A synthesis of evidence for policy from behavioural science during COVID-19.

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

Intravenous Levothyroxine for Unstable Brain-Dead Heart Donors.

BACKGROUND: Hemodynamic instability and myocardial dysfunction are major factors preventing the transplantation of hearts from organ donors after brain death. Intravenous levothyroxine is widely used in donor care, on the basis of observational data suggesting that more organs may be transplanted from donors who receive hormonal supplementation. METHODS: In this trial involving 15 organ-procurement organizations in the United States, we randomly assigned hemodynamically unstable potential heart donors within 24 hours after declaration of death according to neurologic criteria to open-label infusion of intravenous levothyroxine (30 µg per hour for a minimum of 12 hours) or saline placebo. The primary outcome was transplantation of the donor heart; graft survival at 30 days after transplantation was a prespecified recipient safety outcome. Secondary outcomes included weaning from vasopressor therapy, donor ejection fraction, and number of organs transplanted per donor. RESULTS: Of the 852 brain-dead donors who underwent randomization, 838 were included in the primary analysis: 419 in the levothyroxine group and 419 in the saline group. Hearts were transplanted from 230 donors (54.9%) in the levothyroxine group and 223 (53.2%) in the saline group (adjusted risk ratio, 1.01; 95% confidence interval [CI], 0.97 to 1.07; P = 0.57). Graft survival at 30 days occurred in 224 hearts (97.4%) transplanted from donors assigned to receive levothyroxine and 213 hearts (95.5%) transplanted from donors assigned to receive saline (difference, 1.9 percentage points; 95% CI, -2.3 to 6.0; P<0.001 for noninferiority at a margin of 6 percentage points). There were no substantial between-group differences in weaning from vasopressor therapy, ejection fraction on echocardiography, or organs transplanted per donor, but more cases of severe hypertension and tachycardia occurred in the levothyroxine group than in the saline group. CONCLUSIONS: In hemodynamically unstable brain-dead potential heart donors, intravenous levothyroxine infusion did not result in significantly more hearts being transplanted than saline infusion. (Funded by Mid-America Transplant and others; ClinicalTrials.gov number, NCT04415658.).

Adaptations to infer fitness interdependence promote the evolution of cooperation.

The evolution of cooperation is a major question in the biological and behavioral sciences. While most theoretical studies model cooperation in the context of an isolated interaction (e.g., a Prisoner's Dilemma), humans live in heterogeneous social environments, characterized by large variations in fitness interdependence-the extent to which one's fitness is affected by others. Theoretical and experimental work indicates that humans can infer, and respond to, variations in interdependence. In a heterogeneous ancestral environment, these psychological mechanisms to infer fitness interdependence could have provided a selective advantage, allowing individuals to maximize their fitness by deciding when and with whom to cooperate. Yet, to date, the link between cognitive inference, variation in fitness interdependence, and cooperation remains unclear. Here we introduce a theoretical framework to study the evolution of inference and cooperation in heterogeneous social environments, where individuals experience interactions with varying levels of corresponding interests. Using a combination of evolutionary game theory and agent-based modeling, we model the evolution of adaptive agents, who incur a cost to infer interdependence, in populations of fixed-behavior agents who always cooperate or defect. Our results indicate that natural selection could promote the evolution of psychological mechanisms to infer fitness interdependence, provided that there is enough variation in fitness interdependence to offset the cost of inference. Under certain conditions, the fixation of adaptive agents results in higher levels of cooperation. This depends crucially on the type of inference performed and the features of the interdependence landscape.

Love and hate do not modulate the attentional blink but improve overall performance.

How may feelings of love and hate impact people's attention? We used a modified Attentional Blink (AB) task in which 300 participants were asked to categorise a name representing a person towards whom they felt either hate, love, or neutral (first target) plus identify a number word (second target), both embedded in a rapidly presented stream of other words. The lag to the second target was systematically varied. Contrary to our hypothesis, results revealed that both hated and loved names resulted in higher accuracy for the second target than neutral names, which was largely independent of lag. Also, there we observed no sustained transfer effects of love and hate onto neutral name trials. The findings differ from prior research on attentional blink and transient, non-personal, stimulus-driven emotions, suggesting that interpersonal feelings activate different attention-relevant mechanisms. Relevant to future research, we speculate that love and hate are motivators of goal-directed behaviour that facilitate subsequent information processing.

Human Cooperation and the Crises of Climate Change, COVID-19, and Misinformation.

Contemporary society is facing many social dilemmas-including climate change, COVID-19, and misinformation-characterized by a conflict between short-term self-interest and longer-term collective interest. The climate crisis requires paying costs today to reduce climate-related harms and risks that we face in the future. The COVID-19 crisis requires the less vulnerable to pay costs to benefit the more vulnerable in the face of great uncertainty. The misinformation crisis requires investing effort to assess truth and abstain from spreading attractive falsehoods. Addressing these crises requires an understanding of human cooperation. To that end, we present (a) an overview of mechanisms for the evolution of cooperation, including mechanisms based on similarity and interaction; (b) a discussion of how reputation can incentivize cooperation via conditional cooperation and signaling; and (c) a review of social preferences that undergird the proximate psychology of cooperation, including positive regard for others, parochialism, and egalitarianism. We discuss the three focal crises facing our society through the lens of cooperation, emphasizing how cooperation research can inform our efforts to address them.

Peptide microarray-based analysis of antibody responses to SARS-CoV-2 identifies unique epitopes with potential for diagnostic test development.

Humoral immunity to the Severe Adult Respiratory Syndrome (SARS) Coronavirus (CoV)-2 is not fully understood yet but is a crucial factor of immune protection. The possibility of antibody cross-reactivity between SARS-CoV-2 and other human coronaviruses (HCoVs) would have important implications for immune protection but also for the development of specific diagnostic ELISA tests. Using peptide microarrays, n = 24 patient samples and n = 12 control samples were screened for antibodies against the entire SARS-CoV-2 proteome as well as the Spike (S), Nucleocapsid (N), VME1 (V), R1ab, and Protein 3a (AP3A) of the HCoV strains SARS, MERS, OC43, and 229E. While widespread cross-reactivity was revealed across several immunodominant regions of S and N, IgG binding to several SARS-CoV-2-derived peptides provided statistically significant discrimination between COVID-19 patients and controls. Selected target peptides may serve as capture antigens for future, highly COVID-19-specific diagnostic antibody tests.

Measuring the cortical tracking of speech with optically-pumped magnetometers.

During continuous speech listening, brain activity tracks speech rhythmicity at frequencies matching with the repetition rate of phrases (0.2-1.5 Hz), words (2-4 Hz) and syllables (4-8 Hz). Here, we evaluated the applicability of wearable MEG based on optically-pumped magnetometers (OPMs) to measure such cortical tracking of speech (CTS). Measuring CTS with OPMs is a priori challenging given the complications associated with OPM measurements at frequencies below 4 Hz, due to increased intrinsic interference and head movement artifacts. Still, this represents an important development as OPM-MEG provides lifespan compliance and substantially improved spatial resolution compared with classical MEG. In this study, four healthy right-handed adults listened to continuous speech for 9 min. The radial component of the magnetic field was recorded simultaneously with 45-46 OPMs evenly covering the scalp surface and fixed to an additively manufactured helmet which fitted all 4 participants. We estimated CTS with reconstruction accuracy and coherence, and determined the number of dominant principal components (PCs) to remove from the data (as a preprocessing step) for optimal estimation. We also identified the dominant source of CTS using a minimum norm estimate. CTS estimated with reconstruction accuracy and coherence was significant in all 4 participants at phrasal and word rates, and in 3 participants (reconstruction accuracy) or 2 (coherence) at syllabic rate. Overall, close-to-optimal CTS estimation was obtained when the 3 (reconstruction accuracy) or 10 (coherence) first PCs were removed from the data. Importantly, values of reconstruction accuracy (~0.4 for 0.2-1.5-Hz CTS and ~0.1 for 2-8-Hz CTS) were remarkably close to those previously reported in classical MEG studies. Finally, source reconstruction localized the main sources of CTS to bilateral auditory cortices. In conclusion, t his study demonstrates that OPMs can be used for the purpose of CTS assessment. This finding opens new research avenues to unravel the neural network involved in CTS across the lifespan and potential alterations in, e.g., language developmental disorders. Data also suggest that OPMs are generally suitable for recording neural activity at frequencies below 4 Hz provided PCA is used as a preprocessing step; 0.2-1.5-Hz being the lowest frequency range successfully investigated here.

Costs, needs, and integration efforts shape helping behavior toward refugees.

Recent political instabilities and conflicts around the world have drastically increased the number of people seeking refuge. The challenges associated with the large number of arriving refugees have revealed a deep divide among the citizens of host countries: one group welcomes refugees, whereas another rejects them. Our research aim is to identify factors that help us understand host citizens' (un)willingness to help refugees. We devise an economic game that captures the basic structural properties of the refugee situation. We use it to investigate both economic and psychological determinants of citizens' prosocial behavior toward refugees. In three controlled laboratory studies, we find that helping refugees becomes less likely when it is individually costly to the citizens. At the same time, helping becomes more likely with the refugees' neediness: helping increases when it prevents a loss rather than generates a gain for the refugees. Moreover, particularly citizens with higher degrees of prosocial orientation are willing to provide help at a personal cost. When refugees have to exert a minimum level of effort to be eligible for support by the citizens, these mandatory "integration efforts" further increase prosocial citizens' willingness to help. Our results underscore that economic factors play a key role in shaping individual refugee helping behavior but also show that psychological factors modulate how individuals respond to them. Moreover, our economic game is a useful complement to correlational survey measures and can be used for pretesting policy measures aimed at promoting prosocial behavior toward refugees.

Coping with noise in social dilemmas: Group representatives fare worse than individuals because they lack trust in others' benign intentions.

Research on interindividual-intergroup discontinuity has illuminated distinct patterns of cognition, motivation, and behavior in interindividual versus intergroup contexts. However, it has examined these processes in laboratory environments with perfect transparency, whereas real-life interactions are often characterized by noise (i.e., misperceptions and unintended errors). This research compared interindividual and intergroup interactions in the presence or absence of noise. In a laboratory experiment, participants played 35 rounds of a dyadic give-some dilemma, in which they acted as individuals or group representatives. Noise was manipulated, such that players' intentions either were perfectly translated into behavior or could deviate from their intentions in certain rounds (resulting in less cooperative behavior). Noise was more detrimental to cooperation in intergroup contexts than in interindividual contexts, because (a) participants who formed benign impressions of the other player coped better with noise, and (b) participants were less likely to form such benign impressions in intergroup than interindividual interactions.

PSA screening, prostate biopsy, and treatment of prostate cancer in the years surrounding the USPSTF recommendation against prostate cancer screening.

BACKGROUND: The 2012 United States Preventive Services Task Force recommendation against screening for prostate cancer has impacted rates of prostate-specific antigen (PSA) screening and appears to be associated with declining prostate cancer incidence. Our objective was to characterize health care utilization that may explain these observed trends. METHODS: MarketScan claims, which capture >30 million privately insured patients in the United States, were queried for all men aged 40-64 years for the years 2008-2014. PSA testing, prostate biopsy, prostate cancer diagnosis, and definitive local treatment were determined using associated International Classification of Diseases, Ninth Revision and Current Procedural Terminology, Fourth Edition codes. RESULTS: There were approximately 6 million qualifying men with a full year of data. PSA testing, prostate biopsy, and prostate cancer detection declined significantly between 2009 and 2014, most notably after 2011. The prostate biopsy rate per 100 patients with a PSA test decreased over the study period from 1.95 (95% confidence interval [CI], 1.92-1.97) to 1.52 (95% CI, 1.50-1.54). Prostate cancer incidence per prostate biopsy increased over the study period from 0.36 (95% CI, 0.35-0.36) to 0.39 (95% CI, 0.39-0.40). Of new prostate cancer diagnoses, the proportion managed with definitive local treatment decreased from 69% (95% CI, 69%-70%) to 54% (95% CI, 53%-55%). Both PSA testing and prostate cancer incidence decreased significantly after 2011 (P < .001). CONCLUSION: In a large cohort of privately insured men, PSA testing, prostate biopsy, prostate cancer incidence, and local definitive treatment for prostate cancer decreased between 2008 and 2014, most notably after 2011. This decrease may be driven by differential referral patterns from primary care providers to urologists. Cancer 2018;124:2733-2739. © 2018 American Cancer Society.

CLASH: Climate (change) and cultural evolution of intergroup conflict.

Aggression and violence levels generally increase as one moves closer to the equator, but why? We developed a new theoretical model, CLimate, Aggression, and Self-control in Humans (CLASH; van Lange, Rinderu, & Bushman, 2017b, 2017c), to understand differences within and between countries in aggression and violence in terms of differences in climate. Colder temperatures, and especially larger degrees of seasonal variation in climate, call for individuals and groups to adopt a slower life history strategy, revealed in a greater focus on the future (vs. present) and a stronger focus on self-control-variables that are known to inhibit aggression and violence. Other variables (e.g., wealth, income inequality, parasite stress) are also linked to both climate differences and to aggression and violence differences. When people think of the consequences of climate change, they rarely think of the impact on aggression and violence levels, but they should. CLASH has broad implications for the effects of climate change on intergroup conflict.

Political Ideology, Trust, and Cooperation: In-group Favoritism among Republicans and Democrats during a US National Election.

Theories suggest that political ideology relates to cooperation, with conservatives being more likely to pursue selfish outcomes, and liberals more likely to pursue egalitarian outcomes. In study 1, we examine how political ideology and political party affiliation (Republican vs. Democrat) predict cooperation with a partner who self-identifies as Republican or Democrat in two samples before (n = 362) and after (n = 366) the 2012 US presidential election. Liberals show slightly more concern for their partners' outcomes compared to conservatives (study 1), and in study 2 this relation is supported by a meta-analysis (r = .15). However, in study 1, political ideology did not relate to cooperation in general. Both Republicans and Democrats extend more cooperation to their in-group relative to the out-group, and this is explained by expectations of cooperation from in-group versus out-group members. We discuss the relation between political ideology and cooperation within and between groups.

LuCaP Prostate Cancer Patient-Derived Xenografts Reflect the Molecular Heterogeneity of Advanced Disease an--d Serve as Models for Evaluating Cancer Therapeutics.

BACKGROUND: Metastatic prostate cancer is a common and lethal disease for which there are no therapies that produce cures or long-term durable remissions. Clinically relevant preclinical models are needed to increase our understanding of biology of this malignancy and to evaluate new agents that might provide effective treatment. Our objective was to establish and characterize patient-derived xenografts (PDXs) from advanced prostate cancer (PC) for investigation of biology and evaluation of new treatment modalities. METHODS: Samples of advanced PC obtained from primary prostate cancer obtained at surgery or from metastases collected at time of death were implanted into immunocompromised mice to establish PDXs. Established PDXs were propagated in vivo. Genomic, transcriptomic, and STR profiles were generated. Responses to androgen deprivation and docetaxel in vivo were characterized. RESULTS: We established multiple PDXs (LuCaP series), which represent the major genomic and phenotypic features of the disease in humans, including amplification of androgen receptor, PTEN deletion, TP53 deletion and mutation, RB1 loss, TMPRSS2-ERG rearrangements, SPOP mutation, hypermutation due to MSH2/MSH6 genomic aberrations, and BRCA2 loss. The PDX models also exhibit variation in intra-tumoral androgen levels. Our in vivo results show heterogeneity of response to androgen deprivation and docetaxel, standard therapies for advanced PC, similar to the responses of patients to these treatments. CONCLUSIONS: The LuCaP PDX series reflects the diverse molecular composition of human castration-resistant PC and allows for hypothesis-driven cause-and-effect studies of mechanisms underlying treatment response and resistance. Prostate 77: 654-671, 2017. © 2017 The Authors. The Prostate Published by Wiley Periodicals, Inc.

The Road to Bribery and Corruption.

Major forms of corruption constitute a strong threat to the functioning of societies. The most frequent explanation of how severe corruption emerges is the slippery-slope metaphor-the notion that corruption occurs gradually. While having widespread theoretical and intuitive appeal, this notion has barely been tested empirically. We used a recently developed paradigm to test whether severely corrupt acts happen gradually or abruptly. The results of four experimental studies revealed a higher likelihood of severe corruption when participants were directly given the opportunity to engage in it (abrupt) compared with when they had previously engaged in minor forms of corruption (gradual). Neither the size of the payoffs, which we kept constant, nor evaluations of the actions could account for these differences. Contrary to widely shared beliefs, sometimes the route to corruption leads over a steep cliff rather than a slippery slope.

Functional Interdependence Theory: An Evolutionary Account of Social Situations.

Social interactions are characterized by distinct forms of interdependence, each of which has unique effects on how behavior unfolds within the interaction. Despite this, little is known about the psychological mechanisms that allow people to detect and respond to the nature of interdependence in any given interaction. We propose that interdependence theory provides clues regarding the structure of interdependence in the human ancestral past. In turn, evolutionary psychology offers a framework for understanding the types of information processing mechanisms that could have been shaped under these recurring conditions. We synthesize and extend these two perspectives to introduce a new theory: functional interdependence theory (FIT). FIT can generate testable hypotheses about the function and structure of the psychological mechanisms for inferring interdependence. This new perspective offers insight into how people initiate and maintain cooperative relationships, select social partners and allies, and identify opportunities to signal social motives.

The Logic of Climate and Culture: Evolutionary and Psychological Aspects of CLASH.

A total of 80 authors working in a variety of scientific disciplines commented on the theoretical model of CLimate, Aggression, and Self-control in Humans (CLASH). The commentaries cover a wide range of issues, including the logic and assumptions of CLASH, the evidence in support of CLASH, and other possible causes of aggression and violence (e.g., wealth, income inequality, political circumstances, historic circumstances, pathogen stress). Some commentaries also provide data relevant to CLASH. Here we clarify the logic and assumptions of CLASH and discusses its extensions and boundary conditions. We also offer suggestions for future research. Regardless of whether none, some, or all of CLASH is found to be true, we hope it will stimulate future research on the link between climate and human behavior. Climate is one of the most presing issues of our time.

Aggression and violence around the world: A model of CLimate, Aggression, and Self-control in Humans (CLASH).

Worldwide there are substantial differences within and between countries in aggression and violence. Although there are various exceptions, a general rule is that aggression and violence increase as one moves closer to the equator, which suggests the important role of climate differences. While this pattern is robust, theoretical explanations for these large differences in aggression and violence within countries and around the world are lacking. Most extant explanations focus on the influence of average temperature as a factor that triggers aggression (The General Aggression Model), or the notion that warm temperature allows for more social interaction situations (Routine Activity Theory) in which aggression is likely to unfold. We propose a new model, CLimate, Aggression, and Self-control in Humans (CLASH), that helps us to understand differences within and between countries in aggression and violence in terms of differences in climate. Lower temperatures, and especially larger degrees of seasonal variation in climate, call for individuals and groups to adopt a slower life history strategy, a greater focus on the future (vs. present), and a stronger focus on self-control. The CLASH model further outlines that slow life strategy, future orientation, and strong self-control are important determinants of inhibiting aggression and violence. We also discuss how CLASH differs from other recently developed models that emphasize climate differences for understanding conflict. We conclude by discussing the theoretical and societal importance of climate in shaping individual and societal differences in aggression and violence.

Characterizing the molecular features of ERG-positive tumors in primary and castration resistant prostate cancer.

BACKGROUND: The TMPRSS2-ERG gene fusion is detected in approximately half of primary prostate cancers (PCa) yet the prognostic significance remains unclear. We hypothesized that ERG promotes the expression of common genes in primary PCa and metastatic castration-resistant PCa (CRPC), with the objective of identifying ERG-associated pathways, which may promote the transition from primary PCa to CRPC. METHODS: We constructed tissue microarrays (TMA) from 127 radical prostatectomy specimens, 20 LuCaP patient-derived xenografts (PDX), and 152 CRPC metastases obtained immediately at time of death. Nuclear ERG was assessed by immunohistochemistry (IHC). To characterize the molecular features of ERG-expressing PCa, a subset of IHC confirmed ERG+ or ERG- specimens including 11 radical prostatectomies, 20 LuCaP PDXs, and 45 CRPC metastases underwent gene expression analysis. Genes were ranked based on expression in primary PCa and CRPC. Common genes of interest were targeted for IHC analysis and expression compared with biochemical recurrence (BCR) status. RESULTS: IHC revealed that 43% of primary PCa, 35% of the LuCaP PDXs, and 18% of the CRPC metastases were ERG+ (12 of 48 patients [25%] had at least one ERG+ metastasis). Based on gene expression data and previous literature, two proteins involved in calcium signaling (NCALD, CACNA1D), a protein involved in inflammation (HLA-DMB), CD3 positive immune cells, and a novel ERG-associated protein, DCLK1 were evaluated in primary PCa and CRPC metastases. In ERG+ primary PCa, a weak association was seen with NCALD and CACNA1D protein expression. HLA-DMB association with ERG was decreased and CD3 cell number association with ERG was changed from positive to negative in CRPC metastases compared to primary PCa. DCLK1 was upregulated at the protein level in unpaired ERG+ primary PCa and CRPC metastases (P = 0.0013 and P < 0.0001, respectively). In primary PCa, ERG status or expression of targeted proteins was not associated with BCR-free survival. However, for primary PCa, ERG+DCLK1+ patients exhibited shorter time to BCR (P = 0.06) compared with ERG+DCLK1- patients. CONCLUSIONS: This study examined ERG expression in primary PCa and CRPC. We have identified altered levels of inflammatory mediators associated with ERG expression. We determined expression of DCLK1 correlates with ERG expression and may play a role in primary PCa progression to metastatic CPRC. Prostate 76:810-822, 2016. © 2016 Wiley Periodicals, Inc.

NCCN Guidelines Insights: Prostate Cancer Early Detection, Version 2.2016.

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Prostate Cancer Early Detection provide recommendations for prostate cancer screening in healthy men who have elected to participate in an early detection program. The NCCN Guidelines focus on minimizing unnecessary procedures and limiting the detection of indolent disease. These NCCN Guidelines Insights summarize the NCCN Prostate Cancer Early Detection Panel's most significant discussions for the 2016 guideline update, which included issues surrounding screening in high-risk populations (ie, African Americans, BRCA1/2 mutation carriers), approaches to refine patient selection for initial and repeat biopsies, and approaches to improve biopsy specificity.

Reputational concerns as a general determinant of group functioning.

To understand a group's (dys)functionality, we propose focusing on its members' concerns for their reputation. The examples of prosocial behavior and information exchange in decision-making groups illustrate that empirical evidence directly or indirectly suggests that reputational concerns play a central role in groups. We argue that our conceptualization fulfills criteria for a good theory: enhancing understanding, abstraction, testability, and applicability.