Impact of Charlson Comorbidity Index on in-hospital mortality of patients with hyperglycemic crises: A propensity score matching analysis

AIM

This study was designed to investigate the association between Charlson Comorbidity Index (CCI) and in-hospital mortality and other clinical outcomes among patients with hyperglycemic crises.

METHOD

This retrospective cohort study was conducted using data from electric medical records. A total of 1668 diabetic patients with hyperglycemic crises from six tertiary hospitals met the inclusion criteria. CCI < 4 was defined as low CCI and CCI ≥ 4 was defined as high CCI. Propensity score matching (PSM) with the 1:1 nearest neighbour matching method and the caliper value of 0.02 was used to match the baseline characteristics of patients with high CCI and low CCI to reduce the confounding bias. In-hospital mortality, ICU admission, hypoglycemia, hypokalemia, acute kidney injury, length of stay (LOS), and hospitalisation expense between low CCI and high CCI were compared and assessed. Univariate and multivariate regression were applied to estimate the impact of CCI on in-hospital and other clinical outcomes.

OUTCOME

One hundred twenty-one hyperglycemic crisis (HC) patients died with a mortality rate of 7.3%. After PSM, compared with low CCI, patients with high CCI suffered higher in-hospital mortality, ICU admission, LOS, and hospitalisation expenses. After multivariate regression, age (aOR: 1.12, 95% confidence interval [CI]: 1.06-1.18, p < 0.001), CCI(aOR: 4.42, 95% CI: 1.56-12.53, p = 0.005), uninsured (aOR: 22.32, 95% CI: 4.26-116.94, p < 0.001), shock (aOR: 10.57, 95% CI: 1.41-79.09, p = 0.022), mechanical ventilation (aOR: 75.29, 95% CI: 12.37-458.28, p < 0.001), and hypertension (aOR: 4.34, 95% CI: 1.37-13.82, p = 0.013) were independent risk factors of in-hospital mortality of HC patients. Besides, high CCI was an independent risk factor for higher ICU Admission (aOR: 5.91, 95% CI: 2.31-15.08, p < 0.001), hypoglycemia (aOR: 2.19, 95% CI:1.01-4.08, p = 0.049), longer LOS (aOR: 1.23, 95% CI: 1.19-2.27, p = 0.021), and higher hospitalisation expense (aOR: 2089.97, 95% CI: 193.33-3988.61, p = 0.031) of HC patients.

CONCLUSION

CCI is associated with in-hospital mortality, ICU admission, hypoglycemia, LOS, and hospitalisation expense of HC patients. CCI could be an ideal indicator to identify, monitor, and manage chronic comorbidities among HC patients.

Suppression on the basis of template for rejection is reactive: Evidence from human electrophysiology

According to most theories of attention, the selection of task-relevant visual information can be enhanced by holding them in visual working memory (VWM). However, there has been a long-standing debate concerning whether similar optimization can also be achieved for task-irrelevant information, known as a "template for rejection". The present study aimed to explore this issue by examining the consequence of cue distractors before visual search tasks. For this endeavor, we manipulated the display heterogeneity by using two distractor conditions, salient and non-salient, to explore the extent to which holding the distractor color in VWM might affect attentional selection. We measured the reaction times of participants while their EEG activity was recorded. The results showed that WM-matched distractors did not improve reaction times but rather slowed them down in both tasks. Event-related potential (ERP) results showed that the display heterogeneity had no modulatory effect on the degree of distractor suppression. Even in the salient distractor condition, the WM-matched distractor received no greater suppression. Furthermore, the WM-matched distractor but not the neutral distractor elicited an N2pc before the PD in salient distractor conditions. This suggests that the template for rejection operates reactively since suppression occurs after extra attentional processes to the distractor. Moreover, the presence of WM-matched distractors led to a reduction of P3b, indicating a competition between target processing and WM-matched distractor rejection. Our findings provide insights into the mechanisms underlying the optimization of attentional selection, and have implications for future studies aimed at understanding the role of VWM in cognition.

Tislelizumab, a novel PD-1 monoclonal antibody in urothelial cancer: A real-world study

OBJECTIVE

Tislelizumab, a monoclonal antibody against programed death protein-1 (PD-1), has shown encouraging antitumor activity in urothelial cancer. This study was designed to assess the efficacy and safety of tislelizumab in urotelial cancer in a real-world setting.

METHODS

The study was a real-world retrospective study undertaken at Liaoning Cancer Hospital & Institute, China. Eligible patients were ≥18 years. Patients received 200-mg tislelizumab monotherapy intravenously every 3 weeks until the disease progressed to intolerable toxicity. Outcomes included an objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and safety.

RESULTS

Between March 2020 and December 2022, 33 patients were enrolled. The median follow-up was 10.17 (IQR 5.73-12.47) months. Of all 33 patients, ORR and DCR were 30.30% (95% CI 15.6%-48.7%) and 42.42% (95% CI 25.48%-60.78%), respectively. The median PFS was 5.73 (95% CI 3.27-13.00) months, with a 12-month PFS rate of 31.90% (95% CI 19.20%-53.00%). The median OS was 17.7 (95% CI 12.80-not reach) months, with a 12-month OS rate of 67.50% (95% CI 52.70%-86.40%). Eleven (33.33%) and 8 (24.24%) experienced ≥grade 3 treatment-related adverse events (TRAEs) and immune-related Aes, respectively. No treatment-related deaths occurred.

CONCLUSION

The excellent efficacy and controllable safety of tislelizumab in locally advanced or metastatic urothelial cancer suggest that it may be a promising therapeutic option for this population.

Relative saliency affects attentional capture and suppression of color and face singleton distractors: evidence from event-related potential studies

Prior research has yet to fully elucidate the impact of varying relative saliency between target and distractor on attentional capture and suppression, along with their underlying neural mechanisms, especially when social (e.g. face) and perceptual (e.g. color) information interchangeably serve as singleton targets or distractors, competing for attention in a search array. Here, we employed an additional singleton paradigm to investigate the effects of relative saliency on attentional capture (as assessed by N2pc) and suppression (as assessed by PD) of color or face singleton distractors in a visual search task by recording event-related potentials. We found that face singleton distractors with higher relative saliency induced stronger attentional processing. Furthermore, enhancing the physical salience of colors using a bold color ring could enhance attentional processing toward color singleton distractors. Reducing the physical salience of facial stimuli by blurring weakened attentional processing toward face singleton distractors; however, blurring enhanced attentional processing toward color singleton distractors because of the change in relative saliency. In conclusion, the attentional processes of singleton distractors are affected by their relative saliency to singleton targets, with higher relative saliency of singleton distractors resulting in stronger attentional capture and suppression; faces, however, exhibit some specificity in attentional capture and suppression due to high social saliency.

The impact of insurance status on in-hospital mortality in patients with hyperglycaemic crisis: A propensity score matching analysis

AIM

This study was designed to determine the associations between insurance status and clinical outcomes among patients with hyperglycaemic crisis.

METHODS

Overall, 1668 patients with hyperglycaemic crisis were recruited from the Chongqing Medical University Medical Data Science Academy's big data platform. In-hospital mortality, length of stay and complications (i.e., hypoglycaemia, hypokalemia, pulmonary infection, multiple systemic organ failure, acute kidney injury and deep venous thrombosis) were assessed. Propensity score matching analysis was used to reduce the confounding bias, and univariate and multivariate logistic regression were used to estimate the effect of insurance status on mortality in patients with hyperglycaemic crisis.

RESULTS

After matching one uninsured patient to two insured patients with a calliper of 0.02, the uninsured group suffered a higher burden of in-hospital mortality than the insured group (16.9% vs. 9.8%); the insured status (odds ratio = 0.216, 95% confidence interval = 0.079-0.587) was a potential protect factor for in-hospital mortality of patients with hyperglycaemic crisis in the multivariate logistic regression analysis.

CONCLUSIONS

Insurance status is associated with the outcomes of hospitalisation for hyperglycaemic crisis; uninsured patients with hyperglycaemic crisis face a higher risk of mortality in China.

Different prioritization states of working memory representations affect visual searches: Evidence from an event-related potential study

Previous evidence has shown that the contents of working memory (WM) can bias visual selection. However, not much is known about how WM effects change when the WM representation is held in different prioritization states. Here, we investigated this problem using event-related potentials. Subjects maintained two colors in WM while performing a search task. One of the colors was retro-cued, indicating that it was 80 % likely to be the target of the memory test. During the search display, one of the distractors was a salient color singleton, and this singleton distractor could carry the same color as the cued WM representation, the uncued WM representation, or be irrelevant to the memory content. Behaviorally, the memory test performance was found to be better for the cued color than for the uncued color, and we observed lower search accuracy (ACC) and longer search reaction time (RT) when the singleton distractor matched the cued WM representation than when it matched an uncued or an irrelevant WM representation. Event-related potential (ERP) data showed that the P3 amplitude of cue-color distractor conditions was smaller than that of uncued-color distractor conditions and irrelevant-color distractor conditions. These findings clearly indicate that prioritizing an item for enhanced representational quality enables the item to bias attention to a greater extent.

An effector of 'Candidatus Liberibacter asiaticus' manipulates autophagy to promote bacterial infection

Autophagy functions in plant host immunity responses to pathogen infection. The molecular mechanisms and functions used by the citrus Huanglongbing (HLB)-associated intracellular bacterium 'Candidatus Liberibacter asiaticus' (CLas) to manipulate autophagy are unknown. We identified a CLas effector, SDE4405 (CLIBASIA_04405), which contributes to HLB progression. 'Wanjincheng' orange (Citrus sinensis) transgenic plants expressing SDE4405 promotes CLas proliferation and symptom expression via suppressing host immunity responses. SDE4405 interacts with the ATG8-family of proteins (ATG8s), and their interactions activate autophagy in Nicotiana benthamiana. The occurrence of autophagy is also significantly enhanced in SDE4405-transgenic citrus plants. Interrupting NbATG8s-SDE4405 interaction by silencing of NbATG8c reduces Pseudomonas syringae pv. tomato strain DC3000ΔhopQ1-1 (Pst DC3000ΔhopQ1-1) proliferation in N. benthamiana, and transient overexpression of CsATG8c and SDE4405 in citrus promotes Xanthomonas citri subsp. citri (Xcc) multiplication, suggesting that SDE4405-ATG8s interaction negatively regulates plant defense. These results demonstrate the role of the CLas effector protein in manipulating autophagy, and provide new molecular insights into the interaction between CLas and citrus hosts.

Faces do not guide attention in an object-based facilitation manner

Numerous studies on face processing have revealed their special ability to affect attention, but relatively little research has been done on how faces guide spatial attention allocation. To enrich this field, this study resorted to the object-based attention (OBA) effect in a modified double-rectangle paradigm where the rectangles were replaced with human faces and mosaic patterns (non-face objects). Experiment 1 replicated the typical OBA effect in the non-face objects, but this effect was absent in Asian and Caucasian faces. Experiment 2 removed the eye region from Asian faces, but still found no object-based facilitation in the faces without eyes. In Experiment 3, the OBA effect was also observed for faces when the faces disappear a short period before the responses. Overall, these results revealed that when two faces are presented together, they do not exert object-based facilitation regardless of their facial features such as race and the presence of eyes. We argue that the lack of a typical OBA effect is due to the filtering cost induced by the entire face content. This cost slows down the response when attention shifts within a face and results in the absence of object-based facilitation.

[A medium- and long-term comparative observation on volumetric changes of cervical disc herniation after symmetrically or asymmetrically decompression and conservative treatment for cervical spondylotic myelopathy]

Objective: To compare the volumetric changes of cervical disc herniation (CDH) after cervical microendoscopic laminoplasty(CMEL),expansive open-door laminoplasty (EOLP) and conservative treatment. Methods: A retrospective study was conducted involving 101 patients with cervical spondylotic myelopathy(CSM),at the Department of Orthopaedic Surgery,the First Affiliated Hospital of Zhengzhou University from April 2012 to April 2021. The patients included 52 males and 49 females with an age of (54.7±11.8) years(range:25 to 86 years). Among them, 35 patients accepted CMEL treatment,33 patients accepted EOLP treatment,while 33 patients accepted conservative treatment. Volume data of CDH were measured by three-dimensional analysis of the initial and follow-up MRI images. The absorption rate and reprotrusion rate of CDH were calculated. The happening of resorption or reprotrusion was defined when the ratio was greater than 5%. The clinical outcomes and quality of life were evaluated by the Japanese Orthopaedic Association (JOA) score and the neck disability index (NDI).Quantitative data was analyzed by one-way ANOVA with post LSD-t test (multiple comparison) or Kruskal-Wallis test. Categorical data was analyzed by χ2 test. Results: The follow-up time of the CMEL group,EOLP group and the conservative treatment group were (27.6±18.8)months,(21.6±6.9)months and(24.9±16.3)months respectively with no significant difference(P>0.05). Changes of CDH volume in patients:(1) There were 96 CDH of 35 patients in the CMEL group,among which 78 showed absorption. The absorption frequency was 81.3%(78/96) and the absorption rate was ranged 5.9% to 90.9%;9 CDH showed reprotrusion,the reprotrusion frequency was 9.4% (9/96) and the reprotrusion rate was 5.9% to 13.3%;(2) There were 94 CDH of 33 patients in the EOLP group,of which 45 showed absorption. The absorption prevalence was 47.9% (45/94) and the absorption rate was 5.0% to 26.7%;20 CDH showed reprotruded,with the reprotrusion frequency of 21.3% (20/94) and the reprotrusion rate was 5.8% to 28.3%;(3) There were 102 CDH in 33 patients of the conservative group. Among them, 5 showed absorption. The absorption frequency was 4.9% (5/102),and the absorption rate was 7.2% to 14.3%;58 CDH showed reprotruded with the re-protrusion ratio of 56.9% (58/102) and the re-protrusion rate was 5.4% to 174.1%. The absorption ratio and reprotrusion ratio of the CMEL group were statistically different from EOLP group or the conservative group (P<0.01).The absorption ratio and reprotrusion ratio of the EOLP group was different from conservative group (all P<0.01). In terms of clinical outcomes, the excellent/good rate of the JOA score and NDI scores in the CMEL group were different from that of conservative group (all P<0.01) but not from that of the EOLP group(P>0.05). Conclusions: CMEL is an effective method for the treatment of CSM,making CDH easier to resorption compared to the EOLP or conservative treatment,thus making a better decompression effect on the nerves. This study enlightened on a new strategy for the clinical treatment of CSM.

A Sec-dependent effector, CLIBASIA_04425, contributes to virulence in 'Candidatus Liberibater asiaticus'

Citrus Huanglongbing (HLB) is the most destructive citrus disease worldwide, mainly caused by 'Candidatus Liberibacter asiaticus' (CLas). It encodes a large number of Sec-dependent effectors that contribute to HLB progression. In this study, an elicitor triggering ROS burst and cell death in Nicotiana benthamiana, CLIBASIA_04425 (CLas4425), was identified. Of particular interest, its cell death-inducing activity is associated with its subcellular localization and the cytoplasmic receptor Botrytis-induced kinase 1 (BIK1). Compared with CLas infected psyllids, CLas4425 showed higher expression level in planta. The transient expression of CLas4425 in N. benthamiana and its overexpression in Citrus sinensis enhanced plant susceptibility to Pseudomonas syringae pv. tomato DC3000 ΔhopQ1-1 and CLas, respectively. Furthermore, the salicylic acid (SA) level along with the expression of genes NPR1/EDS1/NDR1/PRs in SA signal transduction was repressed in CLas4425 transgenic citrus plants. Taken together, CLas4425 is a virulence factor that promotes CLas proliferation, likely by interfering with SA-mediated plant immunity. The results obtained facilitate our understanding of CLas pathogenesis.

The application of artificial intelligence technology in education influences Chinese adolescent's emotional perception

Humans need to accurately infer the intentions and feelings of others to engage in successful social interaction. However, the application of artificial intelligence technology in Education (AIEd) forms a human-machine collaborative environment which changed the interaction relationship of individuals, it may have an affect on them. This study aimed to explore whether AIEd affects adolescents' emotional perception. Combined with the actual teaching situation and the result of the questionnaire, 1332 students recruited through random sampling from AI Curriculum Reform Demonstration Schools in Guangzhou participated in this study. Different emotional priming stimulative materials (sentences and situational pictures) were used in the experiments. The task was designed to investigate adolescents' reaction time to emotional faces (positive, negative). After eliminating blank data and invalid data with response time greater than 150 ms, 977 and 962 valid data were included in the statistical analysis in experiment 1 and experiment 2 respectively. Results show that AIEd has a negative effect on adolescents' emotional perception. Prior research has focused on theory to the exclusion of practical applications and the psychological impact of AIEd, thus this study makes an innovative contribution in exploring the impact of the application of artificial intelligence technology in education on adolescents' physical and mental development by using empirical research methods.

YAP activation inhibits inflammatory signalling and cartilage breakdown associated with reduced primary cilia expression

OBJECTIVE

To clarify the role of YAP in modulating cartilage inflammation and degradation and the involvement of primary cilia and associated intraflagellar transport (IFT).

METHODS

Isolated primary chondrocytes were cultured on substrates of different stiffness (6-1000 kPa) or treated with YAP agonist lysophosphatidic acid (LPA) or YAP antagonist verteporfin (VP), or genetically modified by YAP siRNA, all ± IL1β. Nitric oxide (NO) and prostaglandin E2 (PGE2) release were measured to monitor IL1β response. YAP activity was quantified by YAP nuclear/cytoplasmic ratio and percentage of YAP-positive cells. Mechanical properties of cartilage explants were tested to confirm cartilage degradation. The involvement of primary cilia and IFT was analysed using IFT88 siRNA and ORPK cells with hypomorphic mutation of IFT88.

RESULTS

Treatment with LPA, or increasing polydimethylsiloxane (PDMS) substrate stiffness, activated YAP nuclear expression and inhibited IL1β-induced release of NO and PGE2, in isolated chondrocytes. Treatment with LPA also inhibited IL1β-mediated inflammatory signalling in cartilage explants and prevented matrix degradation and the loss of cartilage biomechanics. YAP activation reduced expression of primary cilia, knockdown of YAP in the absence of functional cilia/IFT failed to induce an inflammatory response.

CONCLUSIONS

We demonstrate that both pharmaceutical and mechanical activation of YAP blocks pro-inflammatory signalling induced by IL1β and prevents cartilage breakdown and the loss of biomechanical functionality. This is associated with reduced expression of primary cilia revealing a potential anti-inflammatory mechanism with novel therapeutic targets for treatment of osteoarthritis (OA).

Neural correlates of conscious processing of emotional faces: Evidence from event-related potentials

There is a theoretical debate between the early and late neural correlates of consciousness (NCCs). Previous studies using neutral face stimuli supported an early NCC and suggested that visual awareness negativity (VAN) is associated with consciousness, while late positivity (LP) reflects post-perceptual activity. However, emotional faces may help to examine the relationship between LP and consciousness due to the differences in late processing between emotional and neutral faces. To explore the effects of facial emotional information on NCCs, the present study manipulated consciousness with the inattentional blindness paradigm and used happy, fearful, and neutral faces as visual stimuli. The results showed that the conscious processing of emotional faces was correlated with VAN and LP, while the conscious processing of neutral faces was associated with VAN. First, the results suggest that VAN is an NCC, and the relationship between LP and consciousness is affected by facial emotional information. Second, VAN reflects the early perceptual experience of emotional faces, whereas LP may reflect the late conscious processing of emotional faces. Furthermore, source localization analysis showed that the LPs of emotional faces were mainly located in the frontal and parietal lobes, whereas those of neutral faces showed no significant activation. This suggests that facial emotional information may affect the brain regions associated with conscious processing. Time-frequency analysis showed that conscious processing is related to the enhancement of alpha and theta oscillation, indicating that conscious processing may be associated with the suppression of irrelevant stimuli. Overall, the present study suggests that the integration of the theories that support early and late NCCs helps explain the conscious processing of emotional faces.

Characterization of a kg-scale archaeological lead-based PbWO4 cryogenic detector for the RES-NOVA experiment

Core-collapse Supernovae (SNe) are one of the most energetic events in the Universe, during which almost all the star's binding energy is released in the form of neutrinos. These particles are direct probes of the processes occurring in the stellar core and provide unique insights into the gravitational collapse. RES-NOVA will revolutionize how we detect neutrinos from astrophysical sources, by deploying the first ton-scale array of cryogenic detectors made from archaeological lead. Pb offers the highest neutrino interaction cross-section via coherent elastic neutrino-nucleus scattering (CEνNS). Such process will enable RES-NOVA to be equally sensitive to all neutrino flavours. For the first time, we propose the use archaeological Pb as sensitive target material in order to achieve an ultra-low background level in the region of interest (O(1 keV)). All these features make possible the deployment of the first cm-scale neutrino telescope for the investigation of astrophysical sources. In this contribution, we will characterize the radiopurity level and the performance of a small-scale proof-of-principle detector of RES-NOVA, consisting in a PbWO₄ crystal made from archaeological-Pb operated as cryogenic detector.

Saliency affects attentional capture and suppression of abrupt-onset and color singleton distractors: Evidence from event-related potential studies

Attention is the process of selecting relevant information and suppressing irrelevant information. However, it is still controversial whether attentional capture by salient but task-irrelevant stimuli operates in a bottom-up fashion (stimulus-driven theory) or a top-down fashion (goal-driven theory) or if even salient distractors can be suppressed before capturing attention (signal suppression theory). In the present study, we investigated how saliency affects attentional capture (indexed by N2-posterior-contralateral [N2pc]) and suppression (indexed by distractor positivity [P_D ]) of abrupt-onset and color singleton distractors in a visual search task. Experiment 1 showed that an abrupt-onset distractor elicited both N2pc and P_D , while a color singleton distractor elicited only P_D . Moreover, the abrupt-onset distractor elicited a larger N2pc and a larger P_D relative to the color singleton distractor. In addition, both distractors elicited an early positive component, the positivity posterior contralateral (Ppc), which was also larger for abrupt onsets than for color singletons. Experiment 2 further demonstrated that when both the abrupt onset and color singleton were designed as targets, and thus required no attentional suppression, Ppc was elicited, but P_D was not. This corroborated the finding in Experiment 1 that the later P_D , not the early Ppc, reflected attentional suppression. Therefore, a more salient distractor demonstrates stronger early perceptual processing, can capture attention better and needs more attentional resources to be suppressed later. Based on these results, a three-stage hypothesis is proposed, in which the saliency of a distractor modulates processing at early perception, attentional capture, and suppression stages.

Prediction of knee pain improvement over two years for knee osteoarthritis using a dynamic nomogram based on MRI-derived radiomics: a proof-of-concept study

OBJECTIVES

To develop and validate a nomogram to detect improved knee pain in osteoarthritis (OA) by integrating magnetic resonance imaging (MRI) radiomics signature of subchondral bone and clinical characteristics.

METHODS

Participants were selected from the Vitamin D Effects on Osteoarthritis (VIDEO) study. The primary outcome was 20% improvement of knee pain score over 2 years in participants administrated either vitamin D or placebo. Radiomics features of subchondral bone and clinical characteristics from 216 participants were extracted and analyzed. The participants were randomly split into the training and validation cohorts at a ratio of 8:2. Least absolute shrinkage and selection operator (LASSO) regression was used to select features and generate radiomics signatures. The optimal radiomics signature and clinical indicators were fitted into a nomogram using multivariable logistic regression model.

RESULTS

The nomogram showed favorable discrimination performance [AUC_training, 0.79 (95% CI: 0.72-0.79), AUC_validation, 0.83 (95% CI: 0.70-0.96)] as well as a good calibration. Additional contributing value of fusion radiomics signature to the nomogram was statistically significant (NRI, 0.23; IDI, 0.14, P < 0.001 in training cohort and NRI, 0.29; IDI, 0.18, P < 0.05 in validating cohort). Decision curve analysis confirmed the clinical usefulness of nomogram.

CONCLUSION

The radiomics-based nomogram comprising the MR radiomics signature and clinical variables achieves a favorable predictive efficacy and accuracy in differentiating improvement in knee pain among OA patients. This proof-of-concept study provides a promising way to predict clinically meaningful outcomes.

Interaction between the flagellum of Candidatus Liberibacter asiaticus and the vitellogenin-like protein of Diaphorina citri significantly influences CLas titer

Huanglongbing (HLB) is a global devastating citrus disease that is mainly caused by "Candidatus Liberibacter asiaticus" (CLas). It is mostly transmitted by the insect Asian citrus psyllid (ACP, Diaphorina citri) in a persistent and proliferative manner. CLas traverses multiple barriers to complete an infection cycle and is likely involved in multiple interactions with D. citri. However, the protein-protein interactions between CLas and D. citri are largely unknown. Here, we report on a vitellogenin-like protein (Vg_VWD) in D. citri that interacts with a CLas flagellum (flaA) protein. We found that Vg_VWD was upregulated in CLas-infected D. citri. Silencing of Vg_VWD in D. citri via RNAi silencing significantly increased the CLas titer, suggesting that Vg_VWD plays an important role in the CLas-D. citri interaction. Agrobacterium-mediated transient expression assays indicated that Vg_VWD inhibits BAX- and INF1-triggered necrosis and suppresses the callose deposition induced by flaA in Nicotiana benthamiana. These findings provide new insights into the molecular interaction between CLas and D. citri.

Hair Zinc and Chromium Levels Were Associated with a Reduced Likelihood of Age Related Cognitive Decline in Centenarians and Oldest-Old Adults

BACKGROUND

Cognitive function has inevitable decline with advancing age in nature, and age-related cognitive decline (ARCD) is of increasing concern to aging population. Scarce study has involved the associations between hair trace elements and ARCD in older adults, especially in centenarians and oldest-old adults. This study was to investigate the associations between hair trace elements and ARCD in centenarians and oldest-old adults.

METHODS

Based on the household registration information of centenarians and oldest-old adults provided by the Civil Affairs Department of Hainan Province, China, the investigators conducted a one-to-one household survey among centenarians (≥100 years old) and oldest-old adults (80-99 years old). All 50 centenarians had a median age of 103 years and females accounted for 68.0%. All 73 oldest-old adults aged 80-99 years had a median age of 90 years and females accounted for 82.2%. Basic information were obtained with questionnaire interview, physical examination, biological test and hair collection by pre-trained local doctors and nurses. An inductively coupled plasma mass spectrometer was used to measure hair trace elements. All data in this study comes from China. Age, sex, body mass index, systolic blood pressure, diastolic blood pressure, smoking, drinking, hemoglobin, albumin, fasting blood pressure, zinc, chromium, copper, selenium, iron, manganese, strontium, lead, magnesium, potassium, and barium were simultaneously included in multivariate Logistic regression analysis. One adjusted model was done with all hair trace elements together.

RESULTS

Zinc and chromium levels were significantly lower in participants with ARCD than those without ARCD (P < 0.05 for all). Multivariate Logistic regression analysis indicated that zinc [odds ratio (OR): 0.988, 95%confidence interval (95%CI): 0.977-0.999] and chromium (OR: 0.051, 95%CI: 0.004-0.705) were associated with a reduced likelihood of ARCD (P < 0.05 for all).

CONCLUSIONS

Hair zinc and chromium levels were associated with a reduced likelihood of ARCD in centenarians and oldest-old adults. Further studies are necessary to verify if zinc and chromium supplementation has the potential to improve cognitive function and prevent ARCD development.

Influence of artificial intelligence in education on adolescents' social adaptability: The mediatory role of social support

Artificial intelligence (AI) is widely used in the field of education at present, but people know little about its possible impacts, especially on the physical and mental development of the educated. It is important to explore the possible impacts of the application of artificial intelligence in education (AIEd) in order to avoid the possible adverse effects. Prior research has focused on theory to the exclusion of the psychological impact of AIEd, and the empirical research was relatively lacking. This study aimed to identify the influence of AIEd on adolescents' social adaptability via social support. A total of 1332 students were recruited using random sampling from 13 Artificial Intelligence Curriculum Reform Experimental Schools in Guangzhou, Southern China, completed the survey. There were 342 primary school students (Meanage = 10.6), 351 junior high school students (Meanage = 13.1), and 639 senior high school students (Meanage = 15.8). Results showed that AIEd has a negative impact on adolescents' social adaptability, and is significantly negatively correlated with social adaptability and family support, but there is no significant correlation with school support. AIEd could not only affect social adaptability directly, but also could affected it through the family support.

Attentional Bias Is Associated with Negative Emotions in Problematic Users of Social Media as Measured by a Dot-Probe Task

OBJECTIVE

Social media (SM) have flourished and are affecting human lives on an unprecedented scale. Problematic social media use (PSMU) is a recently emerging problematic behavior that affects both physical and mental health. The purpose of this study was to investigate whether problematic users of SM display attentional bias (AB) toward SM-related cues, as well as the relationships between AB, the severity of PSMU, and negative emotions.

METHOD

1000 college students were recruited through classes and online forums and then tested using the Bergen Social Media Addiction Scale (BSMAS). Eventually, 60 participants, identified by the cut-off point for BSMAS, consented to participate in the study and were divided into two groups (i.e., a problematic use group and a typical use group). The severity of PSMU and negative emotions (i.e., anxiety, depression, social fear, and loneliness) were evaluated by self-report questionnaires. AB was assessed by an addiction Stroop task and a dot-probe task (DPT).

RESULTS

PSMU was found to be positively associated with anxiety (r = 0.28, p < 0.05), depression (r = 0.35, p < 0.01), and social fear (r = 0.38, p < 0.01), but not with loneliness (r = 0.19, p = 0.15). Participants with a tendency toward PSMU displayed AB toward SM-related cues in the DPT [F (1, 58) = 26.77, p < 0.001, ηp2 = 0.32], but not in the Stroop task [F (1, 58) = 0.61, p = 0.44, ηp2 = 0.01]. Moreover, AB toward SM-related stimuli was found to be positively correlated with the severity of PSMU (r = -0.51, p < 0.001), anxiety (r = -0.37, p < 0.01), depression (r = -0.51, p < 0.001), and social fear (r = -0.30, p < 0.05) in the DPT.

CONCLUSIONS

Problematic users of SM show AB towards SM-related cues in the DPT, which is more reliable for assessing AB than the Stroop task. Moreover, it is suggested that in clinical interventions we should work to change the AB towards SM-related stimuli and improve negative emotions to decrease risks of PSMU.

Development and validation of a predictive model for diagnosing prostate cancer after transperineal prostate biopsy

Objective

This study aimed to develop and validate a nomogram to predict the probability of prostate cancer (PCa) after transperineal prostate biopsy by combining patient clinical information and biomarkers.

Methods

First, we retrospectively collected the clinicopathologic data from 475 patients who underwent prostate biopsy at our hospital between January 2019 to August 2021. Univariate and multivariate logistic regression analyses were used to select risk factors. Then, we established the nomogram prediction model based on the risk factors. The model performance was assessed by receiver operating characteristic (ROC) curves, calibration plots and the Hosmer–Lemeshow test. Decision curve analysis (DCA) was used to evaluate the net benefit of the model at different threshold probabilities. The model was validated in an independent cohort of 197 patients between September 2021 and June 2022.

Results

The univariate and multivariate logistic regression analyses based on the development cohort indicated that the model should include the following factors: age (OR = 1.056, p = 0.001), NEUT (OR = 0.787, p = 0.008), HPR (OR = 0.139, p &lt; 0.001), free/total (f/T) PSA (OR = 0.013, p = 0.015), and PI-RADS (OR = 3.356, p &lt; 0.001). The calibration curve revealed great agreement. The internal nomogram validation showed that the C-index was 0.851 (95% CI 0.809-0.894). Additionally, the AUC was 0.851 (95% CI 0.809-0.894), and the Hosmer–Lemeshow test result presented p = 0.143 &gt; 0.05. Finally, according to decision curve analysis, the model was clinically beneficial.

Conclusion

Herein, we provided a nomogram combining patients’ clinical data with biomarkers to help diagnose prostate cancers.

Early on-treatment tumor growth rate (EOT-TGR) determines treatment outcomes of advanced non-small-cell lung cancer patients treated with programmed cell death protein 1 axis inhibitor

BACKGROUND

Tumor growth rate (TGR), denoted as percentage change in tumor size per month, is a well-established indicator of tumor growth kinetics. The predictive value of early on-treatment TGR (EOT-TGR) for immunotherapy remains unclear. We sought to establish and validate the association of EOT-TGR with treatment outcomes in patients with advanced non-small-cell lung cancer (aNSCLC) undergoing anti-PD-1/PD-L1 (programmed cell death protein 1/programmed death-ligand 1) therapy.

PATIENTS AND METHODS

This bicenter retrospective cohort study included a training cohort, a contemporaneously treated internal validation cohort, and an external validation cohort. Computed tomography images were retrieved to calculate EOT-TGR, denoted as tumor burden change per month during a period between baseline and the first imaging evaluation after immunotherapy. Kaplan-Meier methodology and Cox regression analysis were conducted for survival analyses.

RESULTS

In the pooled cohort (n = 172), 125 patients (72.7%) were males; median age at diagnosis was 58 (range 28-79) years. Based on the training cohort, we determined the optimal cut-off value for EOT-TGR as 10.4%/month. Higher EOT-TGR was significantly associated with inferior overall survival [OS; hazard ratio (HR) 2.93, 95% confidence interval (CI) 1.47-5.83; P = 0.002], worse progression-free survival (PFS; HR 2.44, 95% CI 1.46-4.08; P = 0.001), and lower objective response rate (3.3% versus 20.9%; P = 0.040) and durable clinical benefit rate (6.7% versus 41.9%; P = 0.001). Results were reproducible in the two validation cohorts for OS and PFS. Among 43 patients who had a best response of progressive disease in the training cohort, those with high EOT-TGR had worse OS (HR 2.64; P = 0.041) and were more likely to progress due to target lesions at the first tumor evaluation (85.2% versus 0.0%; P <0.001).

CONCLUSIONS

Higher EOT-TGR was associated with inferior OS and immunotherapeutic response in patients with aNSCLC undergoing anti-PD-1/PD-L1 therapy. This easy-to-calculate radiologic biomarker may help evaluate the abilities of immunotherapy to prolong survival and assist in tailoring patients' management.

TRIAL REGISTRATION

ClinicalTrials.govNCT04722406; https://clinicaltrials.gov/ct2/show/NCT04722406.

Processing stage flexibility of the SNARC effect: Task relevance or magnitude relevance?

Previous studies have shown that the processing stage of the spatial-numerical association of response codes (SNARC) effect is flexible. Two recent studies used the same experimental paradigm to check whether the SNARC effect occurred in the semantic-representation stage but reached contradictory conclusions, showing that the SNARC effect was influenced by a magnitude Stroop effect in a magnitude comparison task but not by a parity Stroop effect in a parity judgment task. Those two studies had two distinct operational factors: the task type (magnitude comparison task or parity judgment task, with the numerical magnitude information task-relevant or task-irrelevant) and the semantic representation stage-related interference information (magnitude or parity Stroop effect, with the interference information magnitude-relevant or magnitude-irrelevant). To determine which factor influenced the SNARC effect, in the present study, the Stroop effect was switched in the two tasks based on the previous studies. The findings of four experiments consistently showed that the SNARC effect was not influenced by the parity Stroop effect in the magnitude comparison task but was influenced by the magnitude Stroop effect in the parity judgment task. Combined with the results of those two contradictory studies, the findings indicated that regardless of the task type or the task relevance of numerical magnitude information, magnitude-relevant interference information was the primary factor to affect the SNARC effect. Furthermore, a two-stage processing model that explained the observed flexibility of the SNARC effect was proposed and discussed.

A "Candidatus Liberibacter asiaticus"-secreted polypeptide suppresses plant immune responses in Nicotiana benthamiana and Citrus sinensis

Citrus Huanglongbing (HLB), known as the most economically devastating disease in citrus industry, is mainly caused by phloem-restricted Gram-negative bacterium "Candidatus Liberibacter asiaticus" (CLas). To date, CLas is still unculturable in vitro, which has been dramatically delaying the research on its pathogenesis, and only few Sec-dependent effectors (SDEs) have been identified to elucidate the pathogenesis of CLas. Here, we confirmed that a CLas-secreted Sec-dependent polypeptide, namely SECP8 (CLIBASIA_05330), localized in nucleus, cytoplasm and cytoplasmic membrane, and showed remarkably higher transcript abundance in citrus than in psyllids. Potato virus X (PVX)-mediated transient expression assays indicated that mSECP8 (the mature form of SECP8) suppressed pro-apoptotic mouse protein BAX and Phytophthora infestans elicitin INF1-triggered hypersensitive response (HR) associated phenotypes, including cell death, H2O2 accumulation and callose deposition. Intriguingly, mSECP8 also inhibited SDE1 (CLIBASIA_05315)-induced water-soaked and dwarfing symptoms in Nicotiana benthamiana. In addition, mSECP8 can promote the susceptibility of transgenic Wanjincheng orange (Citrus sinensis) to CLas invasion and further HLB symptom development, and it contributes to the proliferation of Xanthomonas citri subsp. citri (Xcc). Moreover, the expression of ten immunity-related genes were significantly down-regulated in mSECP8 transgenic citrus than those in wide-type (WT) plants. Overall, we propose that mSECP8 may serve as a novel broad-spectrum suppressor of plant immunity, and provide the first evidence counteractive effect among CLas effectors. This study will enrich and provide new evidences for elucidating the pathogenic mechanisms of CLas in citrus host.

[A preliminary exploration into the efficacy of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula]

To explore the efficacy and value of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula based on the size of the maxillary sinus perforation and maxillary sinus fistula. A total of 28 patients with maxillary sinus perforation and maxillary sinus fistula who were admitted to the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University from July 2017 to May 2020 were included to conduct a prospective case clinical study. After the inflammation in the maxillary sinus was controlled, a proper surgical repair method was selected according to the size of the perforation and fistula based on the double-layer closure technique. The diameter of the perforation and fistula was measured with the assistance of cone-beam CT. After that, the platelet rich fibrin (PRF) repair was performed on the perforation and fistula with 3 mm≤diameter<7 mm in size in 14 patients. The PRF repair and buccal flap repair were performed on the perforation and fistula with 7 mm ≤diameter<15 mm in size in 7 patients. The adjacent buccal pad repair, palatine flap repair, and buccal flap repair were performed on the perforation and fistula with 15 mm≤ diameter<25 mm in size in 4 patients. The nasolabial axial flap repair and nasolabial free flap repair were performed on the perforation and fistula with a diameter ≥25 mm in size in 3 patients. The medical follow-up was conducted in all patients in the 1st, 2nd, and 4th week after surgery, with an overall success rate reaching 96.4% (27/28) after the initial intervention. The relapse of disease occurred in one patient (4.6%) with diabetes and a smoking history in the 2nd week after surgery. Identifying a proper surgical repair method according to the size of the oral and maxillary sinus perforation and maxillary sinus fistula based on the double-layer closure technique can improve the one-time cure rate in these patients under the premise that the inflammation in the maxillary sinus can be controlled.

Population Diversity of 'Candidatus Liberibacter asiaticus' and Diaphorina citri in Sichuan: A Case Study for Huanglongbing Monitoring and Interception

Citrus huanglongbing (HLB) is present in 10 provinces in China and is associated with 'Candidatus Liberibacter asiaticus' (CLas), which is transmitted by the Asian citrus psyllid (Diaphorina citri, ACP). To date, HLB and ACP have expanded to Yibin city of Sichuan Province, posing an imminent threat to the citrus belt of the upper and middle reaches of the Yangtze River, an important late-maturing citrus-producing area in China. To understand the epidemiological route of CLas and ACP in newly invaded regions of Sichuan and thereby better establish an HLB interception zone ranging from Leibo to Yibin, we evaluated the molecular variability of 19 CLas draft genomes from citrus or dodder (Cuscuta campestris). They include three type-specific prophage loci, three variable number tandem repeat loci, a miniature inverted-repeat transposable element, and population diversity of 44 ACP mitochondrial genomes. The results indicated that CLas isolates in the newly invaded area (Pingshan) were more diverse than those in the HLB endemic areas (Leibo and Ningnan). Phylogenetic analysis based on mitochondrial genomes demonstrated that ACPs in Leibo, Pingshan, and Xuzhou (rural areas) represent a new mitochondrial group (MG4), distinguished by the three unique single-nucleotide polymorphisms in cox1, nad4, and cytb. However, the ACPs sampled from the urban areas of Cuiping and Xuzhou belonged to the southeastern China group (MG2-1). Altogether, our study revealed multiple sources of ACP and CLas in the HLB interception zone and proposed their transmission route. This study contributes to the formulation of precise HLB prevention and control strategies in the HLB interception zone in Sichuan and could be useful for HLB management efforts in other regions.

Configural but Not Featural Face Information Is Associated With Automatic Processing

Configural face processing precedes featural face processing under the face-attended condition, but their temporal sequence in the absence of attention is unclear. The present study investigated this issue by recording visual mismatch negativity (vMMN), which indicates the automatic processing of visual information under unattended conditions. Participants performed a central cross size change detection task, in which random sequences of faces were presented peripherally, in an oddball paradigm. In Experiment 1, configural and featural faces (deviant stimuli) were presented infrequently among original faces (standard stimuli). In Experiment 2, configural faces were presented infrequently among featural faces, or vice versa. The occipital-temporal vMMN emerged in the 200–360 ms latency range for configural, but not featural, face information. More specifically, configural face information elicited a substantial vMMN component in the 200–360 ms range in Experiment 1. This result was replicated in the 320–360 ms range in Experiment 2, especially in the right hemisphere. These results suggest that configural, but not featural, face information is associated with automatic processing and provides new electrophysiological evidence for the different mechanisms underlying configural and featural face processing under unattended conditions.

A bilateral SPCN is elicited by to-be-memorized visual stimuli displayed along the vertical midline

We recently showed that deploying attention to target stimuli displayed along the vertical meridian elicits a bilateral N2pc, that we labeled N2pcb (Psychophysiology). Here we investigated whether a different component, the sustained posterior contralateral negativity (SPCN), shows the same property when a varying number of visual stimuli are displayed either laterally or on the vertical meridian. We displayed one or two cues that designated candidate targets to be detected in a search array that was displayed after a retention interval. The cues were either on the horizontal meridian or on the vertical meridian. When the cues were on the horizontal meridian, we observed an N2pc followed by an SPCN in their classic form, as negativity increments contralateral to the cues. As expected, SPCN amplitude was greater when two cues had to be memorized than when only one cue had to be memorized. When the cues were on the vertical meridian, we observed an N2pcb followed by a bilateral SPCN (or SPCNb). Critically, like SPCN, SPCNb amplitude was greater when two cues had to be memorized than when only one cue had to be memorized. A series of additional parametrical and topographical comparisons between N2pcb and SPCNb revealed similarities but also some important differences between these two components that we interpreted as evidence for their distinct neural sources.

We challenge the view that the SPCN ERP component cannot track the memory maintenance of objects displayed along the vertical meridian. Owing to the receptive fields of posterior neurons straddling on the intersection of the two visual hemifields, bilateral N2pc (N2pcb) and SPCN (SPCNb) activity can be detected using a cued visual search design.

Visual Mismatch Negativity Reflects Enhanced Response to the Deviant: Evidence From Event-Related Potentials and Electroencephalogram Time-Frequency Analysis

Automatic detection of information changes in the visual environment is crucial for individual survival. Researchers use the oddball paradigm to study the brain’s response to frequently presented (standard) stimuli and occasionally presented (deviant) stimuli. The component that can be observed in the difference wave is called visual mismatch negativity (vMMN), which is obtained by subtracting event-related potentials (ERPs) evoked by the deviant from ERPs evoked by the standard. There are three hypotheses to explain the vMMN. The sensory fatigue (or refractoriness) hypothesis considers that weakened neural activity caused by repetition results in decreased ERPs of the standard. The memory trace hypothesis proposes that vMMN results from increased responses to the deviant. The predictive coding hypothesis attributes the difference to enhanced responses for deviants and suppression for standards. However, when distinguishing between these effects, previous researchers did not consider the effect of low-level features on the vMMN. In this experiment, we used face sequences composed of different emotions (e.g., neutral and fearful face) and presented an oddball sequence, a reverse oddball sequence, and an equiprobable sequence to participants. The deviant of the oddball sequence was subtracted from the standard of the oddball sequence, the reverse oddball sequence, and the same type of stimulus of the equiprobable sequence to get oddball-vMMN (vMMN1), reverse oddball-vMMN (vMMN2), and equiprobable-vMMN (vMMN3), respectively. The results showed no significant difference between vMMN2 and vMMN3 in 100–350 ms following stimulus onset, while the vMMN effect was significant, indicating that the probability of the standard did not affect vMMN, which supported the memory trace hypothesis. Additionally, the fearful-related vMMN were more negative than the neutral-related vMMN within the range of 100–150 ms, suggesting a negative bias. We analyzed the source location of different vMMNs. There was no significant difference in brain regions between different vMMNs. Time-frequency analysis showed that the deviant had stronger theta-band oscillatory than the standard (visual mismatch oscillatory responses, vMORs). However, there was no difference between vMORs2 and vMORs3, indicating that vMORs reflect an enhanced response to the deviant in terms of neural oscillation, supporting the memory trace hypothesis.

Integrated Analysis of the miRNAome and Transcriptome Reveals miRNA-mRNA Regulatory Networks in Catharanthus roseus Through Cuscuta campestris-Mediated Infection With "Candidatus Liberibacter asiaticus"

Citrus Huanglongbing (HLB) is the most devastating disease of citrus caused by the Gram-negative phloem-limited bacterium "Candidatus Liberibacter asiaticus" (CLas). It can be transmitted by the Asian citrus psyllid "Diaphorina citri," by grafting, and by the holoparasitic dodder. In this study, the non-natural host periwinkle (Catharanthus roseus) was infected via dodder (Cuscuta campestris) from CLas-infected citrus plants, and the asymptomatic leaves (AS) were subjected to transcriptomic and small-RNA profiling. The results were analyzed together with a transcriptome dataset from the NCBI repository that included leaves for which symptoms had just occurred (S) and yellowing leaves (Y). There were 3,675 differentially expressed genes (DEGs) identified in AS, and 6,390 more DEGs in S and further 2109 DEGs in Y. These DEGs were commonly enriched in photosystem, chloroplast, membrane, oxidation-reduction process, metal/zinc ion binding on GO. A total of 14,974 DEGs and 336 DE miRNAs (30 conserved and 301 novel) were identified. Through weighted gene co-expression network and nested network analyses, two critical nested miRNA-mRNA regulatory networks were identified with four conserved miRNAs. The primary miR164-NAC1 network is potentially involved in plant defense responses against CLas from the early infection stage to symptom development. The secondary network revealed the regulation of secondary metabolism and nutrient homeostasis through miR828-MYB94/miR1134-HSF4 and miR827-ATG8 regulatory networks, respectively. The findings discovered new potential mechanisms in periwinkle-CLas interactions, and its confirmation can be done in citrus-CLas system later on. The advantages of periwinkle plants in facilitating the quick establishment and greater multiplication of CLas, and shortening latency for disease symptom development make it a great surrogate for further studies, which could expedite our understanding of CLas pathogenesis.

The Impact of COVID-19 on the Acute Stroke Care Pathway: Looking Beyond the Short Term

Background

Methods

Results

Conclusion

EXPRESS: Contextual uncertainty of visual scene modulates object-based attention

Contextual information involves invariant properties that are critical in selective attention. There is no direct evidence showing the effect of contextual information on object-based selective attention. The current study aimed to investigate the role of contextual uncertainty on object-based effect using a flanker task and to clarify the contradictory results obtained in previous studies. Herein, contextual uncertainty specifically referred to the configurations of the stimuli presented randomly as vertical or horizontal displays (high contextual uncertainty) that was reduced by showing consistent configurations within a block, via implicit learning of configuration (low contextual uncertainty). In Experiment 1, the object-based effect was observed under the high uncertainty condition and disappeared under the low uncertainty condition, demonstrating that contextual uncertainty modulated object-based attention. Experiment 2 provided explicit knowledge of the configural orientations, which can be utilised to sufficiently guide subsequent perception with increase in cueing interval, and therefore, affected contextual uncertainty. Relative to a short cueing interval, the long cueing interval enabled the participants to utilise the contextual knowledge for guiding visual attention and reducing uncertainty. Consistent with the finding in Experiment 1, the explicit manipulation of contextual uncertainty affected the object-based effect. The results proved that contextual uncertainty played an important role in prioritisation in object-based attentional selection. The mechanism of the interplay between contextual uncertainty and object-based attention was discussed.

The spatiotemporal characteristics of N170s for faces and words: A meta-analysis study

N170 is a negative event-related potential (ERP) component in response to visual stimuli, such as faces. It remains controversial whether N170 reflects the specific processing of faces or can also be elicited by objects of expertise (e.g., words). In this research, we conducted a meta-analysis for the spatiotemporal characteristics of N170 of face and word stimuli from 24 studies in which both stimuli were presented for each subject. We observed that (1) both face and word stimuli can elicit conspicuous N170s and that there was no difference between the amplitude of face-N170 and word-N170; (2) there is no difference in the latencies between the two N170s; and (3) both N170s are distributed in the occipitotemporal regions but with a reversed hemispheric distribution pattern-face-N170 is more negative in the right than left occipitotemporal regions, while word-N170 is the opposite. These results showed that the face- and word-N170s are qualitatively the same but have different hemispheric lateralization advantages-N170 might be a general neural index of the expertise-dependent object-recognition process in occipitotemporal regions.

Cross-cultural asymmetries in oculomotor interference elicited by gaze distractors belonging to Asian and White faces

The averted gaze of others triggers reflexive attentional orienting in the corresponding direction. This phenomenon can be modulated by many social factors. Here, we used an eye-tracking technique to investigate the role of ethnic membership in a cross-cultural oculomotor interference study. Chinese and Italian participants were required to perform a saccade whose direction might be either congruent or incongruent with the averted-gaze of task-irrelevant faces belonging to Asian and White individuals. The results showed that, for Chinese participants, White faces elicited a larger oculomotor interference than Asian faces. By contrast, Italian participants exhibited a similar oculomotor interference effect for both Asian and White faces. Hence, Chinese participants found it more difficult to suppress eye-gaze processing of White rather than Asian faces. The findings provide converging evidence that social attention can be modulated by social factors characterizing both the face stimulus and the participants. The data are discussed with reference to possible cross-cultural differences in perceived social status.

PIK3CA mutations in plasma circulating tumor DNA predict survival and treatment outcomes in patients with advanced cancers

Background

Oncogenic mutations in PIK3CA are prevalent in diverse cancers and can be targeted with inhibitors of the phosphoinositide-3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway. Analysis of circulating tumor DNA (ctDNA) provides a minimally invasive approach to detect clinically actionable PIK3CA mutations.

Patients and methods

We analyzed PIK3CA hotspot mutation frequency by droplet digital PCR (QX 200; BioRad) using 16 ng of unamplified plasma-derived cell-free DNA from 68 patients with advanced solid tumors (breast cancer, n = 41; colorectal cancer, n = 13; other tumor types, n = 14). Results quantified as variant allele frequencies (VAFs) were compared with previous testing of archival tumor tissue and with patient outcomes.

Results

Of 68 patients, 58 (85%) had PIK3CA mutations in tumor tissue and 43 (74%) PIK3CA mutations in ctDNA with an overall concordance of 72% (49/68, κ = 0.38). In a subset analysis, which excluded samples from 26 patients known not to have disease progression at the time of sample collection, we found an overall concordance of 91% (38/42; κ = 0.74). PIK3CA-mutated ctDNA VAF of ≤8.5% (5% trimmed mean) showed a longer median survival compared with patients with a higher VAF (15.9 versus 9.4 months; 95% confidence interval 6.7-17.1 months; P = 0.014). Longitudinal analysis of ctDNA in 18 patients with serial plasma collections (range 2-22 time points, median 5) showed that those with a decrease in PIK3CA VAF had a longer time to treatment failure (TTF) compared with patients with an increase or no change (10.7 versus 2.6 months; P = 0.048).

Conclusions

Detection of PIK3CA mutations in ctDNA is concordant with testing of archival tumor tissue. Low quantity of PIK3CA-mutant ctDNA is associated with longer survival and a decrease in PIK3CA-mutant ctDNA on therapy is associated with longer TTF.

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Testing for PIK3CA mutations in ctDNA is concordant with testing of tumor tissue.

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High PIK3CA-mutant abundance in ctDNA was associated with shorter survival.

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Increasing PIK3CA-mutant abundance in serial blood samples was associated with shorter TTF.

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Longitudinal monitoring of PIK3CA-mutant ctDNA tracked with cancer clinical course.

Fabrication of Ag/TiO2 Cotton Fabric to Enhance Photocatalytic Degradation of Anionic Dye

Ag/TiO2 composite fabric was prepared by coprecipitation with TiCl4 as a titanium source and AgNO3 as a silver source. The samples were characterized by scanning electron microscope (SEM), thermogravimetric analyzer (TG) and Fourier transform infrared spectrometer (FTIR). The photocatalytic activity of synthetic fabrics was measured by the degradation of anion dyes under ultraviolet light. The effects of silver loading concentration, fabric area, initial concentration, and photocatalytic time on photocatalytic activity were investigated. The experimental results showed that the degradation rate of Ag/TiO2 composite fabric on anion dyes could reach 70.76% in 50 minutes, indicating that the prepared Ag/TiO2 composite fabrics had high photocatalytic activity.

[Correlation of baseline serum 25-hydroxyvitamin D level with the risk of type 2 diabetes mellitus: a prospective cohort study]

OBJECTIVE

To investigate the correlation of baseline serum 25(OH) D level with the risk of type 2 diabetes mellitus (T2DM) and blood glucose control in diabetic patients among the middle-aged and elderly individuals in Chengguan District of Lanzhou, Gansu Province.

OBJECTIVE

Residents aged 40 to 75 years in Lanzhou were selected from the "REACTION" study conducted in 2011 and had been followed up since 2014. A total of 5044 subjects with complete data from the two surveys were analyzed. Participants were divided into Q1, Q2, Q3, and Q4 subgroups based on quartiles of serum 25(OH)D level for comparison of the incidence of T2DM and blood glucose control.

OBJECTIVE

Baseline 25(OH)D level was not found to correlate with FPG, 2h-PG or HbA1c levels among the residents (P>0.05). The participants were followed up for a mean of 3.4±0.6 years, and compared with those in Q1 group, the participants in Q2, Q3 and Q4 groups did not show significantly lowered risk of prediabetes or diabetes regardless of glucose tolerance status. Among the patients with T2DM, the compliance rate of glycemic control after the follow-up was significantly higher than that before the follow-up (63.4% vs 60.6%), and the levels of HbA1c, FPG, and 2h-PG decreased obviously after the follow-up. But compared with Q1 group, Q2, Q3 and Q4 groups showed no significant changes in glycemic control compliance rate or levels of HbA1c, FPG and 2h-PG after the follow-up (P>0.05).

OBJECTIVE

There is no evidence that baseline 25(OH)D levels are associated with the risk of diabetes and blood glucose control in patients with T2DM.

Cabazitaxel versus abiraterone or enzalutamide in poor prognosis metastatic castration-resistant prostate cancer: a multicentre, randomised, open-label, phase II trial

BACKGROUND

Treatment of poor prognosis metastatic castration-resistant prostate cancer (mCRPC) includes taxane chemotherapy and androgen receptor pathway inhibitors (ARPI). We sought to determine optimal treatment in this setting.

PATIENTS AND METHODS

This multicentre, randomised, open-label, phase II trial recruited patients with ARPI-naive mCRPC and poor prognosis features (presence of liver metastases, progression to mCRPC after <12 months of androgen deprivation therapy, or ≥4 of 6 clinical criteria). Patients were randomly assigned 1 : 1 to receive cabazitaxel plus prednisone (group A) or physician's choice of enzalutamide or abiraterone plus prednisone (group B) at standard doses. Patients could cross over at progression. The primary endpoint was clinical benefit rate for first-line treatment (defined as prostate-specific antigen response ≥50%, radiographic response, or stable disease ≥12 weeks).

RESULTS

Ninety-five patients were accrued (median follow-up 21.9 months). First-line clinical benefit rate was greater in group A versus group B (80% versus 62%, P = 0.039). Overall survival was not different between groups A and B (median 37.0 versus 15.5 months, hazard ratio (HR) = 0.58, P = 0.073) nor was time to progression (median 5.3 versus 2.8 months, HR = 0.87, P = 0.52). The most common first-line treatment-related grade ≥3 adverse events were neutropenia (cabazitaxel 32% versus ARPI 0%), diarrhoea (9% versus 0%), infection (9% versus 0%), and fatigue (7% versus 5%). Baseline circulating tumour DNA (ctDNA) fraction above the cohort median and on-treatment ctDNA increase were associated with shorter time to progression (HR = 2.38, P < 0.001; HR = 4.03, P < 0.001). Patients with >30% ctDNA fraction at baseline had markedly shorter overall survival than those with undetectable ctDNA (HR = 38.22, P < 0.001).

CONCLUSIONS

Cabazitaxel was associated with a higher clinical benefit rate in patients with ARPI-naive poor prognosis mCRPC. ctDNA abundance was prognostic independent of clinical features, and holds promise as a stratification biomarker.

Safety and activity of vandetanib in combination with everolimus in patients with advanced solid tumors: a phase I study

Background

Preclinical studies suggest that combining vandetanib (VAN), a multi-tyrosine kinase inhibitor of rearranged during transfection (RET) proto-oncogene, vascular endothelial growth factor receptor (VEGFR), and epidermal growth factor receptor (EGFR), with everolimus (EV), a mammalian target of rapamycin (mTOR) inhibitor, may improve antitumor activity. We determined the safety, maximum tolerated dose (MTD), recommended phase II dose (RP2D), and dose-limiting toxicities (DLTs) of VAN + EV in patients with advanced solid cancers and the effect of combination therapy on cancer cell proliferation and intracellular pathways.

Patients and methods

Patients with refractory solid tumors were enrolled in a phase I dose-escalation trial testing VAN (100-300 mg orally daily) + EV (2.5-10 mg orally daily). Objective responses were evaluated using RECIST v1.1. RET mutant cancer cell lines were used in cell-based studies.

Results

Among 80 patients enrolled, 72 (90%) patients were evaluable: 7 achieved partial response (PR) (10%) and 37 had stable disease (SD) (51%; duration range: 1-27 cycles). Clinical benefit (SD or PR ≥ 6 months) was observed in 26 evaluable patients [36%, 95% confidence intervals (CI) (25% to 49%)]. In 80 patients, median overall survival (OS) was 10.5 months [95% CI (8.5-16.1)] and median progression-free survival (PFS) 4.1 months [95% CI (3.4-7.3)]. Six patients (7.5%) experienced DLTs and 20 (25%) required dose modifications. VAN + EV was safe, with fatigue, rash, diarrhea, and mucositis being the most common toxicities. In cell-based studies, combination therapy was superior to monotherapy at inhibiting cancer cell proliferation and intracellular signaling.

Conclusions

The MTDs and RP2Ds of VAN + EV are 300 mg and 10 mg, respectively. VAN + EV combination is safe and active in refractory solid tumors. Further investigation is warranted in RET pathway aberrant tumors.

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VAN + EV is safe, active and provides clinical benefit in some patients with refractory solid cancers.

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Dual therapy is superior to monotherapy at inhibiting proliferation and intracellular signaling of RET mutant cancer cells.

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This study highlights the importance of identifying novel combination therapies to overcome therapeutic resistance.

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Next-generation sequencing of advanced solid tumors may inform treatment strategies and guide future drug development.