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13. There are three structurally isomeric ethers with the formula C₃H₆O.

【題組】(3) Rearrange all 7 compounds with increasing boiling point. (2 pts)
【題組】(2) There are four other compounds with the formula C₃H₆O that are not ethers. Draw the structures of these compounds, and identify all functional groups present in the molecule. (4 pts)
【題組】 (1) Draw structural formulas for these three compounds. (3 pts)
Passage 2 The news that one of the Hollywood superstars was diagnosed the aphasia drew everyone’s attention on the causes and effects of such disease. According to the medical statistics in the USA, approximately one-third of stroke survivors suffer from impaired communication abilities, and 30%–42% of these patients have longstanding symptoms of aphasia, and the most common, Broca’s aphasia, is caused by lesions on anterior brain regions, which often require long-term care, leading to substantial economic and mental health burdens on the family and society. Community medical resources have confirmed that promoting full engagement with rehabilitation treatment for post-stroke patients has reduced the disability rate below 40% and increased activities of daily living by 35%. In addition, intensive speech and language therapy (SLT) improves the functional reorganization of the central nervous system； however, high-intensity and high-dose interventions may not be acceptable to all patients. Therefore, other treatments adjunct to SLT might be useful. More specifically, while intensive SLT is effective, recent evidence suggests that scalp acupuncture therapy (SAT) may have beneficial effects on comprehension, oral expression, repetition, denomination, reading and writing in postapoplectic aphasia (Tang, Tang, & Yang, 2019). One research group from Taiwan (Liu, Huang, Xu, Wu, Tao, & Chen, 2021) tried to appraise the costeffectiveness of combining SAT with SLT community patients with Broca’s aphasia after stroke, 中國醫藥大學 112 學年度學士後中醫學系入學招生考試英文試題本試題（含封面）共計9頁之第8頁 compared to SLT alone. They found that combination therapy was cost-effective and reduced the use of non-standard treatments and medications, leading to lower direct non-medical costs and self-paid expenses. In Liu et al.’s (2021) research, a within-trial cost-effectiveness analysis was applied among 203 participants with Broca’s aphasia after stroke who had been randomly assigned to receive scalp acupuncture with SLT (intervention) or SLT alone (control). Both groups underwent SLT, which roughly last 30 minutes each day, 5 days a week for 4 weeks； while the intervention group simultaneously received scalp acupuncture. Moreover, outcomes were measured using informal assessments and self-report questionnaires and the incremental cost-effectiveness ratios (ICERs) were calculated as a measure of the additional costs necessary to achieve greater treatment outcomes. The results of this economic analysis revealed that patients receiving combination therapy reduced their use of non-standard treatment interventions and medications, reflected in reduced direct non-medical costs and self-paid expenses. Combination therapy was less costly than SLT alone calculated according to the modified intention-to-treat principle. In other words, SAT is a cost-effective treatment option for patients with Broca’s aphasia after stroke, compared to SLT alone. In short, the study, which included the first economic evaluation of acupuncture treatment in patients with Broca’s aphasia after stroke, had valuable findings and methodological limitations. There are only a few studies on acupuncture treatment in patients with Broca’s aphasia after stroke, Liu et al. (2021) concluded that acupuncture seems to be effective in improving post-stroke aphasia, functional communication and language function, and the best curative effect was achieved with the combination of acupuncture with speech and language training. Potential limitations included lack of blinding, variability of treatment regimens, and a heterogeneous patient sample. While SAT appears to be an effective treatment for post-stroke aphasia, the real-world implementation of SAT in lowincome and middle-income countries and regions may be restricted by poor acupuncture services, inefficient systems, and a deficiency of therapists. Standardized education and training for the public, community physicians, and government agencies are needed to improve awareness of the benefits and cost-effectiveness of SAT. Still, although the effects of acupuncture appear to be persistent as the differences between the groups were slightly larger after 12 weeks follow-up investigation than those who received immediately post-treatment, long-lasting health economic effects require further study.
【題組】50. What did the economic analysis demonstrate about scalp acupuncture therapy (SAT) in comparison to speech and language therapy (SLT) alone? (A) SAT and SLT are equally effective. (B) SAT is less effective and less accessible. (C) SAT is more expensive and less effective. (D) SAT is cost-effective and more accessible
【題組】49. What is needed to improve awareness of the benefits and cost-effectiveness of SAT? (A) Increased investment in research and development (B) Increased availability of acupuncture services (C) Standardized education and training (D) More robust economic analyses
【題組】48. What information was true in Liu et al.’s design of research? (A) Different instruments were used to collect data such as questionnaires. (B) A total of 203 participants with Broca’s aphasia were equally allotted. (C) Both groups applied the SAT to determine the medical effects. (D) The data collection lasted for one month approximately.

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