Invariant neural subspaces maintained by feedback modulation.

Sensory systems reliably process incoming stimuli in spite of changes in context. Most recent models accredit this context invariance to an extraction of increasingly complex sensory features in hierarchical feedforward networks. Here, we study how context-invariant representations can be established by feedback rather than feedforward processing. We show that feedforward neural networks modulated by feedback can dynamically generate invariant sensory representations. The required feedback can be implemented as a slow and spatially diffuse gain modulation. The invariance is not present on the level of individual neurons, but emerges only on the population level. Mechanistically, the feedback modulation dynamically reorients the manifold of neural activity and thereby maintains an invariant neural subspace in spite of contextual variations. Our results highlight the importance of population-level analyses for understanding the role of feedback in flexible sensory processing.

Learning excitatory-inhibitory neuronal assemblies in recurrent networks.

Understanding the connectivity observed in the brain and how it emerges from local plasticity rules is a grand challenge in modern neuroscience. In the primary visual cortex (V1) of mice, synapses between excitatory pyramidal neurons and inhibitory parvalbumin-expressing (PV) interneurons tend to be stronger for neurons that respond to similar stimulus features, although these neurons are not topographically arranged according to their stimulus preference. The presence of such excitatory-inhibitory (E/I) neuronal assemblies indicates a stimulus-specific form of feedback inhibition. Here, we show that activity-dependent synaptic plasticity on input and output synapses of PV interneurons generates a circuit structure that is consistent with mouse V1. Computational modeling reveals that both forms of plasticity must act in synergy to form the observed E/I assemblies. Once established, these assemblies produce a stimulus-specific competition between pyramidal neurons. Our model suggests that activity-dependent plasticity can refine inhibitory circuits to actively shape cortical computations.

A thalamocortical top-down circuit for associative memory.

The sensory neocortex is a critical substrate for memory. Despite its strong connection with the thalamus, the role of direct thalamocortical communication in memory remains elusive. We performed chronic in vivo two-photon calcium imaging of thalamic synapses in mouse auditory cortex layer 1, a major locus of cortical associations. Combined with optogenetics, viral tracing, whole-cell recording, and computational modeling, we find that the higher-order thalamus is required for associative learning and transmits memory-related information that closely correlates with acquired behavioral relevance. In turn, these signals are tightly and dynamically controlled by local presynaptic inhibition. Our results not only identify the higher-order thalamus as a highly plastic source of cortical top-down information but also reveal a level of computational flexibility in layer 1 that goes far beyond hard-wired connectivity.

Presynaptic inhibition rapidly stabilises recurrent excitation in the face of plasticity.

Hebbian plasticity, a mechanism believed to be the substrate of learning and memory, detects and further enhances correlated neural activity. Because this constitutes an unstable positive feedback loop, it requires additional homeostatic control. Computational work suggests that in recurrent networks, the homeostatic mechanisms observed in experiments are too slow to compensate instabilities arising from Hebbian plasticity and need to be complemented by rapid compensatory processes. We suggest presynaptic inhibition as a candidate that rapidly provides stability by compensating recurrent excitation induced by Hebbian changes. Presynaptic inhibition is mediated by presynaptic GABA receptors that effectively and reversibly attenuate transmitter release. Activation of these receptors can be triggered by excess network activity, hence providing a stabilising negative feedback loop that weakens recurrent interactions on sub-second timescales. We study the stabilising effect of presynaptic inhibition in recurrent networks, in which presynaptic inhibition is implemented as a multiplicative reduction of recurrent synaptic weights in response to increasing inhibitory activity. We show that networks with presynaptic inhibition display a gradual increase of firing rates with growing excitatory weights, in contrast to traditional excitatory-inhibitory networks. This alleviates the positive feedback loop between Hebbian plasticity and network activity and thereby allows homeostasis to act on timescales similar to those observed in experiments. Our results generalise to spiking networks with a biophysically more detailed implementation of the presynaptic inhibition mechanism. In conclusion, presynaptic inhibition provides a powerful compensatory mechanism that rapidly reduces effective recurrent interactions and thereby stabilises Hebbian learning.

Same Goals, Yet Different Outcomes: Analysing the Current State of eHealth Adoption and Policies in Austria, Germany, and Switzerland Using a Mixed Methods Approach.

Despite similar policy goals, the adoption of eHealth practices took different paths in Austria (AT), Switzerland (CH), and Germany (GER). We seek to provide a rigorous analysis of the current state of hospitals by focusing on three key eHealth areas: electronic patient records (EPR), health information exchange (HIE), electronic patient communication. For validation and in order to gain better contextual insight we applied a mixed method approach by combining survey results from clinical directors with qualitative interview data from eHealth experts of all three countries. Across countries, EPR adoption rates were reported highest (AT: 52%, CH: 78%, GER: 50%), HIE-rates were partly lower (AT: 52%, CH: 14%, GER: 17%), and electronic patient communication was reported lowest overall (AT: 17%, CH: 8%, GER: 19%). Amongst others, results indicate patient awareness about eHealth to be equally weak across countries, which thus may be an important focal point of future policy initiatives.

Experts' Insights into eHealth-Legislation: Comparing Switzerland and Germany.

This prospective longitudinal study aims at better understanding eHealth success factors in different European nations, esp. the role of eHealth-legislation in Switzerland and Germany. Qualitative interviews with 39 matched experts from a large variety of institutions in both nations were conducted. The individual statements in the interviews and the overall satisfaction rating indicate a clear trend for a more optimistic attitude towards the law in Switzerland than in Germany. This result is not surprising given the history of a telematics infrastructure in Germany. Cross-country learning topics for German politicians are the inclusion of the inpatient sector and the focus on one major application. In a next step, interview results from Austria will be included and with that the scope of study findings enriched.

Innovative Power of Health Care Organisations Affects IT Adoption: A bi-National Health IT Benchmark Comparing Austria and Germany.

Multinational health IT benchmarks foster cross-country learning and have been employed at various levels, e.g. OECD and Nordic countries. A bi-national benchmark study conducted in 2007 revealed a significantly higher adoption of health IT in Austria compared to Germany, two countries with comparable healthcare systems. We now investigated whether these differences still persisted. We further studied whether these differences were associated with hospital intrinsic factors, i.e. the innovative power of the organisation and hospital demographics. We thus performed a survey to measure the "perceived IT availability" and the "innovative power of the hospital" of 464 German and 70 Austrian hospitals. The survey was based on a questionnaire with 52 items and was given to the directors of nursing in 2013/2014. Our findings confirmed a significantly greater IT availability in Austria than in Germany. This was visible in the aggregated IT adoption composite score "IT function" as well as in the IT adoption for the individual functions "nursing documentation" (OR = 5.98), "intensive care unit (ICU) documentation" (OR = 2.49), "medication administration documentation" (OR = 2.48), "electronic archive" (OR = 2.27) and "medication" (OR = 2.16). "Innovative power" was the strongest factor to explain the variance of the composite score "IT function". It was effective in hospitals of both countries but significantly more effective in Austria than in Germany. "Hospital size" and "hospital system affiliation" were also significantly associated with the composite score "IT function", but they did not differ between the countries. These findings can be partly associated with the national characteristics. Indicators point to a more favourable financial situation in Austrian hospitals; we thus argue that Austrian hospitals may possess a larger degree of financial freedom to be innovative and to act accordingly. This study is the first to empirically demonstrate the effect of "innovative power" in hospitals on health IT adoption in a bi-national health IT benchmark. We recommend directly including the financial situation into future regression models. On a political level, measures to stimulate the "innovative power" of hospitals should be considered to increase the digitalisation of healthcare.

Personality judgments based on physical appearance.

Despite the crucial role of physical appearance in forming first impressions, little research has examined the accuracy of personality impressions based on appearance alone. This study examined the accuracy of observers' impressions on 10 personality traits based on full-body photographs using criterion measures based on self and peer reports. When targets' posture and expression were constrained (standardized condition), observers' judgments were accurate for extraversion, self-esteem, and religiosity. When targets were photographed with a spontaneous pose and facial expression (spontaneous condition), observers' judgments were accurate for almost all of the traits examined. Lens model analyses demonstrated that both static cues (e.g., clothing style) and dynamic cues (e.g., facial expression, posture) offered valuable personality-relevant information. These results suggest that personality is manifested through both static and expressive channels of appearance, and observers use this information to form accurate judgments for a variety of traits.