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IntroductionNumerous 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.MethodsWe 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.DiscussionThese 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.

Introduction: In comparison to the audiovisual integration of younger adults, the same process appears more complex and unstable in older adults. Previous research has found that stimulus intensity is one of the most important factors influencing audiovisual integration.Methods: The present study compared differences in audiovisual integration between older and younger adults using dynamic hand-held tool stimuli, such as holding a hammer hitting the floor. Meanwhile, the effects of stimulus intensity on audiovisual integration were compared. The intensity of the visual and auditory stimuli was regulated by modulating the contrast level and sound pressure level.Results: Behavioral results showed that both older and younger adults responded faster and with higher hit rates to audiovisual stimuli than to visual and auditory stimuli. Further results of event-related potentials (ERPs) revealed that during the early stage of 60–100 ms, in the low-intensity condition, audiovisual integration of the anterior brain region was greater in older adults than in younger adults; however, in the high-intensity condition, audiovisual integration of the right hemisphere region was greater in younger adults than in older adults. Moreover, audiovisual integration was greater in the low-intensity condition than in the high-intensity condition in older adults during the 60–100 ms, 120–160 ms, and 220–260 ms periods, showing inverse effectiveness. However, there was no difference in the audiovisual integration of younger adults across different intensity conditions.Discussion: The results suggested that there was an age-related dissociation between high- and low-intensity conditions with audiovisual integration of the dynamic hand-held tool stimulus. Older adults showed greater audiovisual integration in the lower intensity condition, which may be due to the activation of compensatory mechanisms.

As older adults experience degenerations in perceptual ability, it is important to gain perception from audiovisual integration. Due to attending to one or more auditory stimuli, performing other tasks is a common challenge for older adults in everyday life. Therefore, it is necessary to probe the effects of auditory attentional load on audiovisual integration in older adults. The present study used event-related potentials (ERPs) and a dual-task paradigm [Go / No-go task + rapid serial auditory presentation (RSAP) task] to investigate the temporal dynamics of audiovisual integration. Behavioral results showed that both older and younger adults responded faster and with higher accuracy to audiovisual stimuli than to either visual or auditory stimuli alone. ERPs revealed weaker audiovisual integration under the no-attentional auditory load condition at the earlier processing stages and, conversely, stronger integration in the late stages. Moreover, audiovisual integration was greater in older adults than in younger adults at the following time intervals: 60–90, 140–210, and 430–530 ms. Notably, only under the low load condition in the time interval of 140–210 ms, we did find that the audiovisual integration of older adults was significantly greater than that of younger adults. These results delineate the temporal dynamics of the interactions with auditory attentional load and audiovisual integration in aging, suggesting that modulation of auditory attentional load affects audiovisual integration, enhancing it in older adults.

Audiovisual integration is an essential process that influences speech perception in conversation. However, it is still debated whether older individuals benefit more from audiovisual integration than younger individuals. This ambiguity is likely due to stimulus features, such as stimulus intensity. The purpose of the current study was to explore the effect of aging on audiovisual integration, using event-related potentials (ERPs) at different stimulus intensities. The results showed greater audiovisual integration in older adults at 320–360 ms. Conversely, at 460–500 ms, older adults displayed attenuated audiovisual integration in the frontal, fronto-central, central, and centro-parietal regions compared to younger adults. In addition, we found older adults had greater audiovisual integration at 200–230 ms under the low-intensity condition compared to the high-intensity condition, suggesting inverse effectiveness occurred. However, inverse effectiveness was not found in younger adults. Taken together, the results suggested that there was age-related dissociation in audiovisual integration and inverse effectiveness, indicating that the neural mechanisms underlying audiovisual integration differed between older adults and younger adults.

BackgroundHypertrophic cardiomyopathy (HCM) is a widely distributed, but clinically heterogeneous genetic heart disease, affects approximately 20 million people worldwide. Nowadays, HCM is treatable with the advancement of medical interventions. However, due to occult clinical presentations and a lack of easy, inexpensive, and widely popularized screening approaches in the general population, 80–90% HCM patients are not clinically identifiable, which brings certain safety hazards could have been prevented. The majority HCM patients showed abnormal and diverse electrocardiogram (ECG) presentations, it is unclear which ECG parameters are the most efficient for HCM screening.ObjectiveWe aimed to develop a pragmatic prediction model based on the most common ECG features to screen for HCM.MethodsBetween April 1st and September 30th, 2020, 423 consecutive subjects from the International Cooperation Center for Hypertrophic Cardiomyopathy of Xijing Hospital [172 HCM patients, 251 participants without left ventricular hypertrophy (non-HCM)] were prospectively included in the training cohort. Between January 4th and February 30th, 2021, 163 participants from the same center were included in the temporal internal validation cohort (62 HCM patients, 101 non-HCM participants). External validation was performed using retrospectively collected ECG data from Xijing Hospital (3,232 HCM ECG samples from January 1st, 2000, to March 31st, 2020; 95,184 non-HCM ECG samples from January 1st to December 31st, 2020). The C-statistic was used to measure the discriminative ability of the model.ResultsAmong 30 ECG features examined, all except abnormal Q wave significantly differed between the HCM patients and non-HCM comparators. After several independent feature selection approaches and model evaluation, we included only two ECG features, T wave inversion (TWI) and the amplitude of S wave in lead V1 (SV1), in the HCM prediction model. The model showed a clearly useful discriminative performance (C-statistic > 0.75) in the training [C-statistic 0.857 (0.818–0.896)], and temporal validation cohorts [C-statistic 0.871 (0.812–0.930)]. In the external validation cohort, the C-statistic of the model was 0.833 [0.825–0.841]. A browser-based calculator was generated accordingly.ConclusionThe pragmatic model established using only TWI and SV1 may be helpful for predicting the probability of HCM and shows promise for use in population-based HCM screening.

Nephrocutaneous fistula (NCF) is a rare and severe complication of renal disease and surgical procedures. Treatments for NCF are based on the renal function, and can include nephrectomy, heminephrectomy, nephroureterectomy, endourological maneuvers or antibiotic therapy alone. Here we report a case of a chronic NCF which occurred 5 years after partial nephrectomy. In this report, we describe a new surgical approach for the management of a patient with postoperative NCF. In the present case, in addition to removing the fistulous tract, we also performed an omental flap grafting to tightly cover the kidney. In addition to limiting and controlling the local inflammation, the omental flap prevents contact between the kidney and the flank muscle on its posterior rim. No recurrence or complications occurred throughout 10 months of follow-up. The NCF was successfully treated with completely removal of the sinus tract and omental flap grafting, without nephrectomy. This case adds new aspects to the treatment of NCF.

Previous studies confirmed that the cognitive resources are limited for each person, and perceptual load affects the detection of stimulus greatly; however, how the visual perceptual load influences audiovisual integration (AVI) is still unclear. Here, 20 older and 20 younger adults were recruited to perform an auditory/visual discrimination task under various visual perceptual-load conditions. The analysis for the response times revealed a significantly faster response to the audiovisual stimulus than to the visual stimulus or auditory stimulus (all p < 0.001), and a significantly slower response by the older adults than by the younger adults to all targets (all p ≤ 0.024). The race-model analysis revealed a higher AV facilitation effect for older (12.54%) than for younger (7.08%) adults under low visual perceptual-load conditions; however, no obvious difference was found between younger (2.92%) and older (3.06%) adults under medium visual perceptual-load conditions. Only the AV depression effect was found for both younger and older adults under high visual perceptual-load conditions. Additionally, the peak latencies of AVI were significantly delayed in older adults under all visual perceptual-load conditions. These results suggested that visual perceptual load decreased AVI (i.e., depression effects), and the AVI effect was increased but delayed for older adults.

Depression is related to the defect of emotion processing, and people's emotional processing is crossmodal. This article aims to investigate whether there is a difference in audiovisual emotional integration between the depression group and the normal group using a high-resolution event-related potential (ERP) technique. We designed a visual and/or auditory detection task. The behavioral results showed that the responses to bimodal audiovisual stimuli were faster than those to unimodal auditory or visual stimuli, indicating that crossmodal integration of emotional information occurred in both the depression and normal groups. The ERP results showed that the N2 amplitude induced by sadness was significantly higher than that induced by happiness. The participants in the depression group showed larger amplitudes of N1 and P2, and the average amplitude of LPP evoked in the frontocentral lobe in the depression group was significantly lower than that in the normal group. The results indicated that there are different audiovisual emotional processing mechanisms between depressed and non-depressed college students.

At the beginning of the coronavirus disease 2019 (COVID-19) outbreak, college students returning home from Wuhan, Hubei Province, experienced various degrees of discrimination. This study first investigates perceived discrimination among college students returning home from Wuhan. Then, an experimental method is used to investigate the effectiveness of an intervention designed to reduce the perceived discrimination among those who returned to towns outside of Hubei Province. A total of 63 college students participated in the experiment. In the experimental group (N = 31), a wise intervention based on reading and writing was adopted to intervene in perceived discrimination among the participants. The results showed that the perceived discrimination among students returning from Wuhan to towns outside of Hubei Province was significantly higher than that among students returning to towns within Hubei Province. The wise intervention reduced the perceived discrimination in the experimental group but not in the control group. Further analysis found that perceived social support fully mediated the relationship between the intervention and perceived discrimination. These results provide insights on how the content of intervention (perceived social support) and the form of intervention (wise intervention) can prevent the occurrence of psychological problems in epidemic situations.

Audio-visual integration (AVI) is higher in attended conditions than in unattended conditions. Here, we explore the AVI effect when the attentional recourse is competed by additional visual distractors, and its aging effect using single- and dual-tasks. The results showed the highest AVI effect under single-task-attentional-load condition than under no- and dual-task-attentional-load conditions (all P < 0.05) in both older and younger groups, but the AVI effect was weaker and delayed for older adults compared to younger adults for all attentional-load conditions (all P < 0.05). The non-phase-locked oscillation for AVI analysis illustrated the highest theta and alpha oscillatory activity for single-task-attentional-load condition than for no- and dual-task-attentional-load conditions, and the AVI oscillatory activity mainly occurred in the Cz, CP1 and Oz of older adults but in the Fz, FC1, and Cz of younger adults. The AVI effect was significantly negatively correlated with FC1 (r2 = 0.1468, P = 0.05) and Cz (r2 = 0.1447, P = 0.048) theta activity and with Fz (r2 = 0.1557, P = 0.043), FC1 (r2 = 0.1042, P = 0.008), and Cz (r2 = 0.0897, P = 0.010) alpha activity for older adults but not for younger adults in dual task. These results suggested a reduction in AVI ability for peripheral stimuli and a shift in AVI oscillation from anterior to posterior regions in older adults as an adaptive mechanism.

The regulatory effect of embodied emotion on one’s general emotion and the impact of the compatibility or incompatibility of the two types of emotion on creative thinking are still debatable. The purpose of this study is to investigate these issues experimentally. In Experiment 1, participants completed an explicit positive and negative emotion test [Positive and Negative Affect Schedule (PANAS)] and an implicit positive and negative emotion test [Implicit Positive and Negative Affect Test (IPANAT)] twice on a computer after emotional video priming was used to induce negative emotions and facial expression manipulation was performed to induce embodied positive or negative emotions. It was found that maintaining the expression of a suppressed smile was helpful in regulating negative emotions (p = 0.047). Specifically, the implicit negative emotions induced by facial expression manipulation had a positive regulating effect on the implicit negative emotions induced by the video (T1, M = 47.813; to T2, M = 44.188). In Experiment 2, the positive or negative emotions of the participants were induced using emotional videos, and facial expression manipulation was used to induce their embodied positive or negative emotions. Then, the participants completed a creative test by completing alternative use tasks (AUTs) and Chinese character riddles. The AUT fluency score in the emotionally compatible group was significantly higher than that in the emotionally incompatible group (p = 0.032), but while experiencing negative emotions, the emotionally compatible group had a significantly higher originality score and insight in Chinese character riddle score than the emotionally incompatible group (p = 0.017, p = 0.004). Therefore, embodied negative emotion has a significant regulating effect on implicit negative emotion. The compatibility of emotion activated by facial expression and viewing a video contributes to creative thinking, whereas the incompatibility of emotion hinders creative thinking. The compatibility of emotion under positive emotions improved thinking fluency, whereas under negative emotions, it activated originality and insight in creative thinking. The influence of such emotional compatibility on creative thinking may be due to the regulating effect of embodied emotions on implicit emotions induced by emotional stimuli.

This article aims to investigate the interaction effects of emotional valence (negative, positive) and stimulus type (sticker, face) on attention allocation and information retrieval in spatial working memory (WM). The difference in recognition of emotional faces and stickers was also further explored. Using a high-resolution event-related potential (ERP) technique, a time-locked delayed matching-to-sample task (DMST) was employed that allowed separate investigations of target, delay, and probe phases. Twenty-two subjects participated in our experiment. The results indicated that negative face can catch early attention in information encoding, which was indicated by the augmentation of the attention-related P200 amplitude. In the delay phase, the N170 component represents facial specificity and showed a negative bias against stickers. For information retrieval, the increase in the emotion-related late positive component (LPC) showed that positive emotion could damage spatial WM and consume more cognitive resources. Moreover, stickers have the ability to catch an individual’s attention throughout the whole course of spatial WM with larger amplitudes of the attention-related P200, the negative slow wave (NSW), and the LPC. These findings highlight the role of stickers in different phases of spatial WM and provide new viewpoints for WM research on mental patients.

In older adults, cognitive abilities, such as those associated with vision and hearing, generally decrease with age. According to several studies, audio-visual perceptual training can improve perceived competence regarding visual and auditory stimuli, suggesting that perceptual training is effective and beneficial. However, whether audio-visual perceptual training can induce far-transfer effects in other forms of untrained cognitive processing that are not directly trained in older adults remains unclear. In this study, the classic P300 component, a neurophysiological indicator of cognitive processing of a stimulus, was selected as an evaluation index of the training effect. We trained both young and older adults on the ability to judge the temporal and spatial consistency of visual and auditory stimuli. P300 amplitudes were significantly greater in the posttraining session than in the pretraining session in older adults (P = 0.001). However, perceptual training had no significant effect (P = 0.949) on the P300 component in young adults. Our results illustrate that audio-visual perceptual training can lead to far-transfer effects in healthy older adults. These findings highlight the robust malleability of the aging brain, and further provide evidence to motivate exploration to improve cognitive abilities in older adults.

Audiovisual integration significantly changes over the lifespan, but age-related functional connectivity in audiovisual temporal asynchrony integration tasks remains underexplored. In the present study, electroencephalograms (EEGs) of 27 young adults (22–25 years) and 25 old adults (61–76 years) were recorded during an audiovisual temporal asynchrony integration task with seven conditions [auditory (A), visual (V), AV, A50V, A100V, V50A and V100A]. We calculated the phase lag index (PLI)-weighted connectivity networks modulated by the audiovisual tasks and found that the PLI connections showed obvious dynamic changes after stimulus onset. In the theta (4–7 Hz) and alpha (8–13 Hz) bands, the AV and V50A conditions induced stronger functional connections and higher global and local efficiencies, reflecting a stronger audiovisual integration effect, which was attributed to the auditory information arriving at the primary auditory cortex earlier than the visual information reaching the primary visual cortex. Importantly, the functional connectivity and network efficiencies of old adults revealed higher global and local efficiencies and higher degree in both the theta and alpha bands. These larger network efficiencies indicated that old adults might experience more difficulties in attention and cognitive control during the audiovisual integration task with temporal asynchrony than young adults. There were significant associations between network efficiencies and peak time of integration only in young adults. We propose that an audiovisual task with multiple conditions might arouse the appropriate attention in young adults but would lead to a ceiling effect in old adults. Our findings provide new insights into the network topography of old adults during audiovisual integration and highlight higher functional connectivity and network efficiencies due to greater cognitive demand.

Audiovisual integration occurs frequently and has been shown to exhibit age-related differences via behavior experiments or time-frequency analyses. In the present study, we examined whether functional connectivity influences audiovisual integration during normal aging. Visual, auditory, and audiovisual stimuli were randomly presented peripherally; during this time, participants were asked to respond immediately to the target stimulus. Electroencephalography recordings captured visual, auditory, and audiovisual processing in 12 old (60–78 years) and 12 young (22–28 years) male adults. For non-target stimuli, we focused on alpha (8–13 Hz), beta (13–30 Hz), and gamma (30–50 Hz) bands. We applied the Phase Lag Index to study the dynamics of functional connectivity. Then, the network topology parameters, which included the clustering coefficient, path length, small-worldness global efficiency, local efficiency and degree, were calculated for each condition. For the target stimulus, a race model was used to analyze the response time. Then, a Pearson correlation was used to test the relationship between each network topology parameters and response time. The results showed that old adults activated stronger connections during audiovisual processing in the beta band. The relationship between network topology parameters and the performance of audiovisual integration was detected only in old adults. Thus, we concluded that old adults who have a higher load during audiovisual integration need more cognitive resources. Furthermore, increased beta band functional connectivity influences the performance of audiovisual integration during normal aging.