Social incentives foster cooperation through guilt aversion: An effect that diminishes with primary psychopathic traits.

The association between primary psychopathic traits and non-cooperative behaviors is well-identified. There is a lack of studies on how to motivate cooperative behaviors in individuals with primary psychopathic traits. This study investigated the effects of monetary incentives and social incentives on promoting cooperation in healthy adults with varying primary psychopathic traits. Participants played a one-shot public goods game (PGG) with other anonymous players in three different contexts: a social incentives context where participants' decisions would be judged by others, a monetary incentives context where participants' decisions would result in winning or losing money depending on their contributions, and a control condition where no additional incentives were implemented. We found that, compared to the control condition, both monetary and social incentives significantly improved participants' contributions to the public project-an indicator of cooperative behavior. However, the association between higher primary psychopathic traits and less cooperation was only observed in the context of social incentives. Computational modeling further revealed that this effect can be explained by the diminishing guilt aversion when participants deliberately violated their inferred expectations of themselves from others' perspectives. This study found that social incentives can encourage cooperative behaviors in non-clinical psychopathy, and identified the mental processes navigating this effect.

The stability of multidimensional subclinical apathy during a pandemic and its relations to psycho-behavioral factors.

Apathy is a clinical symptom prevalent in many neuropsychiatric pathologies. Subclinical apathy is found in 35% of the general population. Despite high prevalence and negative consequences, underlying mechanisms are poorly understood, perhaps because the concept of apathy is one-dimensional. The current investigation aims to address the incidence of multidimensional apathetic trait in three distinct forms in a student population, to specify its determinants and to evaluate its stability during a global pandemic. Two online surveys, conducted 1 year apart on two separate cohorts of university students, with qualitative measures and validated scales. The final analysis included, respectively, 2789 and 1678 students. The three forms of apathetic trait were present, with the same debilitating consequences as apathetic symptom but independent determinants. Executive apathy was predicted by depressive symptoms, emotional apathy by motivational deficit and initiative apathy comprised a mixed executive-emotional form and a pure deficit of action initiation. The three forms of subclinical apathy remained similar in the context of increased depressive symptoms due to a global pandemic. This study confirmed the presence and independence of three forms of subclinical apathy in healthy students, which remained similar even in the light of increased depressive scores. These results shed light on cognitive and neuronal mechanisms underlying multidimensional apathy, allowing new, targeted treatments.

Lactobacillus rhamnosus CNCM I-3690 decreases subjective academic stress in healthy adults: a randomized placebo-controlled trial.

Psychological stress negatively affects the intestinal barrier function in animals and humans. We aimed to study the effect of Lactobacillus rhamnosus CNCM I-3690 on intestinal permeability and stress-markers during public speech. Healthy students were randomized to L. rhamnosus-containing (test) or acidified (placebo) milk consumed twice daily for 4 weeks, with 46 subjects per treatment group. Small intestinal permeability was quantified by a 2 h urinary lactulose-mannitol ratio (LMR, primary outcome), fractional excretion of lactulose (FEL) and mannitol (FEM). Salivary cortisol, State-Trait Anxiety Inventory (STAI) and Perceived Stress scores (PSS) were collected. No between-treatment differences were found for LMR (p = .71), FEL or FEM. Within-treatment analyses showed similar LMR and FEL but a stress-induced increase of FEM with the placebo (p < .05) but not test product. Despite a similar increase in salivary cortisol, the stress-induced increase in STAI was significantly lower with the test product vs. placebo (p = .01). Moreover, a stress-preventative effect of the probiotic was found for PSS and more pronounced in subjects with high stress-induced cortisol (p = .01). While increased FEM was mediated by salivary cortisol levels, the effect of the test product on subjective stress was not mediated by changes in FEM. No serious adverse events occurred. In conclusion, we demonstrated that L. rhamnosus CNCM I-3690 prevented stress-induced hyperpermeability to mannitol. Subjective but not objective stress-markers were reduced with L. rhamnosus vs. placebo, suggesting anxiolytic effects, which were independent of barrier stabilization and attractive for the reduction of stress in both health and disease. Clinicaltrials.gov, number NCT03408691.

Neuronally-enriched exosomal microRNA-27b mediates acute effects of ibuprofen on reward-related brain activity in healthy adults: a randomized, placebo-controlled, double-blind trial.

This double-blind, randomized, within-subjects design evaluated whether acute administration of an anti-inflammatory drug modulates neuron-specific, inflammation-modulating microRNAs linked to macroscopic changes in reward processing. Twenty healthy subjects (10 females, 10 males) underwent a functional magnetic resonance imaging scan while performing a monetary incentive delay (MID) task and provided blood samples after administration of placebo, 200 mg, or 600 mg of ibuprofen. Neuronally-enriched exosomal microRNAs were extracted from serum and sequenced. Results showed that: (1) 600 mg of ibuprofen exhibited higher miR-27b-3p, miR-320b, miR-23b and miR-203a-3p expression than placebo; (2) higher mir-27b-3p was associated with lower insula activation during MID loss anticipation; and (3) there was an inverse relationship between miR-27b-3p and MID gain anticipation in bilateral putamen during placebo, a pattern attenuated by both 200 mg and 600 mg of ibuprofen. These findings are consistent with the hypothesis that miR-27b could be an important messaging molecule that is associated with regulating the processing of positive or negative valenced information.

Building memories on prior knowledge: behavioral and fMRI evidence of impairment in early Alzheimer's disease.

Impaired memory is a hallmark of prodromal Alzheimer's disease (AD). Prior knowledge associated with the memoranda improves memory in healthy individuals, but we ignore whether the same occurs in early AD. We used functional MRI to investigate whether prior knowledge enhances memory encoding in early AD, and whether the nature of this prior knowledge matters. Patients with early AD and Controls underwent a task-based fMRI experiment where they learned face-scene associations. Famous faces carried pre-experimental knowledge (PEK), while unknown faces with which participants were familiarized prior to learning carried experimental knowledge (EK). Surprisingly, PEK strongly enhanced subsequent memory in healthy controls, but importantly not in patients. Partly nonoverlapping brain networks supported PEK vs. EK associative encoding in healthy controls. No such networks were identified in patients. In addition, patients displayed impaired activation in a right sub hippocampal region where activity predicted successful associative memory formation for PEK stimuli. Despite the limited sample sizes of this study, these findings suggest that the role prior knowledge in new learning might have been so far overlooked and underestimated in AD patients. Prior knowledge may drive critical differences in the way healthy elderly and early AD patients learn novel associations.

A comparative study of cumulative stress patterns within 14 days postpartum in healthy mothers and those with gestational diabetes: A prospective study.

ABSTRACT: Although the number of mothers with gestational diabetes mellitus (GDM) is on the rise, only few studies have examined the cumulative stress associated with breastfeeding after childbirth. GDM mothers are susceptible to stress due to insulin resistance, and their level of stress is associated with breastfeeding. This study aimed to identify patterns of stress change over time in GDM mothers and healthy mothers and to identify the factors influencing those patterns.The participants of this study were mothers within 14 days after childbirth. The GDM group consisted of 32 mothers, and the healthy group comprised 30 mothers. Cumulative stress was measured in terms of heart rate variability, and linear mixed models were used to analyze changes over time.The cumulative stress of healthy mothers was about 8 points higher than that of mothers with GDM (t = -2.95, P = .005). The cumulative stress level was inversely associated with the mother's age (ß=-1.20, P = .018), the mother's weight (ß=-0.64, P = .008), and the baby's body mass index (ß=-3.09, P = .038). Furthermore, an insufficient amount of breast milk was associated with higher stress (ß=16.09, P = .007).GDM mothers and healthy mothers experienced different patterns of cumulative stress. Breastfeeding should be started quickly to promote health and stress reduction among mothers who are physically and psychologically vulnerable after childbirth.It is necessary to incorporate programs to promote breastfeeding considering stress levels at an appropriate time according to the mother's health condition.

Evidence for a pervasive autobiographical memory impairment in Logopenic Progressive Aphasia.

Although characterized primarily as a language disorder, mounting evidence indicates episodic amnesia in Logopenic Progressive Aphasia (LPA). Whether such memory disturbances extend to information encoded pre-disease onset remains unclear. To address this question, we examined autobiographical memory in 10 LPA patients, contrasted with 18 typical amnestic Alzheimer's disease and 16 healthy Control participants. A validated assessment, the Autobiographical Interview, was employed to explore autobiographical memory performance across the lifespan under free and probed recall conditions. Relative to Controls, LPA patients showed global impairments across all time periods for free recall, scoring at the same level as disease-matched cases of Alzheimer's disease. Importantly, these retrieval deficits persisted in LPA, even when structured probing was provided, and could not be explained by overall level of language disruption or amount of information generated during autobiographical narration. Autobiographical memory impairments in LPA related to gray matter intensity decrease in predominantly posterior parietal brain regions implicated in memory retrieval. Together, our results suggest that episodic memory disturbances may be an under-appreciated clinical feature of LPA.

Let the team fix it?-Performance and mood of depressed workers and coworkers in different work contexts.

Depression in the workplace is a significant factor for reduced personal well-being and productivity. Consequently, this has negative effects on the economic success of the companies in which depressed people are employed. In addition, the economy has to deal with the significant burden of this illness on the health system. In this paper, we investigated how different working contexts-working in a group or individually-influenced depressed individuals towards higher or lower well-being and productivity. We examined this using a laboratory experiment. In this setting, we were also able to analyze how, in turn, a depressive individual impacted the productivity and affective situation of their workgroup, reflecting the company perspective. The experimental design mimicked the very basic processes of a workplace in a stylized way. We used two distinct samples: subclinically and clinically depressed, both working in a group with healthy controls. As expected, we found generally lower performance in the clinically depressed sample, but in the subclinically depressed sample, we only found this in the individual work context. In contrast to our expectations, the performance of subclinically depressed individuals working in groups with healthy controls was even higher than that of healthy controls in homogenously healthy groups. The performance of the entire group with a depressed member was lower for the sample with clinically manifested depression, while the performance of groups with a subclinically depressed participant was significantly higher than the performance of homogeneously non-depressed control groups. We discuss our results with a focus on the design of workplaces to both re-integrate clinically depressed employees and prevent subclinically depressed employees from developing major depression.

Family members' perspectives on learning cognitively unimpaired older adults' amyloid-ß PET scan results.

BACKGROUND/OBJECTIVES: Disclosure of Alzheimer's disease (AD) risk information to cognitively unimpaired older adults may become more common if preclinical AD is shown to be identifiable and amenable to treatment. Little, however, is known about how families will react to this information. DESIGN AND SETTING: Semi-structured telephonic interviews. PARTICIPANTS: Seventy study partners (mean age = 68 [±11]; 50% female; 70% spouses/significant others; 18% children, siblings; 12% friends) of cognitively unimpaired adults who learned a personalized AD dementia risk estimate and an amyloid-ß PET scan result through their participation in preclinical AD research. MEASUREMENT: Interviewees were asked about their desire for information regarding their family member's AD dementia risk, baseline expectations of risk, understanding of amyloid-ß PET scan results, and the impact of AD dementia risk information on emotions, health behaviors, and future plans, as well as on perceptions of their family member's or friend's memory. RESULTS: Interviewees generally understood the AD dementia risk information (83%) and considered it valuable (75%). Risk information perceived as favorable elicited feelings of happiness and relief; unfavorable information elicited disappointment, as well as increased awareness of the participants' memory and monitoring for incipient changes in cognition. While noting that AD dementia risk information was not medically actionable at this time due to the lack of disease-modifying therapies, some interviewees described changes to their family members' and their own health behaviors and future plans. CONCLUSION: Guidelines for the disclosure of AD dementia risk estimates and biomarker results to cognitively unimpaired adults should account for the needs and interests of individuals and their family members, who may step into a pre-caregiver role.

Reasons for undergoing amyloid imaging among cognitively unimpaired older adults.

OBJECTIVES: Preclinical Alzheimer's disease (AD) clinical trials screen cognitively unimpaired older adults for biomarker criteria and disclose their results. We examined whether participants in the Anti-Amyloid Treatment in Asymptomatic Alzheimer's disease Study with "elevated" and "not elevated" amyloid differed in scores on the "Views and Perceptions of Amyloid Imaging" questionnaire. We hypothesized that, prior to disclosure, those with elevated amyloid would score higher than those with not elevated amyloid. We also quantified how responses changed after result disclosure. METHODS: We assessed data from 4327 individuals who completed the questionnaire at screening visit 1 and after amyloid disclosure. We used linear regression models to assess the relationship between questionnaire category scores and amyloid status. We also quantified the relationship between category score changes and amyloid status. RESULTS: Overall, participants scored altruism and contribution to research as the strongest motivations for undergoing amyloid imaging. Those with elevated amyloid scored 0.23 points higher in the Perceived Risk category, on average, than those who had not elevated amyloid prior to disclosure; this effect attenuated towards zero after adjusting for Cognitive Function Instrument score. After disclosure, participants with elevated amyloid demonstrated less within-subject change in Perceived Risk, on average, compared to those with similar pre-disclosure scores who had not elevated amyloid, while demonstrating greater changes in the altruism and planning categories. INTERPRETATION: Altruism and learning disease risk motivated enrollment in this preclinical AD trial. Participants with elevated amyloid differed from their not elevated counterparts in their perceptions of amyloid imaging, even before undergoing the procedure.

Resting-state EEG alpha/theta power ratio discriminates early-onset Alzheimer's disease from healthy controls.

OBJECTIVES: The present study aims to compare early-onset Alzheimer's disease (EOAD) patients with healthy controls (HC), and late-onset Alzheimer's disease (LOAD) patients using resting-state delta, theta, alpha, and beta oscillations and provide a cut-off score of alpha/theta ratio to discriminate individuals with EOAD and young HC. METHODS: Forty-seven individuals with EOAD, 51 individuals with LOAD, and demographically-matched 49 young and 51 older controls were included in the study. Spectral-power analysis using Fast-Fourier Transformation (FFT) is performed on resting-state electroencephalography (EEG) data. Delta, theta, alpha, and beta oscillations compared between groups and Receiver Operating Characteristic (ROC) curve analysis was conducted. RESULTS: Compared to healthy controls individuals with EOAD showed an increase in slow frequency bands and a decrease in fast frequency bands. Frontal alpha/theta power ratio is the best discriminating value between EOAD and young HC with the sensitivity and specificity greater than 80% with area under the curve (AUC) 0.881. CONCLUSIONS: EOAD display more widespread and severe electrophysiological abnormalities than LOAD and HC which may reflect more pronounced pathological burden and cholinergic deficits in EOAD. Additionally, the alpha/theta ratio can discriminate EOAD and young HC successfully. SIGNIFICANCE: This study is the first to report that resting-state EEG power can be a promising marker for diagnostic accuracy between EOAD and healthy controls.

Differential neural structures, intrinsic functional connectivity, and episodic memory in subjective cognitive decline and healthy controls.

The neural correlates of subjective cognitive decline (SCD; i.e., without objectifiable deficit) remain to be elucidated. Possible causes of SCD include early neurodegeneration related to Alzheimer's disease or functional and structural changes related to sub-clinical depression. We investigated the relationship between episodic memory performance or memory complaints and structural or functional magnetic resonance imaging (MRI) measures in participants with SCD (n=18) but without psychiatric disorders and healthy controls (n=31). In SCD, memory complaints were not associated with memory performance but with sub-clinical depression and executive functions. SCD-associated memory complaints correlated with higher amygdala and parahippocampal gyrus (specifically subiculum) gray matter density. In controls, but not in SCD, mesiotemporal gray matter density and superior frontal gyrus functional connectivity predicted memory performance. In contrast, in SCD, only a trend toward a correlation between memory performance and gray matter density in the parietooccipital lobes was observed. In our memory-clinic sample of SCD, we did not observe incipient neurodegeneration (limited to structural and functional MRI) but rather sub-clinical depression underlying subjective cognitive complaints.

Fat and Carbohydrate Interact to Potentiate Food Reward in Healthy Weight but Not in Overweight or Obesity.

Prior work suggests that actual, but not estimated, energy density drives the reinforcing value of food and that energy from fat and carbohydrate can interact to potentiate reward. Here we sought to replicate these findings in an American sample and to determine if the effects are influenced by body mass index (BMI). Thirty participants with healthy weight (HW; BMI 21.92 ± 1.77; M ± SD) and 30 participants with overweight/obesity (OW/OB; BMI 29.42 ± 4.44) rated pictures of common American snacks in 120-kcal portions for liking, familiarity, frequency of consumption, expected satiety, healthiness, energy content, energy density, and price. Participants then completed an auction task where they bid for the opportunity to consume each food. Snacks contained either primarily carbohydrate, primarily fat, or roughly equal portions of fat and carbohydrate (combo). Replicating prior work, we found that participants with HW bid the most for combo foods in linear mixed model analyses. This effect was not observed among individuals with OW/OB. Additionally, in contrast with previous reports, our linear regression analyses revealed a negative relationship between the actual energy density of the snacks and bid amount that was mediated by food price. Our findings support altered macronutrient reinforcement in obesity and highlight potential influences of the food environment on the regulation of food reward.

Acute subjective effects in LSD- and MDMA-assisted psychotherapy.

BACKGROUND: Lysergic acid diethylamide (LSD) and 3,4-methylenedioxymethamphetamine (MDMA) were used in psychotherapy in the 1960s-1980s, and are currently being re-investigated as treatments for several psychiatric disorders. In Switzerland, limited medical use of these substances is possible in patients not responding to other treatments (compassionate use). METHODS: This study aimed to describe patient characteristics, treatment indications and acute alterations of mind in patients receiving LSD (100-200 µg) and/or MDMA (100-175 mg) within the Swiss compassionate use programme from 2014-2018. Acute effects were assessed using the 5 Dimensions of Altered States of Consciousness scale and the Mystical Experience Questionnaire, and compared with those in healthy volunteers administered with LSD or MDMA and patients treated alone with LSD in clinical trials. RESULTS: Eighteen patients (including 12 women and six men, aged 29-77 years) were treated in group settings. Indications mostly included posttraumatic stress disorder and major depression. Generally, a drug-assisted session was conducted every 3.5 months after 3-10 psychotherapy sessions. LSD induced pronounced alterations of consciousness on the 5 Dimensions of Altered States of Consciousness scale, and mystical-type experiences with increases in all scales on the Mystical Experience Questionnaire. Effects were largely comparable between patients in the compassionate use programme and patients or healthy subjects treated alone in a research setting. CONCLUSION: LSD and MDMA are currently used medically in Switzerland mainly in patients with posttraumatic stress disorder and depression in group settings, producing similar acute responses as in research subjects. The data may serve as a basis for further controlled studies of substance-assisted psychotherapy.

[Investigation of Relationships among Health Literacy, Social Determinants of Health, Menopausal Symptoms, Lifestyle-related Diseases, and Depression in Menopausal Women].

OBJECTIVES: The aim of this study was to clearly identify the relationships among health literacy, social determinants of health, health behaviors, menopausal symptoms, lifestyle-related diseases, and depression in healthy menopausal women. METHOD: A cross-sectional study was conducted using a questionnaire among menopausal women (45 to 60 years of age) who visited a facility offering various medical checkups to receive a specific medical checkup.Logistic regression was used to analyze the association of health literacy and social determinants of health with health behaviors for 162 subjects adjusted for age. Moreover, the association of several factors (health literacy, social determinants of health, and health behaviors) with menopausal symptoms, borderline zones for lifestyle-related diseases, and depression was also analyzed in the same way. RESULTS: It was shown that educational history was associated with smoking habit with an age-adjusted odds ratio OR of 3.23 (95% confidence interval [CI]: 1.103-9.443). It was shown that health literacy was associated with smoking habit, age-adjusted OR 4.07 (95% CI: 1.337-12.388), menopausal symptoms, age-adjusted OR 2.48 (95% CI: 1.177-5.235), and depression, age-adjusted OR 6.24 (95% CI: 2.421-16.092). CONCLUSION: It was found that poor health literacy was associated with smoking habit and the severity of menopausal symptoms and depression.

Using Positive Attribute Framing to Attenuate Nocebo Side Effects: A Cybersickness Study.

BACKGROUND: Side effect warnings can contribute directly to their occurrence via the nocebo effect. This creates a challenge for clinicians and researchers, because warnings are necessary for informed consent, but can cause harm. Positive framing has been proposed as a method for reducing nocebo side effects whilst maintaining the principles of informed consent, but the limited available empirical data are mixed. PURPOSE: To test whether positive attribute framing reduces nocebo side effects relative to negative framing, general warning, and no warning. METHODS: Ninety-nine healthy volunteers were recruited under the guise of a study on virtual reality (VR) and spatial awareness. Participants were randomized to receive positively framed ("7 out of 10 people will not experience nausea"), negatively framed ("3 out of 10 people will experience nausea"), general ("a proportion of people will experience nausea"), or no side effect warnings prior to VR exposure. RESULTS: Receiving a side effect warning increased VR cybersickness relative to no warning overall, confirming that warnings can induce nocebo side effects. Importantly, however, positive framing reduced cybersickness relative to both negative framing and the general warning, with no difference between the latter two. Further, there was no difference in side effects between positive framing and no warning. CONCLUSIONS: These findings suggest that positive framing not only reduces nocebo side effects relative to negative framing and general warnings, but actually prevents nocebo side effects from occurring at all. As such, positive attribute framing may be a cheap and ethical way to reduce nocebo side effects.

Associations of loneliness with risk of Alzheimer's disease dementia in the Framingham Heart Study.

INTRODUCTION: The relationship between persistent loneliness and Alzheimer's disease (AD) is unclear. We examined the relationship between different types of mid-life loneliness and the development of dementia and AD. METHODS: Loneliness was assessed in cognitively normal adults using one item from the Center for Epidemiologic Studies Depression Scale. We defined loneliness as no loneliness, transient loneliness, incident loneliness,or persistent loneliness, and applied Cox regression models and Kaplan-Meier plots with dementia and AD as outcomes (n = 2880). RESULTS: After adjusting for demographics, social network, physical health, and apolipoprotein E ε4, persistent loneliness was associated with higher (hazard ratio [HR], 1.91; 95% confidence interval [CI] 1.25-2.90; P < .01), and transient loneliness with lower (HR, 0.34; 95% CI 0.14-0.84; P < .05), risk of dementia onset, compared to no loneliness. Results were similar for AD risk. DISCUSSION: Persistent loneliness in mid-life is an independent risk factor for dementia and AD, whereas recovery from loneliness suggests resilience to dementia risk.

The Relationship between Perceived Self-Efficacy and Cervical Cancer Screening among Village Health Volunteers in Suratthani Province, Thailand.

OBJECTIVE: This research aimed to examine the relationship between perceived self-efficacy and cervical cancer screening of village health volunteers. METHODS: The researchers conducted this descriptive research with 279 samples, each recruited using the stratified random samplings. Data were collected in August 2020 using two research instruments included general data and the self-efficacy assessment. The self-efficacy assessment was tested, yielding a reliability score of 0.90. Data were then analyzed using descriptive statistics and point- biserial correlation. RESULTS: The results revealed that the mean scores of perceived self-efficacy were at a high level in (Mean= 4.35, S.D.= 0.77) and perceived self-efficacy of each has the mean scores of at a high level in strength, generality, and magnitude dimension (Mean= 4.27, S.D.= 0.76; Mean= 4.40, S.D.= 1.01; Mean= 4.35, S.D.= 0.76) respectively. There were significantly positive correlations between the perceived self-efficacy and cervical cancer screening at a very high level (r= 0.81, p <0.001). The relationship between the perceived self-efficacy of each in the strength dimension and magnitude dimension with cervical cancer screening was at a very high level of relationship significantly (r= 0.84, 0.82, p < 0.001). The generality dimension was at a high level of relationship significantly. (r= 0.66, p < 0.001). CONCLUSION: This study showed that village health volunteers with high perceived self-efficacy correlated with their confidence screening for cervical cancer. Therefore, village health volunteers should emphasize that women learn and acknowledge the importance of obtaining cervical cancer screening to prevent cervical cancer effectively. 
.

A Cross-Sectional Study about Knowledge, Awareness and Perception of Risk Factors for Cancer among Cancer-Patients Relatives and Healthy Adults in Ho Chi Minh City, Vietnam.

BACKGROUND AND AIMS: Although cancer is common in Ho Chi Minh city, Vietnam, the community awareness is still unknown. The primary objective of this study was to examine and compare the knowledge and risk perceptions of cancer possessed by cancer patients - relatives and healthy adults in Ho Chi Minh City, Vietnam. METHODS: A cross-sectional study was conducted from June to August 2019. Cancer patients and their relatives were drawn from those who were hospitalized in the Oncology Hospital, Ho Chi Minh City. Healthy individuals were those without a known diagnosis of cancer, and they were drawn from the participants of the Vietnam Osteoporosis Study. A total of 533 participants including 249 patients and relatives (cancerous group) and 284 healthy individuals (healthy group), were asked to respond to a structured questionnaire that was comprised of items concerning cancer knowledge, risk factor perception, and general attitude towards cancer, using Yes, No, or Likert Scale for response. RESULTS: The findings showed that patients hold poorer knowledge of pathology, signs, symptoms, prevention, and treatment and lower awareness of risk factors but more positive attitude towards cancer as compared to their healthy counterparts. Overall, both groups varied in their cancer knowledge, with many areas remain to be improved. CONCLUSIONS: Knowledge about cancer and its risk factors should be improved among the general population as well as among those with direct experiences with cancer.  Practical implications: The findings provided by this study has major implications for the design of an educational program for cancer patients in clinical settings and awareness programs for the general public as a primary preventive measure for mitigating the cancer burden. Future studies with larger and more diverse samples or qualitative studies exploring the personal narratives of people living with cancer could take advantage from the preliminary data provided by this study. 
.

Effects of open-label placebos on test performance and psychological well-being in healthy medical students: a randomized controlled trial.

Psychological distress is prevalent in students and can predispose to psychiatric disorders. Recent findings indicate that distress might be linked to impaired cognitive performance in students. Experimental findings in healthy participants suggest that placebo interventions can improve cognition. However, whether non-deceptive (i.e., open-label, OLP) placebos can enhance cognitive function and emotional well-being is unclear. Using a randomized-controlled design we demonstrate a positive impact of OLP on subjective well-being (i.e., stress, fatigue, and confusion) after a 21-day OLP application in healthy students during midterm exams. OLP did not improve test performance, but, within the OLP group, test performance was positively correlated with measures of general belief in the benefit of medication. These results show that OLP can counteract negative effects of acute stress on psychological well-being and might improve cognitive performance if supported by positive treatment expectations. Additionally, our findings in healthy volunteers warrant further investigation in exploring the potential of OLP in reducing stress-related psychological effects in patients. The trial was preregistered at the German Clinical Trials Register on December 20, 2017 (DRKS00013557).