Association of brain-autonomic activities and task accuracy under cognitive load: a pilot study using electroencephalogram, autonomic activity measurements, and arousal level estimated by machine learning

The total amount of mental activity applied to working memory at a given point in time is called cognitive load, which is an important factor in various activities in daily life. We have proposed new feature quantities that reflect the time-series changes in the power of typical frequency bands in electroencephalogram (EEG) for use in examining the relationship between brain activity and behavior under cognitive load. We also measured heart rate variability (HRV) and spontaneous skin conductance responses (SCR) to examine functional associations among brain activity, autonomic activity, and behavior under cognitive load. Additionally, we applied our machine learning model previously developed using EEG to the estimation of arousal level to interpret the brain-autonomic-behavior functional association under cognitive load. Experimental data from 12 healthy undergraduate students showed that participants with higher levels of infra-slow fluctuations of alpha power have more cognitive resources and thus can process information under cognitive load more efficiently. In addition, HRV reflecting parasympathetic activity correlated with task accuracy. The arousal level estimated using our machine learning model showed its robust relationship with EEG. Despite the limitation of the sample size, the results of this pilot study suggest that the information processing efficiency of the brain under cognitive load is reflected by time-series fluctuations in EEG, which are associated with an individual's task performance. These findings can contribute to the evaluation of the internal state of humans associated with cognitive load and the prediction of human behaviors in various situations under cognitive load.

Dual decline in subjective gait speed and domain-specific cognition is associated with higher risk of incident dementia in older Japanese adults: A 15-year age-specific cohort study

OBJECTIVES

Dual decline in gait speed and cognition has been found to have higher dementia risk than no decline or pure decline. However, evidence from the Asian population is lacking. Therefore, we aimed to investigate the association of dual decline from age 65 to 70 years with late-life dementia in older Japanese adults with different personal characteristics.

METHODS

Data were collected from an age-specific cohort study conducted in 482 Japanese 65-year-old adults. We investigated participant demographics, medical histories, lifestyles, subjective gait speed, and cognition at both 64/65 and 70/71 years old, and confirmed dementia until age of 85 years. Cox proportion hazard models were used to estimate the risk of dementia, with adjustments for covariates, and death was treated as a competing risk.

RESULTS

After a mean follow-up period of 12.5-years, 111 participants developed dementia. Older adults with dual decline are more likely to have hyperlipidemia, diabetes, and smoking habits. And we found that dual decline in gait speed and domain-specific cognition was associated with a higher risk of dementia compared with no decline in most cognitive tests, with the highest risk observed for gait speed combined with memory (sub-distribution hazard ratio:3.89, 95 %, confidence intervals: [1.68-9.01]). However, significant differences only existed in men after stratification by sex.

CONCLUSIONS

A dual decline in subjective gait speed and cognition may serve as a robust predictor of dementia over a decade prior to its onset, particularly in men. These findings highlighted the importance of screening for dual decline at an early age.

Five-year changes of social activity and incident long-term care needs among depressed older adults: A 15-year follow up

OBJECTIVES

To examine the effects of changes in individual/multiple social activities between 65 and 70 years of age on incident long-term care (LTC) needs between 70 and 80 in older adults with depressive symptoms.

METHODS

Participants were recruited from the New Integrated Suburban Seniority Investigation Project, an ongoing prospective cohort study. A total of 525 older adults with depressive symptoms were included. The validated 15-item Geriatric Depression Scale was used to assess depressive symptoms. A self-report questionnaire was used to measure social activities (social-related, learning, and personal). LTC needs was defined according to Japan's Long-term Care Insurance System. A competing risk model and a Laplace regression model were used to estimate the hazard ratios of LTC needs incidence and the 25th percentile difference in LTC-needs-free survival time and their 95% confidence intervals.

RESULTS

Out of 4314 person-years of mild LTC needs, 108 individuals developed it. Participants who increased their frequency of learning activities have a lower risk of developing mild LTC needs. Increasing the frequency could also prolong LTC-needs-free survival time by approximately 2.61 years. Out of 4535 person-years for severe LTC needs, 54 individuals developed it. Participants with a continuous regular frequency of learning activities had a lower risk of developing severe LTC needs. However, the association between this frequency and LTC-needs-free survival time for severe LTC needs was insignificant in the multivariable models.

CONCLUSIONS

Increased frequency of learning activities reduced the risk of LTC needs among older adults with depressive symptoms and prolonged their LTC-needs-free survival time.

The physiological basis of leader-follower roles in the dyadic alternating tapping task

Introduction

Cooperative and collaborative behaviors are important concepts for co-creative communication. One of the key elements for these behaviors is the leader-follower roles in human communication. Leaders are those who maintain their own pace and rhythm, on the contrary, followers are those who follow the pace and rhythm of the other. Well-coordinated leader-follower roles would produce better cooperative and collaborative behaviors, which could promote co-creative communication.

Methods

Here, to explore the physiological basis for the leader-follower roles, we conducted the dyadic alternating tapping task with electrocardiographic and electroencephalographic recordings. The task would be stable for modeling human communication in the laboratory because it includes timing control in tens of milliseconds and turn-taking. Given that human communications are complex and constantly fluctuating, this study estimated the degree of leader-follower with the state-space model. This model allowed us to calculate two parameters independently for estimating the degree of leader-follower of each participant: αSelf (degree of one's tap(n) was explained by one's tap(n-1)) and αPair (degree of one's tap(n) was explained by one's tap (n-1) and pair's tap (n-1)).

Results

The result showed heart rate synchronization in the group in which both participants had high αPair. Also, the high-frequency component of heart rate variability was positively correlated with αPair. EEG analyses suggested the deactivation of the mirror neuron system (increasing φ1) in the participants with higher αSelf than lower ones. The activation of the mirror neuron system (increasing φ2) was shown in the participants with lower αPair than higher ones.

Discussion

These data of physiological basis for leader-follower roles could be useful for the constructivist approach to co-creative communication.

[Integration of Interoception, Decision-Making, and Affect: Allostasis as Predictive Processing]

Allostasis refers to the mechanism by which the brain changes bodily states to adapt to the environment in order to achieve stability or homeostasis. This concept was originally proposed by Sterling and Eyer in 1988. Recently, allostasis has been reconceptualized from the viewpoint of predictive processing, a theory arguing that the brain regulates perception and motor movement by generating predictions through inner models of the external world and self and minimizing the prediction error between the predictions and sensory signals. This idea provides integrated explanations of a wide range of phenomena, including homeostasis, decision-making, and the accompanying emotions and consciousness. Although this theory is a hypothesis, empirical evidence has been proposed in recent years. This article introduces the theory of predictive processing of allostasis, recent related research findings, and issues to be examined in the future.

Effects of mild psychological stress on facial impressions

Introduction

Appearance plays an important role in maintaining a positive impression in social interactions. Psychological stress is known to have an adverse effect on facial skin, as indicated in previous studies. However, no study has investigated the negative effect of stress on facial impressions. Therefore, we aimed to investigate changes in impressions from facial images before and after mental stress tasks using an online survey.

Method

Thirteen Japanese men were recruited to have their facial photographs taken before and after undergoing a psychological stress task. We observed the physiological effects of an increased heart rate and decreased blood flow on the cheek skin. Four average facial images were created for each time point (control: "baseline;" stress: "0H," "1H," and "3H") from their facial photographs. An online survey was conducted with 700 Japanese participants, who compared the "baseline" to other images and selected one of two options in each of the six questionnaire items of impressions.

Results

The results showed that the rate of participants who chose "baseline" was significantly lower in the items "looks tired," "looks old," and "looks irritated" and higher in "looks clean-cut" and "looks healthy" compared to other images created from photographs after the stress task ("0H," "1H," and "3H").

Conclusion

These results suggest that psychological stress loading not only causes physiological changes in autonomic nervous activity and skin blood flow but also negatively impacts facial impressions for a few hours following a mild stress load.

Effects of interoceptive accuracy on timing control in the synchronization tapping task

Humans often perform rhythmic synchronized movements. Professional musicians and dancers particularly perform such movement tasks well and have a higher interoceptive accuracy (IAcc) than non-musicians and non-dancers. We thus hypothesized that rhythmic synchronized movements might be enhanced by a higher IAcc. To investigate this hypothesis, this study conducted a heartbeat counting task and a rhythmic synchronization tapping task with normal (easier) and slow (harder) tempi metronomes. Inconsistent with our hypothesis, however, a higher IAcc was negatively correlated with timing control, but only in the slow tempo condition [r (30) = 0.46, p < 0.05]. This suggests that a higher IAcc did not enhance timing control in rhythmic synchronized movements but rather weakened it, resting heart rate variability was not correlated with timing control.

Temporal change in the association between life satisfaction and functional decline with gender differences: an age-specific prospective cohort study

BACKGROUND

Although life satisfaction (LS) has been shown to predict mortality, research studying the relationship between LS and functional decline is scarce. This study examined the association between LS and functional decline across four time points in young-old Japanese adults.

METHODS

We analysed 1,899 community-dwelling 65-year-olds in this age-specific cohort study conducted between 2000 and 2005. The Life Satisfaction Index K was used to evaluate LS and was classified into quartiles. Functional decline was determined using the Japanese Long-Term Care Insurance (LTCI) system: 1) mild disability; 2) severe disability; 3) all-cause mortality; 4) mild or severe disability; 5) severe disability or death; 6) mild or severe disability, or death. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) were calculated using the Cox proportional hazard model. The analyses were conducted in the 8^th, 10^th, 12^th, and 14^th years to assess the effect of LS on functional decline across time points.

RESULTS

The impact of LS gradually weakened over time. In the 8^th year (aged 72-73), a higher LS was associated with a lower risk of mild or severe disability among the women participants (adjusted HR [95% CI] = 0.30 [0.11-0.81]). However, the effect disappeared gradually (adjusted HR [95% CI] = 0.55 [0.27-1.14]) in the 10^th year (aged 74-75), 0.72 (0.41-1.26) in the 12^th year (aged 76-77), and 0.68 (0.41-1.14) in the 14^th year (aged 78-79). This trend continued in severe disability or death (adjusted HR [95% CI] = 0.24 [0.06-0.70], 0.31 [0.11-0.76], 0.57 [0.28-1.14], and 0.60 [0.32-1.12]) and mild or severe disability, or death (adjusted HR [95% CI] = 0.30 [0.14-0.68], 0.46 [0.24-0.87], 0.67 [0.41-1.10], and 0.65 [0.42-1.02]) in the 8^th, 10^th, 12^th, and 14^th years, respectively. No statistically significant association was found among men at any time points or in any classification of outcomes.

CONCLUSIONS

Higher LS scores in 65-year-old women were associated with a lower risk for functional decline in any combination of mild disability, severe disability, or death. Additionally, the effect of LS was observed to weaken over time.

TRIAL REGISTRATION

This is not an intervention survey and does not require registration.

Interoceptive accuracy correlates with precision of time perception in the millisecond range

It has been proposed that accuracy in time perception is related to interoceptive accuracy and vagal activity. However, studies investigating time perception in the supra-second range have provided mixed results, and few studies have investigated the sub-second range. Moreover, there is a lack of studies investigating the relationship between precision in time perception and interoceptive accuracy. A recent meta-analytic review of neuroimaging studies proposed a dynamic interaction between two types of timing processing-an endogenous time keeping mechanism and the use of exogenous temporal cues. Interoceptive accuracy may affect both accuracy and precision of primary temporal representations, as they are generated based on the endogenous time keeping mechanism. Temporal accuracy may vary when adapted to the environmental context. In contrast, temporal precision contains some constant noise, which may maintain the relationship with interoceptive accuracy. Based on these assumptions, we hypothesized that interoceptive accuracy would be associated with temporal precision in the sub-second range, while vagal activity would be associated with temporal accuracy. We used the temporal generalization task, which allowed us to calculate the indices of temporal accuracy and temporal precision in line with the existing research, and also compute the index of participants' sensitivity according to the signal detection theory. Specifically, we investigated whether (1) interoceptive accuracy would correlate with temporal accuracy, temporal precision, or sensitivity and (2) resting-state vagal activity would correlate with temporal accuracy, temporal precision, or sensitivity. The results indicated that interoceptive accuracy was positively correlated with temporal precision as well as sensitivity, but not with temporal accuracy, in the sub-second range time perception. Vagal activity was negatively correlated only with sensitivity. Furthermore, we found a moderation effect of sensitivity on the relationship between vagal activity and perceived duration, which affected the association between vagal activity and temporal accuracy. These findings suggest the importance of precision as an aspect of time perception, which future studies should further explore in relation to interoception and vagal activity, and of the moderation effects of factors such as participants' sensitivity in this context.

Changes in behavioral activities and transition of depressive symptoms among younger-old community-dwelling adults during 6 years: An age-specific prospective cohort study

OBJECTIVE

Regular engagement in behavioral activities plays a crucial role against depressive symptoms in older adults. This study aims to explore the relationship between behavioral activities and the temporal evolution of depressive symptoms.

METHODS

We included community-dwelling Japanese adults aged 64 or 65 years with and without depressive symptoms enrolled in the New Integrated Suburban Seniority Investigation (NISSIN) project. Depressive symptoms at baseline and follow-up were assessed using the 15-item Geriatric Depression Scale. Behavioral activities were measured by self-reported questions. Risk ratios and 95% confidence intervals were calculated using modified Poisson regression, adjusting for relevant sociodemographic variables and health-related confounders.

RESULTS

During the 6 year follow-up period, 139 (10.1%) without depressive symptoms at baseline developed such symptoms over time, while 174 (51.6%) with depressive symptoms improved to the point of these symptoms being absent. The participants without depressive symptoms at baseline and those who engaged in social activity or daily walking at a continued regular frequency (CRF) or an increased frequency (IF) and exercise habits at CRF were the least likely to have depressive symptoms onset at follow-up. There was no significant difference between the changes in behavioral activities and the improvement of depressive symptoms after controlling for confounders. Participants engaging in a greater variety of behavioral activities at CRF were less likely to experience a new onset of depressive symptoms.

CONCLUSIONS

Consistent and regular participation in one or more behavioral activities was significantly associated with the onset of depressive symptoms in Japanese community-dwelling older adults.

Somatic Symptoms: Association Among Affective State, Subjective Body Perception, and Spiritual Belief in Japan and Indonesia

This study aimed to examine differences in the following somatic symptoms: affective state (i.e., health concerns, anxiety, and positive and negative affect), somatosensory amplification, spirituality in Japan and Indonesia, and associations among all variables from each culture. Previous studies and a potential bio-psycho-spiritual model has identified the association of each variable in the development of somatic symptoms. Moreover, they demonstrated that individuals who describe themselves as more religious and spiritual report better physical and mental health. A total of 469 and 437 university students from Japan and Indonesia, respectively, completed the questionnaires for assessing somatic symptoms, health concerns, trait anxiety, positive and negative affect, somatosensory amplification, and spiritual belief. This study found significant differences in health concerns, positive and negative affect, state anxiety, and spiritual belief. Moreover, the difference in somatosensory amplification was negligible. There is a shared association in both cultures among somatic symptoms, affective state, subjective body perception, and spirituality. Health concerns and trait anxiety moderated somatosensory amplification in the development of somatic symptoms. However, the role of spirituality belief in somatic symptoms was observed in the Japanese and Indonesian cultures in relation to positive affect.

Interoceptive Accuracy Did Not Affect Moral Decision-Making, but Affect Regret Rating for One’s Moral Choices

Previous studies have revealed the effect of interoceptive accuracy (IAcc), a behavioral measure of the ability to feel physiological states and regulation for that, which origin emotion on decision-making such as gambling. Given that decision-making in moral dilemma situations is affected by emotion, it seems that IAcc also affects moral decision-making. The present study preliminarily investigates whether IAcc affects decision-making and emotional ratings such as regret for one’s own choices in moral dilemma situations. IAcc did not affect moral choice (deontological or utilitarian option), but affected regret ratings for one’s moral choice in portions of dilemma scenarios. Moreover, people with higher IAcc make deontological choices more rapidly than those with lower IAcc in self-related dilemma scenarios. These results suggest that people with higher IAcc feel stronger emotional conflicts about utilitarian choices but weaker conflicts about deontological choices than people with lower IAcc depending on the moral dilemma scenario.

A learning mechanism shaping risk preferences and a preliminary test of its relationship with psychopathic traits

People tend to avoid risk in the domain of gains but take risks in the domain of losses; this is called the reflection effect. Formal theories of decision-making have provided important perspectives on risk preferences, but how individuals acquire risk preferences through experiences remains unknown. In the present study, we used reinforcement learning (RL) models to examine the learning processes that can shape attitudes toward risk in both domains. In addition, relationships between learning parameters and personality traits were investigated. Fifty-one participants performed a learning task, and we examined learning parameters and risk preference in each domain. Our results revealed that an RL model that included a nonlinear subjective utility parameter and differential learning rates for positive and negative prediction errors exhibited better fit than other models and that these parameters independently predicted risk preferences and the reflection effect. Regarding personality traits, although the sample sizes may be too small to test personality traits, increased primary psychopathy scores could be linked with decreased learning rates for positive prediction error in loss conditions among participants who had low anxiety traits. The present findings not only contribute to understanding how decision-making in risky conditions is influenced by past experiences but also provide insights into certain psychiatric problems.

Reliability of Online Surveys in Investigating Perceptions and Impressions of Faces

Online experimental methods are used in psychological studies investigating the perceptions and impressions of facial photographs, even without substantial evidence supporting their reliability and validity. Although, the quality of visual stimuli is more difficult to control remotely, the methods might allow us to obtain a large amount of data. Then the statistical analysis of a larger volume of data may reduce errors and suggest significant difference in the stimuli. Therefore, we analyzed the reliability and validity of online surveys in investigating the perceptions (shine, red, and dark) and impressions (attractiveness, trustworthy, and so on) of facial photographs created from averaged faces with skin tones modified using computer graphics (CG). In this study, we conducted online (Online1) and laboratory experiments with well-controlled conditions (Control). For each experiment, 50 participants (men and women in Japan, age: 20–59years) completed the same questionnaire regarding their impressions of the same 28 CG facial photographs. The results showed significant correlations between the two experiments for all 19 items in the questionnaire. SD in the Online1 compared to the Control from the stimuli and individual differences were 56–84 and 88–104% in each questionnaire items, respectively. Moreover, the rates of mismatching perceptual evaluations to the corresponding physical features demonstrated in the photographs were 4.9–9.7% on average in an additional online survey of another 2,000 participants (Online2). These results suggest that online surveys can be applied to experiments to investigate impressions from CG facial photographs instead of general laboratory experiment by obtaining an appropriate number of participants to offset larger statistical errors that may result from the increased noise in the data from conducting the experiment online.

Association of high serum soluble interleukin 2 receptor levels with risk of adverse events in patients with cardiac sarcoidosis

Background

Sarcoidosis is a systemic granulomatous disease that affects multiple organs. Among these, the presence of cardiac involvement is recognised as a determinant of worse clinical outcomes. Soluble interleukin 2 receptor (sIL-2R) is a potentially useful biomarker in the diagnosis and evaluation of disease severity in patients with sarcoidosis. However, it remains to be seen whether sIL-2R is associated with the severity and activity of disease in patients with cardiac sarcoidosis (CS).

Purpose

The aims of this study were to investigate whether sIL-2R was associated with clinical outcomes and to clarify the relationship between sIL-2R levels and disease activity evaluated by 18F-fluorideoxyglucose in positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with CS.

Methods

We examined 101 consecutive patients with CS who were admitted to our University HospitalbetweenMay 2003 and February 2020. Patients who had no data of serum sIL-2R levels before initiation of immunosuppressive therapy (n=18) were excluded. Ultimately, 83 patients were examined in this study. The primary outcome was a composite of advanced atrioventricular block (AVB), ventricular tachycardia or ventricular fibrillation (VT/VF), heart failure hospitalisation, and all-cause death. Inflammatory activity in the myocardium and lymph nodes were assessed by18F-FDG PET/CT. We used a published program to analyse the cardiac metabolic activity (CMA), and total lymph node glycolysis (TLyG), which are quantitative measures of FDG volume-intensity.

Results

During a median follow-up period of 2.96 (interquartile range 2.24–4.27) years, the primary outcome occurred in 24 patients (29%), including 1 advanced AVB, 13 VT/VF, 5 hospitalisations for heart failure, and 5 all-cause deaths. Kaplan-Meier analyses showed that the primary outcome occurred more frequently in patients with higher sIL-2R levels (&gt;538 U/mL, the median) than in those with lower sIL-2R levels (Figure). A multivariable Cox regression analysis revealed that a higher sIL-2R level was independently associated with an increased subsequent risk of adverse events (hazard ratio 3.71, 95% confidence interval 1.63–8.44, p=0.002), even after adjustments for age, plasma B-type natriuretic peptide, estimated glomerular filtration rate, left ventricular ejection fraction, and late gadolinium enhancement, which are known to be strong determinants of worse clinical outcomes in patients with CS (Table). Furthermore, sIL-2R levels were significantly correlated with TLyG, the inflammatory activity in lymph nodes (r=0.346, p=0.003) but not with CMA, the inflammatory activity in myocardium (r=0.131, p=0.27).

Conclusions

Increased sIL-2R is associated with worse long-term clinical outcomes accompanied by increased systemic inflammatory activity in CS patients. These findings suggest the importance of assessing sIL-2R as a surrogate marker for further risk stratification in these patients.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Japan Society for the Promotion of Science

Diagnostic Accuracy of Diastolic Fractional Flow Reserve for Functional Evaluation of Coronary Stenosis

Background

In the resting conditions, narrowing the window of coronary pressure measurements from the whole cardiac cycle to diastole improves diagnostic performance of coronary pressure–derived physiological index. However, whether this also applies to the hyperemic conditions has not yet been thoroughly evaluated.

Objectives

The purpose of this study was to assess whether diastolic fractional flow reserve (diastolic FFR) has better diagnostic performance in identifying ischemia-causing coronary lesions than conventional FFR in a prospective, multicenter, and independent core laboratory–based environment.

Methods

In this prospective multicenter registry at 29 Japanese centers, we compared the diagnostic performance of FFR, diastolic FFR, resting distal to aortic coronary pressure (Pd/Pa), and diastolic pressure ratio (dPR) using myocardial perfusion scintigraphy (MPS) as the reference standard in 378 patients with single-vessel coronary disease.

Results

Inducible myocardial ischemia was found on MPS in the relevant myocardial territory of the target vessel in 85 patients (22%). In the receiver-operating curve analyses, diastolic FFR had comparable area under the curve (AUC) compared with FFR (AUC_{diastolic FFR}: 0.66; 95% confidence interval [CI]: 0.58-0.73, vs AUC_FFR: 0.66; 95% CI: 0.58-0.74, P = 0.624). FFR and diastolic FFR showed significantly larger AUCs than resting Pd/Pa (0.62; 95% CI: 0.54-0.70; P = 0.033 and P = 0.046) but did not show significantly larger AUCs than dPR (0.62; 95% CI: 0.55-0.70; P = 0.102 and P = 0.113).

Conclusions

Diastolic FFR showed a similar diagnostic performance to FFR as compared with MPS. This result reaffirms the use of FFR as the most accurate invasive physiological lesion assessment. (Diagnostic accuracy of diastolic fractional flow reserve (d-FFR) for functional evaluation of coronary stenosis; UMIN000015906)

Prediction of 11-year incidence of psychophysically dependent status or death among community-dwelling younger elderlies: from an age-specified community-based cohort study (the NISSIN project)

Background

Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex.

Methods

We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2000 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model.

Results

Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714–0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699–0.771).

Conclusions

We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12199-021-00968-8.

The role of right ventricular late gadolinium enhancement scoring by cardiac magnetic resonance imaging in cardiac sarcoidosis

Background

The right ventricular (RV) function is a significant predictor of the prognosis and exercises tolerance in patients with left ventricular dysfunction. The previous study reported that RV late gadolinium enhancements (LGE) as assessed by cardiac magnetic resonance (CMR) imaging were present in 16% of pulmonary sarcoidosis. Although RV LGE is associated with a poor prognosis, a semi-quantitative assessment of RV LGE was not been established so far. Moreover, the frequency of RV dysfunction (RVD) in cardiac sarcoidosis (CS) and predictors of RVD are unclear.

Purpose

Our aim of this study is to establish RV LGE semi-quantitative scores and to clarify the rate and predictors of RVD in CS.

Methods

Forty-four consecutive patients with CS who underwent CMR imaging (median age, 63 [IQR 54–71] years old; 10 males) were studied. They were diagnosed as definitive based on the Heart Rhythm Society expert consensus statement. Two patients were excluded due to no long axial view. Thus, a total of 42 patients were included in this study. RV LGE was semi-quantitatively evaluated using the original score developed by ours. RV was classified into RV outflow tract (OT), basal, middle and apex. RVOT and apex are assigned 1 segment for each, and basal and middle are assigned 4 segments include anterior, septal, inferior and lateral (Figure1). In total, 10 segments were evaluated. RV LGE scores were analysed independently by the two operators. The RV ejection fraction was assessed in a long axial view without an RVOT (20 phases, 12 slices). We divided the cohort into the non-RVD group (RVEF ≥45%) and the RVD group (RVEF &lt;45%) and compared the RV scores between the two groups.

Results

The RVD was present in 31% of the entire cohort. The presence of RV LGE was significantly higher in the RVD group than the non-RVD group (83% vs. 43%, p=0.037). RV LGE score in the RVD group was significantly higher than that in the non-RVD group (2.83±1.95 vs. 0.83±1.21, p=0.001). The septal lesions in basal and middle levels accounted for 54% in all segments. RVEF showed a significant inverse correlation with RV LGE score (r=−0.57, p&lt;0.0001). In the ROC curve for RVD, the RV LGE score of more than 2 and equal could discriminate RVD from non-RVD with AUC of 0.813 (Sensitivity = 0.77, Specificity = 0.76, p=0.003).

Conclusion

RVD was observed in 31% of patients with definitive CS. The septal lesions were the most frequent in the RV LGE site, which suggests that the longitudinal abnormal motion of RV is a significant predictor of the RVD in patients with CS. RV LGE score is a valuable method to assess RVD.

RV LGE score

Funding Acknowledgement

Type of funding source: None

The neural network basis of altered decision-making in patients with amyotrophic lateral sclerosis

OBJECTIVE

Amyotrophic lateral sclerosis (ALS) is a multisystem disorder associated with motor impairment and behavioral/cognitive involvement. We examined decision-making features and changes in the neural hub network in patients with ALS using a probabilistic reversal learning task and resting-state network analysis, respectively.

METHODS

Ninety ALS patients and 127 cognitively normal participants performed this task. Data from 62 ALS patients and 63 control participants were fitted to a Q-learning model.

RESULTS

ALS patients had anomalous decision-making features with little shift in choice until they thought the value of the two alternatives had become equal. The quantified parameters (Pαβ) calculated by logistic regression analysis with learning rate and inverse temperature well represented the unique choice pattern of ALS patients. Resting-state network analysis demonstrated a strong correlation between Pαβ and decreased degree centrality in the anterior cingulate gyrus and frontal pole.

INTERPRETATION

Altered decision-making in ALS patients may be related to the decreased hub function of medial prefrontal areas.

Reward-Driven Arousal Impacts Preparation to Perform a Task via Amygdala-Caudate Mechanisms

Preparing for a challenging task can increase physiological arousal, in particular when potential incentives are large (e.g., a solo musical performance in front of an audience). Here, we examine how potential reward and its influence on arousal, measured by pupil dynamics, are represented in the brain while preparing for a challenging task. We further ask how neural representations during preparation relate to actual performance. Trials resulting in performance failure were characterized by increased pupil dilation as a function of increasing reward magnitude during preparation. Such failure trials were also associated with activation of the right amygdala representing pupil dilation, and the left caudate representing reward magnitude. Notably, increases in functional connectivity between amygdala and caudate preceded performance failure. These findings highlight increased connectivity between neural regions representing reward and arousal in circumstances where reward-driven arousal impairs performance.

Costly group apology communicates a group's sincere "intention"

Groups, such as governments and organizations, apologize for their misconduct. In the interpersonal context, the forgiveness-fostering effect of apologies is pronounced when apologizing entails some cost (e.g., compensating damage, canceling a favorite activity to prioritize the apology) because costly apologies tend to be perceived as more sincere than non-costly apologies (e.g., merely saying "sorry"). Since groups lack a mental state (e.g., sincere intention), this could arguably render a group apology ineffective. This research investigated the possibility that people ascribe intention to group agents and that offering a costly group apology is an effective means of fostering perceived sincerity. A vignette study (Pilot Study) showed that costly group apologies tend to be perceived as more sincere than non-costly group apologies. A subsequent functional magnetic resonance imaging study revealed that costly group apologies engaged the bilateral temporoparietal junction and precuneus more so than non-costly group apologies and no apology did. The bilateral temporoparietal junction and precuneus have been implicated in the reasoning of social/communicative intention. Therefore, these results suggest that although a group mind does not exist, people ascribe a mental state (i.e., sincere intention) to a group especially when the group issues a costly apology after committing some transgression.

The Effect of Reduced Learning Ability on Avoidance in Psychopathy: A Computational Approach

Individuals with psychopathy often show deficits in learning, which often have negative consequences. Several theories have been proposed to explain psychopathic behaviors, but the learning mechanisms in psychopathy are still unclear. To clarify the learning anomalies in psychopathy, we fitted reinforcement learning (RL) models to behavioral data. We conducted two experiments to examine the effect of psychopathy as a group difference (Experiment 1) and as a continuum (Experiment 2). Forty-three undergraduates (in Experiment 1) and fifty-five undergraduate and graduate students (in Experiment 2) performed a go/no-go based learning task with accompanying rewards or punishments. Although we observed no differences in learning performance among the levels of psychopathic traits, the learning rate for the positive prediction error in the loss domain was lower for those with high-psychopathic trait than for those with low-psychopathic trait. This finding indicates that individuals with high-psychopathic traits update an action value less when they avoid a negative outcome. Our model can represent previous theories under a computational framework and provide a new perspective on impaired learning in psychopathy.

4089Prognostic value of cardiac metabolic activity assessed by 18F-FDG PET in patients with cardiac sarcoidosis

Background

Sarcoidosis is a systemic granulomatous disease that affects multiple organs. Among these,the presenceof cardiac involvementis recognized as a determinant of worse clinical outcomes. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a valuable modality for detecting active inflammatory lesions associated with cardiac sarcoidosis (CS). Generally,the maximum standardized uptake value (SUV) is suitable for evaluating disease activity in CS, but this quantitative method had limitations because it does not integrate both volume and intensity of FDG uptake simultaneously. Cardiac metabolic activity (CMA), which is quantitative measures of FDG volume-intensity, could be a diagnostic tool in the evaluation of CS. However, its prognostic implication in patients with CS is unclear.

Purpose

We sought to investigate whether CMA assessed by FDG-PET was associated with long-term worse clinical outcomes in patients with CS.

Methods

A total of 76 consecutive patients suspected CS who underwent FDG-PET between January 2010 and April 2018 in our university hospital were registered. We excluded patients whodid not meet the Japanese Ministry of Health and Welfare 2007 criteria (n=9) and those who received oral corticosteroids at the time of FDG-PET (n=5). Ultimately, 62 CS patients with definitively diagnosed were included in this study.We used a dedicated software to analyze SUV. Cardiac metabolic volume (CMV) was defined as the volume within the boundary determined by the threshold (SUV mean of blood pool × 1.5). CMA was calculated by multiplying CMV by SUV mean. The primary outcome of interest was the composite of advanced atrioventricular block, ventricular tachycardia, ventricular fibrillation, heart failure hospitalization, and all-cause death.

Results

During a median follow-up period of 1287 (IQR 806–1809) days after the first FDG-PET, the adverse events occurred in 12 patients (19%). Events group had significantly higher CMA compared to no events group (83 [IQR 11–330] vs. 354 [IQR 70–577]) (Figure A). Based on ROC analysis, the optimal cut-off value of CMA for the discrimination of the adverse events was 244 ml, and c-index was 0.71 (95% CI, 0.55–0.87). Patients with high CMA (≥244 ml, n=23) had lower LVEF, and higher prevalence of New York Heart Association functional class III or IV, and higher plasma BNP level compared to those with low CMA (<244 ml, n=39). Kaplan-Meier analysis revealed that composite adverse events more frequently occurred in patients with high CMA compared to those with low CMA (Figure B).Univariable Cox regression analysis showed that higher CMA was associated with increased subsequent risk of adverse events (HR 1.47, 95% CI 1.06–2.24).

Conclusions

Higher CMA assessed by FDG-PET was associated with worse clinical long-term outcomes in patients with CS, suggesting that measurement of the volume-intensity of abnormal FDG uptake may be useful for risk stratification in patients with CS.

Reinforcement Learning With Parsimonious Computation and a Forgetting Process

Decision-making is assumed to be supported by model-free and model-based systems: the model-free system is based purely on experience, while the model-based system uses a cognitive map of the environment and is more accurate. The recently developed multistep decision-making task and its computational model can dissociate the contributions of the two systems and have been used widely. This study used this task and model to understand our value-based learning process and tested alternative algorithms for the model-free and model-based learning systems. The task used in this study had a deterministic transition structure, and the degree of use of this structure in learning is estimated as the relative contribution of the model-based system to choices. We obtained data from 29 participants and fitted them with various computational models that differ in the model-free and model-based assumptions. The results of model comparison and parameter estimation showed that the participants update the value of action sequences and not each action. Additionally, the model fit was improved substantially by assuming that the learning mechanism includes a forgetting process, where the values of unselected options change to a certain default value over time. We also examined the relationships between the estimated parameters and psychopathology and other traits measured by self-reported questionnaires, and the results suggested that the difference in model assumptions can change the conclusion. In particular, inclusion of the forgetting process in the computational models had a strong impact on estimation of the weighting parameter of the model-free and model-based systems.

Lifestyle and psychosocial factors and a decline in competence in daily living among Japanese early elderly people: from an age-specified community-based cohort study (NISSIN project)

Background

To let the early elderly live well, understanding how lifestyle and psychosocial factors related to a decline in competence in daily living is important.

Methods

We investigated the associations between lifestyle and psychosocial factors at age 64 years and a decline in the Tokyo Metropolitan Institute of Gerontology Index of Competence score of ≥ 2 points at age 70 years among the participants in comprehensive medical check-ups living in a city in Japan. Multivariable logistic regression analyses were performed separately for men and women.

Results

Of the 1113 eligible men and 1203 eligible women, 110 men and 80 women showed a deteriorated competence in daily living during the 6 years. In men, risk was increased with ≥ 2 nighttime awakenings (multivariable odds ratio [mOR] 2.14, 95% confidence interval [CI] 1.19–3.86) and living alone (mOR 4.68, 95% CI 1.22–18.0), whereas risk was significantly decreased with a medium or fast gait (mOR 0.37 and 0.21, 95% CI 0.21–0.67 and 0.08–0.58) and high academic achievement (mOR 0.32 and 0.43, 95% CI 0.19–0.53 and 0.25–0.72). In women, risk was decreased with high life satisfaction (mOR 0.39, 95% CI 0.16–0.91) and participation in community activities (mOR 0.50, 95% CI 0.29–0.86) but increased with depressive mood (mOR 1.86, 95% CI 1.09–3.18).

Conclusion

Living alone for men and low life satisfaction for women at age 64 years were markedly associated with the risk of a subsequent declining competence in daily living.

Group size effects on inter-blink interval as an indicator of antipredator vigilance in wild baboons

Vigilance in animals is an important means for predator detection. Animals living in groups reduce their predation risk as more individuals are present. In contrast to most other animals studied, many studies on primates do not support the prediction that individual vigilance will decline as group size increases. For animals to obtain visual information during vigilance behaviour, their eyes must be open. Therefore, if animals are able to perceive differential risk of predation, the inter-blink interval (eye-opening) should increase, and the blink duration (eye-closure) should decrease under higher predation risk. We tested this prediction by measuring inter-blink interval in wild anubis baboons (Papio anubis) in peripheral and centre individuals within a group, and between larger and smaller groups. We found that the inter-blink interval for young males, often located at the front edge of the group, was longer than that of adult males, adult females, and young females, often located in the center of the group, and that the inter-blink interval for adult males was longer when the group was smaller. These results suggest that inter-blink interval can be used as an indicator of primate vigilance toward predators.

Prediction of major complications after hepatectomy using liver stiffness values determined by magnetic resonance elastography

BACKGROUND

Liver fibrosis is a risk factor for hepatectomy but cannot be determined accurately before hepatectomy because diagnostic procedures are too invasive. Magnetic resonance elastography (MRE) can determine liver stiffness (LS), a surrogate marker for assessing liver fibrosis, non-invasively. The aim of this study was to investigate whether the LS value determined by MRE is predictive of major complications after hepatectomy.

METHODS

This prospective study enrolled consecutive patients who underwent hepatic resection between April 2013 and August 2016. LS values were measured by imaging shear waves by MRE in the liver before hepatectomy. The primary endpoint was major complications, defined as Clavien-Dindo grade IIIa or above. Logistic regression analysis identified independent predictive factors, from which a logistic model to estimate the probability of major complications was constructed.

RESULTS

A total of 96 patients were included in the study. Major complications were observed in 15 patients (16 per cent). Multivariable logistic analysis confirmed that higher LS value (P = 0·021) and serum albumin level (P = 0·009) were independent predictive factors for major complications after hepatectomy. Receiver operating characteristic (ROC) analysis showed that the best LS cut-off value was 4·3 kPa for detecting major complications, comparable to liver fibrosis grade F4, with a sensitivity of 80 per cent and specificity of 82 per cent. A logistic model using the LS value and serum albumin level to estimate the probability of major complications was constructed; the area under the ROC curve for predicting major complications was 0·84.

CONCLUSION

The LS value determined by MRE in patients undergoing hepatectomy was an independent predictive factor for major complications.

Emotional Arousal at Memory Encoding Enhanced P300 in the Concealed Information Test

Previous studies have reported that the concealed information test (CIT) is a reliable and powerful method for detecting information. However, the external validity of the CIT studies has not been fully proven. In particular, few studies have examined the effects of emotional arousal at memory encoding on physiological responses in the CIT. The present study investigated the influence on the CIT of the magnitude of emotional arousal at memory encoding of a mock crime, using the P300 component of the event-related brain potential (ERP). In accord with the assumptions of excitation-transfer theory, we presented emotionally arousing pictures before a mock crime. Participants were randomly assigned to either a high emotional arousal group (n = 10) or a low emotional arousal group (n = 11), viewing pictures expected to arouse emotion at a high or low level, respectively. Subsequently, all participants enacted the same mock crime, in which they were instructed to stab a pillow with a sharp-edged tool (e.g., a kitchen knife or ice pick) as if harassing a mannequin lying on a bed. After the antecedent emotional experience, the P300-based CIT was conducted. Participants in the high arousal group showed significantly greater P300 amplitudes in response to a probe stimulus compared with the low arousal group. No differences were found between the groups in response to irrelevant stimuli. These results support the notion that emotional arousal influences the P300 in the CIT paradigm.

Neural and Genetic Correlates of the Social Sharing of Happiness

Happiness is regarded as one of the most fundamental human goals. Given recent reports that positive feelings are contagious (e.g., the presence of a happy person enhances others' happiness) because of the human ability to empathize (i.e., sharing emotions), empathic ability may be a key factor in increasing one's own subjective level of happiness. Based on previous studies indicating that a single nucleotide polymorphism in the serotonin 2A receptor gene [HTR2A rs6311 guanine (G) vs. adenine (A)] is associated with sensitivity to emotional stimuli and several mental disorders such as depression, we predicted that the polymorphism might be associated with the effect of sharing happiness. To elucidate the neural and genetic correlates of the effect of sharing happiness, we first performed functional magnetic resonance imaging (fMRI) during a “happy feelings” evocation task (emotional event imagination task), during which we manipulated the valence of the imagined event (positive, neutral, or negative), as well as the presence of a friend experiencing a positive-valence event (presence or absence). We recruited young adult women for this fMRI study because empathic ability may be higher in women than in men. Participants felt happier (p < 0.01) and the mentalizing/theory-of-mind network, which spans the medial prefrontal cortex, temporoparietal junction, temporal poles, and precuneus, was significantly more active (p < 0.05) in the presence condition than in the absence condition regardless of event valence. Moreover, participants with the GG (p < 0.01) and AG (p < 0.05) genotypes of HTR2A experienced happier feelings as well as greater activation of a part of the mentalizing/theory-of-mind network (p < 0.05) during empathy for happiness (neutral/presence condition) than those with the AA genotype. In a follow-up study with a vignette-based questionnaire conducted in a relatively large sample, male and female participants were presented with the same imagined events wherein their valence and the presence of a friend were manipulated. Results showed genetic differences in happiness-related empathy regardless of sex (p < 0.05). Findings suggest that HTR2A polymorphisms are associated with the effect of sharing happiness by modulating the activity of the mentalizing/theory-of-mind network.

Selective Fair Behavior as a Function of Psychopathic Traits in a Subclinical Population

Psychopathy is a group of personality traits that are associated with violations of social norms. Previous studies have suggested that people with psychopathic traits in subclinical populations do not necessarily display antisocial, self-defeating behaviors, and instead may strategically show adaptive behaviors in response to cues during reciprocal social interactions. Therefore, in the present study, we examined whether the association between psychopathic traits and unfair behavior can be moderated by a potential for punishment and social distance (anonymity), which are known to facilitate fair behavior. We focused on two psychopathic traits: primary and secondary psychopathy. Primary psychopathy is characterized by callousness, shallow affect, manipulation, and superficial charm. In contrast, secondary psychopathy is associated with impulsivity and lack of long-term goals, and is related to hostile behavior. A total of 348 undergraduate students determined the amounts of money that they would offer to strangers or friends at their university in hypothetical scenarios of the ultimatum game (UG) and the dictator game (DG). While gender affected decisions in the hypothetical scenarios of the DG, it did not interact with psychopathic traits. The score for primary psychopathy on the Levenson self-report psychopathy scale predicted unfair monetary offers to strangers in the DG, where participants could not be punished. However, compared with their offers in the DG, individuals with higher scores for primary psychopathy made larger offers in the UG, where low offers could trigger punishment from the recipient. Moreover, primary psychopathy did not decrease the amounts of offers in either game when the participant considered the recipient to be a friend. On the other hand, secondary psychopathy was not associated with differences in behavioral fairness depending on a potential for punishment or social distance. Based on these findings, we discuss strategic social skills as a function of primary psychopathy.

[Regulation of Behavior Based on Interoception]

It is well known that the insular cortex (Brodmann areas 13, 14, 15, and 16) located deep inside the Sylvian fissure is associated with mental functions such as perception, language, cognition, affect, and movement. In particular, the insular cortex has been linked to interoception, which is the representation of bodily physiological states that is used to regulate bodily states and mental functions. Recently, a common principle to explain such functions of the insular cortex has been proposed. The principle posits that the anterior insula generates predictions of future bodily states, computes the error by comparing the prediction with the actual sensory signals, and integrates the body with the mind by minimizing the prediction error. This article describes the functions of the insular cortex, and discusses the possibility that an error-minimizing function can affect decision-making to regulate behaviors.

Abstract P3-10-14: Breast cancer provider delay after the 2011 triple disaster in Fukushima, Japan

Introduction

Timely diagnosis and treatment is an indispensable part of breast cancer management. Delay of this process, also known as provider delay, can result in a deteriorated prognosis of affected patients. Although it has been suggested that disasters can impact cancer care and extend provider delay, there is little information available on long-term trends of breast cancer provider delay in post-disaster settings.

So-so district of Fukushima prefecture, Japan, experienced an earthquake, tsunami and the Fukushima Daiichi Nuclear Power Plant Accident in 2011. So-so district has areas falling within the mandatory, voluntary and non-evacuation ordered zones. Due to a long-term shortage of medical staff and closure of medical institutions post-disaster, patients with breast cancer may have experienced longer provider delay in this area.

Objectives

To compare provider delay of breast cancer patients and elucidate contributing factors to delay pre- and post-disaster, in an area severely affected by Japan's 2011 triple disaster.

Methods

We retrospectively investigated data of newly diagnosed breast cancer patients who undertook first medical consultation at the two main cancer centers in the non-evacuation ordered zone of So-so district from 2005 to 2016. Sociodemographic and clinical information was collected from medical records. The main outcome measure was median (days) from first medical consultation to start of breast cancer-specific treatment, pre- and post-disaster, using Mann-Whitney U test. Multivariate linear regression was then conducted to identify any factors which contributed to extended provider delay before and after the disaster.

Results

A total of 157 pre-disaster patients and 121 post-disaster patients were included in the study. There was no significant difference in the interval of median days of first medical consultation to start of first treatment pre- and post-disaster (40 vs. 39, p=0.82). Although diagnosis was made in a shorter interval post-disaster compared to pre-disaster (11 vs. 14, p=0.01) with significantly smaller median number of biopsies (1 vs. 1, p=0.001), this post-disaster improvement in diagnostic process was offset by deferred start of treatment after diagnosis (26 vs. 22, p=0.008). Among the pre-disaster patients, cancer detection by breast cancer screening program (p&lt;0.001), being engaged in full-time job (p&lt;0.042), and number of biopsies before diagnosis (p=0.005) contributed to longer provider delay in multivariate regression. However, consultation from other medical providers (p=0.03) was the only factor which significantly contributed to extended delay post-disaster, after controlling for multiple variables.

Conclusion

There was no significant increase in provider delay among breast cancer patients post-disaster. However, a median interval of 39 days from first medical consultation to start of treatment is much longer than other high-income countries, and shows much room for improvement in future.Introduction

Timely diagnosis and treatment is an indispensable part of breast cancer management. Delay of this process, also known as provider delay, can result in a deteriorated prognosis of affected patients. Although it has been suggested that disasters can impact cancer care and extend provider delay, there is little information available on long-term trends of breast cancer provider delay in post-disaster settings.

So-so district of Fukushima prefecture, Japan, experienced an earthquake, tsunami and the Fukushima Daiichi Nuclear Power Plant Accident in 2011. So-so district has areas falling within the mandatory, voluntary and non-evacuation ordered zones. Due to a long-term shortage of medical staff and closure of medical institutions post-disaster, patients with breast cancer may have experienced longer provider delay in this area.

Objectives

To compare provider delay of breast cancer patients and elucidate contributing factors to delay pre- and post-disaster, in an area severely affected by Japan's 2011 triple disaster.

Methods

We retrospectively investigated data of newly diagnosed breast cancer patients who undertook first medical consultation at the two main cancer centers in the non-evacuation ordered zone of So-so district from 2005 to 2016. Sociodemographic and clinical information was collected from medical records. The main outcome measure was median (days) from first medical consultation to start of breast cancer-specific treatment, pre- and post-disaster, using Mann-Whitney U test. Multivariate linear regression was then conducted to identify any factors which contributed to extended provider delay before and after the disaster.

Results

A total of 157 pre-disaster patients and 121 post-disaster patients were included in the study. There was no significant difference in the interval of median days of first medical consultation to start of first treatment pre- and post-disaster (40 vs. 39, p=0.82). Although diagnosis was made in a shorter interval post-disaster compared to pre-disaster (11 vs. 14, p=0.01) with significantly smaller median number of biopsies (1 vs. 1, p=0.001), this post-disaster improvement in diagnostic process was offset by deferred start of treatment after diagnosis (26 vs. 22, p=0.008). Among the pre-disaster patients, cancer detection by breast cancer screening program (p&lt;0.001), being engaged in full-time job (p&lt;0.042), and number of biopsies before diagnosis (p=0.005) contributed to longer provider delay in multivariate regression. However, consultation from other medical providers (p=0.03) was the only factor which significantly contributed to extended delay post-disaster, after controlling for multiple variables.

Conclusion

There was no significant increase in provider delay among breast cancer patients post-disaster. However, a median interval of 39 days from first medical consultation to start of treatment is much longer than other high-income countries, and shows much room for improvement in future.

Citation Format: Ozaki A, Leppold C, Tsubokura M, Sawano T, Tsukada M, Ohira H. Breast cancer provider delay after the 2011 triple disaster in Fukushima, Japan [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-10-14.

Association of Oxytocin and Parental Prefrontal Activation during Reunion with Infant: A Functional Near-Infrared Spectroscopy Study

Although previous studies have revealed the role of oxytocin (OT) in parental behavior, the role of OT has not been investigated through the direct assessment of prefrontal brain activation during parenting. By using functional near-infrared spectroscopy, we aimed to show the relationship between parental [maternal (N = 15) and paternal (N = 21)] OT levels and the activation of the prefrontal cortex (PFC), while holding their infants after separation. Baseline OT levels were measured in the subjects' saliva samples before the experiment. Prefrontal brain activation was assessed in participants sitting alone on a chair (i.e., separation from their infant for 120 s) and during the target period (i.e., holding their infant for 45 s), which was done in triplicate. The oxygen hemoglobin (oxy-Hb) dissociation curve significantly increased in 9 out of 22 channels on the PFC when maternal and paternal samples were combined. However, only the fathers showed a correlation between salivary OT and oxy-Hb signal. Furthermore, while holding their infants, high-OT fathers showed left hemispheric dominance compared to low-OT fathers, while high-OT mothers showed right hemispheric dominance compared to low-OT mothers. This study showed that fathers with high-OT levels showed neural activation with left hemispheric dominance, while holding their infants, suggesting that increase of OT level might activate paternal PFC related to parenting behavior, although the same is not true for mothers.

Influence of Attention Manipulation on Emotion and Autonomic Responses

Psychopathologies such as depression and anxiety have been associated with self-consciousness, a trait focusing on the self in terms of emotions and social images. A technique designed to shift attention away from the self tends to reduce anxiety, so the present purpose was to assess the effect of self body-state information on an individual's emotional and autonomic activity. 24 undergraduate and graduate students (10 men and 14 women), ages 19 to 27 years ( M = 22.1, SD = 2.5), were recruited as subjects. Focusing on body-state during an anxiety-inducing situation led to an increase of low to high frequency ratio of heart-rate variability which reflected cardiac sympathovagal balance. That is, attending to one's own bodily states enhanced relative sympathetic activity compared to parasympathetic activity, which can be interpreted as one of the physiological emotional responses elicited by anxiety.

Prolonged Effects of Acute Stress on Decision-Making under Risk: A Human Psychophysiological Study

This study investigates the prolonged effects of physiological responses induced by acute stress on risk-taking in decision-making. Participants were divided into a Stress group (N = 14) and a Control group (N = 12). The Trier Social Stress Test was administered as an acute stressor, and reading was administered as a control task; thereafter, participants performed a decision-making task in which they needed to choose a sure option or a gamble option in Gain and Loss frame trials 2 h after (non-) exposure to the stressor. Increased cortisol, adrenaline, heart rate (HR), and subjective stress levels validated acute stress manipulation. Stressed participants made fewer risky choices only in the Gain domain, whereas no effect of stress was shown in the Loss domain. Deceleration of HR reflecting attention was greater for Gains compared with Losses only in the Stress group. Risk avoidance was determined by increased levels of cortisol caused by acute stress. These results suggest that processes regarding glucocorticoid might be involved in the prolonged effects of acute stress on the evaluation of risks and the monitoring of outcomes in decision-making.

Eyeblink Activity as an Index of Cognitive Processing: Temporal Distribution of Eyeblinks as an Indicator of Expectancy in Semantic Priming

Eyeblink activity was examined as a psychophysiological index of cognitive processing during a typical semantic priming task. To examine the expectancy-induced effects, the proportion of semantically related pairs was controlled. 8 undergraduates engaged in a lexical decision task for target words. Each condition differed in target type (Semantically Related with prime vs Unrelated vs Nonword) and proportion of Semantically Related pairs (High vs Low). As a result, the temporal distribution of blinks was clearly influenced by the semantic priming effect. The peak of blink bursts, which is correlated with the end of cognitive processing, occurred the fastest in the semantically Related and High proportion condition. While blink latency showed larger individual differences, the temporal distribution of blinks was suggested as a more efficient index of cognitive processing.

Effects of Stimulus Valence on Recognition Memory and Endogenous Eyeblinks: Further Evidence for Positive-Negative Asymmetry

Japanese college students viewed a series of positive and negative stimulus words printed in katakana, a Japanese syllabary. Jacoby's process-dissociation procedure was used to assess the roles of conscious and unconscious processes in stimulus recognition. There was a stronger conscious recollective component in recognition of negative items and a higher correct rejection rate for negative stimuli, replicating American findings reported by Robinson-Riegler and Winton, and Ortony, Turner, and Antos. In addition, during the encoding phase, negative stimuli were associated with more eyeblinks and longer eyeblink latencies than positive stimuli; this pattern suggests greater cognitive activity in response to negative stimuli, consonant with Taylor's mobilization-minimization hypothesis. The eyeblink response, as measured in the present research, represents a new method for assessing the positive-negative asymmetries that are characteristic of the mobilization process.