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IntroductionWhile nutrition's critical role in enhancing respiratory health is acknowledged, the specific impacts of vitamins A and K on lung function remain largely unexplored. The study aimed to evaluate the relationships between vitamins A and K intake and lung function.MethodsThe cross-sectional study focused on adults aged 20–79 with utilizing data from US National Health and Nutrition Examination Survey (NHANES) 2007–2012. Lung function was assessed by measuring forced expiratory volume (FEV1), forced vital capacity (FVC), and the ratio of these two values (FEV1/FVC). Regression model was performed to determine the associations between intake of vitamins A and K and outcomes.ResultsData of 10,034 participants (representing 142,965,892 adults in the US) were analyzed. After adjusting for relevant confounders, multivariable analysis revealed 1 μg/day increase of vitamin A intake was significantly associated with 0.03 ml increased FEV1 (p = 0.004) and 0.04 ml increased forced vital capacity (FVC) (p < 0.001). In addition, 1 μg/day increase in vitamin K intake was significantly associated with 0.11 ml increased FEV1 (p = 0.022). Neither vitamin A and K intake was associated with FEV1/FVC or presence of airway obstruction.ConclusionsIn relatively healthy population of the US, greater vitamin A or K intake was independently associated with better lung function assessed by spirometry. Benefits of such vitamins for pulmonary health should be confirmed in future randomized controlled trials.

BackgroundMetabolic syndrome (MetS), characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, affects 20-25% of the global population. The creatinine-to-cystatin C ratio (CCR) is an indicator of skeletal muscle mass. While CCR may play a role in MetS development, sex differences in these associations are not fully understood. Therefore, this study aimed to investigate how CCR levels are associated with MetS in a Chinese adult population, focusing on possible sex disparities.MethodWe conducted a retrospective cross-sectional analysis of 9,376 adults from Xiamen Chang Gung Hospital between 2014 to 2016. We examined the relationship between CCR and MetS, adjusting for cardiometabolic risk factors.ResultsThe prevalence of MetS was 24.7% in males and 18.0% in females. Interestingly, we observed significant sex differences in the association between CCR quartiles and MetS. Females in the lowest CCR quartile had a significantly higher risk of MetS (odds ratio=1.84). Receiver operating characteristic curve analysis revealed acceptable diagnostic power of CCR for MetS in females (area under the curve=0.65) but not in males.ConclusionOur findings suggest that CCR is an independent risk factor for MetS in females, highlighting the importance of sex-specific assessments when evaluating MetS risk.

Abstract Metacognition of emotion (meta-emotion) refers to the ability to evaluate and identify one’s emotional feelings. No previous study has defined and measured this construct through objective and quantitative procedures. We established a reliable method to measure meta-emotion. With a two-interval forced-choice procedure, participants selected which of two pictures elicited stronger positive emotion; via the Law of Comparative Judgment, their responses were used to compute individual psychological distances for the emotional responses triggered by the pictures. Then, participants were asked to judge whether a pre-exposed picture induced a stronger positive emotion than the median of that elicited by the whole picture set, followed by a confidence rating. By utilizing each individual’s psychological distance, the correctness of a participant’s emotional experience was quantified by dʹ, and meta-emotion was quantified using meta-dʹ, M-ratio, and M-diff as indices of metacognitive sensitivity and efficiency based on Signal-Detection Theory. Test–retest reliabilities, validated by Spearman correlation, were observed in meta-dʹ, M-ratio, and marginally with M-diff, suggesting the stability of meta-emotion in the current design. This study unveils a validated procedure to quantify meta-emotion, extendable for assessing metacognition of other subjective feelings. Nevertheless, caution is warranted in interpretation, as the measured processes may be influenced by non-metacognitive factors.

Abstract Through development, multisensory systems reach a balance between stability and flexibility: the systems integrate optimally cross-modal signals from the same events, while remaining adaptive to environmental changes. Is continuous intersensory recalibration required to shape optimal integration mechanisms, or does multisensory integration develop prior to recalibration? Here, we examined the development of multisensory integration and rapid recalibration in the temporal domain by re-analyzing published datasets for audio–visual, audio–tactile, and visual–tactile combinations. Results showed that children reach an adult level of precision in audio–visual simultaneity perception and show the first sign of rapid recalibration at 9 years of age. In contrast, there was very weak rapid recalibration for other cross-modal combinations at all ages, even when adult levels of temporal precision had developed. Thus, the development of audio–visual rapid recalibration appears to require the maturation of temporal precision. It may serve to accommodate distance-dependent travel time differences between light and sound.

Abstract Background Insulin resistance (IR) was reported to be associated with renal function impairment, but little is known about the gender difference. Hence, our study aimed to investigate the relationship between IR (estimated by the homeostasis model assessment of IR (HOMA-IR) index) and chronic kidney disease (CKD) in a Chinese population with metabolic syndrome (MetS) and discern whether there was any gender disparity or not. Methods This retrospective cross-sectional study enrolled 13,638 men and 10,450 women who received health examinations from 2013 to 2016 at Xiamen Chang Gung Hospital. Among the participants, 3,253 men (64.3%) and 1,808 women (35.7%) who had MetS and met the inclusion criteria were included for analysis. Spearman’s correlation was conducted to analyze the relationship between HOMA-IR and cardio-metabolic risk factors. Multivariable linear regression was analyzed to explore the relationship between HOMA-IR and cardio-metabolic variables. Logistic regression analysis was performed to assess the association between HOMA-IR and CKD. Results The median HOMA-IR and prevalence of CKD was 2.2 and 11.31%, respectively, for men and 2.09 and 15.93%, respectively, for women. In multivariable linear regression analysis, HOMA-IR was significant associated with estimated GFR, albumin/creatinine ratio in men. Multivariable logistic regression revealed a significant difference between HOMA-IR value and the prevalence of CKD in men but not in women (odds ratio in male = 1.21; 95% CI 1.14–1.28, p ≤ 0.001; odds ratio in female = 1.01; 95% CI 0.99–1.02, p = 0.38). Conclusions HOMA-IR was independently associated with CKD among men with MetS but not in women.

IntroductionA classic example of sound–shape correspondences is the mapping of the vowel /i/ with angular patterns and the vowel /u/ with rounded patterns. Such crossmodal correspondences have been reliably reported when tested in explicit matching tasks. Nevertheless, it remains unclear whether such sound–shape correspondences automatically occur and bidirectionally modulate people’s perception. We address this question by adopting the explicit matching task and two implicit tasks.MethodsIn Experiment 1, we examined the sound–shape correspondences using the implicit association test (IAT), in which the sounds and shapes were both task-relevant, followed by an explicit matching task. In Experiments 2 and 3, we adopted the speeded classification task; when the target was a sound (or shape), a task-irrelevant shape (or sound) that was congruent or incongruent to the target was simultaneously presented. In addition, the participants performed the explicit matching task either before or after the speeded classification task.Results and DiscussionThe congruency effect was more pronounced in the IAT than in the speeded classification task; in addition, a bin analysis of RTs revealed that the congruency effect took time to develop. These findings suggest that the sound–shape correspondences were not completely automatic. The magnitude and onset of visual and auditory congruency effects were comparable, suggesting that the crossmodal modulations were symmetrical. Taken together, the sound–shape correspondences appeared not to be completely automatic, but their modulation was bidirectionally symmetrical once it occurred.

Background/purpose: Superspreading events (SSEs) are pivotal in the spread of SARS-CoV-2. This study aimed to investigate an SSE of COVID-19 in a hospital and explore the transmission dynamics and heterogeneity of SSE. Methods: We performed contact tracing for all close contacts in a cluster. We did nasopharyngeal or throat swabbing for SARS-CoV-2 by real-time RT-PCR. Environmental survey was performed. The epidemiological and clinical characteristics of the SSE were studied. Results: Patient 1 with congestive heart failure and cellulitis, who had onset of COVID-19 two weeks after hospitalization, was the index case. Patient 1 led to 8 confirmed cases, including four health care workers (HCW). Persons tested positive for SARS-CoV-2 were HCW (n = 4), patient 1's family (n = 2), an accompanying person of an un-infected in-patient (n = 1), and an in-patient admitted before the SSE (n = 1). The attack rate among the HCW was 3.2 % (4/127). Environmental survey confirmed contamination at the bed rails, mattresses, and sink in the room patient 1 stayed, suggesting fomite transmission. The index case's sputum remained positive on illness day 35. Except one asymptomatic patient, at least three patients acquired the infection from the index case at the pre-symptomatic period. The effective reproduction number (Rt) was 0.9 (8/9). Conclusion: The host factor (heart failure, longer viral shedding), transmissibility of SARS-CoV-2 (Rt, pre-symptomatic transmission), and possible multiple modes of transmission altogether contributed to the SSE. Rapid response and advance deployment of multi-level protection in hospitals could mitigate COVID-19 transmission to one generation, thereby reducing its impact on the healthcare system.

This study aimed to investigate the risk of vitamin D deficiency in a relatively healthy Asian population, with (i) metabolically healthy normal weight (MHNW) (homeostasis model assessment-insulin resistance [HOMA-IR] < 2. 5 without metabolic syndrome [MS], body mass index [BMI] < 25), (ii) metabolically healthy obesity (MHO) (HOMA-IR < 2.5, without MS, BMI ≥ 25), (iii) metabolically unhealthy normal weight (MUNW) (HOMA-IR ≥ 2.5, or with MS, BMI < 25), and (iv) metabolically unhealthy obesity (MUO) (HOMA-IR ≥ 2.5, or with MS, BMI ≥ 25) stratified by age and sex. This cross-sectional study involved 6,655 participants aged ≥ 18 years who underwent health checkups between 2013 and 2016 at the Chang Gung Memorial Hospital. Cardiometabolic and inflammatory markers including anthropometric variables, glycemic indices, lipid profiles, high-sensitivity C-reactive protein (hs-CRP), and serum 25-hydroxy vitamin D levels, were retrospectively investigated. Compared to the MHNW group, the MHO group showed a higher odds ratio (OR) [1.35, 95% confidence interval (CI) 1.05–1.73] for vitamin D deficiency in men aged < 50 years. By contrast, in men aged > 50 years, the risk of vitamin D deficiency was higher in the MUO group (OR 1.44, 95% CI 1.05–1.97). Among women aged < and ≥ 50 years, the MUO group demonstrated the highest risk for vitamin D deficiency, OR 2.33 vs. 1.54, respectively. Our study revealed that in women of all ages and men aged > 50 years, MUO is associated with vitamin D deficiency and elevated levels of metabolic biomarkers. Among men aged < 50 years, MHO had the highest OR for vitamin D deficiency.

Crossmodal correspondences refer to the fact that certain domains of features in different sensory modalities are associated with each other. Here, we investigated the crossmodal correspondences between speech sounds and visual shapes. Specifically, we tested whether the classification dimensions of English vowels (front–central–back) and consonants (voiced–voiceless, sonorant–obstruent, and stop–continuant) correspond to visual shapes along a bipolar rounded–angular dimension. We adapted eighteen meaningless pseudowords from a previous study that corresponded to either the round or the sharp concept. On each trial, the participants heard one of the pseudowords and saw a rounded shape and an angular shape presented side-by-side on the monitor. Participants judged which shape provided a better match to the spoken pseudoword. A logistic regression was conducted in order to elucidate the effectiveness of classification dimensions of phonemes when predicting variations in the sound–shape matchings. The results demonstrated that the sound–shape matchings were predictable using front–central–back dimensions of vowels, and voiced–voiceless and stop–continuant dimensions of consonants. Hence, we verified that sound–shape matching is underpinned by contrasting dimensions in both vowels and consonants, therefore demonstrating crossmodal correspondences at the phonetic level.

[This corrects the article DOI: 10.1371/journal.pone.0227748.].

BackgroundMetabolic syndrome (MetS) is regarded as a major risk factor for diabetes mellitus and cardiovascular disease (CVD). The optimal threshold of the homeostasis model assessment of insulin resistance (HOMA-IR) has been established for predicting MetS in diverse populations and for different ages. This study assessed the serum HOMA-IR level in a healthy Chinese population aged ≤45 years to determine its relationship with metabolic abnormalities.MethodsCross-sectional study data were collected from health checkup records of Chinese adults aged ≥18 years between 2013 and 2016 at Xiamen Chang Gung Hospital. Participants completed a standardized questionnaire, which was followed by a health examination and blood sample collection. Exclusion criteria were as follows: history of known CVDs; liver, kidney, or endocrine diseases or recent acute illness; hypertension; hyperlipidemia; and pregnancy or lactation.ResultsThe clinical and laboratory characteristics of 5954 men and 4185 women were analyzed. Significant differences were observed in all assessed variables (all P < 0.05). The optimal cutoff point of HOMA-IR for predicting MetS was 1.7 in men and 1.78 in women.ConclusionsWe aimed to determine the optimal cutoff point of HOMA-IR for predicting MetS in a healthy Chinese population aged ≤45 years. The findings of this study would provide an evidence-based threshold for evaluating metabolic syndromes and further implementing primary prevention programs, such as lifestyle changes in the target population.

This study aimed at identifying middle-aged subjects at risk for developing type 2 diabetes mellitus using noninvasive skin carotenoid and vascular function measurements. To this end, 61 subjects (40-65 years of age) without type 2 diabetes mellitus (Group A, Hemoglobin A1c < 6.5%) and 69 subjects (40-65 years of age) with type 2 diabetes mellitus (Group B, Hemoglobin A1c ≥ 6.5%) were recruited (Table 1). The skin carotenoid score was recorded using spectroscopy-based skin carotenoid measurements that approximate dietary fruit and vegetable intake. Endothelial function and heart rate variability were measured for the two groups and correlated with skin carotenoids scores. The daily vegetable and fruit intake was positively correlated with the skin carotenoids score in both groups (Group A, r = 0.598, p < 0.001; Group B, r = 0.449, p < 0.001). There were also significant differences in skin carotenoids score, indices of endothelial function, and heart rate variability between the subjects in group A and group B. There was a negative correlation between skin carotenoids score and individual determinants of metabolic syndrome, including high-density lipoprotein (r = -0.361, p = 0.009), waist circumference (r = -0.450, p < 0.001), fasting blood sugar (r = -0.713, p < 0.001), and Hemoglobin A1c (r = -0.808, p < 0.001); however, systolic blood pressure showed no significant correlation (p = 0.06). In conclusion, carotenoids and cardiovascular parameters are reliable predictive factors of type 2 diabetes mellitus in middle-aged subjects. [ABSTRACT FROM AUTHOR]

Coinfection with Candida and Staphylococcus results in higher mortality in animal studies. However, the pathogenesis and interplay between C. albicans and S. aureus in bloodstream infections (BSIs) is unclear. This study determines the clinical features and outcomes of mixed C. albicans/S. aureus (CA/SA) BSIs and biofilm formation on pathogenesis during coinfection. Demographics and outcomes for mixed BSIs and monomicrobial candidemia were compared. Compared to 115 monomicrobial C. albicans BSIs, 22 patients with mixed CA/SA BSIs exhibited a significantly higher mortality rate and shorter survival time. In vitro and in vivo biofilm analysis showed that C. albicans accounted for the main biofilm architecture, and S. aureus increased its amount. Antibiotic tolerance in S. aureus, which adhered to Candida hyphae observed by scanning electron microscope, was demonstrated by the presence of wild-type C. albicans co-biofilm. Upregulation in exotoxin genes of S. aureus was evidenced by quantitative RT-PCR when a co-biofilm was formed with C. albicans. Mixed CA/SA BSIs result in a higher mortality rate in patients and in vivo surrogate models experiments. This study demonstrates that the virulence enhancement of C. albicans and S. aureus during co-biofilm formation contributes to the high mortality rate.