Humans have a strong need to belong. Thus, when signs of ostracism are detected, adults often feel motivated to affiliate with others in order to reestablish their social connections. This study investigated the importance of affiliation to young children following priming with ostracism. Four-and 5-year-old children were primed with either ostracism or control videos and their understanding of, and responses to, the videos were measured. Results showed that children were able to report that there was exclusion in the ostracism videos, and that they recognized that the ostracized individual felt sad. Most interestingly, when subsequently asked to draw a picture of themselves and their friend, children primed with ostracism depicted relationships that were significantly more affiliative. Children drew themselves and their friend standing significantly closer together and adults rated their drawings as more affiliative overall. These findings introduce drawing as a useful new method for measuring social motivations and processes following an experimental manipulation, and demonstrate that affiliation is particularly important to children following even a vicarious experience of social exclusion.

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Purpose We assess real-world outcomes, including safety and efficacy, of concurrent or sequential treatment with radiotherapy plus programmed cell death protein 1 (PD-1) inhibitors in patients with oligometastatic esophageal cancer (OMEC). Methods This cohort study retrospectively collected clinical data of patients with synchronous or metachronous OMEC. All patients underwent concurrent or sequential treatment with radiotherapy plus PD-1 inhibitors. Each patient had up to five measurable metastatic lesions and up to three organs involved. Study endpoints were progression-free survival (PFS), treatment-related toxicities, locoregional progression-free survival (LRPFS), objective response rate (ORR), and disease control rate (DCR). Description statistics and Kaplan–Meier models were used for statistical analysis. Results A total of 86 patients were included, most of whom were diagnosed with squamous cell carcinoma histology (98%) and presented with synchronous OMEC (64%). The median follow-up period was 17 months (range: 6–32 months), the median PFS was 15.2 months (95% confidence interval: 12.1–18.2 months); and the 1- and 2-year PFS rates were 61.4% and 26.7%, respectively. The 1- and 2-year LRPFS were 91.3% and 57.3%, respectively. The ORR and DCR were 46.5% and 91.8%, respectively. Forty-two patients (48.8%) experienced grade 3 or higher treatment-related adverse events (TRAEs); a grade 5 treatment-related adverse event was observed in one patient (1.2%) who died of immune-related pneumonitis. Conclusion Combining radiotherapy with PD-1 inhibitors is a safe and effective treatment option for patients with OMEC. No new safety concerns were identified in this study. However, due to the potential risk of cumulative toxicity, an individual risk-benefit assessment for each patient is required prior to treatment initiation.

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