Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases:a nationwide population-based propensity score-matched study

Background: In colorectal liver metastases (CRLM) patients, combination of liver resection and ablation permit a more parenchymal-sparing approach. This study assessed trends in use of combined resection and ablation, outcomes, and overall survival (OS). Methods: This population-based study included all CRLM patients who underwent liver resection between 2014 and 2022. To assess OS, data was linked to two databases containing date of death for patients treated between 2014 and 2018. Hospital variation in the use of combined minor liver resection and ablation versus major liver resection alone in patients with 2–3 CRLM and ≤3 cm was assessed. Propensity score matching (PSM) was applied to evaluate outcomes. Results: This study included 3593 patients, of whom 1336 (37.2%) underwent combined resection and ablation. Combined resection increased from 31.7% in 2014 to 47.9% in 2022. Significant hospital variation (range 5.9–53.8%) was observed in the use of combined minor liver resection and ablation. PSM resulted in 1005 patients in each group. Major morbidity was not different (11.6% vs. 5%, P = 1.00). Liver failure occurred less often after combined resection and ablation (1.9% vs. 0.6%, P = 0.017). Five-year OS rates were not different (39.3% vs. 33.9%, P = 0.145). Conclusion: Combined resection and ablation should be available and considered as an alternative to resection alone in any patient with multiple metastases.</p

Rare and low-frequency coding variants alter human adult height

Height is a highly heritable, classic polygenic trait with ~700 common associated variants identified so far through genome - wide association studies . Here , we report 83 height - associated coding variants with lower minor allele frequenc ies ( range of 0.1 - 4.8% ) and effects of up to 2 16 cm /allele ( e.g. in IHH , STC2 , AR and CRISPLD2 ) , >10 times the average effect of common variants . In functional follow - up studies, rare height - increasing alleles of STC2 (+1 - 2 cm/allele) compromise d proteolytic inhibition of PAPP - A and increased cleavage of IGFBP - 4 in vitro , resulting in higher bioavailability of insulin - like growth factors . The se 83 height - associated variants overlap genes mutated in monogenic growth disorders and highlight new biological candidates ( e.g. ADAMTS3, IL11RA, NOX4 ) and pathways ( e.g . proteoglycan/ glycosaminoglycan synthesis ) involved in growth . Our results demonstrate that sufficiently large sample sizes can uncover rare and low - frequency variants of moderate to large effect associated with polygenic human phenotypes , and that these variants implicate relevant genes and pathways

Associating LIPS and SWOLLEN: delayed attentional disengagement following words in sex contexts

<p>With a series of three studies, using an adapted dot-probe paradigm, we investigated the elicitation of spontaneous affective meaning. Although it is well established that humans show delays in disengaging their attention from conventional affective stimuli, it is unknown whether contextually acquired affective meaning similarly impacts attention. We examined attentional disengagement following pairs of neutral or slightly ambiguous words that in combination could evoke sex, violence or neutral associations. Study 1 demonstrated slower disengagement following words that conveyed sex or violence associations compared to words that conveyed neutral associations. This pattern was only present for participants who were aware of sex or violence associations. Study 2 replicated these results in a large sample, but only for sex associations. Study 3 replicated the effect while instructing participants explicitly to expect sex and violence associations. Finally, two control studies countered reasonable alternative explanations for our findings. Together, these studies show that contextually driven affective associations can arise quickly with the potential to influence attentional processes. These findings are consistent with theoretical models of emotion and language that highlight the importance of context in the generation of affective meaning.</p

Bottom-up and top-down attention are independent

What is the relationship between top-down and bottom-up attention? Are both types of attention tightly interconnected, or are they independent? We investigated this by testing a large representative sample of the Dutch population on two attentional tasks: a visual search task gauging the efficiency of top-down attention and a singleton capture task gauging bottom-up attention. On both tasks we found typical performance—i.e., participants displayed a significant search slope on the search task and significant slowing caused by the unique, but irrelevant, object on the capture task. Moreover, the high levels of significance we observed indicate that the current set-up provided very high signal to noise ratios, and thus enough power to accurately unveil existing effects. Importantly, in this robust investigation we did not observe any correlation in performance between tasks. The use of Bayesian statistics strongly confirmed that performance on both tasks was uncorrelated. We argue that the current results suggest that there are two attentional systems that operate independently. We hypothesize that this may have implications beyond our understanding of attention. For instance, it may be that attention and consciousness are intertwined differently for top-down attention than for bottom-up attention

Emotional facial expressions reduce neural adaptation to face identity

In human social interactions, facial emotional expressions are a crucial source of information. Repeatedly presented information typically leads to an adaptation of neural responses. However, processing seems sustained with emotional facial expressions. Therefore, we tested whether sustained processing of emotional expressions, especially threat-related expressions, would attenuate neural adaptation. Neutral and emotional expressions (happy, mixed and fearful) of same and different identity were presented at 3 Hz. We used electroencephalography to record the evoked steady-state visual potentials (ssVEP) and tested to what extent the ssVEP amplitude adapts to the same when compared with different face identities. We found adaptation to the identity of a neutral face. However, for emotional faces, adaptation was reduced, decreasing linearly with negative valence, with the least adaptation to fearful expressions. This short and straightforward method may prove to be a valuable new tool in the study of emotional processing

Exploring the role of low-frequency and rare exonic variants in alcohol and tobacco use

BACKGROUND: Alcohol and tobacco use are heritable phenotypes. However, only a small number of common genetic variants have been identified, and common variants account for a modest proportion of the heritability. Therefore, this study aims to investigate the role of low-frequency and rare variants in alcohol and tobacco use. METHODS: We meta-analyzed ExomeChip association results from eight discovery cohorts and included 12,466 subjects and 7432 smokers in the analysis of alcohol consumption and tobacco use, respectively. The ExomeChip interrogates low-frequency and rare exonic variants, and in addition a small pool of common variants. We investigated top variants in an independent sample in which ICD-9 diagnoses of "alcoholism" (N = 25,508) and "tobacco use disorder" (N = 27,068) had been assessed. In addition to the single variant analysis, we performed gene-based, polygenic risk score (PRS), and pathway analyses. RESULTS: The meta-analysis did not yield exome-wide significant results. When we jointly analyzed our top results with the independent sample, no low-frequency or rare variants reached significance for alcohol consumption or tobacco use. However, two common variants that were present on the ExomeChip, rs16969968 (p = 2.39 × 10-7) and rs8034191 (p = 6.31 × 10-7) located in CHRNA5 and AGPHD1 at 15q25.1, showed evidence for association with tobacco use. DISCUSSION: Low-frequency and rare exonic variants with large effects do not play a major role in alcohol and tobacco use, nor does the aggregate effect of ExomeChip variants. However, our results confirmed the role of the CHRNA5-CHRNA3-CHRNB4 cluster of nicotinic acetylcholine receptor subunit genes in tobacco use