Video-assisted thoracoscopic surgery (VATS) has been widely used for low invasiveness and shorter recovery time. However, patients receiving VATS still experienced moderate-to-severe pain even under both regional and systemic analgesia. Little is known on the effect of non-pharmaceutical method with physical stabilization for post-VATS pain control. The study aims to investigate the feasibility of physical stabilization as a surrogate method for pain control. The single-blinded, randomized-controlled trial recruited the patients into physical stabilization group and standard care group after VATS. The patients in the intervention group tied a thoracic belt for all day, while the control group did not. Both groups had intravenous patient-controlled analgesia (IVPCA) and on-demand oral analgesics. The primary outcome was the visual analogue scale for pain at the 6th, 24th and 48th hour post-VATS and at the hospital discharge. There were 18 patients assigned to the interventional group and 18 patients assigned to the control group. Four patients in the control group were dropped out from the study. Physical stabilization was found to enhance the analgesic effect post-operative 24-48 h compared to standard care (Difference of VAS: 1.11 ± 0.68 v.s. 0.5 ± 0.86, p = 0.031). It had no effect on the dose of IVPCA or the use of oral analgesic agents. No complications direct to the thoracic belt or adverse outcome from the surgery were found in the study. Physical stabilization with thoracic belt to patients receiving VATS benefits to pain control, especially between the 24th and 48th hour post-VATS. Clinical Trial Registry number: NCT04735614.

While Taiwan Mandarin alveolar and velar nasal codas are reported to lose their place contrast in a vowel-dependent fashion (i.e., more pervasive merging in the /iN/ context, followed by the /əN/ context, and no merging in the /aN/ context), other acoustic cues, such as vowel nasalization, have been reported to preserve the contrast. Results from our ultrasound experiment, in which Taiwan Mandarin speakers produced nasal codas in both focused and unfocused conditions, showed that the place contrast was most vulnerable to merger in /iN/ and /əN/ contexts and was not enhanced by focus. Instead, pre-nasal vowel nasalization emerged as a contrastive cue, especially in the highly merged /iN/ context in both focus conditions, suggesting a possible shift from place contrast to nasality contrast in production. A follow-up identification experiment revealed that speakers did not yet utilize the nasalization cues reliably to perceptually identify nasal codas, indicating a mismatch in the perception-production link.

Pei-Lin Lee serves as Clinical Associate Professor, School of Medicine, National Taiwan University; Consultant, Center of Sleep Disorder, National Taiwan University Hospital. Her current academic positions at international sleep societies include American Academy of Sleep Medicine Fellow and Co-Chair International Assembly; Asian Society of Sleep Medicine, Sleep Medicine Education Task Force committee member. Her current research focuses on the era of new technology and big data in sleep medicine; and intervention on sleep and metabolism in sleep disordered breathing.