Aberrant cognitive empathy in individuals with elevated social anxiety and regulation with emotional working memory training.

Social anxiety may disrupt the empathic process, and well-regulated empathy is critical for navigating the social world. Two studies aimed to further understand empathy in the context of social anxiety. Study 1 compared individuals with elevated or normative social anxiety on a measure assessing cognitive and affective empathy for positive and negative emotions conveyed by other people ("targets"), completed under social threat. Relative to individuals with normative social anxiety, individuals with elevated social anxiety had greater cognitive empathy and no differences in affective empathy, regardless of emotion type. As greater cognitive empathy can be maladaptive, Study 2 tested whether this could be down-regulated. Individuals with elevated social anxiety underwent emotional working memory training (eWMT) for negative emotional information, or control training (CT). Effects on an empathy measure completed under social threat were assessed. Cognitive empathy for negative emotions decreased following eWMT but not CT, and this was only evident for those with higher pre-training working memory capacity. Cognitive empathy for positive emotions and affective empathy were not affected. Overall, social anxiety is associated with aberrant elevated cognitive empathy for negative and positive emotions, and the deviation in cognitive empathy for negative emotions can be regulated with eWMT for certain individuals.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618001196235..

Evaluating Dental Monitoring effectiveness compared with conventional monitoring of clear aligner therapy using the Peer Assessment Rating index.

INTRODUCTION: This study aimed to evaluate the effectiveness of Dental Monitoring (DM) (Dental Monitoring SAS, Paris, France) compared with conventional monitoring (CM) during active orthodontic treatment. METHODS: The Peer Assessment Rating (PAR) index was used to evaluate the pretreatment and posttreatment records of 51 patients, with 26 in the CM group and 25 in the DM group. The change in weighted PAR was analyzed to assess the effectiveness of treatment. RESULTS: The chi-square test revealed that the CM group had a higher percentage of patients in the great improvement category compared with the DM group. However, this difference was not statistically significant (P = 0.192). A repeated measures general linear model demonstrated significant improvement over time (P <0.001), with no statistically significant group differences noted between CM and DM (P = 0.181) and no statistically significant time-by-group interaction (P = 0.299). CONCLUSIONS: Both CM and DM showed significant improvements in weighted PAR scores, but no statistically significant difference is present between the 2 groups.

Variant-specific IgA protects against Omicron infection.

BACKGROUND: The emergence of rapidly evolving SARS-CoV-2 variants, coupled with waning vaccine-induced immunity, has contributed to the rise of vaccine breakthrough infections. It is crucial to understand how vaccine-induced protection is mediated. METHODS: We examined two prospective cohorts of mRNA-vaccinated-and-boosted individuals during the Omicron wave of infection in Singapore. RESULTS: We found that, individuals, who remain uninfected over the follow-up period, had a higher variant-specific IgA, but not IgG, antibody response at 1-month post booster vaccination, compared with individuals who became infected. CONCLUSIONS: We conclude that IgA may have a potential contributory role in protection against Omicron infection.

Identifying COVID-19 cases in outpatient settings.

Case identification is an ongoing issue for the COVID-19 epidemic, in particular for outpatient care where physicians must decide which patients to prioritise for further testing. This paper reports tools to classify patients based on symptom profiles based on 236 severe acute respiratory syndrome coronavirus 2 positive cases and 564 controls, accounting for the time course of illness using generalised multivariate logistic regression. Significant symptoms included abdominal pain, cough, diarrhoea, fever, headache, muscle ache, runny nose, sore throat, temperature between 37.5 and 37.9 °C and temperature above 38 °C, but their importance varied by day of illness at assessment. With a high percentile threshold for specificity at 0.95, the baseline model had reasonable sensitivity at 0.67. To further evaluate accuracy of model predictions, leave-one-out cross-validation confirmed high classification accuracy with an area under the receiver operating characteristic curve of 0.92. For the baseline model, sensitivity decreased to 0.56. External validation datasets reported similar result. Our study provides a tool to discern COVID-19 patients from controls using symptoms and day from illness onset with good predictive performance. It could be considered as a framework to complement laboratory testing in order to differentiate COVID-19 from other patients presenting with acute symptoms in outpatient care.

Empathy and well-being correlate with centrality in different social networks.

Individuals benefit from occupying central roles in social networks, but little is known about the psychological traits that predict centrality. Across four college freshman dorms (n = 193), we characterized individuals with a battery of personality questionnaires and also asked them to nominate dorm members with whom they had different types of relationships. This revealed several social networks within dorm communities with differing characteristics. In particular, additional data showed that networks varied in the degree to which nominations depend on (i) trust and (ii) shared fun and excitement. Networks more dependent upon trust were further defined by fewer connections than those more dependent on fun. Crucially, network and personality features interacted to predict individuals' centrality: people high in well-being (i.e., life satisfaction and positive emotion) were central to networks characterized by fun, whereas people high in empathy were central to networks characterized by trust. Together, these findings provide network-based corroboration of psychological evidence that well-being is socially attractive, whereas empathy supports close relationships. More broadly, these data highlight how an individual's personality relates to the roles that they play in sustaining their community.

Factors affecting dental service utilisation among older Singaporeans eligible for subsidized dental care - a qualitative study.

BACKGROUND: The World Health Organization has highlighted the paucity of research into the oral health needs of older adults. In Singapore, until recently, publically funded/subsidized oral health care for adults has been limited to basic primary care at government-funded polyclinics. Access to a more comprehensive range of subsidized care in the private sector was widened through the government-funded Community Health Assistance Scheme (CHAS) in 2012 and Pioneer Generation (PG) scheme in 2015. Little is known about the attitude to dental service utilization among older adults in Singapore since then. METHODS: We conducted semi-structured individual interviews with 25 participants above 65 years of age who were eligible for subsidized dental care plans. Participants were recruited from a public teaching hospital and a public primary care clinic in Singapore. The duration of each interview was 15-30 min. Interviews were transcribed verbatim and the transcripts were analyzed thematically using a phenomenological approach. RESULTS: Pertinent themes emerged related to four major areas: (a) general awareness towards oral health, (b) life course perspective of oral health, (c) barriers to visit the dentist, (d) shaping dental service utilisation behaviours through provision of financial subsidies for dental care. Most participants perceived a strong relationship between oral health and systemic health. However, there were erroneous traditional beliefs such as oral health is not part of physical health and edentulous participants did not need to visit a dentist. Fear, anxiety, previous negative experience and lack of knowledge were barriers to visiting the dentist. Trust and convenience were considerations for patients when deciding whether to switch from public to private dental services where CHAS/PG were only available. CONCLUSION: Our study provided important insights regarding oral health perceptions and beliefs of older people residing in the community which may affect their dental service utilization. This further highlights the importance of understanding the concerns of this group when implementing healthcare policies for elderly in Singapore. The findings of our study will serve as a baseline for future studies in Singapore and inform studies in other countries that implement targeted schemes for older adults.

Strategic Resource Use for Learning: A Self-Administered Intervention That Guides Self-Reflection on Effective Resource Use Enhances Academic Performance.

Many educational policies provide learners with more resources (e.g., new learning activities, study materials, or technologies), but less often do they address whether students are using these resources effectively. We hypothesized that making students more self-reflective about how they should approach their learning with the resources available to them would improve their class performance. We designed a novel Strategic Resource Use intervention that students could self-administer online and tested its effects in two cohorts of a college-level introductory statistics class. Before each exam, students randomly assigned to the treatment condition strategized about which academic resources they would use for studying, why each resource would be useful, and how they would use their resources. Students randomly assigned to the treatment condition reported being more self-reflective about their learning throughout the class, used their resources more effectively, and outperformed students in the control condition by an average of one third of a letter grade in the class.

A Second Look at Automatic Theory of Mind: Reconsidering Kovács, Téglás, and Endress (2010).

In recent work, Kovács, Téglás, and Endress (2010) argued that human adults automatically represented other agents' beliefs even when those beliefs were completely irrelevant to the task being performed. In a series of 13 experiments, we replicated these previous findings but demonstrated that the effects found arose from artifacts in the experimental paradigm. In particular, the critical findings demonstrating automatic belief computation were driven by inconsistencies in the timing of an attention check, and thus do not provide evidence for automatic theory of mind in adults.

Face and context integration in emotion inference is limited and variable across categories and individuals.

The ability to make nuanced inferences about other people's emotional states is central to social functioning. While emotion inferences can be sensitive to both facial movements and the situational context that they occur in, relatively little is understood about when these two sources of information are integrated across emotion categories and individuals. In a series of studies, we use one archival and five empirical datasets to demonstrate that people could be integrating, but that emotion inferences are just as well (and sometimes better) captured by knowledge of the situation alone, while isolated facial cues are insufficient. Further, people integrate facial cues more for categories for which they most frequently encounter facial expressions in everyday life (e.g., happiness). People are also moderately stable over time in their reliance on situational cues and integration of cues and those who reliably utilize situation cues more also have better situated emotion knowledge. These findings underscore the importance of studying variability in reliance on and integration of cues.

A holistic lifestyle mobile health intervention for the prevention of type 2 diabetes and common mental disorders in Asian women with a history of gestational diabetes: a randomised control trial with 3-year follow-up protocol.

BACKGROUND: Women with a history of gestational diabetes mellitus (GDM) are 12-fold more likely to develop type 2 diabetes (T2D) 4-6 years after delivery than women without GDM. Similarly, GDM is associated with the development of common mental disorders (CMDs) (e.g. anxiety and depression). Evidence shows that holistic lifestyle interventions focusing on physical activity (PA), dietary intake, sleep, and mental well-being strategies can prevent T2D and CMDs. This study aims to assess the effectiveness of a holistic lifestyle mobile health intervention (mHealth) with post-GDM women in preventing T2D and CMDs in a community setting in Singapore. METHODS: The study consists of a 1-year randomised controlled trial (RCT) with a 3-year follow-up period. Post-GDM women with no current diabetes diagnosis and not planning to become pregnant will be eligible for the study. In addition, participants will complete mental well-being questionnaires (e.g. depression, anxiety, sleep) and their child's socio-emotional and cognitive development. The participants will be randomised to either Group 1 (Intervention) or Group 2 (comparison). The intervention group will receive the "LVL UP App", a smartphone-based, conversational agent-delivered holistic lifestyle intervention focused on three pillars: Move More (PA), Eat Well (Diet), and Stress Less (mental wellbeing). The intervention consists of health literacy and psychoeducational coaching sessions, daily "Life Hacks" (healthy activity suggestions), slow-paced breathing exercises, a step tracker (including brisk steps), a low-burden food diary, and a journaling tool. Women from both groups will be provided with an Oura ring for tracking physical activity, sleep, and heart rate variability (a proxy for stress), and the "HAPPY App", a mHealth app which provides health promotion information about PA, diet, sleep, and mental wellbeing, as well as display body mass index, blood pressure, and results from the oral glucose tolerance tests. Short-term aggregate effects will be assessed at 26/27 weeks (midpoint) and a 1-year visit, followed by a 2, 3, and 4-year follow-up period. DISCUSSION: High rates of progression of T2D and CMDs in women with post-GDM suggest an urgent need to promote a healthy lifestyle, including diet, PA, sleep, and mental well-being. Preventive interventions through a holistic, healthy lifestyle may be the solution, considering the inextricable relationship between physical and psychological health. We expect that holistic lifestyle mHealth may effectively support behavioural changes among women with a history of GDM to prevent T2D and CMDs. TRIAL STATUS: The protocol study was approved by the National Healthcare Group in Singapore, Domain Specific Review Board (DSRB) [2023/00178]; June 2023. Recruitment began on October 18, 2023. TRIAL REGISTRATION: ClinicalTrials.gov NCT05949957. The first submission date is June 08, 2023.

Enhancing rotational diffusion using oscillatory shear.

Taylor dispersion--shear-induced enhancement of translational diffusion--is an important phenomenon with applications ranging from pharmacology to geology. Through experiments and simulations, we show that rotational diffusion is also enhanced for anisotropic particles in oscillatory shear. This enhancement arises from variations in the particle's rotation (Jeffery orbit) and depends on the strain amplitude, rate, and particle aspect ratio in a manner that is distinct from the translational diffusion. This separate tunability of translational and rotational diffusion opens the door to new techniques for controlling positions and orientations of suspended anisotropic colloids.

Neural signatures of emotional inference and experience align during social consensus.

Humans seamlessly transform dynamic social signals into inferences about the internal states of the people around them. To understand the neural processes that sustain this transformation, we collected fMRI data from participants (N = 100) while they rated the emotional intensity of people (targets) describing significant life events. Targets rated themselves on the same scale to indicate the intended "ground truth" emotional intensity of their videos. Next, we developed two multivariate models of observer brain activity- the first predicted the "ground truth" (r = 0.50, p < 0.0001) and the second predicted observer inferences (r = 0.53, p < 0.0001). When individuals make more accurate inferences, there is greater moment-by-moment concordance between these two models, suggesting that an observer's brain activity contains latent representations of other people's emotional states. Using naturalistic socioemotional stimuli and machine learning, we developed reliable brain signatures that predict what an observer thinks about a target, what the target thinks about themselves, and the correspondence between them. These signatures can be applied in clinical data to better our understanding of socioemotional dysfunction.

Mu rhythm suppression over sensorimotor regions is associated with greater empathic accuracy.

When people encounter others' emotions, they engage multiple brain systems, including parts of the sensorimotor cortex associated with motor simulation. Simulation-related brain activity is commonly described as a 'low-level' component of empathy and social cognition. It remains unclear whether and how sensorimotor simulation contributes to complex empathic judgments. Here, we combine a naturalistic social paradigm with a reliable index of sensorimotor cortex-based simulation: electroencephalography suppression of oscillatory activity in the mu frequency band. We recruited participants to watch naturalistic video clips of people ('targets') describing emotional life events. In two experiments, participants viewed these clips (i) with video and sound, (ii) with only video or (iii) with only sound and provided continuous ratings of how they believed the target felt. We operationalized 'empathic accuracy' as the correlation between participants' inferences and targets' self-report. In Experiment 1 (US sample), across all conditions, right-lateralized mu suppression tracked empathic accuracy. In Experiment 2 (Israeli sample), this replicated only when using individualized frequency-bands and only for the visual stimuli. Our results provide novel evidence that sensorimotor representations-as measured through mu suppression-play a role not only in low-level motor simulation, but also in higher-level inferences about others' emotions, especially when visual cues are crucial for accuracy.

Management of a patient with a severely infraoccluded primary molar and hypodontia.

Infraocclusion of a primary molar is a relatively common occurrence which seldom leads to serious complications, particularly when the succedaneous permanent tooth is present. Despite the relative infrequency of unfavorable outcomes, an infraoccluded primary molar may be associated with other dental anomalies, including hypodontia. If diagnosis is delayed, infraocclusion of a primary molar can become severe, with associated negative effects on the adjacent teeth and alveolar bone. This emphasizes the need for routine and periodic orthodontic assessment of growing patients. Any deviation from the normal eruption sequence of teeth should be diagnosed and managed in a timely manner, to preserve dental arch integrity and reduce the potential for undesirable outcomes. This case report demonstrates how comprehensive assessment of the dentition, logical treatment planning and careful management of challenging orthodontic tooth movements can combine to provide a pleasing treatment outcome.

Interdisciplinary diagnosis and treatment planning for Class III malocclusion and determining the appropriate anterior tooth positions for individual patients.

Patients presenting with Class III malocclusion often present significant challenges for the orthodontist and restorative clinician. The characteristic anterior crossbite is commonly associated with a maxillo-mandibular skeletal base discrepancy leading to both functional and esthetic issues. Three potential incisal tooth positions are discussed using clinical examples including implants.

Impaired empathic accuracy following damage to the left hemisphere.

Failing to understand others accurately can be extremely costly. Unfortunately, events such as strokes can lead to a decline in emotional understanding. Such impairments have been documented in stroke patients and are widely hypothesized to be related to right-hemisphere lesions, as well as to the amygdala, and are thought to be driven in part by attentional biases, for example, less fixation on the eyes. Notably, most of the previous research relied on measurements of emotional understanding from simplified cues, such as facial expressions or prosody. We hypothesize that chronic damage to the left hemisphere could hinder empathic accuracy and emotion recognition in naturalistic social settings that require complex language comprehension, even after a patient regains core language capacities. To assess this notion, we use an empathic accuracy task and eye-tracking measurements with chronic stroke patients with either right (N = 13) or left (N = 11) hemispheric damage-together with aged-matched controls (N = 15)-to explore the patients' understanding of others' affect inferred from stimuli that separates audio and visual cues. While we find that patients with right-hemisphere lesions showed visual attention bias compared to the other two groups, we uncover a disadvantage for patients with left-hemisphere lesions in empathic accuracy, especially when only auditory cues are present. These results suggest that patients with left-hemisphere damage have long-lasting difficulties comprehending real-world complex emotional situations.

A brief intervention to motivate empathy among middle school students.

Empathy tracks socioemotional adjustment during early adolescence, yet adolescents this age tend to show reductions in empathy compared with younger children. Here we took a novel approach to building empathy among early adolescents in four middle schools (n = 857). Rather than addressing the ability to empathize, we targeted the motivation to empathize. To do so, we leveraged strategies demonstrated to change motivation among early adolescents: social norms and mindsets. Compared with those in other conditions, students who received a norms-based intervention reported greater motivation to empathize with others, which was in turn associated with increased peer-reported prosocial behaviors, as well as lower levels of loneliness and aggression. The effects of this norms condition were strongest at schools with relatively high engagement with the intervention. Findings suggest a novel avenue for increasing empathy among early adolescents-focusing on peer-driven motivation-and underscore the importance of context in shaping intervention outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Amplification in the evaluation of multiple emotional expressions over time.

Social interactions are dynamic and unfold over time. To make sense of social interactions, people must aggregate sequential information into summary, global evaluations. But how do people do this? Here, to address this question, we conducted nine studies (N = 1,583) using a diverse set of stimuli. Our focus was a central aspect of social interaction-namely, the evaluation of others' emotional responses. The results suggest that when aggregating sequences of images and videos expressing varying degrees of emotion, perceivers overestimate the sequence's average emotional intensity. This tendency for overestimation is driven by stronger memory of more emotional expressions. A computational model supports this account and shows that amplification cannot be explained only by nonlinear perception of individual exemplars. Our results demonstrate an amplification effect in the perception of sequential emotional information, which may have implications for the many types of social interactions that involve repeated emotion estimation.

Real-world effectiveness of a social-psychological intervention translated from controlled trials to classrooms.

Social-psychological interventions have raised the learning and performance of students in rigorous efficacy trials. Yet, after they are distributed "in the wild" for students to self-administer, there has been little research following up on their translational effectiveness. We used cutting-edge educational technology to tailor, scale up, and track a previously-validated Strategic Resource Use intervention among 12,065 college students in 14 STEM and Economics classes. Students who self-administered this "Exam Playbook" benefitted by an average of 2.17 percentage points (i.e., a standardized effect size of 0.18), compared to non-users. This effect size was 1.65 percentage points when controlling for college entrance exam scores and 1.75 [-1.88] for adding [dropping] the Exam Playbook in stratified matching analyses. Average benefits differed in magnitude by the conduciveness of the class climate (including peer norms and incentives), gender, first-generation status, as well as how often and how early they used the intervention. These findings on how, when, and who naturally adopts these resources address a need to improve prediction, translation, and scalability of social-psychological intervention benefits.

BREAst screening Tailored for HEr (BREATHE)-A study protocol on personalised risk-based breast cancer screening programme.

Routine mammography screening is currently the standard tool for finding cancers at an early stage, when treatment is most successful. Current breast screening programmes are one-size-fits-all which all women above a certain age threshold are encouraged to participate. However, breast cancer risk varies by individual. The BREAst screening Tailored for HEr (BREATHE) study aims to assess acceptability of a comprehensive risk-based personalised breast screening in Singapore. Advancing beyond the current age-based screening paradigm, BREATHE integrates both genetic and non-genetic breast cancer risk prediction tools to personalise screening recommendations. BREATHE is a cohort study targeting to recruit ~3,500 women. The first recruitment visit will include questionnaires and a buccal cheek swab. After receiving a tailored breast cancer risk report, participants will attend an in-person risk review, followed by a final session assessing the acceptability of our risk stratification programme. Risk prediction is based on: a) Gail model (non-genetic), b) mammographic density and recall, c) BOADICEA predictions (breast cancer predisposition genes), and d) breast cancer polygenic risk score. For national implementation of personalised risk-based breast screening, exploration of the acceptability within the target populace is critical, in addition to validated predication tools. To our knowledge, this is the first study to implement a comprehensive risk-based mammography screening programme in Asia. The BREATHE study will provide essential data for policy implementation which will transform the health system to deliver a better health and healthcare outcomes.