Mixed methods research on satisfaction with athletes' compensation

This study explores the factors influencing athletes' compensation satisfaction and their configuration effects. A mixed research approach that combines regression analysis and fuzzy-set qualitative comparative analysis (fsQCA) was applied to process the survey data of 352 athletes from six provinces. The regression analysis results demonstrate that economic compensation, the compensation system, the external environment, and compensation fairness all have a significant positive effect on athletes' compensation satisfaction. Accordingly, the fsQCA approach was applied to explore the combined effects of the factors influencing athletes' compensation satisfaction, which verifies the conclusions drawn from regression analysis and provides improvement paths for increasing athletes' compensation satisfaction.

Epsilon-poly-l-lysine alleviates brown blotch disease of postharvest Agaricus bisporus mushrooms by directly inhibiting Pseudomonas tolaasii and inducing mushroom disease resistance

The natural antimicrobial peptide, epsilon-poly-l-lysine (ε-PL), is widely acknowledged as a food preservative. However, its potential in managing bacterial brown blotch disease in postharvest edible mushrooms and the associated mechanism remain unexplored. In this study, concentrations of ε-PL ≥ 150 mg L-1 demonstrated significant inhibition effects, restraining over 80% of growth and killed over 99% of Pseudomonas tolaasii (P. tolaasii). This inhibition effect occurred in a concentration-dependent manner. The in vivo findings revealed that treatment with 150 mg L-1 ε-PL effectively inhibited P. tolaasii-caused brown blotch disease in Agaricus bisporus (A. bisporus) mushrooms. Plausible mechanisms underlying ε-PL's action against P. tolaasii in A. bisporus involve: (i) damaging the cell morphology and membrane integrity, and increasing uptake of propidium iodide and leakage of cellular components of P. tolaasii; (ii) interaction with intracellular proteins and DNA of P. tolaasii; (iii) inhibition of P. tolaasii-induced activation of polyphenol oxidase, elevation of antioxidative enzyme activities, stimulation of phenylpropanoid biosynthetic enzyme activities and metabolite production, and augmentation of pathogenesis-related protein contents in A. bisporus mushrooms. These findings suggest promising prospects for the application of ε-PL in controlling bacterial brown blotch disease in A. bisporus.

Sleep-dependent consolidation effects on foreign language word acquisition in a virtual reality environment

Sleep-dependent consolidation is important for novel word learning, but previous studies have neglected the potential modulating role of learning environments. The present study examines sleep-dependent consolidation effects by comparing learning in a virtual reality (VR) environment and in a traditional picture-word (PW) environment. Two groups of Chinese-English bilinguals were randomly assigned to a VR or PW environment. In both learning environments, they learned novel words in Korean, a language with which they had no prior experience. All participants learned one set of novel words on Day 1 and another set on Day 2. An explicit recognition task and an implicit primed lexical-decision task were employed to measure sleep-dependent consolidation effects from the two environments. Results revealed sleep-dependent consolidation effects in both explicit and implicit measures, but only the primed lexical-decision task showed an influence of learning environment, suggesting that novel words learned via VR had better consolidation. Taken together, our findings suggest that a VR environment that fosters a rich sensory experience facilitates sleep-dependent consolidation effects. We argue that these results provide new evidence and implications for the complementary learning system (CLS) model.

Asthma and clinical outcomes of COVID-19 in a community setting

OBJECTIVES

The association between asthma and COVID-19 mortality remains inconclusive. We examined the association between asthma and clinical outcomes of patients with COVID-19.

STUDY DESIGN

A case-control study based on a surveillance cohort in Harris County, Texas.

METHODS

Using the data of 21,765 patients who reported having at least one chronic health condition, we investigated the association between asthma and COVID-19 severity, characterized primarily by hospitalization and death. Unconditional logistic regression models were used to estimate the multivariable odds ratio (mOR) and its 95 % confidence interval (CI) of COVID-19 severity associated with asthma and other chronic lung diseases, adjusting for demographic and other comorbidities. A P-value < 0.005 was considered statistically significant after correcting multiple testing.

RESULTS

In total, 3034 patients (13.9 %) had asthma, and 774 (3.56 %) had other chronic lung diseases. The case death rate among patients with asthma and other chronic lung diseases was 0.75 % and 19.0 %, respectively. Compared to patients without the respective conditions, patients with asthma had lower odds of death (mOR = 0.44, 95 % CI: 0.27-0.69), while patients with other chronic lung diseases had higher odds of hospitalization (mOR = 2.02, 95 % CI: 1.68-2.42) and death (mOR = 1.95, 95 % CI: 1.52-2.49) (P-values < 0.005). Risk factors for COVID-19 mortality included older age, male gender, diabetes, obesity, hypertension, cardiovascular disease, active cancer, and chronic kidney disease.

CONCLUSIONS

The public health surveillance data suggested that preexisting asthma was inversely associated with COVID-19 mortality.

Patulin induces ROS-dependent cardiac cell toxicity by inducing DNA damage and activating endoplasmic reticulum stress apoptotic pathway

Patulin (PAT) is one of the mycotoxins commonly found in agricultural products and fruits, and has obvious toxic effects on animals and humans. PAT has been found to cause myocardial toxicity and oxidative damage, but the mechanism of myocardial toxicity remained to be elucidated. We investigated the toxic effects and potential mechanisms of PAT on human cardiomyocytes and explored the effects of reactive oxygen species (ROS) on them. The study showed that treatment with PAT for 24 h decreased cell viability and superoxide dismutase (SOD) activity, and increased ROS and lactate dehydrogenase (LDH) levels. Moreover, in addition to detecting increased γ-H2AX expression and observing nuclear damage, the comet assay also showed increased DNA tail distance in the PAT-treated group, followed by an increase in phosphorylation of the p53 protein and p21 protein expression, and a decrease in CDK1 and Cyclin B1 protein expression, and G2/M phase arrest. In addition, PAT induced endoplasmic reticulum stress (ERS) and induced apoptosis, as evidenced by Ca2+ increase, ER enlargement and swelling, and upregulation of ERS-related genes and proteins expression, and increased expression of three apoptotic pathway proteins under ERS, including CHOP, JNK, and caspase-12. Meanwhile, N-acetylcysteine (NAC, a ROS scavenger) reversed the negative effects of PAT treatment on cells. These results clarify that excessive ROS production by PAT-treated AC16 cells not only causes DNA damage, leading to cell cycle arrest, but also causes ERS, which triggers apoptotic pathways to cause apoptosis.

[Analysis of clinical characteristics and treatment status of atopic dermatitis in a children's hospital in Beijing from 2015 to 2019]

To analyze the clinical characteristics and treatment status of atopic dermatitis (AD) in children in the outpatient department of a children's hospital in Beijing from 2015 to 2019. This study used a cross-sectional study method to retrospectively analyze the data of AD patients who visited the Dermatology outpatient department of Beijing Children's Hospital, Capital Medical University, from April 2015 to April 2019. A total of 1 926 AD patients aged 0-17.5 years old living in Beijing and its surrounding areas were included, and the general situation, severity and distribution of AD disease, clinical characteristics and severity of AD, relevant influencing factors of AD onset, AD disease prognosis and treatment status were recorded. SAS 9.4, SPSS19.0, and R software were used for data processing, and descriptive statistical analysis, Chi-square test, Analysis of Variance, and correspondence analysis were used for statistical analysis. The results showed that the male to female ratio of AD patients in children included in this study was 1.4∶1; 79.0% (1 522/1 926), 86.1%(1 658/1 926), 91.3%(1 758/1 926), and 97.3%(1 907/1 926) of AD onset at the age of 6 months, 1 year, 2 years, and 5 years, respectively; mild of AD patients accounted for 13.2% (255/1 926)(SCORAD score 0-24), moderate of AD patients accounted for 50.1%(965/1 926) (SCORAD score 25-50), and severe of AD patients accounted for 36.7% (706/1 926)(SCORAD score>50).The age of severe AD patients were younger than mild and moderate AD patients. The face, head, trunk, and lower limbs were common areas of onset for moderate to severe AD, while the hands, feet, and ears were common areas of onset for severe AD patients. Temperature changes, hot water factors, mental and emotional states, and spring and winter were the main aggravation factors of AD;35.2% (678/1 926) aggravated and 61.8% (1 191/1 926) persistent. The more frequent bathing, the less severity of AD disease (χ2=29.791,P<0.001); 28.0% (520/1 856) of AD patients have no moisturizing habits, which were correlated with the severity of AD disease (χ2=15.908, P<0.05); the proportion of combined treatment medications in children with moderate to severe AD was significantly higher than mild AD patients. In conclusion, the patients with AD who went to specialist clinics were mainly moderate to severe patients and developed disease before the age of 5 years from 2015 to 2019.The severity of AD were mainly moderate to severe, and most of these patients had poor disease control. Traditional treatment plans had limitations. Identifying the clinical characteristics and treatment status of childhood AD would help us to carry out more targeted prevention and management work.

Clinical Relevance of Plaque Distribution for Basilar Artery Stenosis

BACKGROUND AND PURPOSE

There is no clear association between plaque distribution and postoperative complications in patients with basilar artery atherosclerotic stenosis. The aim of this study was to determine whether plaque distribution and postoperative complications after endovascular treatment for basilar artery stenosis are related.

MATERIALS AND METHODS

Our study enrolled patients with severe basilar artery stenosis who were scanned with high-resolution MR imaging and followed by DSA before the intervention. According to high-resolution MR imaging, plaques can be classified as ventral, lateral, dorsal, or involved in 2 quadrants. Plaques affecting the proximal, distal, or junctional segments of the basilar artery were classified according to DSA. An experienced independent team assessed ischemic events after the intervention using MR imaging. Further analysis was conducted to determine the relationship between plaque distribution and postoperative complications.

RESULTS

A total of 140 eligible patients were included in the study, with a postoperative complication rate of 11.4%. These patients were an average age of 61.9 (SD, 7.7) years. Dorsal wall plaques accounted for 34.3% of all plaques, and plaques distal to the anterior-inferior cerebellar artery accounted for 60.7%. Postoperative complications of endovascular treatment were associated with plaques located at the lateral wall (OR = 4.00; 95% CI, 1.21-13.23; P = .023), junctional segment (OR = 8.75; 95% CI, 1.16-66.22; P = .036), and plaque burden (OR = 1.03; 95% CI, 1.01-1.06; P = .042).

CONCLUSIONS

Plaques with a large burden located at the junctional segment and lateral wall of the basilar artery may increase the likelihood of postoperative complications following endovascular therapy. A larger sample size is needed for future studies.

Effect of salidroside on ventricular remodeling after acute myocardial infarction

Purpose: To investigate the remodeling influence of salidroside (SAL) on the ventricles following acute myocardial infarction (AMI) in rats, and the processes involved.Methods: A total of 65 Sprague Dawley (SD) rats were assigned to 5 groups: sham (n = 13), model, and low-, medium- and high-dose SAL groups given SAL at doses of 12, 34, and 36 mg/day, respectively, with 13 rats in each group. Changes in pathological structure, collagen area, ratio of collagen I/collagen III, left ventricular mass index (LVW/BW), ratio of cardiac weight to body weight (HW/BW), creatine kinase MB isoenzyme (CK-MB), lactate dehydrogenase-1 (LDH-1), endothelin (ET), laminin (LN), and hyaluronic acid (HA) were evaluated. Expression levels of dishevelled-1 (DVL-1) and β-catenin in myocardial tissues of the rats were also determined.Results: The LVW/BW values were significantly higher in the low SAL and medium SAL groups than those in AMI rats, while the ratio of collagen I/III and expression levels of DVL-1 and β-catenin proteins were significantly lower than those in the model group (p < 0.05). The myocardial structure of rats in the sham group was normal, with no obvious lesions. The levels of CK-MB, LDH-1, ET, LN, and HA in medium and high-dose SAL groups were significantly lower than those in the model group (p < 0.05).Conclusion: Salidroside mitigates remodeling of ventricles following AMI in rats by modulating the Wnt/β-catenin signal route.

Effects of cold water immersion after exercise on fatigue recovery and exercise performance--meta analysis

Cold water immersion (CWI) is very popular as a method reducing post-exercise muscle stiffness, eliminating fatigue, decreasing exercise-induced muscle damage (EIMD), and recovering sports performance. However, there are conflicting opinions as to whether CWI functions positively or negatively. The mechanisms of CWI are still not clear. In this systematic review, we used meta-analysis aims to examine the effect of CWI on fatigue recovery after high-intensity exercise and exercise performance. A total of 20 studies were retrieved and included from PubMed, PEDro and Elsevier databases in this review. Publication years of articles ranged from 2002 to 2022. In selected studies including randomized controlled trials (RCTs) and Crossover design (COD). Analyses of subjective indicators such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE), and objective indicators such as countermovement jump (CMJ) and blood plasma markers including creatine kinase(CK), lactate/lactate dehydrogenase(LDH), C-reactive protein(CRP), and IL-6 were performed. Pooled data showed as follows: CWI resulted in a significant decline in subjective characteristics (delayed-onset muscle soreness and perceived exertion at 0 h); CWI reduced countermovement jump(CMJ) significantly at 0 h, creatine kinase(CK) was lowered at 24 h, and lactate at 24 and 48 h. There was no evidence that CWI affects C-reactive protein(CRP) and IL-6 during a 48-h recovery period. Subgroup analysis revealed that different CWI sites and water temperatures have no effect on post-exercise fatigue recovery. Recommended athletes immersed in cold water immediately after exercise, which can effectively reduce muscle soreness and accelerate fatigue recovery.

Coptisine attenuates post‑infectious IBS via Nrf2‑dependent inhibition of the NLPR3 inflammasome

Inhibition of the activation of the NLR family pyrin domain‑containing 3 (NLRP3) inflammasome has previously been reported to confer protection against post‑infectious irritable bowel syndrome (PI‑IBS). Coptisine, the second most abundant isoquinoline alkaloid in Coptis chinensis, can inhibit NLRP3 inflammasome activation; however, whether coptisine exhibits protective effects against PI‑IBS remains unclear. In the present study, coptisine significantly reduced gastrointestinal motility and abdominal withdrawal reflex scores in a PI‑IBS rat model that was induced using intragastric administration of Trichinella spiralis larvae. Coptisine treatment significantly decreased the protein levels of oxidative stress markers, 4‑hydroxynonenal, protein carbonyl and 8‑hydroxy‑2'deoxyguanosine, and proinflammatory cytokines, TNF‑α, IL‑1β and IL‑18 in the colon of PI‑IBS rats. Moreover, coptisine treatment significantly increased nuclear factor erythroid 2‑related factor 2 (Nrf2) nuclear translocation and heme oxygenase‑1 protein expression levels, while significantly downregulating the protein expression levels of NLRP3, apoptosis‑associated speck‑like protein containing a CARD and caspase‑1 in the colons of PI‑IBS rats. It is important to note that the anti‑inflammatory effects of coptisine were blocked by the Nrf2 inhibitor ML385. In summary, the present study indicated that coptisine potentially attenuated PI‑IBS in rats via Nrf2‑dependent inhibition of the NLPR3 inflammasome.

Thrombectomy Using the EmboTrap Clot-Retrieving Device for the Treatment of Acute Ischemic Stroke: A Glimpse of Clinical Evidence

BACKGROUND

The EmboTrap Recanalization Device is a novel stent retriever for thrombectomy in the setting of acute ischemic stroke due to large-vessel occlusion.

PURPOSE

Our aim was to summarize the safety and efficacy of the EmboTrap Recanalization Device in acute ischemic stroke-large-vessel occlusion through a systematic review and meta-analysis.

DATA SOURCES

Medline, EMBASE, the Cochrane Library, Web of Science, and Google Scholar were searched up to April 2022.

STUDY SELECTION

Nine observational studies using the EmboTrap Recanalization Device were selected.

DATA ANALYSIS

We adapted effect size with 95% CIs for dichotomous data. P value <.05 was statistically significant.

DATA SYNTHESIS

The estimated rate of successful recanalization (modified TICI 2b-3) was 90% (95% CI, 86%-95%; I ² = 82.4%); 90-day favorable outcome (mRS 0-2), 53% (95% CI, 42%-63%; I ² = 88.6%); modified first-pass effect, 43% (95% CI, 35%-51%; I ² = 63.7%); and first-pass effect, 36% (95% CI, 29%-46%; I ² = 10.7%). The rate of any intracerebral hemorrhage was 19% (95% CI, 16%-22%; I ² = 0.0%); symptomatic intracerebral hemorrhage, 5% (95% CI, 1%-8%; I ² = 84.6%); and 90-day mortality, 14% (95% CI, 9%-19%; I ² = 79.3%). Subgroup analysis showed higher rates of complete recanalization for EmboTrap II than for the EmboTrap System.

LIMITATIONS

The included studies are single-arm without direct comparison with other stent retrievers. Some of the studies recruited had a small sample size and were limited by the retrospective study design. In addition, the uncertain heterogeneity among studies was high.

CONCLUSIONS

The EmboTrap Recanalization Device is safe and efficient in treating acute ischemic stroke due to large-vessel occlusion.

Effect of Sodium Selenite on the Metabolite Profile of Epichloë sp. Mycelia from Festuca sinensis in Solid Culture

Selenium (Se) is an essential micronutrient with many beneficial effects for humans and other living organisms. Numerous microorganisms in culture systems enrich and convert inorganic selenium to organic selenium. In this study, Epichloë sp. from Festuca sinensis was exposed to increasing Na2SeO3 concentrations (0, 0.1, 0.2, 0.3, and 0.4 mmol/L) in Petri dishes with potato dextrose agar (PDA) for 8 weeks. Epichloë sp. mycelia were immediately collected after mycelial diameters were measured at 4, 5, 6, 7, and 8 weeks of cultivation, respectively. Gas chromatography-mass spectrometer (GC-MS) analysis was performed on different groups of Epichloë sp. mycelia. Different changes were observed as Epichloë sp. was exposed to different selenite conditions and cultivation time. The colony diameter of Epichloë sp. decreased in response to increased selenite concentrations, whereas the inhibitory effects diminished over time. Seventy-two of the 203 identified metabolites did not differ significantly across selenite treatments within the same time point, while 82 compounds did not differ significantly between multiple time points of the same Se concentration. However, the relative levels of 122 metabolites increased the most under selenite conditions. Specifically, between the 4th and 8th weeks, there were increases in 2-keto-isovaleric acid, uridine, and maltose in selenite treatments compared to controls. Selenium increased glutathione levels and exhibited antioxidant properties in weeks 4, 5, and 7. Additionally, we observed that different doses of selenite could promote the production of carbohydrates such as isomaltose, cellobiose, and sucrose; fatty acids such as palmitoleic acid, palmitic acid, and stearic acid; and amino acids such as lysine and tyrosine in Epichloë sp. mycelia. Therefore, Epichloë sp. exposed to selenite stress may benefit from increased levels of some metabolite compounds.

442 A Comparison of Short-Term Outcomes in Robotic and Laparoscopic Distal Pancreatectomy

Aim

Technical limitations of laparoscopic distal pancreatectomy (LDP) may translate to high conversion postoperative complications rates. Robotic distal pancreatectomy (RDP) can potentially allow for better visualisation and greater freedom of movement, improving surgical outcomes. The aim of this retrospective observational study is to compare short term outcomes between RDP and LDP.

Method

We retrospectively analysed all RDP and LDP procedures performed at our centre by a single surgeon between December 2009 and July 2021. We recorded demographic data for 62 consecutive LDP cases and 27 RDP cases and compared the perioperative outcomes, 90-day morbidity and mortality.

Results

Both groups were comparable with respect to baseline characteristics. The conversion to open rate was significantly higher in the laparoscopic group (21.0% vs. 3.7%, p = 0.04). Operative time (176.5 min RDP vs. 156.8 min LDP, p = 0.503) and number of operations with clinically significant estimated blood loss (&gt; 500ml) (1 RDP vs. 3 LDP, p = 0.998) was comparable in both groups. For the benign conditions, the spleen preservation rate showed no significant difference between the two groups (14.8 vs. 11.3%, p = 0.729). In both groups, three patients were readmitted within 90 days. There was no 90-day mortality in either group.

Conclusions

According to our results, RDP was equivalent to LDP in nearly all short-term operative outcomes and safety but significantly reduced the risk of conversion to open resection. However, the evidence is limited, and larger multi-centre randomised trials are needed to investigate the long-term outcomes.

The Role of Language Switching During Cross-Talk Between Bilingual Language Control and Domain-General Conflict Monitoring

The relationship between bilingual language control and executive control is debated. The present study investigated the effect of short-term language switching in a comprehension task on executive control performance in unbalanced bilinguals. Participants were required to perform a context task and an executive control task (i.e., flanker task) in sequence. A picture-word matching task created different language contexts in Experiment 1 (i.e., L1, L2, and dual-language contexts). By modifying the color-shape switching task, we created different contexts that do not involve language processing in Experiment 2 (i.e., color, shape, and dual context). Experiment 1 showed overall faster responses (in both congruent and incongruent trials) in the flanker task after a language switching context than after single (L1 or L2) contexts. This suggests that the language switching in a comprehension task affected general monitoring performance. By contrast, the nonlinguistic contexts in Experiment 2 did not affect flanker performance. This provides further evidence for the crucial role of language processing during switching to elicit short-term adaptions on domain-general conflict monitoring. Overall, our findings add to the previous studies by showing cross-talk between bilingual language control and domain-general conflict monitoring when language switching occurs in a comprehension task.

Control mechanisms in voluntary versus mandatory language switching: Evidence from ERPs

The present study measured event-related potentials (ERP) and behavioral performance to examine whether inhibitory control is involved in voluntary language switching, and if so, to explore the differences in inhibitory control between voluntary and mandatory language switching. Unbalanced Chinese-English bilinguals completed two picture naming tasks: one involving mandatory language switches and one in which participants could voluntarily switch between the two languages. Behavioral data showed significant switch costs and a reversed language dominance effect in both switching tasks. Critically, both effects were larger in mandatory compared to voluntary switching. ERP results revealed that neural switch costs during mandatory switching was significantly different than voluntary switching in both N2 and LPC amplitudes. In contrast, a significant difference in the reversed language dominance effect between both tasks was only observed in LPC amplitude. Together, these findings suggest the involvement of inhibitory control in both mandatory and voluntary language switching, but the degree of inhibition and the time-course of control processes between both tasks appear to be distinct.

Bilingual Language Control Flexibly Adapts to Cultural Context

How does bilingual language control adapt to the cultural context? We address this question by looking at the pattern of switch cost and reversed language dominance effect, which are suggested to separately reflect reactive and proactive language control mechanisms, in the contexts with culturally-neutral pictures (i. e., baseline context) or culturally-biased pictures (i.e., congruent context where culture matched the language to be spoken or incongruent context where culture mismatched the language to be spoken). Results showed an asymmetric switch cost with larger costs for L2 in the congruent context as compared with the baseline and incongruent contexts, but the reversed language dominance effect was not changed across contexts, suggesting that cultural context plays a critical role in modulating reactive but not proactive language control. These findings reveal the dynamic nature of language control in bilinguals and have important implications for the current models of bilingual language control.

Structural brain changes with second language learning: A longitudinal voxel-based morphometry study

The underlying mechanisms that adapt with L2 learning are still poorly understood. The present longitudinal study examined the effects of L2 learning on grey matter structure of Chinese college freshmen majoring in English. Participants were scanned twice, one year apart. Our voxel-based morphometry analyses revealed that gray matter volume (GMV) decreased in the left anterior cingulate cortex (ACC) and right inferior frontal gyrus (IFG) after L2 learning for one year. Critically, these structural adaptations correlated with changes in participants' language control ability across L2 learning. Moreover, age of acquisition of L2 was a significant predictor of volumetric change in the left ACC and L2 proficiency was a significant predictor of volumetric change in the right IFG. Overall, these findings enrich our understanding of the dynamic nature of structural brain adaptations, and the mechanisms these adaptations index, as a function of classroom L2 learning.

Cardiovascular benefits outweigh risks in patients with atrial fibrillation in REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial)

Background/Introduction

REDUCE-IT, a multinational, double-blind trial, randomized 8179 statin-treated patients with controlled low density lipoprotein cholesterol, elevated triglycerides, and cardiovascular (CV) risk, to icosapent ethyl (IPE) 4 grams/day or placebo. IPE reduced the primary (CV death, myocardial infarction [MI], stroke, coronary revascularization, hospitalization for unstable angina) and key secondary (CV death, MI, stroke) endpoints 25% and 26%, respectively (each p&lt;0.0001), and individual components including stroke (28%), MI (31%), cardiac arrest (48%), and sudden cardiac death (31%) (all p≤0.01). With IPE, bleeding was greater (11.8% vs 9.9%; p=0.006), serious bleeding trended higher (2.7% vs 2.1%; p=0.06), and atrial fibrillation/flutter (AF/F) hospitalization endpoints increased (3.1% vs 2.1%; p=0.004).

Purpose

To evaluate the effects of IPE on the risk of CV events and safety measures in patients by either history of AF/F or in-study occurrence of positively adjudicated AF/F hospitalization.

Methods

Conduct post hoc efficacy and safety subgroup analyses of patients with or without either baseline history of AF/F or in-study adjudicated AF/F hospitalization, including hospitalization for ≥24 hours; AF/F not meeting endpoint criteria were reported as adverse events.

Results

Patients with (n=751; 9.2%) AF/F history at baseline (vs without; n=7428; 90.8%) (Figure 1), or those with (n=211; 2.6%) positively adjudicated in-study AF/F hospitalization endpoints (vs without; n=7968; 97.4%) (Figure 2), had higher event rates of primary, key secondary, and fatal or nonfatal stroke endpoints, but relative risk reductions with IPE were not significantly different (all interaction p-values [pint]=ns). Similar reductions were observed with IPE across the prespecified endpoint testing hierarchy in patients with or without AF/F history or in-study hospitalization endpoints. Patients with baseline AF/F history had similar relative risk for in-study occurrence of AF/F hospitalization with IPE versus placebo (pint=0.21) but had greater absolute risk (12.5% vs 6.3%, IPE vs placebo) vs patients without baseline AF/F history (2.2% vs 1.6%, IPE vs placebo); i.e., recurrent AF/F in those with a prior history of AF/F was more prevalent than de novo AF/F. Serious bleeding trended higher regardless of AF/F history or in-study AF/F hospitalization endpoints (all pint=ns); absolute risk of serious bleeding was greater in patients with AF/F history at baseline (7.3% vs 6.0%) vs those without a baseline history of AF/F (2.3% vs 1.7%), and serious bleeding also trended higher in patients with in-study AF/F hospitalization (8.7% vs 6.0%) vs without (2.5% vs 2.0%) [all IPE vs placebo].

Conclusion

REDUCE-IT patients with AF/F history or in-study AF/F hospitalization endpoints had greater CV risk, but similar relative risk reduction in primary, key secondary, and fatal or nonfatal stroke endpoints with IPE.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Amarin Pharma, Inc.

Fitness comparison of Plutella xylostella on original and marginal hosts using age-stage, two-sex life tables

The diamondback moth, Plutella xylostella, is an important agricultural pest that severely damages cruciferous vegetables. Although previously considered a threat only to Brassica species, P. xylostella has been observed to feed on noncruciferous vegetables. Here, we established a population of P. xylostella on the pea Pisum sativum (PxP population). We compared this PxP population's performance on the pea host plant to a population (PxR) reared on the original host plant radish (Raphanus sativus) for several generations using an age-stage, two-sex life table and analyzed the correlations between different fitness parameters. In the 1st generation of the PxP population, survival rate of immature stage was 17%, while the survival rate of PxR was 68%; the duration of the 4th larval instar (5.30 d) and mortality (25%) of this generation were significantly longer (2.8 d) and higher (1%) than that of PxR, respectively (both p < .001). Upon long-term acclimation, the PxP fitness improved significantly, especially that the survival rate of immature stages increased to approximately 60% in the 15th, 30th, and 45th generations. However, PxP feeding on pea exhibited poorer fitness with longer larval developmental time, shorter total life span, lighter pupa, and lower fecundity in different generations compared with PxP feeding on radish. PxP feeding on pea also showed a significantly lower intrinsic rate of increase (r), net reproduction rate (R 0), finite increase rate (λ), and longer mean generation time (T) than PxP feeding on radish in all generations tested. Significant positive correlations were observed between pupal weight and female fecundity in pea-fed populations, and between female longevity and female fecundity in pea-fed and radish-fed populations. Our findings suggest that P. xylostella adaptation to pea does not improve overall fitness compared with the original host radish, making pea a marginal host for P. xylostella.

Switching between newly learned languages impacts executive control

Previous research has explored the relationship between language control and executive control based on performance in bilinguals' skilled languages. However, this relationship between bilingualism and executive control has not been examined at the very initial stage of language learning. In the present study, we trained Chinese speakers to learn words in German and Japanese, two languages with which they had no prior experience. In pre- and post-training, we measured participants' electrophysiological data to investigate how switching between these two newly learned languages affected executive control. We observed that, while lacking the language switching effect in the behavioral data, a flanker task elicited larger N2 and P3 amplitudes in the post-training session when participants were required to switch between German and Japanese compared to when they responded to only German or Japanese. These results provided evidence of language control of newly learned languages on domain-general executive control, specifically at the (very) initial period of language learning. Our findings support the adaptive nature of the relationship between bilingual language control and executive control.

REDUCE-IT: outcomes by baseline statin type

Background

REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) randomized 8,179 statin-treated patients with elevated triglycerides and increased cardiovascular (CV) risk to either icosapent ethyl (IPE), a pure, stable prescription form of eicosapentaenoic acid, 4g/day or placebo. IPE significantly reduced time to first occurrence of the primary composite endpoint of major adverse CV events (CV death, nonfatal myocardial infarction [MI], nonfatal stroke, coronary revascularization, or hospitalization for unstable angina) (HR 0.75, CI 0.68–0.83) and key secondary endpoint events (composite of CV death, nonfatal MI, or nonfatal stroke) (HR 0.74, CI 0.65–0.83) versus placebo (all p&lt;0.0001). A modest reduction in placebo-corrected LDL-C was observed (−6.6%; p&lt;0.0001). The mechanisms for the CV benefit of icosapent ethyl are not fully understood.

Purpose

Explore the impact of statin type and lipophilic/lipophobic category on outcomes, and on LDL-C, to further consider the possible relevance of LDL-C pathways to the observed CV benefit of icosapent ethyl.

Methods

Primary and key secondary endpoint analyses and LDL-C changes from baseline were explored by individual statin type (atorvastatin, simvastatin, rosuvastatin, or pravastatin) at baseline, and then by categorizing these statins into lipophilic (i.e., hydrophobic: atorvastatin, simvastatin) and lipophobic (i.e., hydrophilic: rosuvastatin, pravastatin) statin groups; 96.1% of patients fell within these individual statin groups.

Results

CV outcomes were similar across statin types (interaction p=0.61) and lipophilic/lipophobic categories (interaction p=0.51) (Figure). Statin type and category had a similar lack of meaningful impact on the modest placebo-corrected median LDL-C changes from baseline to one year, which ranged from −5.8 to −8.4% (all p≤0.0003).

Conclusion

No meaningful treatment differences in the primary or key secondary endpoints across statin type or lipophilic/lipophobic category were observed. A similar lack of treatment difference was observed in LDL-C changes from baseline to one year. Therefore, the LDL-C changes and CV risk reduction in REDUCE-IT appear independent of the type of concomitant statin therapy. These data provide clinicians with additional insight regarding concomitant statin therapy considerations when prescribing icosapent ethyl and suggest there are important mechanisms of action for the substantial CV risk reduction observed with icosapent ethyl that are distinct from the LDL receptor pathway.

Funding Acknowledgement

Type of funding source: Other. Main funding source(s): The study was funded by Amarin Pharma, Inc.

Language control network adapts to second language learning: A longitudinal rs-fMRI study

The current longitudinal resting-state functional magnetic resonance imaging study examined changes in language control network after one year of L2 English classroom learning. A group of Chinese college freshmen majoring in English underwent two scans, one before (i.e., Session 1) and one after (i.e., Session 2) the one-year L2 courses. Learners' language control abilities were assessed via a behavioral language switching task. Our graph theory and functional connectivity analyses revealed that with increased exposure to the L2, nodal betweenness in language control areas, such as the dorsal anterior cingulate cortex (dACC), decreased and connectivity between dACC and pre-supplementary motor area (pre-SMA) increased. Critically, these neural changes were correlated with participants' behavioral performance on the language switching task. Taken together, these findings suggest that the language control network in resting brain could be modulated by long-term L2 learning in a naturalistic classroom setting, and that the dACC/pre-SMA complex appears to play a critical role in language control.

REDUCE-IT: accumulation of data across prespecified interim analyses to final results

Background

REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial), an event-driven trial, randomized 8,179 statin-treated patients with elevated triglycerides (TGs) and increased cardiovascular (CV) risk to icosapent ethyl (IPE); pure, stable prescription eicosapentaenoic acid, 4g/day or placebo. 1,612 primary endpoint events (CV death, nonfatal myocardial infarction [MI], nonfatal stroke, coronary revascularization, or hospitalization for unstable angina) projected 90% power to detect 15% relative risk reduction (5% 2-sided alpha). The key secondary composite endpoint was CV death, nonfatal MI, or nonfatal stroke. An independent data and safety monitoring committee (DMC) performed prespecified interim analyses (IAs) at ∼60% (IA1 31 May 2016 data cutoff; 2.9 y median primary endpoint follow-up) and ∼80% (IA2 01 May 2017; 3.7 y) of events; final analysis included 1,606 events (06 Sep 2018; 4.9 y median study follow-up).

Purpose

Explore REDUCE-IT efficacy and safety across prespecified IAs for insight into progression of robustness and consistency of conclusions.

Methods

The interim statistical analysis plan guided study continuation decisions by a prespecified decision-making process, including assessment of safety, treatment arm performance, primary composite endpoint formal analyses, and informal robustness analyses, with no futility or efficacy stopping requirements. Prior to DMC IA study continuation decisions, the need for a mature dataset to support the robustness of final efficacy and safety findings was discussed. Sponsor, Steering Committee, and Clinical Endpoint Committee were blinded throughout.

Results

Primary and key secondary endpoints achieved statistical significance at IA1 and IA2 that persisted at final analyses (p-value below final adjusted 2-sided alpha of 0.0437); hazard ratios also remained consistent and similar robustness was observed across individual endpoint components; clarity of findings across endpoints and subgroups improved with more events. Stopping for overwhelming efficacy was discussed at each IA; prior to IA study continuation recommendations, the DMC considered historical examples of failed CV outcome studies for TG-lowering and mixed omega-3 therapies, reflected on the potential for overestimating final demonstrated benefit using incomplete data, and weighed societal impacts of fuller datasets relative to patient therapy access.

Conclusions

Consistent, potent efficacy emerged early and persisted across the two prespecified interim and final analyses. The mature dataset demonstrated highly statistically significant reductions in the primary (25%; p=0.00000001) and key secondary (26%; p=0.0000006) endpoints and allowed robust analyses to support overall efficacy and safety conclusions. Allowing the REDUCE-IT dataset to fully mature provided clinicians with robust, consistent, and reliable data upon which to base clinical decisions for IPE in CV risk reduction.

Funding Acknowledgement

Type of funding source: Other. Main funding source(s): The study was funded by Amarin Pharma, Inc.

REDUCE-IT: total ischemic events reduced across the full range of baseline LDL cholesterol and other key subgroups

Background

REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial), a study of 8,179 randomized statin-treated patients with elevated triglycerides (TG) and increased cardiovascular (CV) risk followed for a median of 4.9 years, demonstrated robust results. Icosapent ethyl (IPE), a pure and stable prescription form of eicosapentaenoic acid, 4g/day reduced both time-to-first and total primary endpoint ischemic events (CV death, nonfatal myocardial infarction [MI], nonfatal stroke, coronary revascularization, or hospitalization for unstable angina) by 25% (HR 0.75; 95% CI 0.68–0.83; p&lt;0.0001) and 30% (rate ratio 0.70; 95% CI 0.62–0.78; p&lt;0.0001), respectively. Similar substantial reductions in first and total key secondary endpoint ischemic events (composite of CV death, nonfatal MI, or nonfatal stroke) were also observed. Demographic and baseline disease characteristics were generally balanced across treatment groups. Time-to-first event analyses showed robust and generally consistent benefit across subgroups. Previous total event analyses by baseline TG demonstrated large, consistent, statistically significant reductions across tertiles, suggesting the CV benefit of IPE is tied primarily to non-TG factors.

Purpose

Further explore the extent to which IPE reduced total primary and key secondary events across prespecified baseline demographic, disease, treatment, and lipid/lipoprotein/inflammatory biomarker subgroups.

Methods

Total events across subgroups were assessed with the prespecified negative binomial regression method. Main outcomes were total (first and subsequent) primary and key secondary composite endpoint events.

Results

Median baseline LDL-C levels in ascending tertiles were 58, 76, and 96 mg/dL; there were large, significant relative reductions in total primary endpoint events with IPE across tertiles (35%, 28%, and 27%, respectively; interaction p=0.62), with parallel substantial absolute risk reductions. Similar, significant relative reductions of 33%, 28%, and 24% in total key secondary endpoint events were observed, along with substantial absolute risk reductions. Total events analyses of prespecified subgroups also demonstrated robust and generally consistent findings for the primary and key secondary composite endpoints.

Conclusion

REDUCE-IT demonstrated substantial reductions in first and total primary and key secondary endpoint ischemic events, with robust and generally consistent results across baseline TG and LDL-C levels, as well as other prespecified baseline biomarker, demographic, disease, and treatment subgroups. These analyses provide useful insights for clinicians considering the range of patients who may benefit from IPE therapy and suggest that mechanisms beyond the lipid/lipoprotein/inflammatory pathways tested, including mechanisms beyond the LDL receptor pathways, may contribute to the observed substantial reductions in total ischemic burden with IPE therapy.

Funding Acknowledgement

Type of funding source: Other. Main funding source(s): The study was funded by Amarin Pharma, Inc.

1009 Sleep Apnea and Colorectal Adenoma in the Veteran Population: A Case-Control Study

Introduction

Colorectal cancer is the third most common cancer in the United States, with over half of colorectal cancers estimated to be the result of modifiable risk factors. Studies relating sleep apnea (SA) and colorectal adenoma (CRA) are limited and the findings are equivocal. The objective of this study was to examine the association between SA and risk of CRA.

Methods

This was a retrospective cross-sectional case-control study of data collected from 460 veterans, ages 50-79, seen in the colonoscopy clinic at the Michael E. DeBakey VA Medical Center between 2014 and 2018. Information on demographics, sleep history, and co-morbidities were obtained through lifestyle questionnaire. Self-reported SA was diagnosed by a prior sleep study. Cases consisted of 297 participants had pathologically confirmed adenoma (including 117 participants having advanced CRA with villous component or diameter of polyp &gt; 1 cm). Controls consisted of 173 polyp-free participants. The distribution of demographics and lifestyle factors were compared between CRA and non-CRA using the Student’s t or chi-square tests. Odds ratios (OR) and 95% confidence intervals (CI) of CRA in association with CRA were calculated using univariate and multivariate unconditional logistic regression models. The confounding factors included age, sex, ethnicity, obesity, smoking status, alcohol use, hypertension, and sleep duration.

Results

Compared with non-SA, the multivariable OR (95% CI) for CRA was 0.92 (0.58-1.48); for non-advanced CRA was 1.14 (0.68-1.91), and for advanced CRA was 0.61 (0.32-1.17) in SA participants. Adjustment of sleep duration in the model did not change the risk estimates.

Conclusion

Sleep-study diagnosed SA was not associated with development of CRA in this veteran population. Further studies are needed to confirm this observation and incorporate the severity and treatment of SA, and undiagnosed SA in risk assessment.

Support

This research is supported in part by the Gillson Longenbaugh Foundation, and Golfers Against Cancer organization (to LJ), the Cancer Prevention Research Institute of Texas (CPRIT) (RP#140767, to LJ).

The modality switching costs of Chinese-English bilinguals in the processing of L1 and L2

Modality switching cost indicates that people's performance becomes worse when they judge sequential information that is related to different sensory modalities than judging information that is related to the same modality. In this study, we conducted three experiments on proficient and non-proficient bilingual individuals to investigate the modality switching costs in L1 and L2 processing separately. In Experiment 1, materials were L1 and L2 words that were either conceptually related to a visual modality (e.g., light) or related to an auditory modality (e.g., song). The modality switching costs were investigated in a lexical decision task in both L1 and L2. Experiment 2 further explored the modality switching costs while weakening the activation level of the perceptual modality by adding a set of fillers. Experiment 3 used a word-naming task to explore the modality switching effect in language production in L1 and L2. Results of these experiments showed that the modality switching costs appeared in both language comprehension and production in L1 and L2 conditions. The magnitude of the modality switching costs was conditionally modulated by the L2 proficiency level, such as in the L2 condition in Experiment 1 and in both L1 and L2 conditions in Experiment 3. These results suggest that sensorimotor simulation is involved in not only language comprehension but also language production. The sensorimotor simulation that is acquired in L1 can be transferred to L2.

Training in Language Switching Facilitates Bilinguals' Monitoring and Inhibitory Control

In the present study, we use a training design in two experiments to examine whether bilingual language switching facilitates two components of cognitive control, namely monitoring and inhibitory control. The results of Experiment 1 showed that training in language switching reduced mixing costs and the anti-saccade effect among bilinguals. In Experiment 2, the findings revealed a greater decrease of mixing costs and a smaller decrease of the anti-saccade effect from pre- to post-training for the language switching training group compared to the second language training group. Overall, the results suggest that extensive exercise in monitoring and inhibitory control in an experimental setting may enhance the corresponding components of cognitive control. We discuss these findings in the context of the relationship between bilingual language control and executive control.

The influence of contextual faces on bilingual language control

How do faces with social-cultural identity affect bilingual language control? We approach this question by looking at the switch cost patterns and reversed language dominance effect, which are suggested to reflect bilingual language control mechanisms, in the absence (i.e., baseline context) or presence of faces with socio-cultural identity (Asian or Caucasian). In separate blocks, the face matched (i.e., congruent context) or mismatched (i.e., incongruent context) the language to be spoken. In addition, cue preparation time was manipulated to be long (Experiment 1) or short (Experiment 2). In both experiments, a unique asymmetric switch cost with larger costs for L2 was observed in the congruent context as compared with the baseline and incongruent contexts. Furthermore, the reversed language dominance effect was not modulated across contexts. These results suggest a critical role of contextual faces in modulating local but not global language control. Thus, bilingual language control changes flexibly within an environment that includes faces with socio-cultural identity.

The contributions of language control to executive functions: From the perspective of bilingual comprehension

Previous studies have suggested that bilingual production experience has beneficial effects on executive functions. In the current study, four experiments were conducted to investigate whether bilingual comprehension experience influences executive functions. In Experiments 1 and 2, Chinese–English bilinguals completed a flanker task interleaved with a language comprehension task (reading comprehension in Experiment 1 and listening comprehension in Experiment 2). There were three blocks distinguished by language context, with a Chinese (L1) block, an English (L2) block, and a mixed (L1 and L2) block. Results showed that performance in the mixed block was better on both congruent and incongruent flanker trials when compared with the L1 and L2 blocks, indicating better monitoring functions overall. In Experiments 3 and 4 (reading comprehension and listening comprehension, respectively), participants were also exposed to three language contexts (i.e., L1, L2, and mixed block) but performed a non-conflict control task that did not require any conflict resolution. The results of Experiments 3 and 4 showed similar performance under the three different language contexts. Taken together, these results indicate that language control mechanisms involved in bilingual comprehension contribute to domain-general executive control performance. The results suggest a monitoring mechanism establishes a bridge connecting executive functions and bilingual language control during comprehension.

[Occupational activity disorders of extremely severe mass burn patients in recovery period after injury: a cross-sectional survey]

Objective: To observe the distribution of occupational activity disorders of extremely severe mass burn patients in recovery period after injury. Methods: From December 2014 to December 2015, 65 extremely severe burn patients conforming to the inclusion criteria involved in August 2 Kunshan factory aluminum dust explosion accident were admitted to Kunshan Rehabilitation Hospital. They received comprehensive rehabilitation treatment after burns, including wearing pressure clothes, ultrasound treatment, semiconductor laser and red light irradiation, motor function training, and so on. Over 2 years after injury, a cross-sectional survey was conducted on the patients' occupational activity disorders. Modified Barthel index (MBI) was used to assess the degree of activities of daily living (ADL) disorder of patients and to grade the independent level of completing each item of MBI, and then the independent level of patients completing self-care MBI items (bathing, dressing, grooming, eating, going to the toilet, urine control, and stool control) was compared with that of mobility items (going up and down stairs, bed and chair transfer, and walking). The Canadian Occupational Performance Measure (COPM) was used to assess the distribution of occupational activity disorders of patients. The distribution of the five most serious occupational activity disorders was counted, then the frequency and probability of which with frequency greater than or equal to 16 times were calculated. Data were processed with Pearson Chi-square test. Results: Over 2 years after injury, the MBI score of patients was (76±22) points, and the ADL of 83.08% (54/65) patients reached completely self-care or light ADL disorder level. The MBI items arranged according to the completing independent level of patients from high to low were urine control/stool control, walking, bed and chair transfer, going up and down stairs, going to the toilet, eating, grooming, dressing, and bathing. The independent level of patients completing self-care MBI items was lower than that of mobility items (χ(2)=62.298, P<0.001). Over 2 years after injury, the five most serious occupational activity disorders in COPM dimension were mainly concentrated in the self-care dimension, accounting for 55.38% (180/325), followed by 22.46% (73/325) of production activities and 22.15% (72/325) of recreational activities, and the centrally distributed item was the personal self-care item under self-care dimension, accounting for 42.46% (138/325). Over 2 years after injury, the five most serious occupational activity disorders with frequency greater than or equal to 16 times were dressing and undressing, bathing, perineal cleaning, wearing pressure clothes, caring for children, visiting relatives and friends, 31, 25, 16, 17, 18, and 22 times respectively, with a probability of 47.69%, 38.46%, 24.62%, 26.15%, 27.69%, and 33.85% respectively. Conclusions: Over 2 years after injury, most of the patients with extremely severe burns caused by the aluminum dust explosion were completely or basically self-care in their daily life. The disorder of self-care ADL was more serious than that of mobility, and the disorder of individual self-care activity was still the most serious occupational activity disorder of patients in this stage. Clinical trial registration: Chinese clinical trial registry, ChiCTR-OOC-16009188.

Evolution of the Kondo lattice and non-Fermi liquid excitations in a heavy-fermion metal

Strong electron correlations can give rise to extraordinary properties of metals with renormalized Landau quasiparticles. Near a quantum critical point, these quasiparticles can be destroyed and non-Fermi liquid behavior ensues. YbRh2Si2 is a prototypical correlated metal exhibiting the formation of quasiparticle and Kondo lattice coherence, as well as quasiparticle destruction at a field-induced quantum critical point. Here we show how, upon lowering the temperature, Kondo lattice coherence develops at zero field and finally gives way to non-Fermi liquid electronic excitations. By measuring the single-particle excitations through scanning tunneling spectroscopy, we find the Kondo lattice peak displays a non-trivial temperature dependence with a strong increase around 3.3 K. At 0.3 K and with applied magnetic field, the width of this peak is minimized in the quantum critical regime. Our results demonstrate that the lattice Kondo correlations have to be sufficiently developed before quantum criticality can set in.

Primary Angioplasty without Stenting for Symptomatic, High-Grade Intracranial Stenosis with Poor Circulation

BACKGROUND AND PURPOSE

Although the Stenting versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study demonstrated a high incidence of perioperative complications for Intracranial Atherosclerotic disease (ICAD) treatments with stent placement, some studies have shown that submaximal angioplasty with an undersized balloon limits the risks of perioperative complications, suggesting that intervention may remain an alternative option for ICAD if perioperative complications are minimized. We sought to evaluate clinical and angiographic outcomes after primary angioplasty without stent placement in patients with symptomatic, high-grade intracranial stenosis and poor antegrade flow who were refractory to medical therapy.

MATERIALS AND METHODS

All cases with high-grade, symptomatic intracranial stenosis and poor antegrade flow treated with intracranial angioplasty without stent placement at Xuanwu Hospital, Capital Medical University, from January 2010 to December 2016, were retrospectively reviewed. The main outcomes included the changes in antegrade flow and residual stenosis and any stroke or death within 1 month. We also evaluated functional outcomes, stroke, and restenosis in patients on follow-up.

RESULTS

Thirty-five patients (mean age, 64.3 years) were included, and the mean follow-up time was 9.7 months. The average preprocedural stenosis was 88.4%. The immediate, average postprocedure stenosis rate was 25.3%, and the average postprocedural stenosis rate at last angiographic follow-up was 34.7%. The primary end point of major stroke or death at 30 days was observed in 1 patient (1/35, 2.9%), and no patient had intraprocedural complications. The incidence of stroke or death at the last follow-up was 2.9%, which was superior to the results of the medical and stent-placement arms of the SAMMPRIS study. Severe restenosis was observed in 3 (3/25, 12%) patients but without any symptoms.

CONCLUSIONS

In this retrospective series, primary balloon angioplasty was an effective treatment option for symptomatic intracranial stenosis with a high risk of stroke.

[Influence of two kinds of probiotics combined with bismuth quadruple therapy for Helicobacter pylori eradication]

Objective: To investigate the efficacy and safety of Compound Lactobacillus Tablets or Saccharomyces boulardii Sachets combining with bismuth quadruple therapy for Helicobacter pylori(H.pylori) eradication. Methods: A total of 360 H. pylori- infected patients were enrolled and randomly assigned into three groups. Group A received esomeprazole 20 mg bid+ bismuth potassium citrate 220 mg bid+ amoxicillin 1 000 mg bid+ furazolidone 100 mg bid for 10 days. Group B or group C received the same quadruple therapy for 10 days as group A, as well as Compound Lactobacillus Tablets 1 000 mg tid or Saccharomyces boulardii Sachets 500 mg bid for 14 days. Drug-related side effects and adverse reactions were collected during the therapy, and H. pylori eradication results were confirmed by (13)C/(14)C-UBT at least 4 weeks after cessation of therapy. Results: The H. pylori eradication rates in group A, B and C were 81.7%, 84.2% and 85.0% by ITT analysis (P=0.768) and 92.5%, 90.1% and 93.6% by PP analysis (P=0.770), respectively. The overall side effects and adverse reactions rates (P=0.008) and occurrence of diarrhea (P<0.001) were significantly lower in group B than group A. The overall side effect rates (P=0.003) and occurrence of diarrhea (P<0.001), abdominal distension (P=0.004) and constipation(P=0.002) were significantly lower in group C than group A. There was no significant difference in side effects and adverse reactions rates between the two probiotics groups. Conclusions: Both Compound Lactobacillus Tablets and Saccharomyces boulardii Sachets, combining with bismuth quadruple therapy, reduced the overall side effects and adverse reactions rates for H. pylori eradication. Moreover, the former can reduce the incidence of diarrhea, and the latter can reduce the incidence of diarrhea, abdominal distension and constipation.

Eph/ephrin signalling serves a bidirectional role in lipopolysaccharide‑induced intestinal injury

A growing body of evidence has demonstrated that Eph/ephrin signalling may serve a central role in intestinal diseases. However, whether erythropoietin-producing hepatocellular (Eph)/ephrin signalling is associated with the development of post-infectious irritable bowel syndrome (PI-IBS) is still unknown. In the present study, the role of Eph/Ephrin signalling in lipopolysaccharide (LPS)-induced intestinal injury was evaluated in vivo and in vitro. LPS treatment significantly increased the levels of proinflammatory mediators [monocyte chemoattractant protein-1, tumour necrosis factor α, interleukin (IL)-1β, IL-6, intercellular adhesion molecule 1 and vascular cell adhesion molecule-1], activated the EphA2-Ephrin A1, protein kinase B (Akt)-nuclear factor (NF)-κB, Src-NF-κB and Wnt/β-catenin signalling pathways, and inhibited EphB1-Ephrin B3 signalling in colon tissues, and primary cultured enteric neuronal and glial cells. Notably, EphA2 monoclonal antibody (mAb) treatment or Ephrin B3 overexpression could partially alleviate the LPS-induced upregulation of proinflammatory mediators, and Akt-NF-κB, Src-NF-κB and Wnt/β-catenin signalling pathways. In addition, EphA2 mAb treatment could partially inhibit LPS-induced inactivation of EphB-Ephrin B3 signalling, while Ephrin B3 overexpression could abrogate LPS-induced activation of EphA2-Ephrin A1 signalling. EphB1/Ephrin B3 signalling may antagonise the EphA2/Ephrin A1-dependent pathway following LPS treatment. The results associated with the EphA2 signaling pathway, indicated that Eph/ephrin signalling may serve a bidirectional role in LPS-induced intestinal injury. Eph/ephrin signalling may be a novel therapeutic target for LPS-induced intestinal injury and potentially PI-IBS.

Identification of gene-specific DNA methylation signature for Colorectal Cancer

BACKGROUND

Colorectal Cancer (CC), a common disease causing approximately million deaths annually, has been the third most frequent type of malignancy. We aimed to identify gene-specific DNA methylation signature to function as prognostic and predictive markers for CC patient survival.

METHODS

Expression profiles of gene-specific DNA methylation and the corresponding clinical information of 201 CC patients were downloaded from The Cancer Genome Atlas (TCGA) dataset and differentially expressed gene-specific DNA methylation was identified after tumor subtype classification. A risk score model was further built by analyzing the expression data of these gene-specific DNA methylations from the training dataset of CC patients.

RESULTS

Totally, 214 gene-specific DNA methylations were found to be expressed significantly between different subtypes of CC, including 150 up-regulated and 64 down-regulated ones. Up-regulated gene-specific DNA methylation accounted for 70.1% and the down-regulated gene-specific DNA methylation accounted for 29.9%. Hereinto, six gene-specific DNA methylations were obtained, including methy_vimentin and methy_ TFPI2, which were found significantly correlated with overall survival status of patients with CC.

CONCLUSIONS

With the six gene-specific DNA methylation signatures, patients in the training set were divided into low-risk and high- risk groups. What's more, gene-specific DNA methylation target genes were highly associated with protein phosphorylation, which indicated that further research on phosphorylation of target gene-coding protein might provide new sight on the treatment of CC.

A Novel EphA2 Inhibitor Exerts Beneficial Effects in PI-IBS in Vivo and in Vitro Models via Nrf2 and NF-κB Signaling Pathways

Though the detailed pathological mechanism of post-infectious irritable bowel syndrome (PI-IBS) remains unclear, accumulating evidence indicates that oxidative stress and inflammation are implicated in the process of PI-IBS. Oxidative stress and inflammation are regulated by Nrf2 and NF-κB signaling pathways, respectively. EphA2, a member of Eph receptor family, promotes oxidative stress and inflammatory responses via regulation of Nrf2 and NF-κB signaling pathways in various types of human diseases. Understanding the mechanisms by which EphA2 regulate oxidative stress and inflammation in PI-IBS is important for the development of new strategies to treat PI-IBS. However, the effects of ALW-II-41-27, a novel EphA2 inhibitor on PI-IBS and the underlying molecular mechanisms have never been studied. In the present study, we showed that ALW-II-41-27 decreased gastrointestinal motility and abdominal withdrawal reflex (AWR) scores, markedly reduced the levels of oxidative stress markers [4-hydroxy-2-nonenal (4-HNE), protein carbonyl, and 8-hydroxy-2-de-axyguanine (8-OHdG)] and proinflammatory cytokines (TNF-α, IL-6, IL-17, and ICAM-1), and remarkably increased the level of anti-inflammatory cytokine (IL-10) in serum and colon of Trichinella spiralis-infected mice. Moreover, ALW-II-41-27 was effective in suppressing oxidative stress and inflammation in LPS-treated NCM460 colonic cells. Treatment of ALW-II-41-27 reversed the activation of NF-κB and inactivation of Nrf2 in LPS-treated NCM460 cells. Importantly, these protective effects of ALW-II-41-27 were partially inhibited by EphA2 KO and abolished by EphA2 overexpression. In conclusion, EphA2 may represent a promising therapeutic target for patients with PI-IBS and ALW-II-41-27 might function as a novel therapeutic agent for PI-IBS.

[Effect and mechanism of silibinin on the inhibition of ALK positive NSCLC cells by sensitizing crizotinib]

Objective: To explore the synergistic effect of silibinin combined with crizotinib on anaplastic lymphoma kinase positive (ALK+ ) non-small cell lung cancer (NSCLC) cells and its mechanism. Methods: H2228 and H3122 cells were treated with silibinin, crizotinib alone or in combination. Cell proliferation was measured by 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay and colony formation assay. Migration or invasion ability was tested by wound healing assay or transwell assay, respectively. Expressions of E-Cadherin and vimentin protein were examined by immunofluorescence staining. The protein expressions of ALK, p-ALK, E-Cadherin and Vimentin were detected by western blotting.The anti-cancer effect of silibinin combined with crizotinib in vivo was determined by subcutaneously injecting 2×10(6) H2228 cells into immunodeficient nude mice. Results: The result of MTT assay showed that the cell viability of H2228 or H3122 treated with 100 μmol/L silibinin was (88.38±4.10)% or (72.27±3.62)%, respectively, marginally decreased compared with that of the control. The 50% inhibitory concentration (IC(50)) of H2228 cells treated with crizotinib alone or combined with 100 μmol/L silibinin was (917.10±7.75) nmol/L or (238.73±7.67) nmol/L, respectively. The IC(50) of H3122 cells treated with crizotinib alone or combined with 100 μmol/L silibinin was (472.50±15.70) nmol/L or (206.10±12.01) nmol/L, respectively. The IC(50s) of H2228 and H3122 cells were significantly decreased by combined treatment of crizotinib and silibinin compared to crizotinib treatment alone (P<0.01). When compared with the control group, colony forming ratios of H2228 cells were (83.34±2.72)% in 100 μmol/L silibinin treatment group, (69.42±3.06)% in 400 nmol/L crizotinib treatment group and (27.32±1.42)% in combined treatment group. When compared with the control group, colony forming ratios of H3122 cells were (84.45±5.67)% in 100 μmol/L silibinin treatment group, (45.02±5.83)% in 400 nmol/L crizotinib treatment group and (17.43±3.83)% in combined treatment group. Silibinin combined with crizotinib treatment significantly inhibited the colony formation ability of H2228 and H3122 cells (P<0.01). Migration and invasion results showed that combined treatment of crizotinib and silibinin markedly inhibited the migration and invasion ability of H2228 cells (P<0.01). Western blot results indicated that treated with silibinin alone or in combination of crozitinib for 48 hours, the protein level of E-cadherin in H2228 cells was upregulated, while the expressions of p-ALK and vimentin were downregulated, without obvious alteration of ALK protein expression. In the xenograft model, the mean tumor weight was (9.40±2.58)g in crizotinib treatment group and (4.58±1.07)g in the combined treatment group. The inhibitory effect of tumor growth in vivo of combined treatment was significantly superior to that of crizotinib treatment alone (P<0.05). Conclusion: Silibinin enhances the inhibitory effect of crizotinib on ALK positive NSCLC cells, which may be associated with suppression of ALK activity and mesenchymal-epithelial transition.

Additional energy scale in SmB6 at low-temperature

Topological insulators give rise to exquisite electronic properties because of their spin-momentum locked Dirac-cone-like band structure. Recently, it has been suggested that the required opposite parities between valence and conduction band along with strong spin-orbit coupling can be realized in correlated materials. Particularly, SmB6 has been proposed as candidate material for a topological Kondo insulator. Here we observe, by utilizing scanning tunnelling microscopy and spectroscopy down to 0.35 K, several states within the hybridization gap of about ±20 meV on well characterized (001) surfaces of SmB6. The spectroscopic response to impurities and magnetic fields allows to distinguish between dominating bulk and surface contributions to these states. The surface contributions develop particularly strongly below about 7 K, which can be understood in terms of a suppressed Kondo effect at the surface. Our high-resolution data provide insight into the electronic structure of SmB6, which reconciles many current discrepancies on this compound.

Multiple quantum phase transitions and superconductivity in Ce-based heavy fermions

Heavy fermions have served as prototype examples of strongly-correlated electron systems. The occurrence of unconventional superconductivity in close proximity to the electronic instabilities associated with various degrees of freedom points to an intricate relationship between superconductivity and other electronic states, which is unique but also shares some common features with high temperature superconductivity. The magnetic order in heavy fermion compounds can be continuously suppressed by tuning external parameters to a quantum critical point, and the role of quantum criticality in determining the properties of heavy fermion systems is an important unresolved issue. Here we review the recent progress of studies on Ce based heavy fermion superconductors, with an emphasis on the superconductivity emerging on the edge of magnetic and charge instabilities as well as the quantum phase transitions which occur by tuning different parameters, such as pressure, magnetic field and doping. We discuss systems where multiple quantum critical points occur and whether they can be classified in a unified manner, in particular in terms of the evolution of the Fermi surface topology.

Two-Gap Superconductivity in LaNiGa_{2} with Nonunitary Triplet Pairing and Even Parity Gap Symmetry

The nature of the pairing states of superconducting LaNiC_{2} and LaNiGa_{2} has to date remained a puzzling question. Broken time reversal symmetry has been observed in both compounds and a group theoretical analysis implies a nonunitary triplet pairing state. However, all the allowed nonunitary triplet states have nodal gap functions but most thermodynamic and NMR measurements indicate fully gapped superconductivity in LaNiC_{2}. Here we probe the gap symmetry of LaNiGa_{2} by measuring the London penetration depth, specific heat, and upper critical field. These measurements demonstrate two-gap nodeless superconductivity in LaNiGa_{2}, suggesting that this is a common feature of both compounds. These results allow us to propose a novel triplet superconducting state, where the pairing occurs between electrons of the same spin, but on different orbitals. In this case the superconducting wave function has a triplet spin component but isotropic even parity gap symmetry, yet the overall wave function remains antisymmetric under particle exchange. This model leads to a nodeless two-gap superconducting state which breaks time reversal symmetry, and therefore accounts well for the seemingly contradictory experimental results.