower success rates, longer response times, and significantly stronger "Aha!" emotional experiences (mainly in terms of surprise and suddenness). This study provides evidence for the contribution of both decomposition and composition processes to restructuring in creative insight.

High C-reactive protein to lymphocyte ratio predicts mortality outcomes of patients with severe fever with thrombocytopenia syndrome: A multicenter study in China.

Severe fever with thrombocytopenia syndrome (SFTS) is a life-threatening infectious disease caused by the SFTS virus (SFTSV). This study aimed to evaluate the predictive power of C-reactive protein to lymphocyte ratio (CLR) and establish an early-warning model for SFTS mortality. We retrospectively analyzed hospitalized SFTS patients in six clinical centers from May 2011 to 2022. The efficacy of CLR prediction was evaluated by the receiver operating characteristic (ROC) analysis. A nomogram was established and validated. Eight hundred and eighty-two SFTS patients (median age 64 years, 48.5% male) were enrolled in this study, with a mortality rate of 17.8%. The area under the ROC curve (AUC) of CLR was 0.878 (95% confidence interval [CI]: 0.850-0.903, p < 0.001), which demonstrates high predictive strength. The least absolute shrinkage and selection operator regression selected seven potential predictors. Multivariate logistic regression analysis determined three independent risk factors, including CLR, to construct the nomogram. The performance of the nomogram displayed excellent discrimination and calibration, with significant net benefits in clinical uses. CLR is a brand-new predictor for SFTS mortality. The nomogram based on CLR can serve as a convenient tool for physicians to identify critical SFTS cases in clinical practice.

The inhibitory effect of moral emotions on malevolent creativity: Exploring the mediation role of emotional valence and prosocial behavior.

The current study aims to investigate the influence of positive and negative moral emotions (gratitude and guilt) on malevolent creativity by exploring the potential mediation role of valence and prosocial behavior. Using autobiographical recall, three groups of participants developed gratitude, guilt, or neutral emotion, respectively, and then their prosocial behavior and malevolent creativity performance were compared. Results showed that compared with the neutral condition, individuals in the gratitude state experienced more positive emotions with less malevolent creative ideas, but the positive valence pathway had a positive effect on malevolent creativity, indicating the promoting effect of positive emotion on creativity. By contrast, individuals in the guilt state experienced more negative emotions, which result in less malevolent creativity. Gratitude and guilt promoted prosocial behaviors, which did not mediate the effect of gratitude or guilt on malevolent creativity. In short, the results indicate that the positive and negative moral emotions (gratitude and guilt) inhibit malevolent creativity, which is mediated by valence, instead of prosocial behavior.

Diagnostic accuracy of ultrasonography for the prenatal diagnosis of esophageal atresia and tracheoesophageal fistula.

Ultrasound is recommended as a first-line requirement prior to MRI or amniotic fluid analysis, which have high diagnostic accuracy for esophageal atresia (EA). Therefore, the aim of the present prospective study was to evaluate the accuracy of high-performance ultrasound for the prenatal examination of EA/tracheoesophageal fistula (TOF). In total, 64 pregnant women with fetuses suspected of having EA/TOF participated in the study. The gestational age of the fetuses ranged between 16 and 40 weeks, with a mean of 26.33±3.57 weeks. Ultrasound images of the esophagus and trachea on parasternal and para-aortic axis longitudinal and transverse sections were compared with the results of standard postnatal diagnostic tests. Sensitivity and specificity values were determined and a receiver operating characteristic (ROC) curve was generated. Among all the fetuses screened, 16 were suspected of having EA/TOF during the prenatal ultrasonography. In postnatal examinations, 34 cases of EA/TOF were confirmed, corresponding to an EA/TOF incidence of 53.2% (95% CI, 40.2-65.7%). The area under the ROC curve (AUC) was lower for prenatal ultrasonography compared with postnatal diagnostic tests (AUC=0.55; 95% CI, 0.44-0.65). Considering postnatal examination as the gold standard, prenatal ultrasonography had a sensitivity of 29.4% (95% CI, 15.1-47.5%) and a specificity of 80% (95% CI, 61.4-92.3%) for the diagnosis of EA/TOF. In addition, the positive predictive value was 62.5% (95% CI, 35.4-82.8%), the negative predictive value was 50% (95% CI, 35.2-64.8%), the positive likelihood ratio was 1.47 (95% CI, 0.61-3.56) and the negative likelihood ratio was 0.88 (95% CI, 0.67-1.17). The results of the present study indicate that preoperative ultrasound has poor sensitivity but very good specificity for the diagnosis of EA/TOF. The use of ultrasound alone would result in a high rate of a false-positive diagnoses. However, prenatal ultrasonography may be useful as a preliminary screening tool to exclude patients for suspected EA/TOF.

Left-hemispheric predominance on appropriateness evaluation of restructuring during chunk decomposition problem solving.

Restructuring refers to achieving satisfactory solutions by breaking obstacles or forming novel associations in problem-solving. One critical question arises regarding how an appropriate solution is processed in our brain during the restructuring of problem representations. This study aims to explore the electrophysiological correlates of appropriateness evaluation of restructuring by employing a chunk decomposition task. During loose or tight chunk decomposition, participants needed to assess whether they could get a valid solution after probe removal from a source character chunk. As reflected by the late positive complex, the processing of appropriateness exhibited the greatest effect (appropriate vs. inappropriate) in left parietal regions for tight chunk decomposition, but exhibited insignificant differences across most brain regions for loose chunk decomposition. This study provides the first primary electrophysiological evidence that both hemispheres contribute to and the left hemisphere plays a predominant role in evaluating the appropriateness of restructuring in problem solving.

The late parietal event-related potential component is hierarchically sensitive to chunk tightness during chunk decomposition.

The current study analyzed event-related potentials (ERPs) associated with visuo-spatial transformation in order to examine how "chunk tightness" affects the difficulty of chunk decomposition problems. Participants completed a Chinese character decomposition task in three conditions according to the tightness of the to-be-decomposed chunk (tight vs. medium vs. loose). Behavioral data showed that performance became worse (longer reaction time, lower accuracy) as chunk tightness increased. ERP data showed that, as chunk tightness increased, the LPC exhibited a significant decrease at posterior electrode sites. The results indicate that chunk tightness might exert its primary effect on chunk decomposition difficulty by increasing the difficulty of visuo-spatial transformation, a process linked to the parietal LPC.

Stimulus complexity and chunk tightness interact to impede perceptual restructuring during problem solving.

The mutual influence of stimulus complexity and chunk tightness on perceptual restructuring was examined using a chunk decomposition task (CDT). Participants attempted to remove components of Chinese characters in order to produce new, valid characters. Participants had their electroencephalogram recorded while completing a CDT in conditions of low or high stimulus complexity, crossed with two levels of chunk tightness. Tight chunks overlapped spatially whereas loose chunks did not. Both increasing chunk tightness and increasing stimulus complexity impaired performance (lower accuracy, longer reaction times), and these factors interacted such that highly complex, tight chunks produced the worst performance. These factors also had interacting effects on the late positive complex (LPC). The LPC amplitude was reduced by increasing chunk tightness, but this effect was attenuated for highly complex stimuli. These results suggest that though chunk tightness and stimulus complexity impair performance in the CDT, they have dissociable neural underpinnings.

Prenatal diagnosis of hypospadias with 2-dimensional and 3-dimensional ultrasonography.

To compare the prenatal diagnostic performance as well as appearance of ultrasonic details between 2-dimensional ultrasonography (2DUS) combined with 3-dimensional ultrasonography (3DUS) and 2DUS alone for hypospadias. A total of 47 fetuses were enrolled and examined by 2DUS and then 3DUS. Postnatal follow-up data were obtained and 28 cases were confirmed of hypospadias. Although not statistically significant, there was a trend toward higher AUC (0.85 vs. 0.76; p = 0.08), ACC (85.1 vs. 76.6%; p = 0.22), SEN (85.7 vs. 78.6%; p = 0.63), and SPE (84.2 vs. 73.7%; p = 0.50) for 2DUS combined with 3DUS compared with 2DUS alone. The agreement between both methods was moderate [kappa = 0.592]. Both modalities showed accurately the short penis and blunt tip of the penis. 2DUS in combination with 3DUS showed more cases in other detailed features, such as "chordee", a "hooded" incomplete prepuce, and so on. Overall 2DUS combined with 3DUS showed a trend toward higher performance compared with 2DUS alone for the diagnosis of hypospadias, although the difference was not statistically significant. 3DUS is a useful complement for 2DUS in the diagnosis of fetal hypospadias and may provide more detailed information related to its diagnosis and prognosis.

Identification and transformation difficulty in problem solving: Electrophysiological evidence from chunk decomposition.

A wealth of studies have investigated how to overcome experience-based constraints in creative problem solving. One such experience-based constraint is the tendency for people to view tightly organized visual stimuli as single, unified percepts, even when decomposition of those stimuli into component parts (termed chunk decomposition) would facilitate problem solving. The current study investigates the neural underpinnings of chunk decomposition in creative problem solving by analyzing event-related potentials. In two experiments, participants decomposed Chinese characters into the character's component elements and then used the base elements to form a new valid character. The action could require decomposing a "tight" chunk, meaning that the component elements intersected spatially, or a "loose" chunk, in which the component elements did not overlap in space. Behaviorally, individuals made more errors and responded slower to trials involving tight chunks relative to loose chunks. Analysis of the ERPs revealed that relative to loose chunks, the electrophysiological response to tight chunks contained an increased N2, an increased N400, and a decreased late positive complex. Taken together, these results suggest that chunk tightness is a principle determinant of the difficulty of chunk decomposition, and that chunk tightness provokes neural conflict and semantic violations, factors known to influence the N2 and N400 ERP components.

Prenatal sonographic characteristics and postnatal outcomes of umbilical-portal-systemic venous shunts under the new in-utero classification: A retrospective study.

An in-utero re-classification of umbilical-portal-systemic venous shunt (UPSVS) has recently been proposed. We retrospectively reviewed the sonograms of a large cohort of fetuses, identified and analyzed UPSVS cases, and presented the prenatal sonographic characteristics, birth outcomes, and follow-up results following the new classification system.Sonograms and clinical data of all participants who visited our departments from April 2016 to July 2018 were retrospectively reviewed. Identified cases of UPSVS were analyzed according to the new classification: Type I: umbilical-systemic shunt (USS); Type II: ductus venosus-systemic shunt (DVSS); Type IIIa: intrahepatic portal-systemic shunt (IHPSS) and Type IIIb: extrahepatic portal-systemic shunt (EHPSS). Postnatal follow-ups ranged from 3 months to 1 year.A total of 10 UPSVS cases were identified in 61,082 fetuses: 4 with Type I, 3 with Type II and 3 with Type IIIa. All 4 cases of USS had complete agenesis of the portal venous system, and had the umbilical vein drained into the inferior vena cava. Two USS cases also had trisomy 21. Pregnancy was terminated in all cases with a Type I shunt. Two fetuses with DVSS had normal portal venous system and were born full term. The pregnancy of 1 DVSS case was terminated due to the detection of trisomy 21. Three cases were IHPSS with full-term birth. One had chromosomal abnormality and 1 had surgery to repair the shunt 12-days post birth. In the 2 cases that did not receive repair surgery, sonographic examination revealed the portal-hepatic venous shunt was not closed at the 6-month follow-up period. However, the 1 case that had repair surgery appeared healthy at the 3-month follow-up period.UPSVS is extremely rare. Type I shunts have the poorest prognosis, and the presence of the intrahepatic portal venous system is key to live birth in UPSVS regardless of types. Chromosomal abnormalities and other organ anomalies can occur in any types of UPSVS. Therefore, karyotyping and examination of other organs should be performed once UPSVS is detected.

The Effect of the Embodied Guidance in the Insight Problem Solving: An Eye Movement Study.

Insight is an important cognitive process in creative thinking. The present research applied embodied cognitive perspective to explore the effect of embodied guidance on insight problem solving and its underlying mechanisms by two experiments. Experiment 1 used the matchstick arithmetic problem to explore the role of embodied gestures guidance in problem solving. The results showed that the embodied gestures facilitate the participants' performance. Experiment 2 investigated how embodied attention guidance affects insight problem solving. The results showed that participants performed better in prototypical guidance condition. Experiment 2a adopted the Duncker's radiation problem to explore how embodied behavior and prototypical guidance influence problem solving by attention tracing techniques. Experiment 2b aimed to further examine whether implicit attention transfer was the real cause which resulted in participants over-performing in prototypical guidance condition in Experiment 2a. The results demonstrated that overt physical motion was unnecessary for individuals to experience the benefits of embodied guidance in problem solving, which supported the reciprocal relation hypothesis of saccades and attention. In addition, the questionnaire completed after experiments showed that participants did not realize the relation between guidance and insight problem solving. Taken together, the current study provided further evidence for that embodied gesture and embodied attention both facilitated the insight problem solving and the facilitation is implicit.

Automatic Processing of Emotional Words in the Absence of Awareness: The Critical Role of P2.

It has been long debated to what extent emotional words can be processed in the absence of awareness. Behavioral studies have shown that the meaning of emotional words can be accessed even without any awareness. However, functional magnetic resonance imaging studies have revealed that emotional words that are unconsciously presented do not activate the brain regions involved in semantic or emotional processing. To clarify this point, we used continuous flash suppression (CFS) and event-related potential (ERP) techniques to distinguish between semantic and emotional processing. In CFS, we successively flashed some Mondrian-style images into one participant's eye steadily, which suppressed the images projected to the other eye. Negative, neutral, and scrambled words were presented to 16 healthy participants for 500 ms. Whenever the participants saw the stimuli-in both visible and invisible conditions-they pressed specific keyboard buttons. Behavioral data revealed that there was no difference in reaction time to negative words and to neutral words in the invisible condition, although negative words were processed faster than neutral words in the visible condition. The ERP results showed that negative words elicited a larger P2 amplitude in the invisible condition than in the visible condition. The P2 component was enhanced for the neutral words compared with the scrambled words in the visible condition; however, the scrambled words elicited larger P2 amplitudes than the neutral words in the invisible condition. These results suggest that the emotional processing of words is more sensitive than semantic processing in the conscious condition. Semantic processing was found to be attenuated in the absence of awareness. Our findings indicate that P2 plays an important role in the unconscious processing of emotional words, which highlights the fact that emotional processing may be automatic and prioritized compared with semantic processing in the absence of awareness.

Approaching the Distinction between Intuition and Insight.

Intuition and insight share similar cognitive and neural basis. Though, there are still some essential differences between the two. Here in this short review, we discriminated between intuition, and insight in two aspects. First, intuition, and insight are toward different aspects of information processing. Whereas intuition involves judgment about "yes or no," insight is related to "what" is the solution. Second, tacit knowledge play different roles in between intuition and insight. On the one hand, tacit knowledge is conducive to intuitive judgment. On the other hand, tacit knowledge may first impede but later facilitate insight occurrence. Furthermore, we share theoretical, and methodological views on how to access the distinction between intuition and insight.

The influence of element type and crossed relation on the difficulty of chunk decomposition.

Chunk decomposition is an aspect of problem solving that involves decomposing a pattern into its component parts in order to regroup them into a new pattern. Previous work suggests that the primary source of difficulty in chunk decomposition is whether a problem's solution requires removing a part that is a meaningful perceptual pattern (termed a chunk) or not (a non-chunk). However, the role of spatial overlap (crossed relation or not) has been ignored in this line of research. Here, we dissociated the role of element type and crossed relation in chunk decomposition problems by employing a Chinese character transformation task. We replicated the finding that when the to-be-removed element is a non-chunk, the problem is more difficult to solve than when the element is a chunk. However, this result held only if the elements had no crossed relation. Relative to non-crossed relation, problems that involved removing elements that overlapped with the remaining character were more difficult to solve irrespective of the element type. We conclude that both element type and crossed relation can cause the difficulty of chunk decomposition and crossed relation plays more important role in preventing people from finding insightful ways to decompose chunk relative to element type.

Chunk decomposition contributes to forming new mental representations: An ERP study.

Whereas previous studies mainly focused on the role of chunk decomposition on how to break impasse in insight occurrence, our study aimed to investigate the role of chunk decomposition in forming new mental representations. For this purpose, the Chinese riddle comprehension task was employed in which the riddle involves either tight or loose chunk decomposition. The event-related potentials (ERPs) were measured after the onset of an answer hint, with which participants were instructed to comprehend the Chinese riddles. The behavioral results showed that participants performed worse on riddle comprehension in tight chunk condition than in loose chunk condition. In addition, we found larger N100 and P300 deflections in the former condition than in the latter condition. These findings suggest that early perceptual processing is crucially required by chunk decomposition, which contributes to forming new mental representations by integrating the perceptual and semantic information.