Brainwide mesoscale functional networks revealed by focal infrared neural stimulation of the amygdala.

The primate amygdala serves to evaluate emotional content of sensory inputs and modulate emotional and social behaviors; prefrontal, multisensory and autonomic aspects of these circuits are mediated predominantly via the basal (BA), lateral (LA), and central (CeA) nuclei, respectively. Based on recent electrophysiological evidence suggesting mesoscale (millimeters-scale) nature of intra-amygdala functional organization, we have investigated the connectivity of these nuclei using infrared neural stimulation (INS) of single mesoscale sites coupled with mapping in ultrahigh field 7T functional magnetic resonance imaging (fMRI), namely INS-fMRI. Following stimulation of multiple sites within amygdala of single individuals, a 'mesoscale functional connectome' of amygdala connectivity (of BA, LA, and CeA) was obtained. This revealed the mesoscale nature of connected sites, the spatial patterns of functional connectivity, and the topographic relationships (parallel, sequential, or interdigitating) of nucleus-specific connections. These findings provide novel perspectives on the brainwide circuits modulated by the amygdala.

Mesoscale organization of ventral and dorsal visual pathways in macaque monkey revealed by 7T fMRI.

In human and nonhuman primate brains, columnar (mesoscale) organization has been demonstrated to underlie both lower and higher order aspects of visual information processing. Previous studies have focused on identifying functional preferences of mesoscale domains in specific areas; but there has been little understanding of how mesoscale domains may cooperatively respond to single visual stimuli across dorsal and ventral pathways. Here, we have developed ultrahigh-field 7 T fMRI methods to enable simultaneous mapping, in individual macaque monkeys, of response in both dorsal and ventral pathways to single simple color and motion stimuli. We provide the first evidence that anatomical V2 cytochrome oxidase-stained stripes are well aligned with fMRI maps of V2 stripes, settling a long-standing controversy. In the ventral pathway, a systematic array of paired color and luminance processing domains across V4 was revealed, suggesting a novel organization for surface information processing. In the dorsal pathway, in addition to high quality motion direction maps of MT, MST and V3A, alternating color and motion direction domains in V3 are revealed. As well, submillimeter motion domains were observed in peripheral LIPd and LIPv. In sum, our study provides a novel global snapshot of how mesoscale networks in the ventral and dorsal visual pathways form the organizational basis of visual objection recognition and vision for action.

A 16-channel loop array for in vivo macaque whole-brain imaging at 7 T.

Combining multimodal approaches with functional magnetic resonance imaging (fMRI) has catapulted the research on brain circuitries of non-human primates (NHPs) into a new era. However, many studies are constrained by a lack of appropriate RF coils. In this study, a single loop transmit and 16-channel receive array coil was constructed for brain imaging of macaques at 7 Tesla (7 T). The 16 receive channels were mounted on a 3D-printed helmet-shaped form closely fitting the macaque head, with fourteen openings arranged for multimodal devices around the cortical regions. Coil performance was evaluated by quantifying and comparing signal-to-noise ratio (SNR) maps, noise correlations, g-factor maps and flip-angle maps with a 28-channel commercial knee coil. The in vivo results suggested that the macaque coil has higher SNR in cortical regions and better acceleration ability in parallel imaging, which may benefit revealing mesoscale organizations in the brain.

Functional topography of pulvinar-visual cortex networks in macaques revealed by INS-fMRI.

The pulvinar in the macaque monkey contains three divisions: the medial pulvinar (PM), the lateral pulvinar (PL), and the inferior pulvinar (PI). Anatomical studies have shown that connections of PM are preferentially distributed to higher association areas, those of PL are biased toward the ventral visual pathway, and those of PI are biased with the dorsal visual pathway. To study functional connections of the pulvinar at mesoscale, we used a novel method called INS-fMRI (infrared neural stimulation and functional magnetic resonance imaging). This method permits studies and comparisons of multiple pulvinar networks within single animals. As previously revealed, stimulations of different sites in PL and PI produced topographically organized focal activations in visual areas V1, V2, and V3. In contrast, PM stimulation elicited little or diffuse response. The relative activations of areas V1, V2, V3A, V3d, V3v, V4, MT, and MST revealed that connections of PL are biased to ventral pathway areas, and those of PI are biased to dorsal areas. Different statistical values of activated blood-oxygen-level-dependent responses produced the same center of activation, indicating stability of connectivity; it also suggests possible dynamics of broad to focal responses from single stimulation sites. These results demonstrate that infrared neural stimulation-induced connectivity is largely consistent with previous anatomical connectivity studies, thereby demonstrating validity of our novel method. In addition, it suggests additional interpretations of functional connectivity to complement anatomical studies.

Causal optimal and optically transparent ultra-wideband microwave metamaterials absorber with high angular stability.

Wideband microwave absorbers, especially those with high optical transparency, are significantly used in civil and military fields. This paper proposes an ultra-wideband optically transparent metamaterial absorber (MMA) with causal optimal thickness and high angular stability. Based on the equivalent circuits model of the MMA, a genetic algorithm is adopted to identify the best circuit parameters that can realize broadband microwave absorption. High transparent indium tin oxide and poly-methyl methacrylate are utilized to realize the absorber. Optimization and simulation results show that the designed MMA presents a high microwave absorption above 90%, covering a wide frequency of 2.05-15.5 GHz with an impressive FBW of 153.3%. The proposed MMA exhibits extraordinary angular stability. For TM polarization, it can still maintain a fractional bandwidth (FBW) over 114.5% at an incidence angle of 70° and over 142% at an incidence angle of 60°, while the FBW of both TE polarization and TM polarization exceeds 150% when the incidence angle is below 45°. Furthermore, the proposed absorber has the advantages of high transparency and polarization insensitiveness. A prototype of the proposed MMA is fabricated and experimentally tested. The measured results are in excellent agreement with the optimized design and the full-wave simulation results, demonstrating its excellent performance. Most significantly, the overall thickness of the absorber is 0.102 λ at the lowest working frequency and only 1.08 times the causality-dictated minimum sample thickness. The MMA proposed herein provides methods to achieve high compatibility with wideband microwave absorption, optical transparency, and wide-angle incidence, thus enabling a wide range of applications in stealth, electromagnetic pollution reduction, and electromagnetic compatible facilities.

Linezolid in the treatment of severe intraabdominal infection: A STROBE-compliant retrospective study.

Safety concerns over bone marrow suppression and thrombocytopenia may inhibit the use of linezolid to treat intraabdominal infection (IAI). To evaluate the effectiveness, safety, and prognosis of linezolid in the treatment of severe IAI (SIAI). Patients were divided into a linezolid group and nonlinezolid group according to whether linezolid was prescribed. Subgroup analysis (thrombocytopenia treated with linezolid group (I), and thrombocytopenia treated with nonlinezolid group (II) also was performed. We evaluated the effectiveness of linezolid by analyzing the changes in white blood cells (WBC) and procalcitonin, evaluated safety by analyzing the changes in platelet counts, and evaluated patient outcomes by analyzing the length of hospital stay, the length of ICU stay, and the rates of clinical improvement. Sixty-six adult SIAI patients were treated with anti-gram-positive (G+) bacteria drugs for more than 7 days from January 1, 2014, to December 31, 2020. The length of hospital stay, the length of ICU stay, and the rates of clinical improvement were not significantly different between the linezolid group and nonlinezolid group. On the 15th day after anti-G + bacteria treatment, the WBC of the linezolid group was significantly lower than in the nonlinezolid group (9.00 ± 4.30 vs 13.1 ± 6.19, P < .05). The time for a statistical difference in the decrease of procalcitonin in the linezolid group was earlier than in the nonlinezolid group (day 6 vs day 7, P < .05). There was no statistically significant difference in the changes of platelet counts in the subgroup I (P > .05), but compared with the baseline data (day 0), the time for the statistical difference in the increase of platelets in thrombocytopenia treated with linezolid group was earlier (day 5 vs day 6, P < .05). There was no statistical difference in the changes of platelets in subgroup II (P > .05). In the treatment of severe intraabdominal infection in a single-center, retrospective study, linezolid was not inferior to other antibiotics in patient clinical outcomes or seral WBC and procalcitonin values. Linezolid also induced no evident bone marrow suppression or thrombocytopenia. Linezolid is a good choice for treatment of SIAI.

Safety, efficacy and biomarkers analysis of mesenchymal stromal cells therapy in ARDS: a systematic review and meta-analysis based on phase I and II RCTs.

BACKGROUND: Mesenchymal stromal cells (MSCs) therapy for acute respiratory distress syndrome (ARDS) is an emerging treatment, but most of the current trials of MSCs stay in the animal experimental stage, and the safety and efficacy of MSCs in clinical application are not clear. We aimed to analyze the safety, efficacy and biomarkers of mesenchymal stromal cells in the treatment of ARDS. METHODS: For this systematic review and meta-analysis, we searched PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of science, CNKI, VIP and Wan Fang data, studies published between database inception and Mar 17, 2022. All randomized controlled trials (RCT) of stem cell interventions for ARDS were included, without language or date restrictions. We did separate meta-analyses for mortality, subjects with adverse events (AEs) and subjects with serious adverse events (SAEs). Since the trials data are dichotomous outcomes, the odds ratio (OR) is adopted for meta-analysis. The quality of the evidence was assessed with the Cochrane risk of bias tool. FINDINGS: In total, 5 trials involving 171 patients with ARDS were included in this meta-analysis. A total of 99 individuals were randomly assigned to receive MSCs treatment, and 72 were randomly assigned to receive placebo treatment. Treatment with MSCs appeared to increase the occurrence of adverse events, but this result was not statistically significant (OR, 1.58; 95%CI, 0.64-3.91; P = 0.32). The occurrence of serious adverse events was lower in the MSCs group than in the placebo group (OR, 0.57; 95%CI, 0.14-2.32; P = 0.43); there seems to be no significant difference between the two groups in terms of 28 days mortality (OR, 0.93; 95%CI, 0.45-1.89); oxygenation index and biomarkers showed a tendency to improve in treatment, but there was a lack of more statistically significant clinical evidence to support them. INTERPRETATION: Based on the current clinical trials, MSCs intervention has some safety for ARDS patients, but its effectiveness and predictive value of airspace biomarkers need to be determined by more large-scale, standard randomized controlled trials.

Critical factors in achieving fine-scale functional MRI: Removing sources of inadvertent spatial smoothing.

Ultra-high Field (≥7T) functional magnetic resonance imaging (UHF-fMRI) provides opportunities to resolve fine-scale features of functional architecture such as cerebral cortical columns and layers, in vivo. While the nominal resolution of modern fMRI acquisitions may appear to be sufficient to resolve these features, several common data preprocessing steps can introduce unwanted spatial blurring, especially those that require interpolation of the data. These resolution losses can impede the detection of the fine-scale features of interest. To examine quantitatively and systematically the sources of spatial resolution losses occurring during preprocessing, we used synthetic fMRI data and real fMRI data from the human visual cortex-the spatially interdigitated human V2 "thin" and "thick" stripes. The pattern of these cortical columns lies along the cortical surface and thus can be best appreciated using surface-based fMRI analysis. We used this as a testbed for evaluating strategies that can reduce spatial blurring of fMRI data. Our results show that resolution losses can be mitigated at multiple points in preprocessing pathway. We show that unwanted blur is introduced at each step of volume transformation and surface projection, and can be ameliorated by replacing multi-step transformations with equivalent single-step transformations. Surprisingly, the simple approaches of volume upsampling and of cortical mesh refinement also helped to reduce resolution losses caused by interpolation. Volume upsampling also serves to improve motion estimation accuracy, which helps to reduce blur. Moreover, we demonstrate that the level of spatial blurring is nonuniform over the brain-knowledge which is critical for interpreting data in high-resolution fMRI studies. Importantly, our study provides recommendations for reducing unwanted blurring during preprocessing as well as methods that enable quantitative comparisons between preprocessing strategies. These findings highlight several underappreciated sources of a spatial blur. Individually, the factors that contribute to spatial blur may appear to be minor, but in combination, the cumulative effects can hinder the interpretation of fine-scale fMRI and the detectability of these fine-scale features of functional architecture.

Proactive Motor Functional Recovery Following Immersive Virtual Reality-Based Limb Mirroring Therapy in Patients with Subacute Stroke.

Virtual reality (VR) is considered to be a promising therapeutic technology for the rehabilitation of upper extremities (UEs) post-stroke. Recently, we designed and then implemented a neuroscientifically grounded VR protocol for the rehabilitation of patients with stroke. The system provides unilateral and bilateral limb mirroring exercises in a fully immersive virtual environment that may stimulate and activate the mirror neuron system in the brain to help patients for their rehabilitation. Twelve patients with subacute stroke underwent the newly implemented VR treatment in addition to conventional rehabilitation for 8 consecutive weekdays. The treatment effect on brain reorganization and motor function was investigated using resting-state fMRI (rs-fMRI) and the Fugl-Meyer assessment for Upper Extremity (FM-UE), respectively. Fifteen healthy controls (HCs) also underwent rs-fMRI scanning one time. The study finally obtained usable data from 8 patients and 13 HCs. After the intervention, patients demonstrated significant improvement in their FM-UE scores (p values < 0.042). Voxel-wise functional connectivity (FC) analysis based on the rs-fMRI data found that HCs showed widespread bilateral FC patterns associated with the dominant hemispheric primary motor cortex (M1). However, the FC patterns in patients revealed intra-hemispheric association with the ipsilesional M1 seed and this association became visible in the contra-hemisphere after the intervention. Moreover, the change of FC values between the bilateral M1 was significantly correlated with the changes in FM-UE scores (p values < 0.037). We conclude that unilateral and bilateral limb mirroring exercise in an immersive virtual environment may enhance cortical reorganization and lead to improved motor function.

Higher Sensitivity and Reproducibility of Wavelet-Based Amplitude of Resting-State fMRI.

The fast Fourier transform (FFT) is a widely used algorithm used to depict the amplitude of low-frequency fluctuation (ALFF) of resting-state functional magnetic resonance imaging (RS-fMRI). Wavelet transform (WT) is more effective in representing the complex waveform due to its adaptivity to non-stationary or local features of data and many varieties of wavelet functions with different shapes being available. However, there is a paucity of RS-fMRI studies that systematically compare between the results of FFT versus WT. The present study employed five cohorts of datasets and compared the sensitivity and reproducibility of FFT-ALFF with those of Wavelet-ALFF based on five mother wavelets (namely, db2, bior4.4, morl, meyr, and sym3). In addition to the conventional frequency band of 0.0117-0.0781 Hz, a comparison was performed in sub-bands, namely, Slow-6 (0-0.0117 Hz), Slow-5 (0.0117-0.0273 Hz), Slow-4 (0.0273-0.0742 Hz), Slow-3 (0.0742-0.1992 Hz), and Slow-2 (0.1992-0.25 Hz). The results indicated that the Wavelet-ALFF of all five mother wavelets was generally more sensitive and reproducible than FFT-ALFF in all frequency bands. Specifically, in the higher frequency band Slow-2 (0.1992-0.25 Hz), the mean sensitivity of db2-ALFF results was 1.54 times that of FFT-ALFF, and the reproducibility of db2-ALFF results was 2.95 times that of FFT-ALFF. The findings suggest that wavelet-ALFF can replace FFT-ALFF, especially in the higher frequency band. Future studies should test more mother wavelets on other RS-fMRI metrics and multiple datasets.

Amplitude of low-frequency fluctuation of resting-state fMRI in primary nocturnal enuresis and attention deficit hyperactivity disorder.

Children with attention deficit hyperactivity disorder (ADHD) and nocturnal enuresis (NE) have similar symptoms, for example, inattention and dysfunction of working memory. We investigate disorder-specific abnormal activity by using the simple resting-state functional magnetic resonance imaging (RS-fMRI) metric amplitude of low-frequency fluctuation (ALFF). About 18 ADHD, NE, and typically developing children were examined by RS-fMRI and the child behavior checklist (CBCL) test. One-way ANOVA were used to compare the ALFF values of the three groups and post hoc was done. We conducted Pearson correlation analysis on the results of the three groups' scales with ALFF values at the discrepant brain areas after then. Significant group effect was found in the bilateral medial prefrontal cortex (MPFC), left inferior temporal gyrus (ITG), left middle temporal gyrus (MTG), cerebellum anterior lobe (CAL), and left inferior parietal lobule (IPL). There was no shared abnormal region for ADHD and NE. Specially, ADHD showed increased ALFF in the bilateral MPFC, left ITG, and CAL and showed decreased ALFF in the left MTG. The children with NE showed increased ALFF in the left IPL. This study reveals the brain mechanism of cognitive changes on ADHD and NE, which provides neuroimaging basis for behavioral differences among different diseases.

Focal infrared neural stimulation with high-field functional MRI: A rapid way to map mesoscale brain connectomes.

We have developed a way to map brain-wide networks using focal pulsed infrared neural stimulation in ultrahigh-field magnetic resonance imaging (MRI). The patterns of connections revealed are similar to those of connections previously mapped with anatomical tract tracing methods. These include connections between cortex and subcortical locations and long-range cortico-cortical connections. Studies of local cortical connections reveal columnar-sized laminar activation, consistent with feed-forward and feedback projection signatures. This method is broadly applicable and can be applied to multiple areas of the brain in different species and across different MRI platforms. Systematic point-by-point application of this method may lead to fundamental advances in our understanding of brain connectomes.

Intra- and Inter-scanner Reliability of Scaled Subprofile Model of Principal Component Analysis on ALFF in Resting-State fMRI Under Eyes Open and Closed Conditions.

Scaled Subprofile Model of Principal Component Analysis (SSM-PCA) is a multivariate statistical method and has been widely used in Positron Emission Tomography (PET). Recently, SSM-PCA has been applied to discriminate patients with Parkinson's disease and healthy controls with Amplitude of Low Frequency Fluctuation (ALFF) from Resting-State Functional Magnetic Resonance Imaging (RS-fMRI). As RS-fMRI scans are more readily available than PET scans, it is important to investigate the intra- and inter-scanner reliability of SSM-PCA in RS-fMRI. A RS-fMRI dataset with Eyes Open (EO) and Eyes Closed (EC) conditions was obtained in 21 healthy subjects (21.8 ± 1.8 years old, 11 females) on 3 visits (V1, V2, and V3), with V1 and V2 (mean interval of 14 days apart) on one scanner and V3 (about 8 months from V2) on a different scanner. To simulate between-group analysis in conventional SSM-PCA studies, 21 subjects were randomly divided into two groups, i.e., EC-EO group (EC ALFF map minus EO ALFF map, n = 11) and EO-EC group (n = 10). A series of covariance patterns and their expressions were derived for each visit. Only the expression of the first pattern showed significant differences between the two groups for all the visits (p = 0.012, 0.0044, and 0.00062 for V1, V2, and V3, respectively). This pattern, referred to as EOEC-pattern, mainly involved the sensorimotor cortex, superior temporal gyrus, frontal pole, and visual cortex. EOEC-pattern's expression showed fair intra-scanner reliability (ICC = 0.49) and good inter-scanner reliability (ICC = 0.65 for V1 vs. V2 and ICC = 0.66 for V2 vs. V3). While the EOEC-pattern was similar with the pattern of conventional unpaired T-test map, the two patterns also showed method-specific regions, indicating that SSM-PCA and conventional T-test are complementary for neuroimaging studies.

Inconsistency in Abnormal Brain Activity across Cohorts of ADHD-200 in Children with Attention Deficit Hyperactivity Disorder.

Many papers have shown results from the multi-site dataset of resting-state fMRI (rs-fMRI) in attention deficit hyperactivity disorder (ADHD), a data-sharing project named ADHD-200. However, few studies have illustrated that to what extent the pooled findings were consistent across cohorts. The present study analyzed three voxel-wise whole-brain metrics, i.e., amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and degree centrality (DC) based on the pooled dataset as well as individual cohort of ADHD-200. In addition to the conventional frequency band of 0.01-0.08 Hz, sub-frequency bands of 0-0.01, 0.01-0.027, 0.027-0.073, 0.073-0.198, and 0.198-0.25 Hz, were assessed. While the pooled dataset showed abnormal activity in some brain regions, e.g., the bilateral sensorimotor cortices, bilateral cerebellum, and the bilateral lingual gyrus, these results were highly inconsistent across cohorts, even across the three cohorts from the same research center. The standardized effect size was rather small. These findings suggested a high heterogeneity of spontaneous brain activity in ADHD. Future studies based on multi-site large-sample dataset should be performed on pooled data and single cohort data, respectively and the effect size must be shown.

PAIR Comparison between Two Within-Group Conditions of Resting-State fMRI Improves Classification Accuracy.

Classification approaches have been increasingly applied to differentiate patients and normal controls using resting-state functional magnetic resonance imaging data (RS-fMRI). Although most previous classification studies have reported promising accuracy within individual datasets, achieving high levels of accuracy with multiple datasets remains challenging for two main reasons: high dimensionality, and high variability across subjects. We used two independent RS-fMRI datasets (n = 31, 46, respectively) both with eyes closed (EC) and eyes open (EO) conditions. For each dataset, we first reduced the number of features to a small number of brain regions with paired t-tests, using the amplitude of low frequency fluctuation (ALFF) as a metric. Second, we employed a new method for feature extraction, named the PAIR method, examining EC and EO as paired conditions rather than independent conditions. Specifically, for each dataset, we obtained EC minus EO (EC-EO) maps of ALFF from half of subjects (n = 15 for dataset-1, n = 23 for dataset-2) and obtained EO-EC maps from the other half (n = 16 for dataset-1, n = 23 for dataset-2). A support vector machine (SVM) method was used for classification of EC RS-fMRI mapping and EO mapping. The mean classification accuracy of the PAIR method was 91.40% for dataset-1, and 92.75% for dataset-2 in the conventional frequency band of 0.01-0.08 Hz. For cross-dataset validation, we applied the classifier from dataset-1 directly to dataset-2, and vice versa. The mean accuracy of cross-dataset validation was 94.93% for dataset-1 to dataset-2 and 90.32% for dataset-2 to dataset-1 in the 0.01-0.08 Hz range. For the UNPAIR method, classification accuracy was substantially lower (mean 69.89% for dataset-1 and 82.97% for dataset-2), and was much lower for cross-dataset validation (64.69% for dataset-1 to dataset-2 and 64.98% for dataset-2 to dataset-1) in the 0.01-0.08 Hz range. In conclusion, for within-group design studies (e.g., paired conditions or follow-up studies), we recommend the PAIR method for feature extraction. In addition, dimensionality reduction with strong prior knowledge of specific brain regions should also be considered for feature selection in neuroimaging studies.

Naringin ameliorates bone loss induced by sciatic neurectomy and increases Semaphorin 3A expression in denervated bone.

Naringin maintains bone mass in various osteoporosis models, while its effect on bone in disuse osteoporosis has not been reported. The present study explores whether naringin can prevent disuse osteoporosis induced by unilateral sciatic neurectomy (USN) and whether the Semaphorin 3A-induced Wnt/ß-catenin signalling pathway is involved in the osteoprotection of naringin. Naringin dose-dependently prevented the deterioration of bone mineral density (BMD), trabecular structure and biomechanical strength in femur due to USN. Naringin increased bone formation but inhibited resorption, as indicated by bone-turnover markers in blood and urine and the histological staining of Osteocalcin (OCN) and tartrate-resistant acid phosphatase (TRAP) in femur. Semaphorin 3A (Sema3A) and active ß-catenin protein decreased after USN and could be restored by naringin to the levels of the sham-operated rats. In addition, naringin in vitro promoted the differentiation of osteoblasts and inhibited osteoclastic differentiation. Our studies suggest that the down-regulation of Sema3A and the subsequent inactivation of Wnt/ß-catenin signalling may be some of the mechanisms involved in USN-induced osteoporosis. Naringin could increase the expression of Sema3A and the activation of Wnt/ß-catenin signalling to prevent disuse osteoporosis induced by denervation. Thus, naringin functions in bone maintenance and could be a promising therapeutic alternative in preventing disuse osteoporosis.

Involvement of periostin-sclerostin-Wnt/ß-catenin signaling pathway in the prevention of neurectomy-induced bone loss by naringin.

Periostin has an essential role in mechanotransduction in bone. Naringin, a natural flavonoid, has been evidenced for its osteoprotective role in osteoporosis, while its mechanism is far from clear. Here we show that down-regulation of periostin, and up-regulation of its downstream sclerostin and inactivation of Wnt/ß-catenin signaling were implicated in neurectomy-induced bone loss. Naringin could up-regulate periostin and prevent neurectomy-induced deterioration of BMD, trabecular microstructure and bone mechanical characteristics. In conclusion, naringin could prevent progress of disuse osteoporosis in rats, which may be mediated by increased periostin expression and subsequently inhibition of sclerostin and activation of Wnt/ß-catenin signaling pathways.