ABSTRACT Background: Triple-negative breast cancer (TNBC) is a subtype of breast cancer (BC) that lacks receptors for targeted therapy. Deeper insight into the molecular mechanisms regulating TNBC metastasis is urgently needed. The epithelial-mesenchymal transition process facilitates the metastasis of neighboring epithelial tumor cells. Protein kinase, membrane-associated tyrosine/threonine 1 (PKMYT1), a member of the Wee family of protein kinases, is upregulated in BC, and its high expression predicts poor prognosis in BC patients. Notch signaling activation is a pathognomonic feature of TNBC. PKMYT1 has been found to induce EMT in non-small cell lung cancer by activating Notch signaling. However, whether PKMYT1 exerts effects on TNBC progression by regulating Notch signaling remains unknown. Objectives: The objective of this study was to investigate whether PKMYT1 exerts effects on TNBC progression by regulating Notch signaling. Methods: Fifty cases of surgically resected BC samples (tumor and adjacent non-tumor tissue samples) were collected from patients diagnosed with BC. We measured the expression of PKMYT1 in clinical samples with real-time quantitative polymerase chain reaction (RT-qPCR). For in vitro analysis, RT-qPCR and Western blotting were conducted to evaluate PKMYT1 expression in TNBC cells. Then, the viability, migration, and invasion of TNBC cells were detected by cell counting kit-8 assays, wound healing assays, and Transwell assays. The EMT event was examined by evaluating the levels of EMT-associated proteins. For in vivo analysis, xenograft models in nude mice were established to explore PKMYT1 roles. E-cadherin and Ki67 expression in xenograft models were estimated by immunohistochemistry staining. Hematoxylin and eosin staining was performed to assess tumor metastasis. The underlying mechanisms by which PKMYT1 affected the malignant phenotypes of TNBC cells were explored by Western blotting measuring the pathway-associated proteins. Results: PKMYT1 was upregulated in BC tissues and cells, and its knockdown prevented cell proliferation, migration, invasion, and EMT event in TNBC. Mechanistically, Notch signaling was inactivated by PKMYT1 depletion, and Notch activation abolished the PKMYT1 silencing-induced inhibition in the malignant phenotypes of TNBC cells. For in vivo analysis, PKMYT1 knockdown inhibited tumorigenesis and metastasis of TNBC. Conclusion: PKMYT1 promotes EMT, proliferation, migration, and invasion of TNBC cells and facilitates tumor growth and metastasis by activating Notch signaling.

This study, which considers the exchange that occurs between civilisations, attempts to re-examine the question pertaining to the authenticity of sutra. The Guanjing [Guan Wulingshou jing 觀無量ã經 Skt. Amitāyur Dhyāna Sūtra; Contemplation Sūtra], which is an influential Buddhist text, immensely facilitated the first transmission of Zen Buddhism that occurred during the Middle Ages, and it promoted the spread of the Pure Land thought. Because of the modern academic research on the Chinese Buddhist Apocrypha, the discussion pertaining to the authenticity of the Guanjing has become prominent, and for more than half a century, issues pertaining to the place in which it was compiled, the time of its establishment and the absence of the Sanskrit and Tibetan texts have received research attention. Buddhist texts have spread from India to China. If a general literature and linguistics perspective is adopted, the availability of a sutra in the original Indian language becomes a criterion for determining its reliability and authenticity. In addition, the translator, the place in which the translation occurred, the time of translation and the relationship with similar scriptures are all significant factors that can determine whether a sutra is an allegedly forged manuscript. CONTRIBUTION: This article contributes to the understanding of the authenticity and counterfeit nature of Guanjing through a civilisational exchange perspective. This study differs from previous thinking only in terms of Sinicized sects, and the article analyses the possible Indian and Central Asian sources of the text, pointing out the forms in which the Guanjing and Ajātaśatru are reflected.

Abstract Emerging studies indicate the persistence of symptoms beyond the acute phase of COVID-19. Cognitive impairment has been observed in certain individuals for months following infection. Currently, there is limited knowledge about the specific cognitive domains that undergo alterations during the post-acute COVID-19 syndrome and the potential impact of disease severity on cognition. The aim of this review is to examine studies that have reported cognitive impairment in post-acute COVID-19, categorizing them into subacute and chronic phases. The methodology proposed by JBI was followed in this study. The included studies were published between December 2019 and December 2022. The search was conducted in PubMed, PubMed PMC, BVS – BIREME, Embase, SCOPUS, Cochrane, Web of Science, Proquest, PsycInfo, and EBSCOHost. Data extraction included specific details about the population, concepts, context, and key findings or recommendations relevant to the review objectives. A total of 7,540 records were identified and examined, and 47 articles were included. The cognitive domains most frequently reported as altered 4 to 12 weeks after acute COVID-19 were language, episodic memory, and executive function, and after 12 weeks, the domains most affected were attention, episodic memory, and executive function. The results of this scoping review highlight that adults with post-acute COVID-19 syndrome may have impairment in specific cognitive domains.

Resumo Estudos emergentes indicam a persistência dos sintomas além da fase aguda da COVID-19. O comprometimento cognitivo foi observado em alguns indivíduos durante meses após a infecção. Atualmente, há pouco conhecimento sobre os domínios cognitivos específicos que sofrem alterações durante a síndrome pós-aguda da COVID-19 e o possível impacto da gravidade da doença na cognição. O objetivo desta revisão é examinar estudos que relataram comprometimento cognitivo na COVID-19 pós-aguda, categorizando-os em fases subaguda e crônica. A metodologia proposta pela Joanna Briggs Institute foi seguida neste estudo. Os estudos incluídos foram publicados entre dezembro de 2019 e dezembro de 2022. A busca foi realizada no PubMed, PubMed PMC, BVS – BIREME, Embase, SCOPUS, Cochrane, Web of Science, Proquest, PsycInfo e EBSCOHost. A extração de dados incluiu detalhes específicos sobre a população, os conceitos, o contexto e as principais descobertas ou recomendações relevantes para os objetivos da revisão. Um total de 7.540 registros foi identificado e examinado, e 47 artigos foram incluídos. Os domínios cognitivos mais frequentemente relatados como alterados de 4 a 12 semanas após a COVID-19 aguda foram linguagem, memória episódica e função executiva e, após 12 semanas, os domínios mais afetados foram atenção, memória episódica e função executiva. Os resultados dessa revisão de escopo destacam que adultos com síndrome pós-aguda da COVID-19 podem apresentar comprometimento em domínios cognitivos específicos.

This article puts forward love, care, and reverence for all people and our nonhuman kin as the center of posthumanist education. Opening our spiritual eye and building intimate relationships with nature and with all elements of the universe is envisioned as part of a schooling or post-schooling experience; our body, heart and spirit, along with our mind, is an essential part of learning. The article describes the experiences of students taking a graduate level course focusing on global climate change and education at a university in the United States. We use the course as an example to explore what posthumanist education entails. In this qualitative study, students taking the course, along with the faculty designing and teaching the course, describe the course curriculum and pedagogies and reflect on the course's impact on them. Data sources include the syllabus, students' reflection papers, nature contact journals, final projects, art works, and group conversations. Although situated in North America, the article is rich with international perspectives as student authors came from six different countries. The article posits that posthumanist education must be eco-centric and love-based, engaging students' whole being to feel for and love Mother Nature.

Abstract: The privacy problem of facial recognition technology is that commercial companies obtain people’s facial information without the consent of individuals and use facial information to infringe on the privacy of individuals. The importance of human privacy in facial recognition technology is reflected through facial ethics, which requires others to perform corresponding obligations to individuals, such as oral care. Through the analysis of the privacy issues of facial recognition technology, it is found that the two elements of “without personal informed” and “without personal consent” together form the basis for commercial companies to violate personal privacy. The principle of informed consent includes the principle of informed and the principle of consent, which is derived from the principle of informed consent in medical ethics. This paper improves the principles of informed consent in medicine and ethics to better address facial recognition privacy issues.

Resumen: El problema de la privacidad en la tecnología de reconocimiento facial es que las empresas comerciales obtienen información facial de las personas sin el consentimiento de éstas y utilizan la información facial para vulnerar la privacidad de las personas. La importancia de la privacidad de las personas en la tecnología de reconocimiento facial se refleja a través de la ética facial, que exige que otros cumplan las obligaciones correspondientes con los individuos, como el cuidado bucal. A través del análisis de los problemas de privacidad de la tecnología de reconocimiento facial se descubre que los dos elementos de “sin información personal” y “sin consentimiento personal” juntos forman la base para que las empresas comerciales violen la privacidad personal. El principio de consentimiento informado incluye el de información y el de consentimiento, que se deriva del principio de consentimiento informado de la ética médica. Este artículo mejora los principios del consentimiento informado en medicina y ética para abordar mejor los problemas de privacidad del reconocimiento facial.

Resumo: A questão da privacidade na tecnologia de reconhecimento facial é que as companhias comerciais obtém informações faciais das pessoas sem seu consentimento e usam informação facial para infringir sua privacidade. A importância da privacidade humana na tecnologia de reconhecimento facial é refletida através da ética facial, que exige que se cumpram obrigações correspondentes para com os indivíduos, da mesma forma como com cuidados orais. Através da análise de aspectos de privacidade na tecnologia de reconhecimento facial, encontrou-se que os dois elementos “sem informação pessoal” e “sem consentimento pessoal” juntos, formam a base para companhias comerciais violarem a privacidade pessoal. O princípio do consentimento informado inclui o princípio de informação e o princípio de consentimento, os quais derivam do princípio do consentimento informado em ética médica. Esse artigo melhora os princípios do consentimento informado em medicina e ética para melhor incluir aspectos de privacidade no reconhecimento facial.

Abstract Introduction: few previous studies suggest that serum iron status may be associated with liver function, but the relevant evidence remains limited, especially in adolescents. Objective: we aimed to investigate the association between serum ferritin, iron, and liver transaminases in adolescents. Methods: a cross-sectional study including 3,404 adolescents aged 10-19 was performed based on the National Health and Nutrition Examination Survey. Weighted multivariate regression, subgroup analysis, and sensitivity analysis were used. Results: a total of 3,404 adolescents were eventually included. Serum ferritin and iron were positively correlated to alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The association between serum ferritin and ALT remained positive in all genders and races, but only remained positive in girls and several races between serum ferritin and AST. The positive correlations kept present among girls between serum iron and ALT, and also kept present among girls and non-Hispanic whites between serum iron and AST. Additionally, serum ferritin and iron were also positively correlated to elevated ALT and elevated AST using binary logistic regression analysis. After excluding the subjects with serum ferritin levels above the upper limit of normal, the main results remained the same basically. Conclusion: the present results add novel evidences about the associations between serum ferritin, iron, and liver transaminases, which requires more confirmatory studies.

Resumen Introducción: pocos estudios previos sugieren que el estado del hierro sérico pueda estar asociado con la función hepática, pero la evidencia relevante sigue siendo limitada, especialmente en adolescentes. Objetivo: nuestro objetivo fue investigar la asociación entre la ferritina sérica, el hierro y las transaminasas hepáticas en adolescentes. Métodos: se realizó un estudio transversal que incluyó a 3,404 adolescentes de diez a 19 años de edad, basado en la Encuesta Nacional de Examen de Salud y Nutrición. Se utilizaron la regresión multivariada ponderada, el análisis de subgrupos y el análisis de sensibilidad. Resultados: finalmente, se incluyó un total de 3.404 adolescentes. La ferritina sérica y el hierro se correlacionaron positivamente con la alanina aminotransferasa (ALT) y la aspartato aminotransferasa (AST). La asociación entre ferritina sérica y ALT se mantuvo positiva en todos los géneros y razas, pero solo se mantuvo positiva en niñas y en varias razas entre ferritina sérica y AST. Las correlaciones positivas siguieron presentes en las niñas entre el hierro sérico y la ALT, y también en las niñas y personas blancas no hispanas entre el hierro sérico y la AST. Además, la ferritina sérica y el hierro también se correlacionaron positivamente con ALT elevada y AST elevada mediante análisis de regresión logística binaria. Después de excluir a los sujetos con niveles de ferritina sérica por encima del límite superior de la normalidad, los resultados principales se mantuvieron básicamente iguales. Conclusión: los presentes resultados agregan evidencias novedosas sobre las asociaciones entre la ferritina sérica, el hierro y las transaminasas hepáticas, lo que requiere más estudios confirmatorios.

Abstract Objectives: To screen the COL1A1 and COL1A2 gene mutation sites in a family with type I osteogenesis imperfecta (OI)/hearing loss and analyze the characteristics and recovery of hearing loss in patients with osteogenesis imperfecta. Methods: The basic clinical data of Ol proband and her parents were collected, and the COL1A1 and COL1A2 genes were detected in peripheral blood by PCR amplification and generation Sanger sequencing. Literature of stapedial surgery in patients with osteogenesis imperfecta was collected. Results: The heterozygous mutation of the 26 exon c.1922_1923 ins C in the Ol progenitor COL1A1 gene led to the amino acid frameshift mutation of p.Pro 601FS, which was not detected in the phenotypic parents. The homozygous of exon 28 c.1782>G in COL1A2 was detected in the proband and her parents, resulting in changes in the protein p.Pro 549Ala. Conclusion: The clinical symptoms of the Ol proband is caused by heterozygous mutation of the 26 exon c.1922_1923 ins C in COL1A1 gene. Stapedial surgery can provide short-term and long-term hearing benefits for Ol patients with hearing loss. Level of evidence: Level 4.

Abstract Objectives: Observational studies suggested that obesity may promote the development of allergic rhinitis. The aim of this study was to explore the association of obesity, lipids and adipokines with this allergic disease at the genetic level using Mendelian randomization strategies. Methods: Summary data for three obesity indicators (such as body mass index), eight lipid indicators (such as triglycerides) and six adipokines (such as interleukin-6 and adipocyte fatty acid-binding protein) were collected, and suitable instrumental variables were extracted from these summary data according to the three main assumptions of Mendelian randomization. Three Mendelian randomization methods (such as inverse variance weighted) were used to detect the casual effect of the above indicators on allergic rhinitis risk. Sensitivity analyses were performed to assess heterogeneity and horizontal pleiotropy. Results: After Bonferroni correction, the inverse variance weighted reported that elevated levels of interleukin-6 and adipocyte fatty acid-binding protein were nominally associated with the decreased risk of allergic rhinitis (OR = 0.870, 95% CI 0.765-0.990, p = 0.035; OR = 0.732, 95% CI 0.551-0.973, p = 0.032). The other Mendelian randomization methods supported these results. Obesity, lipids and other adipokines were not related to this allergic disease. Sensitivity analyses found no heterogeneity and horizontal pleiotropy in the study. Conclusion: The study provided some interesting, but not sufficient, evidence to suggest that interleukin-6 and adipocyte fatty acid-binding protein might play a protective role in the development of allergic rhinitis at the genetic level. These findings should be validated by more research. Level of evidence: This was a Mendelian randomized study with a level of evidence second only to clinical randomized trials, and higher than cohort and case-control studies.

Ergosterol peroxide (EP) has been extensively studied for its antitumor activities. However, its further development has been restricted due to its limited intracellular accumulation and poor aqueous solubility. In this study, a novel triphenylphosphonium cation (TPP+) moiety was coupled to ergosterol peroxide to precisely target it at tumor cell mitochondria. The synthesized Mito-EP derivatives Mito-EP-3a-3d displayed stronger cytotoxicity than the EP parent and exhibited selectively cytotoxic effects between cancer cells and normal gastric epithelial (GES-1) cells. The most potent compound, Mito-EP-3b, was 9.7-fold more efficacious than ergosterol peroxide in the MCF-7 (breast cancer) cell line and showed good selectivity (SI = IC50GES-1/IC50MCF-7 = 4.04, IC50: concentrations to inhibit 50% of cell growth). Furthermore, Mito-EP-3b was able to decrease the mitochondrial membrane potential and induced reactive oxygen species production, accompanied by activating the expression of cytochrome c and Bax, while Bcl-2 expression was suppressed. The molecular mechanism may refer to the mitochondrial apoptotic pathway. Overall, the above results incentivize the further study of Mito EP-3b derivatives as potent anticancer agents.

Resumo Nas últimas décadas, cresceu o interesse em compreender os mecanismos do desempenho da recuperação de serviço (DRS) na indústria hoteleira. Este estudo introduz uma perspectiva interativa que incorpora fatores extrínsecos e intrínsecos, investigando a influência da liderança inclusiva e da autonomia no trabalho na autoeficácia dos funcionários, sendo que a autoeficácia medeia a suas relações com o DRS. A atuação superficial é proposta como um moderador negativo. Questionários foram aplicados a uma amostra de 83 supervisores e 350 funcionários de front office de 8 hotéis chineses. As metodologias de análise baseiam-se no PLS-SEM e análise de regressão. Os resultados mostram que a liderança inclusiva e a autonomia no trabalho contribuem para uma autoeficácia forte e um DRS aprimorado. A atuação superficial modera a relação entre a liderança inclusiva e a autoeficácia, mas não entre a autonomia no trabalho e a autoeficácia. Esta pesquisa transversal oferece implicações práticas para os gestores hoteleiros, fornecendo orientações para promover ambientes que estimulem a autoeficácia e aprimorem o DRS. As limitações incluem a dependência de medidas autorrelatadas e um design transversal. Pesquisas futuras podem explorar outros moderadores e mediadores, diferentes setores industriais e utilizar designs longitudinais ou experimentais para estabelecer causalidade.

Abstract In recent decades, interest has grown in understanding the mechanisms of service recovery performance (SRP) in the hospitality industry. This study introduces an interactive perspective incorporating both extrinsic and intrinsic factors, investigating the roles of inclusive leadership and job autonomy on employee self-efficacy, with self-efficacy mediating their relationships with SRP. Surface acting is proposed as a negative moderator. A sample of 83 supervisors and 350 frontline employees from 8 Chinese hotels completed questionnaires. Data analysis was conducted using PLS-SEM in Smart PLS 4 and regression analysis in SPSS 25. Results show that inclusive leadership and job autonomy contribute to strong self-efficacy and enhanced SRP. Surface acting moderates the relationship between inclusive leadership and self-efficacy but not between job autonomy and self-efficacy. This cross-sectional survey offers practical implications for hospitality managers, providing guidance on fostering environments that promote self-efficacy and enhance SRP. Limitations include reliance on self-reported measures and a cross-sectional design. Future research could explore other moderators and mediators, different industries, and use longitudinal or experimental designs to establish causality.

Plastic injection molding has complex process parameters. The Six Sigma improvement method mainly uses quality control and statistical methods to improve product quality, so as to reduce the cost and waste caused by defective products. Taiwan is the world leader for original equipment manufacturing in the laptop industry, and related peripheral accessories are also a major concern of customers. The subject of this study was a professional supplier of laptop batteries. Through the collection of customer complaint data, it was found that battery case deformation was the most important problem for customers. Therefore, in order to remain competitive, the battery case deformation problem needed to be overcome first. Enterprises need to improve their existing processes to reduce the rate of product defects, improve output efficiency and product quality, and reduce production costs, so as to improve their competitiveness in the industry.This study took a Taiwanese company as an example to improve the plastic injection process through the improvement steps of Six Sigma. In this process, two key process factors, namely the injection speed and the cooling time, were identified by analytical tools. After calculating customers' daily product demand, the most suitable parameters were found using the 'design of experiments' method. The results showed that the process capacity and product yield could be significantly improved. The key to the success of this Six Sigma project was the project implementer's design of the experiment.

Plastiek spuitgietwerk het komplekse prosesparameters. Die Six Sigma-verbeteringsmetode gebruik hoofsaaklik kwaliteitsbeheer en statistiese metodes om produkkwaliteit te verbeter, om sodoende die koste en vermorsing wat deur gebrekkige produkte veroorsaak word, te verminder. Taiwan is die wêreldleier vir die vervaardiging van oorspronklike toerusting in die skootrekenaarbedryf, en verwante randtoebehore is ook 'n groot bekommernis van kliënte. Die onderwerp van hierdie studie was 'n professionele verskaffer van skootrekenaarbatterye. Deur die insameling van kliënteklagtedata is gevind dat batterykasvervorming die belangrikste probleem vir kliënte was. Daarom, om mededingend te bly, moes die batterykas-vervormingsprobleem eers oorkom word. Ondernemings moet hul bestaande prosesse verbeter om die tempo van produkdefekte te verminder, uitsetdoeltreffendheid en produkkwaliteit te verbeter, en produksiekoste te verminder, om hul mededingendheid in die bedryf te verbeter. Hierdie studie het 'n Taiwanese maatskappy as 'n voorbeeld geneem om inspuitingsproses van die plastiek te verbeter deur die verbeteringstappe van Six Sigma. In hierdie proses is twee sleutelprosesfaktore, naamlik die inspuitspoed en die verkoelingstyd, deur analitiese instrumente geïdentifiseer. Nadat klante se daaglikse produkaanvraag bereken is, is die mees geskikte parameters gevind deur die 'ontwerp van eksperimente'-metode te gebruik. Die resultate het getoon dat die proseskapasiteit en produkopbrengs aansienlik verbeter kan word. Die sleutel tot die sukses van hierdie Six Sigma-projek was die projekimplementeerder se ontwerp van die eksperiment.

The low-temperature electrochemical corrosion behavior of aircraft 2024 aluminum alloy was investigated in different concentrations of potassium-acetate-type fluid, and the results showed that the corrosion medium initially impacted some corrosiveness on the 2024 aluminum alloy. However, the corrosion rate of the alloy decreased with prolonged immersion in the corrosion medium, and this was attributed to the protective effect of the corrosion products layer, which impeded the attack by the aggressive solution. Time-domain analysis of electrochemical noise measurements at -5 °C revealed the occurrence of uniform corrosion on the alloy at the initial stages of immersion, general corrosion at the middle stages of immersion, and a pitting-dominated corrosion type from the middle to late stages of immersion.

Abstract: The co-existence of external referencing pricing (ERP) and reimbursement policy is common in many countries. Thus, this research examines whether or not the imposition of ERP is socially desirable in the presence of reimbursement policy. For direct sales channel, we find that the home social welfare is worse-off with ERP if the home copayment rate is too high. Our main results are robust under indirect sales channel. Moreover, the home social welfare under the pharmacypurchasing-price (PPP) ERP is larger than that under the ex-factory-price (EFP) ERP if the home copayment rate is high enough. Finally, the profit of brand-name firm under indirect sales channel is higher than that under direct sales channel if the home copayment rate is too high.

Resumen: Precios referenciales externos (ERP) y políticas de reembolso coexisten en muchos países. Este documento evalúa si ERP son socialmente deseables en presencia de políticas de reembolso. Para el canal de venta directa, encontramos que el bienestar social del hogar está peor con ERP si la tasa de copago de la vivienda es demasiado alta. Nuestros principales resultados son robustos bajo el canal de ventas indirectas. Además, el bienestar social bajo el precio de compra de farmacia (PPP) es mayor que el del ERP de precio de fábrica (EFP) si la tasa de copago es lo suficientemente alta. Finalmente, el beneficio de la empresa de marca en el canal de ventas indirectas es mayor que el del canal de ventas directas si la tasa de copago es demasiado alta.

Abstract Ketogenic dietary therapies (KDTs) are a safe and effective treatment for pharmacoresistant epilepsy in children. There are four principal types of KDTs: the classic KD, the modified Atkins diet (MAD), the medium-chain triglyceride (MCT) diet, and the low glycemic index diet (LGID). The International Ketogenic Diet Study Group recommends managing KDTs in children with epilepsy. However, there are no guidelines that address the specific needs of the Brazilian population. Thus, the Brazilian Child Neurology Association elaborated on these recommendations with the goal of stimulating and expanding the use of the KD in Brazil.

Resumo As terapias dietéticas cetogênicas (TDC) são um tratamento seguro e eficaz para epilepsia farmacorresistente em crianças. Existem quatro tipos principais de TDCs: a dieta cetogênica (DC) clássica, a dieta de Atkins modificada (DAM), a dieta de triglicerídeos de cadeia média (DTCM) e a dieta de baixo índice glicêmico (DBIG). O Grupo Internacional de Estudos de Dietas Cetogênicas (International Ketogenic Diet Study Group) propõe recomendações para o manejo da DC em crianças com epilepsia. No entanto, faltam diretrizes que contemplem as necessidades específicas da população brasileira. Assim, a Associação Brasileira de Neurologia Infantil elaborou essas recomendações com o objetivo de estimular e expandir o uso da DC no Brasil.

Abstract Objective The role of Primary Tumor Volume (PTV) in Nasopharyngeal Carcinoma (NPC) treated with Volumetric Modulated Arc Therapy (VMAT) is still unclear. The aim of this study was to access the effect of PTV in prognosis prediction of nasopharyngeal carcinoma in era of VMAT. Methods Between January 20 and November 2011, 498 consecutive NPC patients with stage I-IVA disease who received VMAT at a single center were retrospectively analyzed. Receiver Operating Characteristic (ROC) was performed to access the cut-off point of PTV. Univariate Kaplan-Meier and multivariate Cox regression analyses were used to evaluate prognostic value for PTV. The Propensity Score Matching (PSM) was used to adjust baseline potential confounders. Results The 5-year Locol-Regional Failure-Free (L-FFR), Distant Failure-Free Survival (D-FFR), Disease-Free Survival (DFS) and Overall Survival (OS) were 90.6%, 83.7%, 71.5% and 79.3%, respectively. Before PSM, the 5-year L-FFR, D-FFR, DFS, OS rates for NPC patients with PTV ≤ 38 mL vs. PTV > 38 mL were 94.1% vs. 90.4% (p= 0.063), 87.9% vs. 76.3% (p< 0.001), 78.5% vs. 58.5% (p< 0.001) and 86.3% vs. 66.7% (p< 0.001) respectively. Multivariate analysis showed PTV was an independent prognostic factor for D-FFS (p= 0.034), DFS (p= 0.002) and OS (p= 0.001). PTV classified was still an independent prognostic factor for OS after PSM (HR = 2.034, p= 0.025. Conclusions PTV had a substantial impact on the prognosis of NPC patients treated with VMAT before and after PSM simultaneously. PTV > 38 mL may be considered as an indicator of the clinical stage of nasopharyngeal carcinoma. Level of evidence III.