Interactive Effects Research Articles

Interactive effects of ARRB2 and CHRNA5 genetic polymorphisms on cognitive function in Chinese male methamphetamine use disorder patients.

Both β-arrestin2 and nicotinic acetylcholine receptor (nAChR) have been implicated in cognitive processes, particularly in relation to psychiatric disorders, including addiction. Previous studies have suggested that nAChR may be regulated by β-arrestin2. However, no study has investigated the interaction of β-arrestin2 and nAChR on cognition. We aimed to examine the main and interactive effects of their respective encoding genes, ARRB2 and CHRNA5, on cognitive function in MUD patients. We recruited 559 patients with methamphetamine use disorder (MUD) and 459 healthy controls, assessed their cognitive functioning using the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and genotyped ARRB2 rs1045280 and CHRNA5 rs3829787 polymorphisms in MUD patients. Compared to healthy controls, MUD patients scored significantly lower on all RBANS indexes. Neither ARRB2 rs1045280 nor CHRNA5 rs3829787 had main effects on cognitive function in MUD patients, but there were significant interactive effects between the two single nucleotide polymorphisms (SNPs) on multiple RBANS indexes, including immediate memory, visuospatial/constructional, delayed memory, and total score. In detail, among carriers of CHRNA5 rs3829787 T allele, ARRB2 rs1045280 TT carriers had higher RBANS scores than the C allele carriers, whereas among carriers of CHRNA5 rs3829787 CC genotype, ARRB2 rs1045280 TT carriers performed worse in RBANS. Our study identified for the first time an interactive effect between ARRB2 and CHRNA5 on cognitive function in MUD patients, which would enlarge our knowledge of genetic interaction on cognitive function.

The Effectiveness of Teacher-Student Interaction in the English as a Foreign Language Classroom

The aim of the present study is to evaluate the effectiveness of teacher-student interaction in promoting authentic L2 classroom discourse. Classroom discourse is a major part of instruction that promotes speaking and develops students and teachers’ conversational skills. It constitutes a significant factor in the English as a Foreign Language (EFL) classroom, as it promotes communicative activities (reception, production, interaction, mediation) fundamental to L2 learning. A common exchange pattern used extensively in classroom discourse is the Initiation, Response, Feedback (IRF) model, by Sinclair and Coulthard, (1975, 1992), in which the teacher initiates (I) an exchange through questioning the whole class or one single student, the student responds (R) to the question, and then the teacher gives feedback (F). A qualitative case study approach was adopted. Twenty-seven EFL high school classrooms in Israel were observed. Research instruments were: classroom observation forms, filled by the researcher, where instances of IRF exchanges were marked; and semi-structured interviews with seven of the teachers observed to obtain information regarding their use of L1 in IRF exchanges. Findings show that teachers use the IRF exchange model to organize talk and follow basic turn taking rules. However, deviations from common IRF exchanges result in (1) imbalance of dominance between teacher and student talk time; (2) excessive use of L1 in exchanges, minimizing students’ exposure to L2; and (3) limited flow of teacher-student spoken communication and lack of student willingness to participate in the lesson. Practical implications for teacher educators will be discussed.

Photosynthetic efficiency and water retention in okra (Abelmoschus esculentus) contribute to tolerance to single and combined effects of drought and heat stress.

The co-occurrence of drought and heat significantly hampers plant productivity. Although their impacts are well studied, these studies have been based on the effects of individual stressors rather than their combined influence. Okra is crucial for food and nutritional security and livelihoods in many regions, yet it remains under-researched and unimproved. Okra has been proven to be sensitive to both drought and heat stress. This study employed a cost-effective phenotyping method to assess key traits characterising the diversity of okra morphophysiological responses to independent and interactive heat-drought stresses. This study aimed to understand okra responses to stress, identify stress-resilient traits, and characterise okra genotypes. We also addressed the need to examine interactive stress effects, which mirror real-world scenarios more accurately than single-stress studies. Sixty-three okra genotypes were subjected to heat, drought, or concurrent heat-drought stress at the seedling stage in improvised climate-controlled chambers. The germplasm exhibited significant variations in response to the various stresses. The broad-sense heritability was high (> 0.60) for traits such as chlorophyll content, plant biomass, performance indices, electrolyte leakage, and total leaf area. Drought stress alone had a more pronounced effect than heat stress alone, and the adverse impact was worsened under combined heat and drought stress. The interactive impact of drought and heat was more likely additive than antagonistic or synergistic. A positive and strong relationship was observed between photosynthetic efficiency parameters such as the Fv/Fm ratio, chlorophyll content, relative water index, and biomass parameters such as dry shoot weight. The 63 okra genotypes were classified into three distinct clusters, suggesting potential for future breeding efforts. Okra genotype considered to be tolerant or climate resilient (such as GH170, V1060831, GH174, V1060874, and GH106) to drought and heat, maintained enhanced photosynthetic efficiency and high internal water potential, possibly reducing osmotic and oxidative damage. This study revealed some mechanisms underlying the adaptation of okra genotypes to independent and combined heat and drought stress. The results provide a basis for breeding efforts to develop climate-resilient okra varieties.

The interactive effect of the application of accreditation standards (JCIs) and the practice of administrative control in improving the quality of health services: a study on Yemeni hospitals.

This study aimed to examine the interactive effect of applying JCI accreditation standards and administrative control in improving the quality of health services in Yemeni hospitals. By examining the synergistic relationship between these two components, this study sought to shed light on how hospitals can improve their performance and achieve sustainable advancements in healthcare quality. This study utilized a quantitative research design and collected data from Yemeni hospitals. The sample size was determined via the Krejcie and Morgan table, which provides a recommended sample size on the basis of the population. A total of 310 healthcare professionals were selected through a random sampling technique. Hypotheses were formulated to examine the impact of JCI accreditation standards and administrative control on healthcare quality. Statistical analyses were also conducted to test these hypotheses and determine the interaction effect between the two variables. The results confirmed that applying JCI accreditation standards has a statistically significant positive effect on improving the quality of health services in hospitals. Additionally, the practice of administrative control had a statistically significant effect on healthcare quality. Furthermore, there was an interactive effect between the application of JCI accreditation standards and administrative control, indicating that their combined implementation led to even greater improvements in healthcare quality. The significance of this study lies in its potential to inform healthcare policymakers, administrators, and practitioners about the importance of integrating accreditation standards with robust administrative control measures. The findings emphasize the need for hospitals to prioritize both the implementation of accreditation standards and the establishment of effective administrative control systems to ensure the delivery of high-quality healthcare services. This study contributes to the literature by highlighting the interactive impact of these factors and providing insights into their synergistic relationship.

Additive effects of cerebrovascular disease functional connectome phenotype and plasma p-tau181 on longitudinal neurodegeneration and cognitive outcomes.

We investigated the effects of multiple cerebrovascular disease (CeVD) neuroimaging markers on brain functional connectivity (FC), and how such CeVD-related FC changes interact with plasma phosphorylated tau (p-tau)181 (an Alzheimer's disease [AD] marker) to influence downstream neurodegeneration and cognitive changes. Multivariate associations among four CeVD markers and whole-brain FC in 529 participants across the dementia spectrum were examined using partial least squares correlation. Interactive effects of CeVD-related FC patterns and p-tau181 on longitudinal gray matter volume (GMV) and cognitive changes were investigated using linear mixed-effects models. We identified a brain FC phenotype associated with high CeVD burden across all markers. Further, expression of this general CeVD-related FC phenotype and p-tau181 contributed additively, but not synergistically, to baseline and longitudinal GMV and cognitive changes. Our findings suggest that CeVD exerts global effects on the brain connectome and highlight the additive nature of AD and CeVD on neurodegeneration and cognition. Effects of multiple cerebrovascular disease (CeVD) markers on functional connectivity were studied. A global network phenotype linked to high burden across CeVD markers was identified. CeVD phenotype and plasma phosphorylated tau 181 contributed additively to downstream outcomes.

Multiple Structural Breaks in Interactive Effects Panel Data Models

ABSTRACTThis paper develops new econometric methods for multiple structural break detection in panel data models with interactive fixed effects. The new methods include tests for the presence of structural breaks, estimators for the number of breaks and their location, and a method for constructing asymptotically valid break date confidence intervals. The new methodology is applied to a large panel of US banks for a period characterized by massive quantitative easing programs aimed at lessening the impact of the global financial crisis and the COVID‐19 pandemic. The question we ask is as follows: Have these programs been successful in spurring bank lending in the US economy? The short answer turns out to be: “No”.

Interactive effects of intangible cultural heritage and tourism development: a study based on the data panel PVAR model and coupled coordination model

AbstractExploring the coordination and analysis of intangible cultural heritage (ICH) and tourism development is a key issue in advancing cultural heritage and conservation in Chinese society. This paper employs panel data from 30 Chinese provinces from 2013 to 2022, utilizing the coupled coordination degree model and the panel vector autoregression (PVAR) model. In terms of provinces and regions, the data investigates the development relationship between intangible cultural heritage and tourism. The results of the study are: 1. The degree of coupling coordination between the two has shown an increasing trend over the ten-year sample data period. In 2021 and 2022, COVID-19 will have a stronger negative impact on the coupling degree. 2. The eastern coastal provinces of China, as well as the municipal areas, have a higher level of coupling coordination. Inland provinces, such as those in central and western China, exhibit relatively lower levels of coordination. The PVAR model data reveals a positive correlation between the interactions generated by intangible cultural heritage. The development of intangible cultural heritage has a particular impact on tourism. Intangible cultural heritage, in turn, depends on its own development. We should strengthen the development of intangible cultural heritage in the future. The study's findings provide theoretical references for the coordinated development of intangible cultural heritage and tourism in China.

Older Amphibian Larvae Are More Sensitive to Ultraviolet Radiation and Experience More Sublethal Carryover Effects Post-Metamorphosis.

Elevated ultraviolet radiation (UVR) is postulated as one of multiple, interrelated environmental stressors driving amphibian population declines globally. However, key knowledge gaps remain in elucidating the link between elevated UVR and amphibian declines in a changing climate, including whether timing and irradiance of UVR exposure in early life dictates the onset of detrimental carryover effects post-metamorphosis. In this study, striped marsh frog larvae (Limnodynastes peronii) were exposed to UVR at one of two different irradiances for up to 7 days, either as hatchlings (Gosner stage 23) or as older larvae (Gosner stage 25-28). These animals were then reared to metamorphosis in the absence of UVR to examine independent and interactive carryover effects throughout development. Older larvae were more sensitive to UVR than hatchlings, with 53.1% and 15.6% mortality in larvae exposed to high and low irradiance respectively, compared with no mortality of hatchlings in either irradiance treatment. Irradiance and timing of UVR exposure had interactive effects on larval body length, causing stunted growth patterns and a lack of compensatory growth following UVR exposure, particularly in animals exposed to high irradiance UVR later in development. Timing of UVR exposure also determined the severity of carryover effects into metamorphosis, including delayed metamorphosis and the first published account (to our knowledge) of latent UVR-induced depigmentation in an amphibian. These findings highlight how acute changes to the larval UVR exposure regime can impact on amphibian health later in life, with implications for our understanding of the effects of climate change on UVR-related amphibian declines.

Genetics of Hypertension: Additive and Interactive Effects.

Genetics of Hypertension: Additive and Interactive Effects.

Effects of Irrigation Amount and Salinity Levels on Maize (Zea mays L.) Growth, Water Productivity and Carbon Emissions in Arid Region of Northwest China

To address the growing scarcity of freshwater resources, the use of saline water for agricultural irrigation is gaining increasing attention. This study presents findings from a two-year field experiment conducted during the 2023 and 2024 maize-growing seasons in northwestern China. The objective of the experiment was to evaluate the main and interactive effects of saline irrigation water on soil water–salt dynamics, maize growth, photosynthetic characteristics, water productivity, and carbon emissions. The experiment involved nine treatments with three irrigation amounts: 4500 m3 hm−2 (W1), 5625 m3 hm−2 (W2), and 6750 m3 hm−2 (W3), combined with three water salinity levels: 0.85 g L−1 (S1, freshwater), 3 g L−1 (S2), and 5 g L−1 (S3). Results indicated that both irrigation amount and salinity level significantly affected water–salt dynamics, with more soil accumulating in the 0–100 cm soil layer under saline irrigation water; however, this effect diminished with higher irrigation amounts. The maximum leaf area index and plant height were affected by both the irrigation amount and salinity level, as well as their interaction. Photosynthetic capacity declined with increasing salinity of the irrigation water, ultimately reducing grain yield and irrigation water use efficiency. Compared to freshwater (S1), the average maize grain yield under S2 and S3 treatments decreased by 6.28% and 15.43% in 2023 and by 7.82% and 17.48% in 2024, respectively. Additionally, for the same irrigation amount, higher salinity of the irrigation water (S2, S3) significantly reduced total soil CO2 emissions, with reductions of 10.08% and 27.53% in 2023, and 11.97% and 28.01% in 2024, respectively. In summary, to optimize the utilization of saline water, enhance maize yield, and improve soil carbon sequestration, we recommend maintaining the salinity of irrigation water below 3 g L−1, and using an irrigation amount of 6750 m3 hm−2 (W3S2) for optimal outcomes in the study area.

DISP-02. SOCIOECONOMIC FACTORS INFLUENCE OVERALL SURVIVAL IN CHEMORADIATION-TREATED NEWLY DIAGNOSED WHO GRADE 4 GLIOBLASTOMA

Abstract Social determinants of health are known to influence health outcomes, yet the interactive effects of patient-specific socioeconomic variables on overall survival remain poorly characterized in patients with glioblastoma (GBM). We aimed to assess socioeconomic factors associated with overall survival in a clinically homogenous GBM population. Patients with newly diagnosed isocitrate dehydrogenase wild-type glioblastoma, who underwent maximal safe resection of contrast-enhanced (CE) and non-contrast enhanced tissue (NC) tissue with adjuvant chemoradiation from 1997-2017 were selected for inclusion. Socioeconomic factors were collected through retrospective chart review. Variables associated with overall survival on univariate cox proportional hazards models (p<0.05) were selected for multivariate analysis. 272 patients (42.6% female, 14.3% minority) were included. On univariate logistic regression, older age (HR: 1.23, p<0.001), greater residual CE tissue (HR: 3.95, p<0.001), were associated with reduced survival. Greater extent of resection NCE tissue (HR 0.94, p=0.028), higher postoperative KPS (HR 0.89, p=0.034), and unemployment (HR: 0.67, p=0.022), were associated with longer overall survival. On multivariate analysis, age was associated with reduced survival (HR: 1.31, p<0.001), while unemployment (HR:0.69, p=0.049) was associated with longer overall survival. Subgroup multivariate analyses was performed dividing patients into those <65 (n=185, 45% female, 11.9% minority, 48% employed) and those ≥65 (n=87, 37% female, 14% minority, 20% employed). In the <65 cohort, protective factors included retirement (HR: 0.49 p=0.004), and unemployment (HR:.57, p=0.006). Older age (HR: 1.03, p=0.004), and greater residual CE tissue (HR: 1.16, p=0.03) continued to be associated with poorer survival. No variables correlated with outcomes in the ≥65 cohort. Active employment was associated with reduced survival in GBM patients treated with standard care, potentially serving as a proxy for access to subsequent treatment.

Plant pests influence the movement of plant‐fixed carbon and fungal‐acquired nutrients through arbuscular mycorrhizal networks

Abstract Plants typically interact with multiple, co‐occurring symbionts, including arbuscular mycorrhizal (AM) fungi which can form networks, connecting neighbouring plants. A characteristic aspect of the mycorrhizal symbiosis is the bidirectional exchange of nutrients between host plants and fungal partners. Concurrent interactions with competing organisms such as aphids or potato cyst nematodes (PCN) can disrupt the carbon‐for‐nutrient exchange between plants and AM fungi. However, the role of mycorrhizal networks (MNs) in mediating these interactions remains unclear. Using isotope tracing in multi‐plant experimental systems, we investigated the movement of plant photosynthates and fungal‐acquired soil phosphorus through MNs and the interactive effects of PCN infection on this. We found evidence of preferential allocation of fungal‐acquired phosphorus to plants that were not infected by PCN compared with infected neighbours. Contrary to previous findings using single plants, we did not detect a PCN‐induced reduction in the amounts of plant carbon delivered to AM fungi in multi‐plant systems. However, the MN(s) moved plant‐fixed carbon away from PCN‐infected host plants, regardless of the PCN infection status of the neighbouring plant host. Our work highlights the responsiveness of MNs to interactions with below‐ground organisms. It also strengthens the argument for a more mycocentric view of AM–plant symbioses. Experimental designs of increasing ecological complexity are needed for a more comprehensive understanding of the carbon‐for‐nutrient dynamics in AM fungi–plant networks. This will, in turn, elucidate the role of AM fungi in terrestrial carbon cycling and their function in agricultural systems. Read the free Plain Language Summary for this article on the Journal blog.

Interactive Effects of Anthropogenic Stressors on the Temporal Changes in the Size Spectrum of Lake Fish Communities

ABSTRACTThe size spectrum represents a powerful approach for quantifying the effects of environmental changes from individuals to communities in aquatic ecosystems. However, our understanding of its temporal stability in freshwater ecosystems is still limited. In the present study, we used a size spectrum approach to investigate the responses of 126 lake fish communities to changes in the intensity of three common anthropogenic stressors (i.e., global warming, nutrient loading and biological invasions) in French natural lakes and reservoirs over an average 5‐year time period. Using a backward selection on a full model including all possible effects of stressors on the size spectrum slope, we demonstrated that (i) increasing summer temperature shifted fish abundance towards the largest size classes, resulting in a flatter size spectrum slope and (ii) nutrient loading and biological invasions were associated with a shift towards smaller size classes in natural lakes, while the opposite effect was observed in reservoirs. In addition, these two stressors interacted in determining changes in the size structure of fish communities, complicating what the size spectrum can reveal about changes in stressor intensity during monitoring programs. All predictors accounted for a limited part of the observed changes in size spectra, and further investigations are needed to fully apprehend the interplay between natural and human‐induced drivers of the temporal changes in size spectra in contrasting environmental conditions.

SURG-21. DEVELOPMENT AND VALIDATION OF A CLINICAL RISK SCORE FOR POSTOPERATIVE OUTCOME IN NEWLY DIAGNOSED GLIOBLASTOMA: A REPORT OF THE RANORESECT GROUP

Abstract BACKGROUND Following resection or biopsy, patients with newly diagnosed glioblastoma frequently enter clinical trials. Nuanced risk assessment is warranted to reduce imbalances between study arms. Here, we aim to make use of our RANO classification for extent of resection (I) to analyze the interactive effects of residual tumor with clinical and molecular factors on outcome and (II) to define a postoperative risk assessment tool. METHODS The RANO resect group retrospectively compiled an international, seven-center training cohort of patients with newly diagnosed glioblastoma. The combined associations of residual tumor with molecular or clinical factors and survival were analyzed, and recursive partitioning analysis was performed for risk modeling. The resulting model was prognostically verified in a separate external validation cohort. RESULTS Our training cohort compromised 1003 patients with newly diagnosed IDH-wildtype glioblastoma, including 744 patients who underwent adjuvant radiochemotherapy (TMZ/RT→TMZ). Residual tumor, MGMT promotor methylation status, age, and KPS were prognostic of overall survival and forwarded into regression tree analysis. By combining eleven terminal nodes and individually weighting the prognostic factors, an additive scale (range, 0-9 points) integrating these four variables distinguished patients with low (0-2 points), intermediate (3-5 points), and high risk (6-9 points) for poor postoperative outcome (median overall survival: 24 vs. 16 vs. 6 months; p<0.01). The presence of the three risk groups was confirmed in the subgroups of patients treated with or without RT/TMZ→TMZ. The prognostic value of the risk score was verified in a external single-center validation cohort of newly diagnosed glioblastoma (n = 258, p<0.01). Compared to previously postulated models, goodness-of-fit measurements were superior for our score. CONCLUSIONS The novel RANO risk score serves as an easy-to-use, yet highly prognostic tool for postoperative patient stratification prior to further therapy. The score may serve to guide patient management and reduce imbalances between study arms in prospective trials.

Parasympathetic regulation and maternal parenting as longitudinal predictors of preschooler inhibitory control

AbstractMeasures of parasympathetic regulation, such as respiratory sinus arrhythmia (RSA), predict executive function outcomes, including inhibitory control, across childhood. Respiratory sinus arrhythmia augmentation tends to be associated with more maladaptive outcomes, compared to RSA suppression, but the literature regarding RSA profiles and inhibitory control development across infancy and early childhood is contradictory. The goal of our current study was to examine the longitudinal and interactive effects of infant RSA during a frustrating task with negative maternal characteristics on inhibitory control during early childhood. Participants included 410 children (209 girls, 77.6% White, 92.9% non‐Hispanic) and their mothers. With small to moderate effect sizes (r2 range from 0.124 to 0.143), we demonstrated that maternal negative affect when children were 36 months old moderated the association between 10‐month‐old RSA during a frustrating task and 48‐month‐old inhibitory control, such that RSA suppression predicted higher levels of inhibitory control, but only when mothers exhibited high levels of negative affect. Our results highlight the biosocial framework under which child inhibitory control develops.

Brief Analysis of the Interaction and Development between Modern Media and Traditional Culture

With the rapid development of modern media technology, the application fields of modern media are increasingly extensive, playing an important role in people's daily work and life. Chinese culture, with its long and profound history, is facing challenges from various emerging cultures. Increasingly, foreign cultures, leveraging rapidly developing media technologies, have influenced our traditional culture. Therefore, to ensure that traditional culture can quickly adapt to the rapidly developing social environment, it is necessary to explore the integration points between modern media technology and traditional culture and strategically combine them to achieve mutual development. This paper discusses the interactive development of traditional culture and modern media, analyzes the modes of dissemination, interactive effects, and interaction models of traditional culture in modern media, and reveals the positive roles of modern media in promoting the inheritance and innovation of traditional culture, enhancing cultural identity and social cohesion, fostering cross-cultural communication and cultural integration, and driving cultural industry and economic growth, thereby positively influencing the development of traditional culture in China.

Self-Regulated Strategy Development With and Without Peer Interaction: Improving High School Students’ L2 Persuasive Essay Revisions

High school students for whom English is a second language (L2) often struggle with effective text revision because of limited ability to self-regulate their writing, that is, to manage the subprocesses of writing and to use writing-related knowledge and strategies. To help students in China acquire effective text revision skills for English persuasive essays, self-regulated strategy development (SRSD) revision instruction was applied both with and without peer interaction targeting knowledge of six writing dimensions. An experimental design involving 120 Chinese 11th-grade students in three conditions, that is, SRSD revision instruction with and without peer interaction (two treatment conditions) and conventional instruction without SRSD (control condition), was applied to examine the instructional effects on students’ writing and text revisions. Analyses of covariance revealed a statistically significant increase in text length and improvement in students’ text quality regarding higher-order content-level writing dimensions in both treatment conditions compared to the control condition in a post-intervention test. Notably, the most substantial improvement regarding both text length and text quality was observed in the SRSD plus peer interaction condition. Further, students in both treatment conditions made more text revisions involving longer text segments aimed at improving quality and changing meaning compared to those in the control condition. Among these, the students in the SRSD plus peer interaction condition exhibited the highest frequency of high-quality text revision during the posttest. The findings provide new insights into the effectiveness of SRSD revision instruction and peer interaction in developing L2 high school students’ self-regulation in revising English persuasive essays.

Regional cerebral perfusion and sympathetic activation during exercise in hypoxia and hypercapnia: preliminary insight into'Cushing's mechanism'.

We examined the interactive influence of hypoxia and exercise, and hypercapnia and exercise,on regional cerebral perfusion and sympathetic activation. Twenty healthy young adults (seven women) completed study trials including (1) rest in normoxia ( : ∼96%, : ∼36mmHg), normocapnic hypoxia ( : ∼84%, : ∼36mmHg), and normoxic hypercapnia ( : ∼98%, : ∼46mmHg) and (2) unilateral rhythmic handgrip exercise (45% of maximal voluntary contraction at 1Hz for 3min) under the same gas conditions. Based on the exercising arm, blood flow in the contralateral internal carotid (ICABF) and ipsilateral vertebral (VABF) arteries, anterior and posterior cerebral O2 delivery ( ), and muscle sympathetic nerve activity (MSNA) were measured in each trial. During exercise in hypoxia, ICABF, VABF, anterior and posterior were significantly lower, whereas total MSNA was significantly greater, than the sum of the responses evoked by either hypoxia or exercise alone. During exercise in hypercapnia, ICABF and anterior were significantly greater, whereas MSNA was lower, than the sum of the responses evoked by either hypercapnia or exercise alone. The VABF and posterior responses to hypercapnic exercise were not different from the summated responses. These findings suggest that the brain is hypoperfused and sympathetic outflow potentiated during hypoxic exercise, and that the brain is hyperperfused and sympathetic discharge constrained during hypercapnic exercise. The contrasting consequences for cerebral perfusion and sympathetic activation indicate a potential involvement of Cushing's mechanism in the autonomic control during exercise in healthy humans. KEY POINTS: Brain O2-demand and -supply are mismatched, and muscle sympathetic nerve activity (MSNA) is enhanced in humans exercising at high altitude; the link between the two phenomena remains elusive. We evaluated the isolated and interactive effects of exercise, hypoxia, and hypercapnia on blood flow in the internal carotid (ICABF) and vertebral (VABF) arteries, and MSNA. The interaction of hypoxia and exercise was hypo-additive for ICABF and VABF and anterior and posterior cerebral O2 delivery ( ), but hyper-additive for MSNA. The interaction of hypercapnia and exercise was hyper-additive for ICABF and anterior , additive for VABF and posterior , and hypo-additive for MSNA. These observations indicate that a suboptimal brain perfusion during hypoxic exercise coincides with a potentiated sympathetic outflow, while a (supra-)optimal brain perfusion during hypercapnic exercise coincides with a suppressed sympathetic outflow. Our findings suggest that Cushing's mechanism may play a role in the autonomic control in exercising humans.

A study of cognitive factor sequences and relations to creativity quality levels

Cognitive factors such as association, memory, and combination have been verified to be related to the creative design process. However, limited research has considered the effects of cognitive factors and their interaction on creative processes in practical creative design processes. This study aimed to detect the interactive effects of cognitive factors on creative processes in a practical creative design process. In particular, how the sequence of cognitive factors affects creativity quality levels of the creative solutions was investigated. Seventy-one participants were recruited to undertake a design task using the think-aloud method. The results of this study are as follows. (i) The sequences of cognitive factors can contribute to different creativity quality levels of solutions. The sequence of semantic memory, common association, remote association, episodic memory, remote combination, idea expression, and idea evaluation is more likely to lead to a higher creativity quality level of solutions. (ii) The repetition of the same cognitive factor in a creative design process, especially semantic memory, does not necessarily contribute to a high-creativity-quality-level solution. (iii) Creativity quality levels of solutions are related to how many cognitive factors categories are involved in the creative design process. The more cognitive factors included, the higher the creativity quality of the solutions will be.

Association between duration of phenoxybenzamine use and postoperative delirium in suspected adrenal pheochromocytoma: a retrospective cohort study

BackgroundAt present, the available evidence regarding the relationship between duration of phenoxybenzamine use and postoperative delirium is inadequate in suspected adrenal pheochromocytoma.ObjectiveTo understand how changes in the duration of phenoxybenzamine use may affect postoperative delirium. The secondary objective of this study is to explore how the duration of phenoxybenzamine use may jointly influence postoperative delirium together with other interacting variables.MethodsWe conducted a retrospective cohort study involving 527 participants with a preoperative diagnosis of suspected pheochromocytoma. CT characteristics, preoperative preparation, intraoperative infusion, estimated bleeding, use of intraoperative vasoactive drugs, and outcomes were obtained from all participants. Logistic regression and interaction effects were utilized to substantiate the research objectives.ResultsA total of 108 (20.5%) developed postoperative delirium, which was seen in 37 (18.0%) in the pheochromocytoma group and 71 (22.0%) in the non-pheochromocytoma group. The incidence of postoperative delirium showed no statistically significant differences in the two groups. A positive association between the duration of phenoxybenzamine use and the risk of postoperative delirium was observed (OR = 1.05, 95%CI = 1.03–1.08, p < 0.01), independent of confounders. The relationship between the duration of phenoxybenzamine use and postoperative delirium differed according to the presence or absence of pheochromocytoma, suggesting an interactive effect (p < 0.05).ConclusionThis study highlights the influence of inappropriate duration of phenoxybenzamine use on the risk of incident postoperative delirium, independent of confounders. The effect of duration of phenoxybenzamine use causes a further increase in the risk of postoperative delirium, especially in non-pheochromocytomas.