Effect of packaging with versus without candy-oriented marketing themes on the appeal and sensory attributes of flavoured e-cigarettes.

SIGNIFICANCE: E-cigarettes with candy-themed marketing are implicated in decisions to first try e-cigarettes but have unknown effects on the experience of vaping. We compared adults' perceived appeal and sensory attributes after self-administering flavoured e-cigarettes in experimentally manipulated packaging with candy-themed versus standard marketing. We also assessed effect modification by salt vs free-base nicotine formulation. METHODS: Adults who currently used e-cigarettes and/or cigarettes (N=72; age M(SD)=31.4 (12.8) years) completed single-puff self-administrations from eight individually-packaged pods containing fruit or dessert-flavoured e-liquid via staff-guided video sessions. For each e-liquid flavour, we custom-manufactured packaging with standard (eg, 'mango'; mango fruit image) and candy (eg, 'mango gummy bear'; gummy bear image) marketing versions, which we varied within-subject (four pods candy; four pods standard). After participants opened the package and vaped the pod inside, they rated its sensory attributes and appeal (0-100 scale). Participants were randomised between subjects to salt or free-base ~2.3% nicotine in all pods. RESULTS: Marketing theme had no significant main effects on outcomes. Marketing theme × nicotine formulation interactions were significant; candy-themed (vs standard) packaging elevated composite appeal (Bdifference [estimated mean difference between marketing themes]=7.7), liking (Bdifference=8.4), and sweetness (Bdifference=5.7) ratings in free-base but not salt nicotine formulations. Marketing theme did not affect smoothness, harshness and bitterness ratings regardless of nicotine formulation. CONCLUSION: Candy-themed marketing may heighten the appeal and sweet sensory experience of vaping flavoured free-base nicotine e-cigarettes. While marketing restrictions are predominantly intended to prevent e-cigarette initiation, candy-themed marketing restrictions could also prevent persistent use by lowering the appeal of flavoured free-base nicotine e-cigarettes.

An adaptation and exploratory factor analysis of the smoking-related weight and eating episodes test (SWEET) for electronic cigarette users.

INTRODUCTION: Smoking for weight control is a well-documented behavior. There is emerging evidence to suggest electronic cigarettes (e-cigarettes) may be used for similar motivations yet measure development for the use of e-cigarettes for weight control has received less attention. The objective of the current study was to adapt and explore the psychometric properties of The Smoking-Related Weight and Eating Episodes Test (SWEET) for e-cigarette users. METHODS: Young adult (N=1875) current cigarette, e-cigarette, and dual users completed the original SWEET (SWEET-C) and/or adapted SWEET for e-cigarette use (SWEET-EC) based on current tobacco product use. Demographics, associated e-cigarette characteristics, nicotine dependence, outcome expectancies, and eating disorder behaviors were also assessed. Participants were recruited online and measures were completed via self-report. RESULTS: Four exploratory factor analyses using principal components extraction and direct oblimin rotation methods were run to explore the SWEET-C and SWEET-EC. A one-factor solution explaining 66 % of the variance was retained for the SWEET-C, and a one-factor solution explaining 73 % of the variance was retained for the SWEET-EC. Both measures exhibited excellent internal consistency. Higher SWEET-EC scores were observed among dual users, and were associated with daily e-cigarette use, JUUL use, self-reported vaping for weight control, older age, higher body mass index, and problematic eating behaviors. CONCLUSION: Our findings support the adaptation of the SWEET-EC to measure e-cigarette use for weight control. The SWEET-EC will help to better understand how individuals use e-cigarettes to curb eating behavior and for weight control.

Eating Disorder Symptomatology Among Young Adult Cigarette and E-Cigarette Users.

Objective: Tobacco use is elevated among individuals with eating disorders (EDs). Yet, further research is needed to understand associations between cigarette and e-cigarette use patterns and ED symptomatology. To gain a more comprehensive understanding of tobacco use and EDs, this study characterized ED symptomatology and tobacco use patterns, including exclusive cigarette use, e-cigarette use, dual use, and nonuse. Method: Young adults aged 18-24 years who self-reported exclusive cigarette, e-cigarette, dual, or nonuse (N = 2500) were recruited via Lucid, an online survey management company. Participants completed questionnaires assessing body dissatisfaction, global ED psychopathology, binge eating and self-induced vomiting frequency, and demographics. ED diagnostic groups included: anorexia nervosa (AN), bulimia spectrum eating disorders (BSED), atypical AN, and night eating syndrome (NES). Results: Multinomial logistic models revealed those with AN were more likely to be dual users, those with atypical AN were more likely to be exclusive e-cigarette users, and participants with a BSED or NES were more likely to be exclusive e-cigarette or dual users, compared to those without an ED. General linear models suggested body dissatisfaction and global ED psychopathology were higher among exclusive e-cigarette and dual users, while binge eating and self-induced vomiting frequencies were greater among all tobacco use groups compared to nonusers. Discussion: Our findings suggest young adults with ED symptomatology were more likely to be users of e-cigarettes exclusively or dual users. It will be necessary to examine how these associations manifest using longitudinal and clinical populations in future research.

Sweet taste preference is associated with greater hypothalamic response to glucose and longitudinal weight gain.

The hypothalamus has an abundant expression of sweet taste receptors that play a role in glucose sensing and energy homeostasis. Evidence suggests that liking "sweets" can be associated with weight gain, but the relationship between sweet taste preference and hypothalamic regulation of appetite is unknown. This study tested the hypothesis that sweet taste preference is associated with increased hypothalamic activation in response to glucose (a purported neural marker for weight gain risk) and greater longitudinal increases in body mass index (BMI). Fifty-four adults aged 18-35 years with a mean (± SD) BMI of 27.99 ± 5.32 kg/m2 completed the study. Height and weight were measured at baseline and 6-12 months later in a subset of 36 participants. Sweet taste preference was assessed via the Monell 2-series, forced-choice tracking procedure. Arterial spin labeling magnetic resonance imaging was performed before and after oral glucose ingestion to determine hypothalamic blood flow response to glucose. Linear models were used to examine relationships between sweet taste preference and the hypothalamic response to glucose and longitudinal changes in BMI, adjusting for age, sex, and baseline BMI. Sweet taste preference was positively associated with glucose-linked hypothalamic blood flow (beta = 0.017, p = 0.043), adjusted for age, sex and BMI. We also observed a positive association between sweet taste preference and longitudinal change in BMI (beta = 0.088, p = 0.015), adjusted for age, sex and baseline BMI. These findings suggest that heightened sweet taste preference is associated with glucose-linked hypothalamic activation and may be linked to increased susceptibility for weight gain.

The neural correlates of value representation: From single items to bundles.

One of the core questions in Neuro-economics is to determine where value is represented. To date, most studies have focused on simple options and identified the ventromedial prefrontal cortex (VMPFC) as the common value region. We report the findings of an fMRI study in which we asked participants to make pairwise comparisons involving options of varying complexity: single items (Control condition), bundles made of the same two single items (Scaling condition) and bundles made of two different single items (Bundling condition). We construct a measure of choice consistency to capture how coherent the choices of a participant are with one another. We also record brain activity while participants make these choices. We find that a common core of regions involving the left VMPFC, the left dorsolateral prefrontal cortex (DLPFC), regions associated with complex visual processing and the left cerebellum track value across all conditions. Also, regions in the DLPFC, the ventrolateral prefrontal cortex (VLPFC) and the cerebellum are differentially recruited across conditions. Last, variations in activity in VMPFC and DLPFC value-tracking regions are associated with variations in choice consistency. This suggests that value based decision-making recruits a core set of regions as well as specific regions based on task demands. Further, correlations between consistency and the magnitude of signal change with lateral portions of the PFC suggest the possibility that activity in these regions may play a causal role in decision quality.

Essential Role of Social Context and Self-Efficacy in Daily Paretic Arm/Hand Use After Stroke: An Ecological Momentary Assessment Study With Accelerometry.

OBJECTIVE: To determine the momentary effect of social-cognitive factors, in addition to motor capability, on post-stroke paretic arm/hand use in the natural environment. DESIGN: A 5-day observational study in which participants were sent 6 Ecological Momentary Assessment (EMA) prompts/day. SETTING: Participants' daily environment. PARTICIPANTS: Community-dwelling, chronic stroke survivors with right-dominant, mild-moderate upper extremity paresis (N=30). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Time duration of bimanual and unimanual paretic arm/hand use indexed by accelerometry; social-cognitive factors (social context, self-efficacy, mood) captured by EMA; motor capability of the paretic limb measured by Fugl-Meyer Upper Extremity Motor Assessment (FM). RESULTS: After accounting for participants' motor capability, we found that momentary social context (alone or not) and self-efficacy significantly predicted post-stroke paretic arm/hand use behavior in the natural environment. When participants were not alone, paretic arm/hand movement increased both with and without the less-paretic limb (bimanual and unimanual movements, P=.018 and P<.001, respectively). Importantly, participants were more likely to use their paretic arm/hand (unimanually) if they had greater self-efficacy for limb use (P=.042). EMA repeated-measures provide a real-time approach that captures the natural dynamic ebb and flow of social-cognitive factors and their effect on daily arm/hand use. We also observed that people with greater motor impairments (FM<50.6) increase unimanual paretic arm/hand movements when they are not alone, regardless of motor capability. CONCLUSIONS: In addition to motor capability, stroke survivors' momentary social context and self-efficacy play a role in paretic arm/hand use behavior. Our findings suggest the development of personalized rehabilitative interventions which target these factors to promote daily paretic arm/hand use. This study highlights the benefits of EMA to provide real-time information to unravel the complexities of the biopsychosocial (ie, motor capability and social-cognitive factors) interface in post-stroke upper extremity recovery.

FGF21 response to sucrose is associated with BMI and dorsal striatal signaling in humans.

OBJECTIVE: This study examined associations between BMI and dietary sugar intake with sucrose-induced fibroblast growth factor 21 (FGF21) and whether circulating FGF21 is associated with brain signaling following sucrose ingestion in humans. METHODS: A total of 68 adults (29 male; mean [SD), age 23.2 [3.8] years; BMI 27.1 [4.9] kg/m2 ) attended visits after a 12-hour fast. Plasma FGF21 was measured at baseline and at 15, 30, and 120 minutes after sucrose ingestion (75 g in 300 mL of water). Brain cerebral blood flow responses to sucrose were measured using arterial spin labeling magnetic resonance imaging. RESULTS: Higher circulating FGF21 levels were associated with reduced blood flow in the striatum in response to sucrose (ß = -7.63, p = 0.03). This association was greatest among persons with healthy weight (ß = -15.70, p = 0.007) and was attenuated in people with overweight (ß = -4.00, p = 0.63) and obesity (ß = -12.45, p = 0.13). BMI was positively associated with FGF21 levels in response to sucrose (ß = 0.53, p = 0.02). High versus low dietary sugar intake was associated with greater FGF21 responses to acute sucrose ingestion in individuals with healthy weight (ß = 8.51, p = 0.04) but not in individuals with overweight or obesity (p > 0.05). CONCLUSIONS: These correlative findings support evidence in animals showing that FGF21 acts on the brain to regulate sugar consumption through a negative feedback loop.

Changes in Social, Romantic, and General Life Satisfaction Over the Course of a Substance Use Disorder.

Background: The pandemic has highlighted the importance of social connection for health and well-being. Satisfaction across domains of life is associated with substance use outcomes, such as risk of relapse and mortality. Previous work has delineated the relationship between substance use and social connections, yet there is a lack of research exploring the relationship between substance use and satisfaction with domains of life over time. Methods: We retrospectively assessed satisfaction with social life, romantic life, and general life across five phases of substance use among 339 adults, of whom 289 identify as formerly having a problem with substance use, and a comparison group of 50 who report no history of problematic drug use. We compared those whose primary drug of choice was alcohol, marijuana, methamphetamine, non-prescription opioids, and prescription opioids. Results: Those who used prescription opioids reported a larger drop in satisfaction in social life, romantic life, and general life during the course of substance use than those who used other drugs. However, we report no significant differences in current satisfaction, social well-being, or quality of life between people in recovery and people with no history of problematic substance use. Conclusions: These findings-alongside neuropsychological work on the opioid system and sociality-paint a picture that those who formerly used prescription opioids may experience lower satisfaction across life domains during the course of their substance use than those who used other substances. However, people in prolonged recovery-regardless of their drug of choice-all show similar levels of satisfaction compared to people with no history of problematic substance use.

Brain responses to glucose ingestion are greater in children than adults and are associated with overweight and obesity.

OBJECTIVE: This study investigated whether brain regions involved in the regulation of food intake respond differently to glucose ingestion in children and adults and the relationship between brain responses and weight status. METHODS: Data included 87 children (ages 7-11 years) and 94 adults (ages 18-35 years) from two cohorts. Healthy weight, overweight, and obesity were defined by Centers for Disease Control and Prevention criteria. Brain responses to glucose were determined by measuring cerebral blood flow using arterial spin labeling magnetic resonance imaging in brain regions involved in the regulation of eating behavior. RESULTS: Children showed significantly larger increases in brain responses to glucose than adults in the dorsal striatum (p < 0.01), insula (p < 0.01), hippocampus (p < 0.01), and dorsal-lateral prefrontal cortex (p < 0.01). Responses to glucose in the dorsal striatum (odds ratio [OR] = 1.52, 95% CI 1.05-2.20; p = 0.03), hippocampus (OR = 1.51, 95% CI: 1.02-2.22; p = 0.04), insula (OR = 1.64, 95% CI: 1.11-2.42; p = 0.01), and orbitofrontal cortex (OR = 1.63 95% CI: 1.12-2.39; p = 0.01) were positively associated with overweight or obesity, independent of age group. CONCLUSIONS: Children have greater brain responses to glucose ingestion than adults in regions involved in eating behavior, and these responses are associated with weight status.

Obesity and Sex-Related Associations With Differential Effects of Sucralose vs Sucrose on Appetite and Reward Processing: A Randomized Crossover Trial.

Importance: Nonnutritive sweeteners (NNSs) are used as an alternative to nutritive sweeteners to quench desire for sweets while reducing caloric intake. However, studies have shown mixed results concerning the effects of NNSs on appetite, and the associations between sex and obesity with reward and appetitive responses to NNS compared with nutritive sugar are unknown. Objective: To examine neural reactivity to different types of high-calorie food cues (ie, sweet and savory), metabolic responses, and eating behavior following consumption of sucralose (NNS) vs sucrose (nutritive sugar) among healthy young adults. Design, Setting, and Participants: In a randomized, within-participant, crossover trial including 3 separate visits, participants underwent a functional magnetic resonance imaging task measuring blood oxygen level-dependent signal in response to visual cues. For each study visit, participants arrived at the Dornsife Cognitive Neuroimaging Center of University of Southern California at approximately 8:00 am after a 12-hour overnight fast. Blood was sampled at baseline and 10, 35, and 120 minutes after participants received a drink containing sucrose, sucralose, or water to measure plasma glucose, insulin, glucagon-like peptide(7-36), acyl-ghrelin, total peptide YY, and leptin. Participants were then presented with an ad libitum meal. Participants were right-handed, nonsmokers, weight-stable for at least 3 months before the study visits, nondieters, not taking medication, and with no history of eating disorders, illicit drug use, or medical diagnoses. Data analysis was performed from March 2020 to March 2021. Interventions: Participants ingested 300-mL drinks containing either sucrose (75 g), sucralose (individually sweetness matched), or water (as a control). Main Outcomes and Measures: Primary outcomes of interest were the effects of body mass index (BMI) status and sex on blood oxygen level-dependent signal to high-calorie food cues, endocrine, and feeding responses following sucralose vs sucrose consumption. Secondary outcomes included neural, endocrine, and feeding responses following sucrose vs water and sucralose vs water (control) consumption, and cue-induced appetite ratings following sucralose vs sucrose (and vs water). Results: A total of 76 participants were randomized, but 2 dropped out, leaving 74 adults (43 women [58%]; mean [SD] age, 23.40 [3.96] years; BMI range, 19.18-40.27) who completed the study. In this crossover design, 73 participants each received water (drink 1) and sucrose (drink 2), and 72 participants received water (drink 1), sucrose (drink 2), and sucralose (drink 3). Sucrose vs sucralose was associated with greater production of circulating glucose, insulin, and glucagon-like peptide-1 and suppression of acyl-ghrelin, but no differences were found for peptide YY or leptin. BMI status by drink interactions were observed in the medial frontal cortex (MFC; P for interaction < .001) and orbitofrontal cortex (OFC; P for interaction = .002). Individuals with obesity (MFC, ß, 0.60; 95% CI, 0.38 to 0.83; P < .001; OFC, ß, 0.27; 95% CI, 0.11 to 0.43; P = .002), but not those with overweight (MFC, ß, 0.02; 95% CI, -0.19 to 0.23; P = .87; OFC, ß, -0.06; 95% CI, -0.21 to 0.09; P = .41) or healthy weight (MFC, ß, -0.13; 95% CI, -0.34 to 0.07; P = .21; OFC, ß, -0.08; 95% CI, -0.23 to 0.06; P = .16), exhibited greater responsivity in the MFC and OFC to savory food cues after sucralose vs sucrose. Sex by drink interactions were observed in the MFC (P for interaction = .03) and OFC (P for interaction = .03) after consumption of sucralose vs sucrose. Female participants had greater MFC and OFC responses to food cues (MFC high-calorie vs low-calorie cues, ß, 0.21; 95% CI, 0.05 to 0.37; P = .01; MFC sweet vs nonfood cues, ß, 0.22; 95% CI, 0.02 to 0.42; P = .03; OFC food vs nonfood cues, ß, 0.12; 95% CI, 0.02 to 0.22; P = .03; and OFC sweet vs nonfood cues, ß, 0.15; 95% CI, 0.03 to 0.27; P = .01), but male participants' responses did not differ (MFC high-calorie vs low-calorie cues, ß, 0.01; 95% CI, -0.19 to 0.21; P = .90; MFC sweet vs nonfood cues, ß, -0.04; 95% CI, -0.26 to 0.18; P = .69; OFC food vs nonfood cues, ß, -0.08; 95% CI, -0.24 to 0.08; P = .32; OFC sweet vs nonfood cues, ß, -0.11; 95% CI, -0.31 to 0.09; P = .31). A sex by drink interaction on total calories consumed during the buffet meal was observed (P for interaction = .03). Female participants consumed greater total calories (ß, 1.73; 95% CI, 0.38 to 3.08; P = .01), whereas caloric intake did not differ in male participants (ß, 0.68; 95% CI, -0.99 to 2.35; P = .42) after sucralose vs sucrose ingestion. Conclusions and Relevance: These findings suggest that female individuals and those with obesity may be particularly sensitive to disparate neural responsivity elicited by sucralose compared with sucrose consumption. Trial Registration: ClinicalTrials.gov Identifier: NCT02945475.

Effects of addiction science on conceived freewill and responsibility.

Although there is speculation that medicalization of addiction undermines conceived agency, only relatively modest effects have been reported. Research participants generally have ideas about addiction that are informed both by personal experience and by media, and their views may not be wholly updated in response to study-information. Here we examine the potential impact of addiction science theories on perceived volition and responsibility by considering the issues in the context of a hypothetical new drug, "Z." Participants (N = 662) were provided one of three functional accounts that each corresponded to a prominent theory within addiction science: incentive-sensitization, impaired self-control, and habit-system dominance. For half of participants, additional neuroscience mechanism information was included with the functional account. Across explanations, the inclusion of mechanism information was associated with significantly less perceived volition and marginal reduction in blame, For several measures, there was a significant or marginally significant interaction between which addiction explanation was used and whether mechanism information was included, with mechanism generally having the largest impact given the impaired self-control explanation of addiction and little evidence of impact given the incentive-sensitization explanation of addiction. Taken together, these results suggest robust effects of addiction science on judgments of agency when presented in the context of a novel addiction. It is unclear whether a sustained scientific consensus around an existing theory could produce a similar impact on how people understand real addictive behavior.

Obesity and Dietary Added Sugar Interact to Affect Postprandial GLP-1 and Its Relationship to Striatal Responses to Food Cues and Feeding Behavior.

It has been hypothesized that the incretin hormone, glucagon-like peptide-1 (GLP-1), decreases overeating by influencing mesolimbic brain regions that process food-cues, including the dorsal striatum. We previously showed that habitual added sugar intake was associated with lower glucose-induced circulating GLP-1 and a greater striatal response to high calorie food cues in lean individuals. Less is known about how dietary added sugar and obesity may interact to affect postprandial GLP-1 and its relationship to striatal responses to food cues and feeding behavior. The current study aimed to expand upon previous research by assessing how circulating GLP-1 and striatal food cue reactivity are affected by acute glucose consumption in participants with varied BMIs and amounts of habitual consumption of added sugar. This analysis included 72 participants from the Brain Response to Sugar Study who completed two study visits where they consumed either plain water or 75g glucose dissolved in water (order randomized; both drinks were flavored with non-caloric cherry flavoring) and underwent repeated blood sampling, a functional magnetic resonance imaging (fMRI) based food-cue task, and an ad-libitum buffet meal. Correlations between circulating GLP-1 levels, striatal food-cue reactivity, and food intake were assessed, and interactions between obesity and added sugar on GLP-1 and striatal responses were examined. An interaction between BMI and dietary added sugar was associated with reduced post-glucose GLP-1 secretion. Participants who were obese and consumed high levels of added sugar had the smallest increase in plasma GLP-1 levels. Glucose-induced GLP-1 secretion was correlated with lower dorsal striatal reactivity to high-calorie versus low-calorie food-cues, driven by an increase in reactivity to low calorie food-cues. The increase in dorsal striatal reactivity to low calorie food-cues was negatively correlated with sugar consumed at the buffet. These findings suggest that an interaction between obesity and dietary added sugar intake is associated with additive reductions in postprandial GLP-1 secretion. Additionally, the results suggest that changes to dorsal striatal food cue reactivity through a combination of dietary added sugar and obesity may affect food consumption.

Associations Between Exposure to Gestational Diabetes Mellitus In Utero and Daily Energy Intake, Brain Responses to Food Cues, and Adiposity in Children.

OBJECTIVE: Children exposed to gestational diabetes mellitus (GDM) or maternal obesity in utero have an increased propensity to develop obesity. Little is known about the mechanisms underlying this phenomenon. We aimed to examine relationships between exposure to GDM or maternal obesity and daily energy intake (EI), brain responses to food cues within reward regions, and adiposity in children. RESEARCH DESIGN AND METHODS: Participants were 159 children ages 7-11 years. Repeated 24-h recalls were conducted to assess mean daily EI. A subset of children (n = 102) completed a food cue task in the MRI scanner. A priori regions of interest included the orbital frontal cortex (OFC), insula, amygdala, ventral striatum, and dorsal striatum. Adiposity measurements, BMI z-scores, percent body fat, waist-to-height ratio (WtHR), and waist-to-hip ratio (WHR) were assessed. RESULTS: Exposure to GDM was associated with greater daily EI, and children exposed to GDM diagnosed before 26 weeks gestation had greater OFC food cue reactivity. Children exposed to GDM also had larger WHR. Results remained significant after adjusting for child's age and sex, maternal education and race/ethnicity, maternal prepregnancy BMI, and child's physical activity levels. Furthermore, children who consumed more daily calories had greater WHR, and the relationship between GDM exposure and WHR was attenuated after adjustment for daily EI. Prepregnancy BMI was not significantly related to daily EI or food cue reactivity in reward regions. However, prepregnancy BMI was significantly related to all adiposity measurements; results remained significant for BMI z-scores, WtHR, and WHR after controlling for child's age and sex, maternal education and race/ethnicity, maternal GDM exposure, and child's physical activity levels. CONCLUSIONS: Exposure to GDM in utero, in particular before 26 weeks gestation, is associated with increased EI, enhanced OFC food cue reactivity, and increased WHR. Future study with longitudinal follow-up is merited to assess potential pathways of daily EI and food cue reactivity in reward regions on the associations between GDM exposure and childhood adiposity.

A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity.

Use of the paretic arm and hand is a key indicator of recovery and reintegration after stroke. A sound methodology is essential to comprehensively identify the possible factors impacting daily arm/hand use behavior. We combined ecological momentary assessment (EMA), a prompt methodology capturing real-time psycho-contextual factors, with accelerometry to investigate arm/hand behavior in the natural environment. Our aims were to determine (1) feasibility and (2) measurement validity of the combined methodology. We monitored 30 right-dominant, mild-moderately motor impaired chronic stroke survivors over 5 days (6 EMA prompts/day with accelerometers on each wrist). We observed high adherence for accelerometer wearing time (80.3%), EMA prompt response (84.6%), and generally positive user feedback upon exit interview. The customized prompt schedule and the self-triggered prompt option may have improved adherence. There was no evidence of EMA response bias nor immediate measurement reactivity. An unexpected small but significant increase in paretic arm/hand use was observed over days (12-14 min), which may be the accumulated effect of prompting that provided a reminder to choose the paretic limb. Further research that uses this combined methodology is needed to develop targeted interventions that effectively change behavior and enable reintegration post-stroke.

Present-state dependency in valuation of the future.

Ainslie's target article provides a map of distinct mechanisms relevant to self-control, potentially providing needed precision to the field. He also breaks new ground in characterizing the symbiotic relationship between suppression and resolve. In this commentary, I argue that one behaviorism-based feature of his framework, present-state independence, is unjustified and unnecessary for the broader claims of the theory.

The Early Impact of Social Distancing Measures on Drug Use.

BACKGROUND AND OBJECTIVES: Social distancing policies have been widely adopted in response to the COVID-19 pandemic. High levels of social connection are positively associated with beneficial health outcomes, while social isolation is associated with poor long-term health outcomes including reduced life expectancy. The present study evaluates the impact of social distancing measures during the early period of COVID-19 on substance use behaviors among those in the United States. Methods: We used an internet-based survey with participants (n = 157; 86 male) reporting a history of problems related to drug use. We relied on ANOVA and logistic regression techniques to assess the associations between social connection and substance use. Results: People with more severe drug use problems reported feeling more socially isolated during social distancing. Those who primarily use alcohol reported higher global feelings of social connection than those who primarily use opioids. During social distancing, participants reported an increase in alcohol and cigarette consumption, and a decrease in cocaine use. Lastly, those who reported using drugs for social reasons were less likely to have decreased substance use during social distancing. Conclusions: The current study provides evidence that social distancing guidelines have impacted both substance use behaviors and feelings of social and physical connection. Further, there are differential impacts based on drug of choice. These results advance delineation of the connection between sociality and drug use.

The role of maternal BMI on brain food cue reactivity in children: a preliminary study.

Children of overweight and obese parents have an increased risk of obesity. Little is known the neural mechanisms underlying this relationship, specifically the brain systems implicated in self-regulation of food intake. The primary goal here is to examine relationships between maternal body mass index (BMI) and brain responses to food cues in children. Seventy-six children (8.62 ± 1.02 years; 28 M,48F) were included in this study. Height and weight were assessed for children and their biological parents. Maternal height and weight before pregnancy were extracted from the Electronic Medical Records (EMR). BMI (kg/m2) or BMIz (age- and sex-specific BMI) were calculated. Children underwent a magnetic resonance imaging session where they viewed food and non-food images before and after glucose ingestion. The dorsolateral prefrontal cortex (dlPFC) and anterior cingulate cortex (ACC) food cue reactivity was the measurement of interest for region-of-interest (ROI) analyses. Whole-brain exploratory analysis was performed as well. Non-parametric methods were used for data analysis. ROI and whole brain analyses showed that maternal current BMI was inversely associated with child's ACC and dlPFC food cue reactivity after glucose ingestion, adjusting for age and sex. No significant relationships were found between paternal BMI and child's food cue reactivity. Child BMIz was negatively associated with the ACC food cue reactivity after glucose ingestion. Our results supported the role of maternal adiposity on child's responses to appetitive food cues in brain self-regulation circuitry, which may influence eating behavior and obesity risk in children.

Adolescent emotional disorder symptoms and transdiagnostic vulnerabilities as predictors of young adult substance use during the COVID-19 pandemic: mediation by substance-related coping behaviors.

The COVID-19 pandemic presents unique stressors (e.g. social isolation) that may increase substance use risk among young adults with a history of emotional disturbance. This study examined whether emotional disorder symptoms and transdiagnostic vulnerabilities during adolescence predicted young adult substance use during COVID-19, and whether using substances to cope with the pandemic's social conditions mediated these associations. Adolescents (N = 2,120) completed baseline surveys assessing transdiagnostic emotional vulnerabilities (anhedonia, distress intolerance, anxiety sensitivity, negative urgency) and symptoms (major depression[MD], generalized anxiety[GAD], panic disorder[PD], social phobia[SP], obsessive-compulsive disorder[OCD]) in adolescence (September-December 2016; M[SD] age = 17.45[0.38]). At follow-up (May-August 2020; M[SD] age = 21.16[0.39]), past 30-day substance use and using substances to cope with social isolation during the pandemic were reported. Adjusted models showed that baseline distress intolerance, anxiety sensitivity, negative urgency, and MD symptoms each significantly predicted higher number of past-month single-substance using days and number of substances used at follow-up (ßs = 0.04-0.06). In each case, associations were mediated by tendency to use substances to cope with the pandemic (ßindirect range: 0.028-0.061). To mitigate disproportionate escalation of substance use in young adults with a history of certain types of emotional disturbance, interventions promoting healthy coping strategies to deal with the pandemic's social conditions warrant consideration.

Evidence of a Role for the Hippocampus in Food-Cue Processing and the Association with Body Weight and Dietary Added Sugar.

OBJECTIVE: The current analysis used functional magnetic resonance imaging (fMRI) to explore a model of energy regulation postulating that the hippocampus integrates interoceptive signals and environmental stimuli to suppress responding to food cues. It was hypothesized that hippocampal activity would increase in response to food cues under postnutritive relative to fasted conditions, given the role of the hippocampus in integrating postnutritive signals with food cues, and that obesity, added sugar intake, or a combination of these factors would alter this response. METHODS: Data were analyzed on 65 participants (29 males). Participants consumed drinks containing 75 g of glucose or water and underwent an fMRI-based food-cue task. Blood-oxygen-level-dependent (BOLD) fMRI was used to examine hippocampal responses to food and nonfood cues. RESULTS: In lean participants, the hippocampal BOLD signal was higher following glucose compared with water, but participants with obesity showed the opposite pattern. BMI interacted with added sugar intake such that BMI was more negatively correlated with hippocampal food-cue reactivity after glucose ingestion in individuals who consumed high levels of added sugar. Hippocampal BOLD was negatively correlated with prospective food intake. CONCLUSIONS: The findings are consistent with the view that energy regulation involves hippocampal processes in humans and that added sugar and excess weight may impair this function.