Intersubject representational similarity analysis uncovers the impact of state anxiety on brain activation patterns in the human extrastriate cortex.

The current study used functional magnetic resonance imaging (fMRI) and showed that state anxiety modulated extrastriate cortex activity in response to emotionally-charged visual images. State anxiety and neuroimaging data from 53 individuals were subjected to an intersubject representational similarity analysis (ISRSA), wherein the geometries between neural and behavioral data were compared. This analysis identified the extrastriate cortex (fusiform gyrus and area MT) to be the sole regions whose activity patterns covaried with state anxiety. Importantly, we show that this brain-behavior association is revealed when treating state anxiety data as a multidimensional response pattern, rather than a single composite score. This suggests that ISRSA using multivariate distances may be more sensitive in identifying the shared geometries between self-report questionnaires and brain imaging data. Overall, our findings demonstrate that a transient state of anxiety may influence how visual information - especially those relevant to the valence dimension - is processed in the extrastriate cortex.

Effectiveness of an Integrated Ambulatory Care Program in Health Care and Medication Use in Patients With Multimorbidity and Polypharmacy.

BACKGROUND AND OBJECTIVES: Multimorbidity increases risks, such as polypharmacy, inappropriate prescription, and functional decline. It also increases medical care utilization by older adults, placing a burden on health care systems. This study evaluated the effectiveness of an integrated ambulatory care program for health care and medication use in patients with multimorbidity and polypharmacy. METHODS: We conducted a retrospective clinical review of adults with multimorbidity and polypharmacy who attended an integrated ambulatory care program at a 1193-bed university hospital between July 1 and September 30, 2019. This program involves multidisciplinary teamwork, comprehensive assessments, medication reviews, and case management. Outcomes, including the frequency of outpatient visits, emergency department visits, hospitalizations, chronic prescription medications, potentially inappropriate medications (PIMs), health care costs, and total medical expenditure, were compared before and after the program. RESULTS: The mean age of participants (n = 134) at baseline was 74.22 ± 9.75 years. The mean number of chronic diagnoses was 9.45 ± 3.38. Participants included 72 (53.7%) women. At the 1-year follow-up, participants showed a significant decrease in the annual frequency of outpatient visits (19.78 ± 9.98 to 13.90 ± 10.22, P < .001), emergency department visits (1.04 ± 1.70 to 0.73 ± 1.40, P = .029), and chronic disease medications (10.71 ± 3.96 to 9.57 ± 3.67, P < .001) across all age groups. There was also a reduction in the annual number of PIMs (from 1.31 ± 1.01 to 1.12 ± 0.93, P = .002) among patients aged 65 years. However, no effects were observed on annual hospitalization, duration of hospital stay, or total health care expenditure, possibly due to the high disease-related treatment cost for certain participants. CONCLUSIONS: Expanding integrated ambulatory care programs in Taiwan may help patients with multimorbidity reduce their use of outpatient and emergency services, chronic prescriptions, and PIMs.

CLASH Analyst: A Web Server to Identify In Vivo RNA-RNA Interactions from CLASH Data.

Non-coding RNAs, such as miRNAs and piRNAs, play critical roles in gene regulation through base-pairing interactions with their target molecules. The recent development of the crosslinking, ligation, and sequencing of hybrids (CLASH) method has allowed scientists to map transcriptome-wide RNA-RNA interactions by identifying chimeric reads consisting of fragments from regulatory RNAs and their targets. However, analyzing CLASH data requires scientists to use advanced bioinformatics, and currently available tools are limited for users with little bioinformatic experience. In addition, many published CLASH studies do not show the full scope of RNA-RNA interactions that were captured, highlighting the importance of reanalyzing published data. Here, we present CLASH Analyst, a web server that can analyze raw CLASH data within a fully customizable and easy-to-use interface. CLASH Analyst accepts raw CLASH data as input and identifies the RNA chimeras containing the regulatory and target RNAs according to the user's interest. Detailed annotation of the captured RNA-RNA interactions is then presented for the user to visualize within the server or download for further analysis. We demonstrate that CLASH Analyst can identify miRNA- and piRNA-targeting sites reported from published CLASH data and should be applicable to analyze other RNA-RNA interactions. CLASH Analyst is freely available for academic use.

Taking a Computational Cultural Neuroscience Approach to Study Parent-Child Similarities in Diverse Cultural Contexts.

Parent-child similarities and discrepancies at multiple levels provide a window to understand the cultural transmission process. Although prior research has examined parent-child similarities at the belief, behavioral, and physiological levels across cultures, little is known about parent-child similarities at the neural level. The current review introduces an interdisciplinary computational cultural neuroscience approach, which utilizes computational methods to understand neural and psychological processes being involved during parent-child interactions at intra- and inter-personal level. This review provides three examples, including the application of intersubject representational similarity analysis to analyze naturalistic neuroimaging data, the usage of computer vision to capture non-verbal social signals during parent-child interactions, and unraveling the psychological complexities involved during real-time parent-child interactions based on their simultaneous recorded brain response patterns. We hope that this computational cultural neuroscience approach can provide researchers an alternative way to examine parent-child similarities and discrepancies across different cultural contexts and gain a better understanding of cultural transmission processes.

Endogenous variation in ventromedial prefrontal cortex state dynamics during naturalistic viewing reflects affective experience.

How we process ongoing experiences is shaped by our personal history, current needs, and future goals. Consequently, ventromedial prefrontal cortex (vmPFC) activity involved in processing these subjective appraisals appears to be highly idiosyncratic across individuals. To elucidate the role of the vmPFC in processing our ongoing experiences, we developed a computational framework and analysis pipeline to characterize the spatiotemporal dynamics of individual vmPFC responses as participants viewed a 45-minute television drama. Through a combination of functional magnetic resonance imaging, facial expression tracking, and self-reported emotional experiences across four studies, our data suggest that the vmPFC slowly transitions through a series of discretized states that broadly map onto affective experiences. Although these transitions typically occur at idiosyncratic times across people, participants exhibited a marked increase in state alignment during high affectively valenced events in the show. Our work suggests that the vmPFC ascribes affective meaning to our ongoing experiences.

Association of adherence to antiretroviral therapy with economic burden of cardiovascular disease in HIV-infected population.

AIMS: There is a lack of studies that rigorously and systematically assess the economic burden of cardiovascular diseases (CVDs) related to the use of antiretroviral therapy (ART). We aimed to assess the association between adherence to ART and economic burden of CVDs in an HIV-infected population. METHODS: Taiwan's National Health Insurance Research Database 2000-2011 was utilized for analyzing 18,071 HIV-infected patients free of CVDs before HIV diagnosis. The level of adherence to ART was measured by the medication possession ratio (MPR). Generalized estimating equations analysis was applied to estimate the cost impact of a variety of CVDs. All costs were presented in 2018 US dollars. RESULTS: The incidence of CVDs ranged from 0.17/1000 person-years (cardiogenic shock) to 2.60/1000 person-years (ischemic heart diseases (IHDs)). The mean annual medical cost for a base-case patient without CVDs was US$3000. Having cerebrovascular diseases, myocardial infarction, heart failure, arrhythmia, and IHDs increased annual costs by 41%, 33%, 30%, 16%, and 14%, respectively. The cost impact of incident CVDs in years with high adherence to ART (MPR ≥ 0.8) was significantly lower than that in years with low adherence (MPR < 0.1) (e.g. having cerebrovascular diseases in the high- versus low-adherence years increased annual costs by 21% versus 259%, respectively). CONCLUSION: The economic burden of incident CVDs in an HIV-infected population was compelling and varied by the extent of using ART. A reduced economic impact of CVDs was found in years when patients possessed a greater adherence to ART.

Intersubject representational similarity analysis reveals individual variations in affective experience when watching erotic movies.

We spend much of our lives pursuing or avoiding affective experiences. However, surprisingly little is known about how these experiences are represented in the brain and if they are shared across individuals. Here, we explored variations in the construction of an affective experience during a naturalistic viewing paradigm based on subjective preferences in sociosexual desire and self-control using intersubject representational similarity analysis (IS-RSA). We found that when watching erotic movies, intersubject variations in sociosexual desire preferences of 26 heterosexual males were associated with similarly structured fluctuations in the cortico-striatal reward, default mode, and mentalizing networks. In contrast, variations in the self-control preferences were associated with shared dynamics in the fronto-parietal executive control and cingulo-insular salience networks. Importantly, these results were specific to the affective experience, as we did not observe any relationship with variation in preferences when individuals watched neutral movies. Moreover, these results appear to require multivariate representations of preferences as we did not observe any significant associations using single scalar summary scores. Our findings indicate that multidimensional variations in individual preferences can be used to uncover unique dimensions of an affective experience, and that IS-RSA can provide new insights into the neural processes underlying psychological experiences elicited through naturalistic experimental designs.

Socially transmitted placebo effects.

Medical treatments typically occur in the context of a social interaction between healthcare providers and patients. Although decades of research have demonstrated that patients' expectations can dramatically affect treatment outcomes, less is known about the influence of providers' expectations. Here we systematically manipulated providers' expectations in a simulated clinical interaction involving administration of thermal pain and found that patients' subjective experiences of pain were directly modulated by providers' expectations of treatment success, as reflected in the patients' subjective ratings, skin conductance responses and facial expression behaviours. The belief manipulation also affected patients' perceptions of providers' empathy during the pain procedure and manifested as subtle changes in providers' facial expression behaviours during the clinical interaction. Importantly, these findings were replicated in two more independent samples. Together, our results provide evidence of a socially transmitted placebo effect, highlighting how healthcare providers' behaviour and cognitive mindsets can affect clinical interactions.

Reducing reward responsivity and daily food desires in female dieters through domain-specific training.

According to the strength model, self-regulation relies on a domain-general capacity that may be strengthened by training. From this perspective, training self-regulation in one domain may transfer to other domains. Here we used two inhibitory training paradigms, a domain-general and domain-specific stop-signal training task and compared their effects on brain reward activity as well as daily food desires in female dieters. Before and after the training, functional magnetic resonance imaging was used to assess food cue-reactivity, coupled with one week of smart-phone ecological momentary assessments to examine eating urges. Whereas the food-specific inhibitory training was successful in reducing both food cue-reactivity and food desires, the domain-general (sound-cue) training showed no transfer effects. These findings suggest that domain-specific training may be a more effective method for supporting self-regulation than domain-general approaches aimed at strengthening self-regulation across domains.

A balance of activity in brain control and reward systems predicts self-regulatory outcomes.

Previous neuroimaging work has shown that increased reward-related activity following exposure to food cues is predictive of self-control failure. The balance model suggests that self-regulation failures result from an imbalance in reward and executive control mechanisms. However, an open question is whether the relative balance of activity in brain systems associated with executive control (vs reward) supports self-regulatory outcomes when people encounter tempting cues in daily life. Sixty-nine chronic dieters, a population known for frequent lapses in self-control, completed a food cue-reactivity task during an fMRI scanning session, followed by a weeklong sampling of daily eating behaviors via ecological momentary assessment. We related participants' food cue activity in brain systems associated with executive control and reward to real-world eating patterns. Specifically, a balance score representing the amount of activity in brain regions associated with self-regulatory control, relative to automatic reward-related activity, predicted dieters' control over their eating behavior during the following week. This balance measure may reflect individual self-control capacity and be useful for examining self-regulation success in other domains and populations.

Structural integrity between executive control and reward regions of the brain predicts body fat percentage in chronic dieters.

Failure to maintain a healthy body weight may reflect a long-term imbalance between the executive control and reward systems of the brain. The current study examined whether the anatomical connectivity between these two systems predicted individual variability in achieving a healthy body weight, particularly in chronic dieters. Thirty-six female chronic dieters completed a food-cue reactivity task in the scanner. Two regions-of-interest (ROIs) were defined from the reactivity task: the inferior frontal gyrus (IFG), which engages cognitive control and the orbitofrontal cortex (OFC), which represents reward value. A white matter tract connecting these two ROIs was identified across participants using diffusion tensor imaging (DTI) and probabilistic tractography. Results showed a negative relationship between body fat percentage and white matter integrity within the identified tract. This suggests that reduced structural integrity between the OFC and IFG may be related to self-regulatory problems for those who chronically diet to control body weight.

ACTIVITY IN CORTICAL MIDLINE STRUCTURES IS MODULATED BY SELF-CONSTRUAL CHANGES DURING ACCULTURATION.

Recent immigrants to another culture generally experience a period of acculturation during which they show self-construal changes. Here, we examine how this acculturation period alters brain activity associated with self-referential cognition. Twenty-seven native Chinese-speaking recent immigrants completed a trait-judgment task in which they judged whether a series of psychological traits applied to themselves and, separately, whether these traits applied to their mothers. Participants were scanned at two intervals: within the first two months of their arrival in the United States (Time 1), and also six months after the initial scan (Time 2). Results already revealed a significant self-vs.-mother differentiation at Time 1 in the medial prefrontal cortex (MPFC) and posterior cingulate cortex (PCC). However, at time 2, this pattern diverged depending on whether immigrants became more or less like their original culture. That is to say, for immigrants who became less like Easterners, the self vs. mother difference remained, whereas for participants who became even more like Easterners, the self vs. mother difference in cortical midline structures disappeared. These findings support the notion that self-construal changes during the process of acculturation are reflected in the relative engagement of brain structures implicated in self-referential processing (i.e., MPFC and PCC) when judging traits with reference to oneself or a close other.

BRAIN REWARD ACTIVITY TO MASKED IN-GROUP SMILING FACES PREDICTS FRIENDSHIP DEVELOPMENT.

This study examined whether neural responses in the ventral striatum (VS) to in-group facial expressions-presented without explicit awareness-could predict friendship patterns in newly arrived individuals from China six months later. Individuals who initially showed greater VS activity in response to in-group happy expressions during functional neuroimaging later made considerably more in-group friends, suggesting that VS activity might reflect reward processes that drive in-group approach behaviors.