Perceptual training improves audiovisual integration by enhancing alpha-band oscillations and functional connectivity in older adults.

Numerous studies on perceptual training exist, however, most have focused on the precision of temporal audiovisual perception, while fewer have concentrated on ability promotion for audiovisual integration (AVI). To investigate these issues, continuous 5-day audiovisual perceptual training was applied, during which electroencephalography was performed in response to auditory-only (A), visual-only (V) and audiovisual (AV) stimuli before and after training. The results showed that the perceptual sensitivity was greater for training group than for control group and was greater in the posttest than in the pretest. The response to the AV stimulus was significantly faster in the posttest than in the pretest for the older training group but was significantly greater for A and V stimuli for the younger training group. Electroencephalography analysis found higher P3 AVI amplitudes [AV-(A + V)] in the posttest than in the pretest for training group, which were subsequently reflected by an increased alpha (8-12 Hz) oscillatory response and strengthened global functional connectivity (weighted phase lag index). Furthermore, these facilitations were greater for older training groups than for younger training groups. These results confirm the age-related compensatory mechanism for AVI may be strengthened as audiovisual perceptual training progresses, providing an effective candidate for cognitive intervention in older adults.

Audiovisual integration and sensory dominance effects in older adults with subjective cognitive decline: Enhanced redundant effects and stronger fusion illusion susceptibility.

INTRODUCTION: Subjective cognitive decline (SCD) refers to individuals' perceived decline in memory and/or other cognitive abilities relative to their previous level of performance. Sensory decline is one of the main manifestations of decline in older adults with SCD. The efficient integration of visual and auditory information, known as audiovisual integration, is a crucial perceptual process. This study aims to evaluate audiovisual integration in older adults with SCD. METHODS: We adopted the audiovisual detection task, the Colavita task, and the Sound-Induced Flash Illusion (SIFI) task to evaluate the audiovisual integration by examining both redundant and illusory effects. Older adults diagnosed with SCD (N = 50, mean age = 67.8 years) and a control group of non-SCD older adults (N = 51, mean age = 66.5 years) were recruited. All participants took part in the three aforementioned experiments. RESULTS: The outcomes showed that a redundant effect occurred in both SCD and non-SCD older adults, with SCD older adults gaining more benefits in audiovisual detection task. Moreover, an equivalent amount of the visual dominance effect was observed among both SCD and non-SCD older adults in Colavita task. In addition, older adults with SCD perceived an equal fission illusion but a bigger fusion illusion compared with non-SCD older adults in SIFI task. CONCLUSIONS: Overall, older adults with SCD exhibit increased audiovisual redundant effects and stronger fusion illusion susceptibility compared to non-SCD older adults. Besides, visual dominance was observed in both groups via the Colavita task, with no significant difference between non-SCD and SCD older adults. These findings implied that audiovisual integration might offer a potential way for the identification of SCD.

Photocatalytic Formamide Synthesis via Coupling of Electrophilic and Nucleophilic Radicals over Atomically Dispersed Bi Sites.

Formamide (HCONH2) plays a pivotal role in the manufacture of a diverse array of chemicals, fertilizers, and pharmaceuticals. Photocatalysis holds great promise for green fabrication of carbon-nitrogen (C-N) compounds owing to its environmental friendliness and mild redox capability. However, the selective formation of the C-N bond presents a significant challenge in the photocatalytic synthesis of C-N compounds. This work developed a photocatalytic radical coupling method for the formamide synthesis from co-oxidation of ammonia (NH3) and methanol (CH3OH). An exceptional formamide yield rate of 5.47±0.03 mmol ⋅ gcat -1 ⋅ h-1 (911.87±5 mmol ⋅ gBi -1 ⋅ h-1) was achieved over atomically dispersed Bi sites (BiSAs) on TiO2. An accumulation of 45.68 mmol ⋅ gcat -1 (2.0 g ⋅ gcat -1) of formamide was achieved after long-term illumination, representing the highest level of photocatalytic C-N compounds synthesis. The critical C-N coupling for formamide formation originated from the "σ-σ" interaction between electrophilic ⋅CH2OH with nucleophilic ⋅NH2 radical. The BiSAs sites facilitated the electron transfer between reactants and photocatalysts and enhanced the nucleophilic attack of ⋅NH2 radical on the ⋅CH2OH radical, thereby advancing the selective C-N bond formation. This work deepens the understanding of the C-N coupling mechanism and offers an intriguing photocatalytic approach for the efficient and sustainable production of C-N compounds.

Correlation analysis between BRAFV600E mutation and ultrasonic and clinical features of papillary thyroid cancer.

Purpose: The study investigates the value of the BRAFV600E mutation in determining the aggressiveness of papillary thyroid cancer (PTC) and its correlation with ultrasound features. Methods: The study selected 176 patients with BRAFV600E mutation and 80 without the mutation who underwent surgery at Guangxi Medical University Cancer Hospital. Clinical and pathological data were collected, focusing on BRAFV600E mutations and associated ultrasonic features. Correlation analysis, as well as univariate and multivariate logistic regression analysis, were conducted to identify independent risk factors for BRAFV600E mutation. The results were verified using a nomogram model. Results: The analysis results indicate that the BRAFV600E mutation correlates with tumor size, nodule size, taller-than-wide shape, margin, and shape of papillary thyroid cancer. The receiver operating characteristic curve was used to analyze the diagnostic effect of these features on BRAFV600E mutation. The results showed that nodule size had the most significant area under the curve (AUC = 0.665). Univariate and multivariate logistic regression analyses revealed that taller-than-wide shape ≥1, ill-defined margin, irregular shape, nodule size (≤1.40 cm), TT4 (>98.67 nmol/L), and FT3 (<4.14 pmol/L) were independent risk factors for BRAFV600E mutation. While considering all these factors in the nomogram, the Concordance index (C-index) remained high at 0.764. This suggests that the model has a good predictive effect. Conclusion: Ultrasound features including nodule size, taller-than-wide shape ≥1, ill-defined margins, irregular shape, higher TT4 levels, and lower FT3 levels were associated with papillary thyroid cancer aggressiveness and BRAFV600E mutation.

Identification and functional marker development of SbPLSH1 conferring purple leaf sheath in sorghum.

KEY MESSAGE: We identified a SbPLSH1gene conferring purple leaf sheath in sorghum (sorghumbicolor(L.) Moench)and developed a functional markerfor it. The purple leaf sheath of sorghum, a trait mostly related to anthocyanin deposition, is a visually distinguishable morphological marker widely used to evaluate the purity of crop hybrids. We aimed to dissect the genetic mechanism for leaf sheath color to mine the genes regulating this trait. In this study, two F2 populations were constructed by crossing a purple leaf sheath inbred line (Gaoliangzhe) with two green leaf sheath inbred lines (BTx623 and Silimei). Based on the results of bulked-segregant analysis sequencing, bulk-segregant RNA sequencing, and map-based cloning, SbPLSH1 (Sobic.006G175700), which encodes a bHLH transcription factor on chromosome 6, was identified as the candidate gene for purple leaf sheath in sorghum. Genetic analysis demonstrated that overexpression of SbPLSH1 in Arabidopsis resulted in anthocyanin deposition and purple petiole, while two single-nucleotide polymorphism (SNP) variants on the exon 6 resulted in loss of function. Further haplotype analysis revealed that there were two missense mutations and one cis-acting element mutation in SbPLSH1, which are closely associated with leaf sheath color in sorghum. Based on the variations, a functional marker (LSC4-2) for marker-assisted selection was developed, which has a broad-spectrum capability of distinguishing leaf sheath color in natural variants. In summary, this study lays a foundation for analyzing the genetic mechanism for sorghum leaf sheath color.

Low hysteresis, water retention, anti-freeze multifunctional hydrogel strain sensor for human-machine interfacing and real-time sign language translation.

Hydrogel strain sensors have received increasing attention due to their potential applications in human-machine interfaces and flexible electronics. However, they usually suffer from both mechanical and electrical hysteresis and poor water retention, which limit their practical applications. To address this challenge, a poly(acrylic acid-co-acrylamide) hydrogel crosslinked by silica nanoparticles is fabricated via photo polymerization and salting-out of hydrophilic ions for the strain sensor. The resulting hydrogel strain sensor possessed low electrical hysteresis (1.6%), low mechanical hysteresis (<7%), high cycle stability (>10 000 cycles), high durability, water retention and anti-freezing ability. Moreover, this strain sensor can be used as a wearable sensor for real-time control of robotic hands and hand gesture recognition. Finally, a sign language translation system has been demonstrated with the aid of machine learning, achieving recognition rates of over 98% for 15 different sign languages. This work offers a promising prospect for human-machine interfaces, smart wearable devices, and the Internet of Things.

Bioinspired Mechanically Robust and Recyclable Hydrogel Microfibers Based on Hydrogen-Bond Nanoclusters.

Mechanically robust hydrogel fibers have demonstrated great potential in energy dissipation and shock-absorbing applications. However, developing such materials that are recyclable, energy-efficient, and environmentally friendly remains an enormous challenge. Herein, inspired by spider silk, a continuous and scalable method is introduced for spinning a polyacrylamide hydrogel microfiber with a hierarchical sheath-core structure under ambient conditions. Applying pre-stretch and twist in the as-spun hydrogel microfibers results in a tensile strength of 525 MPa, a toughness of 385 MJ m-3, and a damping capacity of 99%, which is attributed to the reinforcement of hydrogen-bond nanoclusters within the microfiber matrix. Moreover, it maintains both structural and mechanical stability for several days, and can be directly dissolved in water, providing a sustainable spinning dope for re-spinning into new microfibers. This work provides a new strategy for the spinning of robust and recyclable hydrogel-based fibrous materials.

The impact of age and number of mutations on the size of clonal hematopoiesis.

Clonal hematopoiesis (CH) represents the clonal expansion of hematopoietic stem cells and their progeny driven by somatic mutations. Accurate risk assessment of CH is critical for disease prevention and clinical decision-making. The size of CH has been showed to associate with higher disease risk, yet, factors influencing the size of CH are unknown. In addition, the characteristics of CH in long-lived individuals are not well documented. Here, we report an in-depth analysis of CH in longevous (≥90 y old) and common (60~89 y old) elderly groups. Utilizing targeted deep sequencing, we found that the development of CH is closely related to age and the expression of aging biomarkers. The longevous elderly group exhibited a significantly higher incidence of CH and significantly higher frequency of TET2 and ASXL1 mutations, suggesting that certain CH could be beneficial to prolong life. Intriguingly, the size of CH neither correlates significantly to age, in the range of 60 to 110 y old, nor to the expression of aging biomarkers. Instead, we identified a strong correlation between large CH size and the number of mutations per individual. These findings provide a risk assessment biomarker for CH and also suggest that the evolution of the CH is influenced by factor(s) in addition to age.

Identification of Cu(111) as Superior Active Sites for Electrocatalytic NO Reduction to NH3 with High Single-Pass Conversion Efficiency.

Opting for NO as an N source in electrocatalytic NH3 synthesis presents an intriguing approach to tackle energy and environmental challenges. However, blindly pursuing high NH3 synthesis rates and Faradaic efficiency (FE) while ignoring the NO conversion ratio could result in environmental problems. Herein, Cu nanosheets with exposed (111) surface is fabricated and exhibit a NO-to-NH3 yield rate of 371.89 µmol cm-2 h-1 (flow cell) and the highest FE of 93.19±1.99 % (H-type cell). The NO conversion ratio is increased to the current highest value of 63.74 % combined with the development of the flow cell. Additionally, Crystal Orbital Hamilton Population (COHP) clearly reveals that the "σ-π* acceptance-donation" is the essence of the interaction between the Cu and NO as also supported by operando attenuated total reflection infrared spectroscopy (ATR-IRAS) in observing the key intermediate of NO- . This work not only achieves a milestone NO conversion ratio for electrocatalytic NO-to-NH3 , but also proposes a new descriptor that utilizes orbital hybridization between molecules and metal centers to accurately identify the real active sites of catalysts.

Promoting the efficiency and selectivity of NO3--to-NH3 reduction on Cu-O-Ti active sites via preferential glycol oxidation with holes.

The combined reductive and oxidative reaction is the essence of a solar-driven photoredox system. Unfortunately, most of these efforts focus on the specific half-reactions, and the key roles of complete photoredox reactions have been overlooked. Taking the nitrate reduction reaction (NO3-RR) as a typical multiple-electrons involved process, the selective reduction of the NO3- into ammonia (NH3) synthesis with high efficiency is still a grand challenge. Herein, a rational oxidative half-reaction is tailored to achieve the selective conversion of NO3- to NH3 on Cu-O-Ti active sites. Through the coupled NO3-RR with glycol oxidation reaction system, a superior NH3 photosynthesis rate of 16.04 ± 0.40 mmol gcat-1 h-1 with NO3- conversion ratio of 100% and almost 100% of NH3 selectivity is reached on Cu-O-Ti bimetallic oxide cluster-anchored TiO2 nanosheets (CuOx@TNS) catalyst. A combination of comprehensive in situ characterizations and theoretical calculations reveals the molecular mechanism of the synergistic interaction between NO3-RR and glycol oxidation pair on CuOx@TNS. The introduction of glycol accelerates the h+ consumption for the formation of alkoxy (•R) radicals to avoid the production of •OH radicals. The construction of Cu-O-Ti sites facilitates the preferential oxidation of glycol with h+ and enhances the production of e- to participate in NO3-RR. The efficiency and selectivity of NO3--to-NH3 synthesis are thus highly promoted on Cu-O-Ti active sites with the accelerated glycol oxidative half-reaction. This work upgrades the conventional half photocatalysis into a complete photoredox system, demonstrating the tremendous potential for the precise regulation of reaction pathway and product selectivity.

Diabetes knowledge predicts HbA1c levels of people with type 2 diabetes mellitus in rural China: a ten-month follow-up study.

Improving diabetes self-management (DSM) is facing real-world challenges among people with type 2 diabetes mellitus (T2DM) who have a low education level in resource-limited areas. This study aimed to investigate whether diabetes knowledge could predict glycemic levels in people with T2DM in rural China. This analytical cross-sectional study recruited 321 people with T2DM from eight villages by purposive sampling at baseline. After 10 months, 206 patients completed the follow-up survey and HbA1c tests, with a response rate of 64.17% (206/321). Multiple regression analysis was employed to explore the correlation between diabetes knowledge and HbA1c levels. The patient's diabetes knowledge was significantly negatively correlated with HbA1c levels before and after controlling for covariates in both hierarchical multiple regression and multiple logistic regression (p < 0.01). In addition, other influencing factors, including sex, age, marital status, employment status, income, and HbA1c levels at baseline, were also identified. Diabetes knowledge could predict HbA1c levels significantly among patients with low education levels in rural China. Therefore, interventions on improving diabetes knowledge need to be strengthened for patients in rural China so that they can improve their health outcomes and reduce the disease burden.

Underlying mechanisms of diabetes knowledge influencing diabetes self-management behaviors among patients with type II diabetes in rural China: Based on health belief model.

OBJECTIVE: To investigate the association between diabetes knowledge and diabetes self-management (DSM) behaviors and to explore the influence mechanism between them among patients with type 2 diabetes mellitus (T2DM) based on health belief model in rural China. METHODS: This cross-sectional study included 483 participants with T2DM from 8 villages of 3 townships in Jiangsu Province. All participants completed a structured questionnaire, including demographic information, diabetes knowledge, DSM behaviors, health beliefs, and cognitive function. Multiple linear regression and mediation analysis were performed to analyze the association between diabetes knowledge and DSM behaviors, furthermore the mechanism between them. RESULTS: Diabetes knowledge and self-efficacy positively influenced DSM behaviors. Health beliefs multiply mediated the association between diabetes knowledge and DSM behaviors. Perceived behavioral barriers mediated the relationship between diabetes knowledge and DSM behaviors, where a suppression effect existed. A chain-mediated effect was found: diabetes knowledge affected perceived benefits, followed by self-efficacy, and finally DSM behaviors. CONCLUSION: Diabetes knowledge acquisition played an important role in improving DSM behaviors, and health beliefs multiply mediated the relationship between them. PRACTICE IMPLICATIONS: When designing interventions, health systems and health providers should refocus on diabetes knowledge, emphasize the benefits of self-management, and consider the barriers that patients may encounter.

Identifying Obstructive Hypertrophic Cardiomyopathy from Nonobstructive Hypertrophic Cardiomyopathy: Development and Validation of a Model Based on Electrocardiogram Features.

Background: The clinical presentation and prognosis of hypertrophic cardiomyopathy (HCM) are heterogeneous between nonobstructive HCM (HNCM) and obstructive HCM (HOCM). Electrocardiography (ECG) has been used as a screening tool for HCM. However, it is still unclear whether the features presented on ECG could be used for the initial classification of HOCM and HNCM. Objective: We aimed to develop a pragmatic model based on common 12-lead ECG features for the initial identification of HOCM/HNCM. Methods: Between April 1st and September 30th, 2020, 172 consecutive HCM patients from the International Cooperation Center for Hypertrophic Cardiomyopathy of Xijing Hospital were prospectively included in the training cohort. Between January 4th and February 30th, 2021, an additional 62 HCM patients were prospectively included in the temporal internal validation cohort. External validation was performed using retrospectively collected ECG data with definite classification (390 HOCM and 499 HNCM ECG samples) from January 1st, 2010 to March 31st, 2020. Multivariable backward logistic regression (LR) was used to develop the prediction model. The discrimination performance, calibration and clinical utility of the model were evaluated. Results: Of all 30 acquired ECG parameters, 10 variables were significantly different between HOCM and HNCM (all P < 0.05). The P wave interval and SV1 were selected to construct the model, which had a clearly useful C-statistic of 0.805 (0.697, 0.914) in the temporal validation cohort and 0.776 (0.746, 0.806) in the external validation cohort for differentiating HOCM from HNCM. The calibration plot, decision curve analysis, and clinical impact curve indicated that the model had good fitness and clinical utility. Conclusion: The pragmatic model constructed by the P wave interval and SV1 had a clearly useful ability to discriminate HOCM from HNCM. The model might potentially serve as an initial classification of HCM before referring patients to dedicated centers and specialists. Highlights: What are the novel findings of this work? Evident differences exist in the ECG presentations between HOCM and HNCM.To the best of our knowledge, this study is the first piece of evidence to quantify the difference in the ECG presentations between HOCM and HNCM.Based on routine 12-lead ECG data, a probabilistic model was generated that might assist in the initial classification of HCM patients.

Continuous NO Upcycling into Ammonia Promoted by SO2 in Flue Gas: Poison Can Be a Gift.

Although ammonia (NH3) synthesis efficiency from the NO reduction reaction (NORR) is significantly promoted in recent years, one should note that NO is one of the major air pollutants in the flue gas. The limited NO conversion ratio is still the key challenge for the sustainable development of the NORR route, which potentially contributes more to contaminant emissions rather than its upcycling. Herein, we provide a simple but effective approach for continuous NO reduction into NH3, promoted by coexisting SO2 poison as a gift in the flue gas. It is significant to discover that SO2 plays a decisive role in elevating the capacity of NO absorption and reduction. A unique redox pair of SO2-NO is constructed, which contributes to the exceptionally high conversion ratio for both NO (97.59 ± 1.42%) and SO2 (99.24 ± 0.49%) in a continuous flow. The ultrahigh selectivity for both NO-to-NH3 upcycling (97.14 ± 0.55%) and SO2-to-SO42- purification (92.44 ± 0.71%) is achieved synchronously, demonstrating strong practicability for the value-added conversion of air contaminants. The molecular mechanism is revealed by comprehensive in situ technologies to identify the essential contribution of SO2 to NO upcycling. Besides, realistic practicality is realized by the efficient product recovery and resistance ability against various poisoning effects. The proposed strategy in this work not only achieves a milestone efficiency for NH3 synthesis from the NORR but also raises great concerns about contaminant resourcing in realistic conditions.

Efficient purification of a nitrate and chlorate mixture in water via photoredox activated intermediate coupling-decoupling pathway.

Nitrate (NO3-) is a widespread contaminant that threatens human health and ecological safety. Meanwhile, the disinfection byproducts chlorate (ClO3-) is generated inevitably in conventional wastewater treatment. Therefore, the contaminants mixture of NO3- and ClO3- are universal in common emission units. Photocatalysis technology is a feasible approach for the synergistic abatement of contaminant mixture, where matching suitable oxidation reactions is a potential strategy to improve the photocatalytic reduction reactions. Herein, formate (HCOOH) oxidation is introduced to facilitate the photocatalytic reduction of the NO3- and ClO3- mixture. As a result, high purification efficiency of NO3- and ClO3- mixture are achieved, evidenced by 84.6% e--dependent removal of the mixture at a reaction time of 30 min, with 94.5% N2 selectivity and 100% Cl- selectivity, respectively. Specifically, by the close combination of in-situ characterizations and theoretical calculations, the detailed reaction mechanism is revealed, in which the intermediate coupling-decoupling route from NO3- reduction and HCOOH oxidation is established by the chlorate-induced photoredox activation, leading to the significantly enhanced efficiency for the wastewater mixture purification. The practical application of this pathway is established for simulated wastewater to show its wide applicability. This work provides new insights into photoredox catalysis technology for its environmental application.

Outlier Expression of Isoforms by Targeted or Total RNA Sequencing Identifies Clinically Significant Genomic Variants in Hematolymphoid Tumors.

Recognition of aberrant gene isoforms due to DNA events can impact risk stratification and molecular classification of hematolymphoid tumors. In myelodysplastic syndromes, KMT2A partial tandem duplication (PTD) was one of the top adverse predictors in the International Prognostic Scoring System-Molecular study. In B-cell acute lymphoblastic leukemia (B-ALL), ERG isoforms have been proposed as markers of favorable-risk DUX4 rearrangements, whereas deletion-mediated IKZF1 isoforms are associated with adverse prognosis and have been extended to the high-risk IKZF1plus signature defined by codeletions, including PAX5. In this limited study, outlier expression of isoforms as markers of IKZF1 intragenic or 3' deletions, DUX4 rearrangements, or PAX5 intragenic deletions were 92.3% (48/52), 90% (9/10), or 100% (9/9) sensitive, respectively, and 98.7% (368/373), 100% (35/35), or 97.1% (102/105) specific, respectively, by targeted RNA sequencing, and 84.0% (21/25), 85.7% (6/7), or 81.8% (9/11) sensitive, respectively, and 98.2% (109/111), 98.4% (127/129), or 98.7% (78/79) specific, respectively, by total RNA sequencing. Comprehensive split-read analysis identified expressed DNA breakpoints, cryptic splice sites associated with IKZF1 3' deletions, PTD of IKZF1 exon 5 spanning N159Y in B-ALL with mutated IKZF1 N159Y, and truncated KMT2A-PTD isoforms. Outlier isoforms were also effective targeted RNA markers for PAX5 intragenic amplifications (B-ALL), KMT2A-PTD (myeloid malignant cancers), and rare NOTCH1 intragenic deletions (T-cell acute lymphoblastic leukemia). These findings support the use of outlier isoform analysis as a robust strategy for detecting clinically significant DNA events.

Audiovisual n-Back Training Alters the Neural Processes of Working Memory and Audiovisual Integration: Evidence of Changes in ERPs.

(1) Background: This study investigates whether audiovisual n-back training leads to training effects on working memory and transfer effects on perceptual processing. (2) Methods: Before and after training, the participants were tested using the audiovisual n-back task (1-, 2-, or 3-back), to detect training effects, and the audiovisual discrimination task, to detect transfer effects. (3) Results: For the training effect, the behavioral results show that training leads to greater accuracy and faster response times. Stronger training gains in accuracy and response time using 3- and 2-back tasks, compared to 1-back, were observed in the training group. Event-related potentials (ERPs) data revealed an enhancement of P300 in the frontal and central regions across all working memory levels after training. Training also led to the enhancement of N200 in the central region in the 3-back condition. For the transfer effect, greater audiovisual integration in the frontal and central regions during the post-test rather than pre-test was observed at an early stage (80-120 ms) in the training group. (4) Conclusion: Our findings provide evidence that audiovisual n-back training enhances neural processes underlying a working memory and demonstrate a positive influence of higher cognitive functions on lower cognitive functions.

Individualized Blind Techniques for Puncture of Intrathoracic and Extrathoracic Subclavian Vein: Three Simple Experience Tips.

BACKGROUND: Although several procedures of subclavian venipuncture have been reported, no standard method has been established yet. The purpose of this study was to investigate some more accurate and improved blind puncture tips. METHODS: A prospective study was conducted on patients who underwent cardiac radio-frequency ablation with the blind technique of subclavian venipuncture from August 2018 to June 2022. All patients were randomly assigned to an intrathoracic approach group or extrathoracic approach group. Each group of patients followed their own specific puncture scheme and tips. RESULTS: About 371 punctures were included. Blind subclavian venipunctures were performed with 98.9% technical success and without complications in all patients. The over-all success rate with an intrathoracic and extrathoracic approach was equivalent (96.7% vs. 98.3%, P =.23). The intrathoracic group showed a higher first-pass success compared with the extrathoracic group (91.9% vs. 80.2%, P = 0.003, respectively). CONCLUSION: We localized the landmark/reference and skin puncture site of an intrathoracic and extrathoracic subclavian venipuncture individually and quantitatively. These experiences make blind techniques more accurate and faster.

Aging effect of cross-modal interactions during audiovisual detection and discrimination by behavior and ERPs.

Introduction: Numerous studies have shown that aging greatly affects audiovisual integration; however, it is still unclear when the aging effect occurs, and its neural mechanism has yet to be fully elucidated. Methods: We assessed the audiovisual integration (AVI) of older (n = 40) and younger (n = 45) adults using simple meaningless stimulus detection and discrimination tasks. The results showed that the response was significantly faster and more accurate for younger adults than for older adults in both the detection and discrimination tasks. The AVI was comparable for older and younger adults during stimulus detection (9.37% vs. 9.43%); however, the AVI was lower for older than for younger adults during stimulus discrimination (9.48% vs. 13.08%) behaviorally. The electroencephalography (EEG) analysis showed that comparable AVI amplitude was found at 220-240 ms for both groups during stimulus detection and discrimination, but there was no significant difference between brain regions for older adults but a higher AVI amplitude in the right posterior for younger adults. Additionally, a significant AVI was found for younger adults in 290-310 ms but was absent for older adults during stimulus discrimination. Furthermore, significant AVI was found in the left anterior and right anterior at 290-310 ms for older adults but in the central, right posterior and left posterior for younger adults. Discussion: These results suggested that the aging effect of AVI occurred in multiple stages, but the attenuated AVI mainly occurred in the later discriminating stage attributed to attention deficit.

Head-to-head comparison of perfluorobutane contrast-enhanced US and multiparametric MRI for breast cancer: a prospective, multicenter study.

BACKGROUND: Multiparametric magnetic resonance imaging (MP-MRI) has high sensitivity for diagnosing breast cancers but cannot always be used as a routine diagnostic tool. The present study aimed to evaluate whether the diagnostic performance of perfluorobutane (PFB) contrast-enhanced ultrasound (CEUS) is similar to that of MP-MRI in breast cancer and whether combining the two methods would enhance diagnostic efficiency. PATIENTS AND METHODS: This was a head-to-head, prospective, multicenter study. Patients with breast lesions diagnosed by US as Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 underwent both PFB-CEUS and MP-MRI scans. On-site operators and three reviewers categorized the BI-RADS of all lesions on two images. Logistic-bootstrap 1000-sample analysis and cross-validation were used to construct PFB-CEUS, MP-MRI, and hybrid (PFB-CEUS + MP-MRI) models to distinguish breast lesions. RESULTS: In total, 179 women with 186 breast lesions were evaluated from 17 centers in China. The area under the receiver operating characteristic curve (AUC) for the PFB-CEUS model to diagnose breast cancer (0.89; 95% confidence interval [CI] 0.74, 0.97) was similar to that of the MP-MRI model (0.89; 95% CI 0.73, 0.97) (P = 0.85). The AUC of the hybrid model (0.92, 95% CI 0.77, 0.98) did not show a statistical advantage over the PFB-CEUS and MP-MRI models (P = 0.29 and 0.40, respectively). However, 90.3% false-positive and 66.7% false-negative results of PFB-CEUS radiologists and 90.5% false-positive and 42.8% false-negative results of MP-MRI radiologists could be corrected by the hybrid model. Three dynamic nomograms of PFB-CEUS, MP-MRI and hybrid models to diagnose breast cancer are freely available online. CONCLUSIONS: PFB-CEUS can be used in the differential diagnosis of breast cancer with comparable performance to MP-MRI and with less time consumption. Using PFB-CEUS and MP-MRI as joint diagnostics could further strengthen the diagnostic ability. Trial registration Clinicaltrials.gov; NCT04657328. Registered 26 September 2020. IRB number 2020-300 was approved in Chinese PLA General Hospital. Every patient signed a written informed consent form in each center.