Behavioral Sessions Research Articles

Dynamic Distortion of Orientation Representation after Learning in the Mouse Primary Visual Cortex.

Learning is an essential cognitive mechanism allowing behavioral adaptation through adjustments in neuronal processing. It is associated with changes in the activity of sensory cortical neurons evoked by task-relevant stimuli. However, the exact nature of those modifications and the computational advantages they may confer are still debated. Here, we investigated how learning an orientation discrimination task alters the neuronal representations of the cues orientations in the primary visual cortex (V1) of male and female mice. When comparing the activity evoked by the task stimuli in naive mice and the mice performing the task, we found that the representations of the orientation of the rewarded and nonrewarded cues were more accurate and stable in trained mice. This better cue representation in trained mice was associated with a distortion of the orientation representation space such that stimuli flanking the task-relevant orientations were represented as the task stimuli themselves, suggesting that those stimuli were generalized as the task cues. This distortion was context dependent as it was absent in trained mice passively viewing the task cues and enhanced in the behavioral sessions where mice performed best. Those modifications of the V1 population orientation representation in performing mice were supported by a suppression of the activity of neurons tuned for orientations neighboring the orientations of the task cues. Thus, visual processing in V1 is dynamically adapted to enhance the reliability of the representation of the learned cues and favor generalization in the task-relevant computational space.SIGNIFICANCE STATEMENT Performance improvement in a task often requires facilitating the extraction of the information necessary to its execution. Here, we demonstrate the existence of a suppression mechanism that improves the representation of the orientations of the task stimuli in the V1 of mice performing an orientation discrimination task. We also show that this mechanism distorts the V1 orientation representation space, leading stimuli flanking the task stimuli orientations to be generalized as the task stimuli themselves.

Exploiting cross‐session information for knowledge‐aware session‐based recommendation via graph attention networks

Session-based recommendation (SBR) aims to predict the next item based on anonymous behavior session, which has become increasingly essential in various online services. Prior efforts mainly focus on modeling user preference based on the current session. Although some of them have been proven effective, they fail to address two main challenges in SBR. First, SBR suffers more from the problem of data sparsity due to the very limited user–item interactions, and hence it cannot sufficiently capture complicated item dependency relationships. Second, most of the user-item interaction sequences may be with noisy preference signals due to the uncertainty of user's behaviors, and it is difficult to distill high-quality item for recommendation. In this study, we propose a novel SBR model that exploits Cross-session information for Knowledge-aware Session-based Recommendation (CKSR) to address these two issues. Specifically, cross-session graph and knowledge graph are combined to model a cross-session knowledge graph, based on which a knowledge-aware attention mechanism is performed to capture the complicated transition pattern among interacted items. Each session is then represented as the composition of the global preference and the current interest of that session. Moreover, we leverage the similar sessions for the target session to establish a similar session referral circle and apply an influence coupler to judge the significance of different session referrals. An attentive network is designed to distill session preferences from its unique session referral circle. It dynamically extracts high-quality item from noisy session. Experiments on two benchmark data sets demonstrate that CKSR outperforms the state-of-the-art methods consistently.

Layer- and cell-type-specific differences in neural activity in mouse barrel cortex during a whisker detection task.

To address the question which neocortical layers and cell types are important for the perception of a sensory stimulus, we performed multielectrode recordings in the barrel cortex of head-fixed mice performing a single-whisker go/no-go detection task with vibrotactile stimuli of differing intensities. We found that behavioral detection probability decreased gradually over the course of each session, which was well explained by a signal detection theory-based model that posits stable psychometric sensitivity and a variable decision criterion updated after each reinforcement, reflecting decreasing motivation. Analysis of multiunit activity demonstrated highest neurometric sensitivity in layer 4, which was achieved within only 30ms after stimulus onset. At the level of single neurons, we observed substantial heterogeneity of neurometric sensitivity within and across layers, ranging from nonresponsiveness to approaching or even exceeding psychometric sensitivity. In all cortical layers, putative inhibitory interneurons on average proffered higher neurometric sensitivity than putative excitatory neurons. In infragranular layers, neurons increasing firing rate in response to stimulation featured higher sensitivities than neurons decreasing firing rate. Offline machine-learning-based analysis of videos of behavioral sessions showed that mice performed better when not moving, which at the neuronal level, was reflected by increased stimulus-evoked firing rates.

Impact of the Cognitive-Behavioral Approach and Psychoeducational Intervention in Breast Cancer Management: A Prospective Randomized Clinical Trial.

(1) Background: Breast cancer (BC) is the most prevalent malignancy in women. High cancer-related psychological distress levels have been observed in BC patients, with a potentially relevant impact on disease management, compliance with disease treatments, and everyday life activities and relationships. This work evaluated the effectiveness of three individual cognitive–behavioral therapy psychoeducational sessions versus a self-managed informative guide with individual counseling sessions without specific psychological treatment. (2) Methods: the intervention group received three individual 50-min sessions of psychoeducational training, and the control group received a self-managed informative guide with individual counseling sessions without any kind of psychological treatment. The Hospital Anxiety Depression Scale (HADS), the Distress Thermometer (DT), and the EORTC (European Organization for Research and Treatment of Cancer) QLQ-C30 were administered at baseline and two months after study inclusion. (3) Results: A total of 60 participants were included in the study (intervention group: 30, control group: 30). Significant improvements were observed in both groups after two months (p < 0.05), but no statistically significant differences emerged between groups. (4) Conclusions: Psychoeducational interventions and CBT help BC patients manage disease-related fear and distress, allowing them to achieve a good quality of life.

Cognitive behavioral program on aggression and self-concept among institutionalized children with conduct disorder

PurposeTo explore the effect of cognitive-behavioral programs on aggression and self-concept among institutionalized children with conduct disorder. A quiz-experimental design was employed in this study. BackgroundConduct Disorder (CD) is defined as repetitive and persistent behavior that violates the rules of society and social norms. It is also characterized by aggressive behaviors toward people or animals, dishonesty or theft, destruction of property, or serious violation of rules, and persists in children or adolescents in the past 12 months before age 18. MethodThis research was carried out at the Dammam Observation Center in Saudi Arabia and the Cairo Caring Center in Egypt. Approximately 100 institutionalized children with conduct disorder who had evidence of conduct disorder were included in the study as part of a purposive sampling procedure. The information was gathered through the use of three different tools: Aggressive behavior and self-concept scales, as well as a sociodemographic data sheet. ResultsAccording to the findings, children with conduct disorder exhibited less aggression after participating in cognitive behavioral sessions (p = .011), resulting in lower mean aggression scores for the intervention group than the control group. After the training, about 64% of them had a moderate level of self-concept, whereas 44% of them had a moderate level of self-concept before the program. The study also revealed a statistically significant negative correlation between aggressive behavior and self-concept. ConclusionThe post-intervention remediation of aggressive behaviors and self-concept improvement point to the positive effect of the cognitive-behavioral program. The current study recommended that a cognitive-behavioral program is an effective, low-cost, and noninvasive intervention to improve self-concept and minimize aggressive behavior among institutionalized children with conduct disorder.

The impact of exercise and cumulative physical activity on energy intake and diet quality in adults enrolled in the Midwest Exercise Trial for the Prevention of Weight Regain.

The purpose of this study was to assess impact of different volumes of exercise as well as cumulative moderate to vigorous physical activity (MVPA) on energy intake (EI) and diet quality, as assessed by the Healthy Eating Index-2010(HEI-2010), across a 12-month weight maintenance intervention. Participants were asked to attend group behavioural sessions, eat a diet designed for weight maintenance and exercise either 150, 225 or 300 min/week. Dietary intake was assessed by 3-d food records, and MVPA was assessed by accelerometry. Two hundred and twenty-four participants (42·5 years of age, 82 % female) provided valid dietary data for at least one time point. There was no evidence of group differences in EI, total HEI-2010 score or any of the HEI-2010 component scores (all P > 0·05). After adjusting for age, sex, time, group and group-by-time interactions, there was an effect of cumulative MVPA on EI (1·08, P = 0·04), total HEI-2010 scores (-0·02, P = 0·003), Na (-0·006, P = 0·002) and empty energy scores (-0·007, P = 0·004. There was evidence of a small relationship between cumulative daily EI and weight (β: 0·00187, 95 % CI 0·001, P = 0·003). However, there was no evidence for a relationship between HEI total score (β: -0·006, 95 % CI 0·07, 0·06) or component scores (all P > 0·05) and change in weight across time. The results of this study suggest that increased cumulative MVPA is associated with clinically insignificant increases in EI and decreases in HEI.

More Prominent Nonlinear Mixed Selectivity in the Dorsolateral Prefrontal than Posterior Parietal Cortex.

Neurons in the dorsolateral prefrontal cortex (dlPFC) and posterior parietal cortex (PPC) are activated by different cognitive tasks and respond differently to the same stimuli depending on task. The conjunctive representations of multiple tasks in nonlinear fashion in single neuron activity, is known as nonlinear mixed selectivity (NMS). Here, we compared NMS in a working memory task in areas 8a and 46 of the dlPFC and 7a and lateral intraparietal cortex (LIP) of the PPC in macaque monkeys. NMS neurons were more frequent in dlPFC than in PPC and this was attributed to more cells gaining selectivity in the course of a trial. Additionally, in our task, the subjects’ behavioral performance improved within a behavioral session as they learned the session-specific statistics of the task. The magnitude of NMS in the dlPFC also increased as a function of time within a single session. On the other hand, we observed minimal rotation of population responses and no appreciable differences in NMS between correct and error trials in either area. Our results provide direct evidence demonstrating a specialization in NMS between dlPFC and PPC and reveal mechanisms of neural selectivity in areas recruited in working memory tasks.

Abstract 007: The Impact Of A Personalized Weight Loss Diet On Dietary Measures In Adults With Prediabetes And Early-stage Type 2 Diabetes

Introduction: There is limited research examining dietary changes in adults with prediabetes who are following a diet personalized to predict postprandial glycemic response (PPGR). Objective: We compared dietary changes in subjects randomized to a low-fat, one-size-fits-all diet ( Standardized ) or to a diet personalized to minimize PPGR ( Personalized ). Methods: Dietary data collected to-date were analyzed from the Personal Diet study, a clinical trial to compare two behavioral weight loss interventions in adults with prediabetes or early-stage type 2 diabetes. All subjects had resting energy expenditure (REE) measured at baseline using indirect calorimetry. Both arms were instructed to restrict energy intake (-500 kcal/day, based on REE and a physical activity factor of 1.4), log daily dietary intake with a smartphone app, and attend scheduled behavioral counseling sessions. The Standardized arm received app feedback about energy and fat intake, while the Personalized arm received app feedback about energy intake and meal specific predicted PPGR determined from a gut microbiome-based machine learning algorithm. At baseline, 3 months, and 6 months, subjects completed one 24-hour dietary recall using the Automated Self-Administered 24-hour Dietary Assessment Tool. Total energy, total carbohydrate, total sugars, fiber, total fat, saturated fat, monounsaturated fat, polyunsaturated fat, and protein were measured using the USDA Food and Nutrient Database for Dietary Studies 2011-2012. Macronutrient intakes were analyzed as percentage of energy (%E). Linear mixed modelling, with random intercepts and slopes and an unstructured covariance pattern, was used to analyze dietary changes within- and between-arms from baseline to 3 and 6 months. Fixed effects were included for study arm, time period, and interaction of study arm and time period. A random effect was included for subjects. Models were adjusted for age and sex. Results: Dietary assessments were completed at baseline (n=66 Personalized ; n=65 Standardized ), 3 months (n=50 Personalized ; n=36 Standardized ), and 6 months (n=47 Personalized ; n=39 Standardized ). The Personalized arm had a greater reduction than the Standardized arm in energy (β: -342 kcal; 95% CI: -672, -12) and %E from carbohydrate (β: -6.2; 95% CI: -11.7, -0.6) and sugars (β: -4.9; 95% CI: -8.8, -1.0) from baseline to 3 months, but there were no between-arm differences in dietary measures at 6 months. Within-arm, Personalized had decreases in energy (β: -327 kcal; 95% CI: -546, -108) and %E from carbohydrate (β: -4.6; 95% CI: -8.2, -0.9) from baseline to 3 months. In the Standardized arm, %E from sugars increased from baseline to 3 months (β: 3.0; 95% CI: 0.02, 5.9). Conclusions: Personalized had greater reductions than Standardized in energy and %E from carbohydrate and sugars over the first 3 months of the intervention, but dietary changes were similar by 6 months.

Primary care behavioral health patients' stage of change: Correlates and relation to follow-up session attendance.

In this study, we examined patients' readiness to change behavior (their stage of change) in a primary care behavioral health (PCBH) setting. We examined sociodemographic and health correlates of patients' stage of change and whether stage of change related to follow-up visit attendance. One-hundred eleven adult primary care patients completed self-report measures of psychiatric symptoms, hope, and stage of change at their initial behavioral health session. Demographic, health information, and follow-up visit attendance were gathered from patient electronic health records. Results suggest most patients referred to PCBH providers were in preparation and action stages of change. At the bivariate level, older age and non-Latinx ethnicity were associated with greater readiness to change. At the multivariate level, older age and higher levels of hope were associated with later stages of change. Patients in preparation, but not action, stages of change were significantly more likely to attend a follow-up behavioral health appointment than were patients in precontemplation/contemplation. Findings suggest most PCBH patients are prepared to take action or have already taken action to improve their behavioral health. Further, a single item assessing patients' stage of change is associated with continued retention in behavioral health treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Treatment Engagement Following a Positive Mental Health Screening Questionnaire

Less than half of U.S. adolescents with major depressive disorder receive treatment. Despite the U.S. Preventive Services Task Force 2016 statement supporting primary care major depressive disorder screening, there is limited data examining whether positive screens prompt treatment engagement. This study evaluated treatment engagement following a positive Patient Health Questionnaire-Adolescent Version screen and assessed the impact of demographics, clinical variables, and provider recommendations on treatment engagement. This was a retrospective cohort study (analysis November 2021) of adolescents aged 11-18 years seen at a primary care clinic of an academic medical center from July 2017 to December 2018 and identified with a positive Patient Health Questionnaire-Adolescent Version (broadest definition score ≥10; ≥1 for Item 9 regarding suicidal thoughts; yes for unscored Items 1, 3, or 4; or very or extremely difficult for unscored Item 2). Positive screen by score ≥10 alone was also considered. The primary outcome was treatment engagement, defined as initiation of a psychotropic medication, or a behavioral health treatment session within 1 year of symptom identification. Of the 1,315 eligible adolescents, 23.0% had a positive Patient Health Questionnaire-Adolescent Version (n=302) by the broadest criteria; 92/302 (30.5%) engaged in treatment. Patients whose providers recommended treatment had 7.32 times the odds (95% CI=3.76, 14.2, p<0.001) of treatment engagement. For those positive by Patient Health Questionnaire-Adolescent Version ≥10 (85/302, 28.1%), 37/85 (43.5%) engaged in treatment. The influence of provider recommendations was comparable (OR=6.96, 95% CI=3.56, 13.6, p<0.001). Less than half of adolescents with a positive Patient Health Questionnaire-Adolescent Version at an academic primary care clinic engaged with treatment. Provider recommendation was an impactful intervention to improve mental healthcare treatment engagement.

Common Cholinergic, Noradrenergic, and Serotonergic Drugs Do Not Block VNS-Mediated Plasticity.

Vagus nerve stimulation (VNS) delivered during motor rehabilitation enhances recovery from a wide array of neurological injuries and was recently approved by the U.S. FDA for chronic stroke. The benefits of VNS result from precisely timed engagement of neuromodulatory networks during rehabilitative training, which promotes synaptic plasticity in networks activated by rehabilitation. Previous studies demonstrate that lesions that deplete these neuromodulatory networks block VNS-mediated plasticity and accompanying enhancement of recovery. There is a great deal of interest in determining whether commonly prescribed pharmacological interventions that influence these neuromodulatory networks would similarly impair VNS effects. Here, we sought to directly test the effects of three common pharmaceuticals at clinically relevant doses that target neuromodulatory pathways on VNS-mediated plasticity in rats. To do so, rats were trained on a behavioral task in which jaw movement during chewing was paired with VNS and received daily injections of either oxybutynin, a cholinergic antagonist, prazosin, an adrenergic antagonist, duloxetine, a serotonin-norepinephrine reuptake inhibitor, or saline. After the final behavioral session, intracortical microstimulation (ICMS) was used to evaluate reorganization of motor cortex representations, with area of cortex eliciting jaw movement as the primary outcome. In animals that received control saline injections, VNS paired with training significantly increased the movement representation of the jaw compared to naïve animals, consistent with previous studies. Similarly, none of the drugs tested blocked this VNS-dependent reorganization of motor cortex. The present results provide direct evidence that these common pharmaceuticals, when used at clinically relevant doses, are unlikely to adversely impact the efficacy of VNS therapy.

Randomized Behavioral Sleep Clinical Trial to Improve Outcomes in Children With Down Syndrome.

Parents of 30 school-age children with Down syndrome participated in a small-scale randomized clinical trial of a behavioral sleep treatment designed specifically for children with Down syndrome. The aim was to improve child sleep, child daytime behavior problems, caregiver sleep, and caregiver stress. The intervention spanned 5-8 weeks, and assessments occurred pre-treatment, immediately post-treatment, and three months post-treatment using a double-blinded design. Both the active treatment and a treatment-as-usual attention-controlled comparison group showed improvements in actigraphy and parent-report measures of child sleep, parent-reported child internalizing behaviors, and actigraphy measures of parent-sleep. The behavioral sleep treatment did not yield significantly different outcomes than a treatment-as-usual approach supplemented with non-sleep-specific behavioral or education sessions. Possible interpretations of study findings are discussed.

Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder.

BackgroundCognitive dysfunction is disproportionately prevalent among persons with opioid use disorder (OUD). Specific domains of cognitive dysfunction (attention, executive functioning, memory, and information processing) may significantly impede treatment outcomes among patients on medication for OUD (MOUD). This limits patient's ability to learn, retain, and apply information conveyed in behavioral intervention sessions. Evidence-based accommodation strategies have been integrated into behavioral interventions for other patient populations with similar cognitive profiles as persons with OUD; however, the feasibility and efficacy of these strategies have not yet been tested among patients on MOUD in a drug treatment setting.MethodsWe conducted a series of focus groups with 25 key informants (10 drug treatment providers and 15 patients on MOUD) in a drug treatment program in New Haven, CT. Using an inductive approach, we examined how cognitive dysfunction impedes participant's ability to retain, recall, and utilize HIV prevention information in the context of drug treatment.ResultsTwo main themes capture the overall responses of the key informants: (1) cognitive dysfunction issues and (2) accommodation strategy suggestions. Subthemes of accommodation strategies involved suggestions about particular evidence-based strategies that should be integrated into behavioral interventions for persons on MOUD. Specific accommodation strategies included: use of a written agenda, mindfulness meditation, multi-modal presentation of information, hands-on demonstrations, and a formal closure/summary of sessions.ConclusionsAccommodation strategies to compensate for cognitive dysfunction were endorsed by both treatment providers and patients on MOUD. These accommodation strategies have the potential to enhance the efficacy of behavioral interventions to reduce HIV transmission among persons on MOUD as well as addiction severity, and overdose.

S157-a structured early intervention program in patients with predicted poor long-term outcome following bariatric surgery: a prospective randomized study.

Early postoperative weight loss can be predictive of one-year outcomes. It is unclear if poor performers identified in the first post-operative month can have improvement in outcomes with additional support and education. To evaluate the impact of a structured targeted support program for patients with lower-than-average early post-operative weight loss on 1-year outcomes. This was a prospective randomized study of bariatric surgery patients who experienced less than 50th percentile excess body weight loss (%EWL) at 3 weeks. Subjects with EWL < 18% were randomized into two groups: an intervention (IV) arm or a control (NI, no intervention) arm. The IV arm was offered a program with 7-weekly behavioral support sessions, while the NI patients received routine post-operative care. A total of 128 patients were randomized: 65 NI and 63 IV. In the IV group, 20 attended all sessions, 7 attended < 4, and 36 did not participate. There was no difference in baseline demographics, procedure type, or BMI. At 1 year, there was no difference in %EWL (ratio 0.993, 95% CI 0.873, 1.131), %EBMIL (ratio 0.997, 95% CI 0.875, 1.137), and %TWL (ratio 1.016, 95% CI 0.901, 1.146) between groups. A subgroup analysis including only the subjects who participated in all seven sessions showed similar results. Patients who present with suboptimal weight loss early after bariatric surgery do not experience a significant weight loss improvement with a structured behavioral support program. Importantly, despite being alerted to their poor early weight loss, patients demonstrated poor adherence to the proposed interventions.

Effectiveness of Internet-Based Cognitive Behavioral Therapy With Telephone Support for Noncardiac Chest Pain: Randomized Controlled Trial.

BackgroundNoncardiac chest pain has a high prevalence and is associated with reduced quality of life, anxiety, avoidance of physical activity, and high societal costs. There is a lack of an effective, low-cost, easy to distribute intervention to assist patients with noncardiac chest pain.ObjectiveIn this study, we aimed to investigate the effectiveness of internet-based cognitive behavioral therapy with telephone support for noncardiac chest pain.MethodsWe conducted a randomized controlled trial, with a 12-month follow-up period, to compare internet-based cognitive behavioral therapy to a control condition (treatment as usual). A total of 162 participants aged 18 to 70 years with a diagnosis of noncardiac chest pain were randomized to either internet-based cognitive behavioral therapy (n=81) or treatment as usual (n=81). The participants in the experimental condition received 6 weekly sessions of internet-based cognitive behavioral therapy. The sessions covered different topics related to coping with noncardiac chest pain (education about the heart, physical activity, interpretations/attention, physical reactions to stress, optional panic treatment, and maintaining change). Between sessions, the participants also engaged in individually tailored physical exercises with increasing intensity. In addition to internet-based cognitive behavioral therapy sessions, participants received a brief weekly call from a clinician to provide support, encourage adherence, and provide access to the next session. Participants in the treatment-as-usual group received standard care for their noncardiac chest pain without any restrictions. Primary outcomes were cardiac anxiety, measured with the Cardiac Anxiety Questionnaire, and fear of bodily sensations, measured with the Body Sensations Questionnaire. Secondary outcomes were depression, measured using the Patient Health Questionnaire; health-related quality of life, measured using the EuroQol visual analog scale; and level of physical activity, assessed with self-report question. Additionally, a subgroup analysis of participants with depressive symptoms at baseline (PHQ-9 score ≥5) was conducted. Assessments were conducted at baseline, posttreatment, and at 3- and 12-month follow-ups. Linear mixed models were used to evaluate treatment effects. Cohen d was used to calculate effect sizes.ResultsIn the main intention-to-treat analysis at the 12-month follow-up time point, participants in the internet-based cognitive behavioral therapy group had significant improvements in cardiac anxiety (–3.4 points, 95% CI –5.7 to –1.1; P=.004, d=0.38) and a nonsignificant improvement in fear of bodily sensations (–2.7 points, 95% CI –5.6 to 0.3; P=.07) compared with the treatment-as-usual group. Health-related quality of life at the 12-month follow-up improved with statistical and clinical significance in the internet-based cognitive behavioral therapy group (8.8 points, 95% CI 2.8 to 14.8; P=.004, d=0.48) compared with the treatment-as-usual group. Physical activity had significantly (P<.001) increased during the 6-week intervention period for the internet-based cognitive behavioral therapy group. Depression significantly improved posttreatment (P=.003) and at the 3-month follow-up (P=.03), but not at the 12-month follow-up (P=.35). Participants with depressive symptoms at baseline seemed to have increased effect of the intervention on cardiac anxiety (d=0.55) and health-related quality of life (d=0.71) at the 12-month follow-up. In the internet-based cognitive behavioral therapy group, 84% of the participants (68/81) completed at least 5 of the 6 sessions.ConclusionsThis study provides evidence that internet-based cognitive behavioral therapy with minimal therapist contact and a focus on physical activity is effective in reducing cardiac anxiety and increasing health related quality of life in patients with noncardiac chest pain.Trial RegistrationClinicalTrials.gov NCT03096925; http://clinicaltrials.gov/ct2/show/NCT03096925

Understanding Query Combination Behavior in Exploratory Searches

In exploratory search, users sometimes combine two or more issued queries into new queries. We present such a kind of search behavior as query combination behavior. We find that the queries after combination usually can better meet users’ information needs. We also observe that users combine queries for different motivations, which leads to different types of query combination behaviors. Previous work on understanding user exploratory search behaviors has focused on how people reformulate queries, but not on how and why they combine queries. Being able to answer these questions is important for exploring how users search and learn during information retrieval processes and further developing support to assist searchers. In this paper, we first describe a two-layer hierarchical structure for understanding the space of query combination behavior types. We manually classify query combination behavior sessions from AOL and Sogou search engines and explain the relationship from combining queries to success. We then characterize some key aspects of this behavior and propose a classifier that can automatically classify types of query combination behavior using behavioral features. Finally, we summarize our findings and show how search engines can better assist searchers.

Functional Reuniens and Rhomboid Nuclei Are Required for Proper Acquisition and Expression of Cued and Contextual Fear in Trace Fear Conditioning.

BackgroundThe reuniens (Re) and rhomboid (Rh) nuclei (ReRh) of the midline thalamus interconnect the hippocampus and the medial prefrontal cortex. The hippocampus and medial prefrontal cortex are both involved in the acquisition of trace fear conditioning, in which a conditioned stimulus (tone) and an aversive unconditioned stimulus (footshock) are paired but separated in time with a trace interval. Earlier, we demonstrated that ReRh inactivation during trace conditioning impaired the acquisition of cued fear. In contrast, ReRh inactivation during both conditioning and test resulted in heightened fear to tones during retrieval. Because there was a generalized contextual fear on top of heightened fear to tones in the latter experiment, here we aimed to examine the specific importance of the functional ReRh in cued fear and contextual fear through introducing prolonged contextual exposure.MethodsThe ReRh were pharmacologically inactivated with muscimol (or saline as controls) before each experimental session.ResultsWe showed that although ReRh inactivation before trace fear conditioning impaired the acquisition of cued fear, the animals still acquired a certain level of fear to the tones. However, without the functional ReRh throughout the entire behavioral sessions, these animals showed heightened contextual fear that did not decline much with the passage of time, which generalized to the other context, and fear to tones reoccurred when the tones were presented.ConclusionsOur results suggested that functional ReRh are important for proper acquisition and expression of fear to context and tones acquired under trace procedure.

Feasibility of combining noninvasive brain stimulation and personalized counseling to increase physical activity

Few older adults meet recommended physical activity guidelines. Behavioral interventions may be more effective when combined with other modalities to promote activity. Transcranial direct current stimulation (tDCS) designed to increase the excitability of the left dorsolateral prefrontal cortex (dlPFC) — a brain region subserving motivation and executive function — has the potential to augment behavioral interventions. We designed a randomized, double-blinded trial to examine the feasibility of combining personalized behavioral counseling and tDCS targeting the left dlPFC to improve physical activity and related outcomes in sedentary older adults living within the supportive housing. Participants wore a Fit-Bit throughout the study period. Baseline step counts were determined for two weeks, then participants completed four bi-weekly personalized counseling sessions over eight weeks. They were also randomized to receive 10 sessions of tDCS or sham stimulation over the two weeks after the baseline. Physical, cognitive, and patient-reported outcomes were assessed at baseline, after ten brain stimulation sessions, and after four behavioral sessions. 33 individuals were screened and 16 enrolled (age=80±7, 13 females). 13 participants completed the study, including 100% of study assessments, 99±5% of brain stimulation sessions, and 98±7% of behavioral sessions. Fit-Bit adherence rate was 93±13%. Daily step counts were 3197±1480 at baseline and 4722±2553 over the last two weeks of the intervention. While the study is ongoing and blinded, these preliminary results indicate that it is feasible to conduct a controlled study of tDCS combined with personalized behavioral counseling to increase physical activity in sedentary older adults living within supportive housing.

Preventing postpartum weight retention following antenatal lifestyle intervention: One year postpartum follow up of the Healthy Lifestyles in Pregnancy (HeLP-her) randomised controlled trial.

Antenatal lifestyle interventions optimise gestational weight gain, yet longer-term efficacy on postpartum weight retention is unclear. Overall, 228 pregnant women <15weeks gestation were randomised to intervention (four behavioural self-management sessions) or control (generic health information). Median weight retention at 12months postpartum was significantly reduced in the intervention with a between group difference of -2.3 (-2.8 (-5.9 to 0.35) vs -0.5 (-2.6 to 2.1) kg, respectively P<0.05, (n=75)±6.3kg vs -0.5±4.7kg, respectively, P<0.05) and associated increased self-weighing behaviours, compared with the control group (regular weighing: 68% vs 43%, P<0.01). Results demonstrate the efficacy of a low-intensity, behavioural lifestyle intervention in limiting postpartum weight retention.

Improved symptoms of complex regional pain syndrome after novel lymphatic treatment and interdisciplinary pain management

IntroductionComplex regional pain syndrome (CRPS) is a pain syndrome with no singular mechanism and no specific cure. The aim of this case report is to study the impact of Lymphatic Enhancement Technology (LET) treatment on CRPS-related symptoms. MethodsA 51 year-old female presented with a chief complaint of severe, refractory ankle pain and CRPS related to a tibial and fibular fracture sustained three years earlier. The patient completed twelve cognitive behavioral therapy sessions over a 4-week period, and eleven physical therapy sessions over a four-month period, six of which utilized LET. ResultsPain and swelling were largely unchanged with interdisciplinary treatment before the introduction of LET. A within-session change of 37.5% in pain intensity and 87.5% in ankle girth was observed immediately after the first application of LET. Three months after beginning LET treatment, the patient maintained a 43.8% improvement in pain intensity and 100% improvement in measurements of lower extremity girth and ankle range of motion. No side effects or adverse events were associated with the LET treatment. ConclusionSwelling, pain, and mobility loss are common symptoms and features of CRPS. LET is a novel, non-invasive treatment that appears to be quite safe and effective for improving pain, swelling, and mobility loss related to CRPS.