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Background. Regarding sustainability in the intensive care unit (ICU), there is increasing interest in reducing material waste and avoiding unnecessary procedures. Therapeutic drug monitoring (TDM) of vancomycin, using a dedicated tube, is standard clinical care during treatment with vancomycin. Furthermore, in the ICU, on a daily basis, arterial blood gas (ABG) tests are frequently performed throughout the day. After analysis, a variable volume of blood is discarded. Lithium heparin (LiHep) syringes for ABG tests differ from normally used dipotassium ethylenediaminetetraacetic acid (K2EDTA) tubes. The primary objective was to compare both containers and validate the use of LiHep syringes. Secondary objectives were to evaluate the potential impact on saving materials, nursing time, and costs when implementing vancomycin TDM via LiHep syringes. Methods. Vancomycin analysis from sampling in lithium heparin (LiHep) syringes for ABG tests was validated and compared with the concentrations from conventional sampling in K2EDTA tubes. For method comparison, a Bland–Altman plot and Deming regression analysis were performed. The method was validated for inter- and intra-day precision and accuracy. Vancomycin was analyzed by means of the validated method using a particle-enhanced turbidimetric inhibition immunoassay (PETINIA) autoanalyzer. Furthermore, an analysis was conducted to evaluate the potential impact of implementing vancomycin sampling via ABG tests on savings in materials, nursing time, and costs. Results. From 18 patients, 24 plasma samples in both K2EDTA tubes and LiHep syringes were obtained and compared. The mean relative difference between the two containers was −2.0% (−3.0 to −0.93%). Both the Deming regression analysis and the Bland–Altman plot met the acceptance criteria. Potentially, over 1000 blood draws and accompanying materials and packaging can be saved when vancomycin samples are obtained by means of scavenged LiHep syringes. The vancomycin analysis for LiHep syringes showed a total interday precision of 1.95% and an accuracy of 99.7%. The total intraday precision was 2.22%, and the accuracy was 99.2%. Accuracy and precision values were within the acceptance criteria of recovery 85 to 115% and ≤15%, respectively. Conclusion. No significant differences were found in vancomycin concentration between the two analyses, and the LiHep analysis was validated for further implementation in clinical care. Residual blood from ABG test samples can be used for TDM of vancomycin, resulting in a potential reduction of materials used and the number of blood draws. These results will contribute to a more sustainable TDM process with benefits for the patient. [ABSTRACT FROM AUTHOR]

Instrumental learning, i.e., learning that specific behaviors lead to desired outcomes, occurs through goal-directed and habit memory systems. Exposure to acute stress has been shown to result in less goal-directed control, thus rendering behavior more habitual. The aim of the current studies was to replicate and extend findings on stress-induced prompting of habitual responding and specifically focused on the role of stress-induced cortisol reactivity. Study 1 used an established outcome devaluation paradigm to assess goal-directed and habitual control. Study 2 utilized a modified version of this paradigm that was intended to establish stronger habitual responding through more extensive reward training and applying a relevant behavioral devaluation procedure (i.e., eating to satiety). Both studies failed to replicate that stress overall, i.e., independent of cortisol reactivity, shifted behavior from goal-directed to habitual control. However, both studies found that relative to stress-exposed cortisol non-responders and no-stress controls, participants displaying stress-induced cortisol reactivity displayed prominent habitual responding. These findings highlight the importance of stress-induced cortisol reactivity in facilitating habits. [ABSTRACT FROM AUTHOR]

What differentiates those who are able to adapt well to adverse life events (i.e., persons who are resilient) from those who are not (e.g., persons who develop post-traumatic stress symptoms)? Previous work suggests that enhanced autobiographical integration of trauma memories is associated with more severe post-traumatic stress symptoms. Extending this line of work, the present study looked at whether the integration of trauma memories, repressive coping and cognitive reactivity are related to post-traumatic stress symptomatology following negative life events among otherwise healthy young adults (N = 213). Results show that while enhanced integration of trauma memories and high levels of dissociation are related to elevated levels of post-traumatic stress, people who generally engage in repressive coping report fewer post-traumatic stress symptoms. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: · Enhanced integration of trauma memories is linked to increased post-traumatic stress. · High levels of trait dissociation are related to elevated levels of post-traumatic stress symptomatology. · A repressive coping style is associated with fewer post-traumatic stress symptoms. [ABSTRACT FROM AUTHOR]

Purpose. The Gudjonsson Suggestibility Scale (GSS; Gudjonsson, 1984, 1997) is a well-established forensic tool for measuring interrogative suggestibility. However, one restriction of this tool is that it requires an extensive testing procedure. The present study examined whether shorter versions of the GSS yield similar results as the original GSS procedure. Methods. One group (N = 20) was given a shortened version of the GSS that consisted of an immediate recall test and the specific questions. GSS scores in this group were compared with those in a group (N = 20) that had the standard procedure which includes a retention interval and immediate and delayed recall tests. A third group (N = 20) was administered a shortened procedure in which the 20 GSS questions immediately followed the GSS story. In the fourth group (N = 20), participants were given the retention interval, but no recall tests were administered. Results. ANOVA showed no differences in GSS scores amongst the four groups. Post hoc power analyses indicated that these non-significant findings were not the result of a power problem and that larger sample sizes are expected to yield comparable results. Further analyses showed that neither the retention delay nor the recall tests affected suggestibility scores. Conclusions. These results suggest that shortened procedures for administering the GSS may be employed in situations where time is a key factor. [ABSTRACT FROM AUTHOR]

Source monitoring refers to cognitive processes involved in making attributions about the origins of memories, knowledge, and beliefs. One particular type of source monitoring with ample practical significance is reality monitoring, i.e., the ability to discriminate between internally vs. externally generated memories. Abundant evidence indicates that exposure to acute stress enhances declarative memory consolidation. To date, no study has looked at whether exposure to acute stress during the consolidation phase may promote reality monitoring performance. The authors examined this by administering cold pressor stress (CPS) or a control procedure to participants (N = 80) after they had either performed or only imagined performing simple motor acts, and assessing reality monitoring 24 h later. When compared with the control condition, CPS significantly elevated salivary free cortisol concentrations and enhanced reality monitoring. Stress-induced cortisol responses, however, were found not to be related to improved reality monitoring performance. Our findings are consistent with the view that post-learning stress hormone-related activity may modulate source memory consolidation. [ABSTRACT FROM AUTHOR]

To explore whether schizotypal traits may undermine source monitoring for actions, 67 undergraduate participants (21 men) completed the Schizotypal Personality Scale and were then given a source-monitoring task in which some specific acts had to be performed, whereas others only had to be imagined. Next, participants had to complete an old-new recognition task and ascribe the source, i.e., whether they had performed or only imagined the items (i.e., source monitoring). Participants also completed a working memory capacity task (i.e., Operation Span task). We found that the higher the Schizotypal Personality Scale scores, the poorer recognition and source attribution scores. Relative to participants with low levels of schizotypal traits (i.e., controls), those with higher levels of schizotypal traits more often falsely claimed to have performed actions when in fact they had only imagined them. Although participants high and low in schizotypical traits did not differ in their working memory capacity, poor working memory capacity was related to source misattribution (i.e., increase false alarms). The present findings indicate that schizotypal traits undermine source monitoring for action in a healthy population. [ABSTRACT FROM AUTHOR]

Abstract: Studies on how acute stress affects learning and memory have yielded inconsistent findings, with some studies reporting enhancing effects while others report impairing effects. Recently, Joëls et al. [Joëls, M., Pu, Z., Wiegert, O., Oitzl, M.S., Krugers, H.J., 2006. Learning under stress: how does it work? Trends in Cognitive Sciences, 10, 152–158] argued that stress will enhance memory only when the memory acquisition phase and stressor share the same spatiotemporal context (i.e., context-congruency). The current study tested this hypothesis by looking at whether context-congruent stress enhances declarative memory performance. Undergraduates were assigned to a personality stress group (n =16), a memory stress group (n =18), or a no-stress control group (n =18). While being exposed to the acute stressor or a control task, participants encoded personality- and memory-related words and were tested for free recall 24h later. Relative to controls, stress significantly enhanced recall of context-congruent words, but only for personality words. This suggests that acute stress may strengthen the consolidation of memory material when the stressor matches the to-be-remembered information in place and time. [Copyright &y& Elsevier]

Obese children are often liable to weight-related teasing, and in earlier studies this childhood teasing has been found to predict body dissatisfaction. Cognitive theory postulates that negative experiences are the source of interpretation biases, implicating that weight-related teasing might make obese children vulnerable to shape- and weight-related interpretation biases. In the present study, it was tested whether young overweight children show interpretation biases related to body weight/shape and self-esteem. A Situation Interpretation Test (SIT) was used to find out whether overweight children (n = 20) interpret neutral and negative ambiguous situations more often in terms of their concerns about body weight/shape and self-esteem than healthy controls (n = 16). The data show that 8- to 12-year-old overweight children indeed show interpretation biases, that is, they were more likely to endorse negative appearance and self-esteem-related interpretations of a neutral or negative event than normal-weight children. Also, the perceived threat value of these events was higher in the overweight group. Interpretation biases like this might increase and maintain body dissatisfaction and psychological distress. It is therefore argued that the vulnerability to the development of an interpretation bias emphasises the need to use cognitive strategies that tackle these biases in the treatment of overweight children. [ABSTRACT FROM AUTHOR]

The relationship between dissociative tendencies, as measured with the Dissociative Experiences Scale and its amnesia, absorption/imaginative involvement, and depersonalization/derealization subscales, and HPA axis functioning was studied in 2 samples of undergraduate students (N = 58 and 67). Acute stress was induced by means of the Trier Social Stress Test. Subjective and physiological stress (i.e., cortisol) responses were measured. Individuals high on the depersonalization/derealization subscale of the Dissociative Experiences Scale exhibited more pronounced cortisol responses, while individuals high on the absorption subscale showed attenuated responses. Interestingly, subjective stress experiences, as indicated by the Tension-Anxiety subscale of the Profile of Mood States, were positively related to trait dissociation. The present findings illustrate how various types of dissociation (i.e., depersonalization/derealization, absorption) are differentially related to cortisol stress responses. [ABSTRACT FROM AUTHOR]

Background: The effects of tailored intervention on multiple behaviors and possible moderators of tailoring effects have not yet been sufficiently demonstrated. Purpose: The purpose of this study was to examine the effectiveness of a computer-tailored intervention on smoking; physical activity; and fruit, vegetable, and fat intake; and to test potential moderators of the effectiveness (BMI, age, SES, gender, motivation, and the number of behaviors for which respondents met the recommendations from national guidelines). Methods: Respondents were randomly assigned to a tailored intervention group, receiving one tailored letter on all of these behaviors, or a control intervention group, receiving one general information letter on all behaviors. Results: Three months after the baseline assessment, the tailored intervention group showed significantly better effects than the control group for all behaviors studied, except for smoking. Notably, the intervention did not enhance the health behaviors, but rather reduced a decline in these behaviors during the 3-month study interval. Effect sizes were small. No moderating factors were found, except for the number of behaviors for which recommendations were met in the tailoring intervention group on fruit consumption. The largest effects of the tailored intervention were found for fruit in respondents who did not meet the recommendations for any behavior (Cohen's d�=�0.3). Conclusions: A tailored intervention on multiple behaviors had significant, but limited effects when compared to generic information. The number of bad habits influenced the effects of the tailored intervention on fruit consumption. [ABSTRACT FROM AUTHOR]

Research on the effect of acute stress and high levels of glucocorticoids on memory has largely focused on memory tasks involving the medial temporal lobe (e.g., declarative memory). Less is known, however, about the effects of stress and glucocorticoids on more strategic memory processes regulated by the prefrontal cortex (e.g., source monitoring). In the current study, the authors investigated whether exposure to acute psychosocial stress would result in altered source monitoring performance relative to the performance of a nonstressed control group. To this end, the authors assigned nonsmoking, healthy, young men to either a stress (n = 22) or a control (n = 18) condition, after which the men were given an internal source monitoring test. Results show that relative to control participants, stressed participants made fewer source monitoring errors. This study suggests that stress may have differential effects on memory, depending on whether the memory test is regulated by the prefrontal cortex or the medial temporal lobe. [ABSTRACT FROM AUTHOR]

Objectives. Eating-disordered subjects feel unattractive, and the current idea is that this feeling reflects a distorted body image. A distorted body image requires a mismatch between the negative self-judgments and more objective judgments of the body.Design and methods. To examine whether eating-disordered subjects have valid reasons for their feelings of unattractiveness, the body images of eating-symptomatic subjects and control models were compared with inter-subjective evaluations of these bodies given by two community samples (panels; N=72, N=88).Results. Although the objective body sizes of the eating-symptomatic subjects were in the normal range and not different from control bodies, the first panel rated the (headless) bodies of the eating-symptomatic subjects as less attractive. This finding was replicated with the second panel. There was also large agreement between the eating-symptomatic subjects and the second panel on the specific body parts that were indicated as unattractive. Contrary to the eating-symptomatic subjects, the control models showed a strong positively biased perception of their own attractiveness: they rated their own bodies more positively than others rated them.Conclusion. Consensual validation of the harsh body appraisals of eating-symptomatic subjects was found. Interestingly, the normal controls were the ones that showed a biased body image; they rated themselves far more attractive than other people rated them. These data suggest that the real problem in eating disorders is not a distorted body image but a lack of a distorted body image, that is, the lack of a self-serving body-image bias. [ABSTRACT FROM AUTHOR]

Defendants and witnesses are often intoxicated by alcohol. We investigated whether memory and resistance to suggestive cues are undermined at blood alcohol concentrations (BACs) that were (close to) zero (MBAC = 0.01%), moderate (MBAC = 0.06%), or high (MBAC = 0.16%). Participants (N = 67) were approached in bars and instructed to commit a mock crime. Immediately after this, their memory and susceptibility to suggestive questions were tested, and these were re-tested during a sober follow-up 3-5 days later. Compared with sober participants, moderate and severe intoxication was associated with lower levels of correctly recalled crime details during both test sessions (i.e. intoxicated and sober). Also, during both sessions, severely intoxicated participants displayed a greater tendency to go along with suggestive cues compared with sober participants. Thus, intoxication impaired memory and increased suggestibility during an immediate interview, and both effects persisted when sober again. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Several protocols have been developed for inducing acute stress in laboratory settings. Still, effectively eliciting stress in a neuroimaging environment remains challenging. Here, we describe the evaluation of a combined physical and psychosocial stress protocol ( n = 42). The imaging Maastricht Acute Stress Test ( iMAST) consists of a 5-min preparation phase and a 10-min acute stress phase, with alternating trials of cold pressor stress generated through an advanced thermal stimulator and mental arithmetic challenges along with social-evaluative pressure (i.e., negative feedback). Results demonstrate that participants displayed meaningful subjective stress responses, as well as significant increases in salivary alpha-amylase and cortisol levels. Our data show that the iMAST may prove to be a potent alternative to existing imaging stress paradigms to explore poststress neuronal changes and brain determinants of resilience. [ABSTRACT FROM AUTHOR]

Purpose. Examine the effects of three iterative tailored feedback letters addressing smoking; physical activity; and fruit, vegetable, and fat intake, and test the additional effects of providingfeedback on action plans. Design. A tailored, print-based intervention was developed and tested in a randomized control trial with a posttest after 9 months. Setting. A total of 2827 respondents agreed to participate. They were recruited from a random sample of 35,000 addresses obtained through the Dutch national telephone company. Subjects. The mean age was 49 years, and 55% were female. Intervention. The experimental group received three printed tailored letters, and the control group received three printed generic letters. Respondents from the experimental group randomly received either a third letter with tailored information or tailored information and action-planning feedback. Measures. The questionnaire assessed physical activity; smoking; consumption of fruit, vegetables and fat; motivational determinants; action plans; and demographics. Results. Tailored information resulted in more improvement over time than generic information for the intake offruit, vegetables, and fat and for physical activity. No differences between the conditions were found for smoking because of high cessation rates in all conditions. Action-planning feed back did not increase the effects. Conclusions. Tailored lifestyle information can be effective for adults in changing nutrition behavior and physical activity. [ABSTRACT FROM AUTHOR]

Addressing multiple health behaviours are important in preventing disease and mortality. The present study investigated the clustering of health behaviours, cognitive determinants and stages of change in 2827 adults for the lifestyle factors of physical activity, fruit, vegetable and fat consumption and smoking. The results showed that only 3% of the total population met recommended guidelines for all of the five behaviours. Behaviours were found to be weakly associated. Behaviour-specific cognitions and stages of change for the behaviours clustered more strongly, however. With respect to diet and physical activity, respondents in the preparation stage for one behaviour were likely also to be preparing to change another behaviour. Possible mechanisms for the apparent general willingness to change multiple behaviours are discussed, as well as potential implications for health promotion practice. [ABSTRACT FROM AUTHOR]

Highlights • 112 healthy participants performed an instrumental learning task. • Individual differences in baseline and stress-induced working memory (WM) were assessed. • Baseline WM capacity modulates effect of stress on instrumental behavior. • Stress induces a shift to less goal-directed behavior at low baseline WM. Abstract Acute stress has been found to impair goal-directed instrumental behaviour, a cognitively flexible behaviour that requires cognitive control. The current study aimed to investigate the role of individual differences in baseline and stress-induced changes in working memory (WM) on the shift to less goal-directed responding under stress. To this end, 112 healthy participants performed an instrumental learning task. In phase 1, participants learned instrumental actions that were associated with two different food rewards. In phase 2, one of these food rewards was devalued by eating until satiety. Before the extinction test in phase 3, participants were subjected to the Maastricht Acute Stress Test or a no-stress control procedure. Results showed that the effect of stress on instrumental behaviour is modulated by baseline, but not stress-induced changes in WM capacity. Specifically, only at low baseline WM capacity did stress induce a shift to less goal-directed behaviour. These findings highlight that our cognitive resources are limited and for those who already have limited resources at baseline taking into account motivational value is impaired under stress. [ABSTRACT FROM AUTHOR]

Reliably eliciting acute stress repeatedly over time is of indispensable value for research into stress vulnerability and for developing interventions aimed at increasing stress resiliency. Here, we evaluated whether the Maastricht Acute Stress Test (MAST), a potent stress protocol that combines physical and psychosocial stress components, can be used to reliably elicit subjective and neuroendocrine stress responses multiple times. Sixty healthy undergraduate participants were exposed to the MAST on three occasions, with intervals of three-weeks and one-month in between sessions. Results showed no significant signs of habituation or sensitization to the MAST in terms of subjective or physiological (salivary alpha-amylase and cortisol) stress reactivity. Fifty-nine percent of the sample displayed a significant physiological stress response (i.e., cortisol) to two MAST exposures and 57% to every MAST exposure. This study demonstrates that the MAST can be used to repeatedly induce significant stress responses. [ABSTRACT FROM AUTHOR]

Frontal asymmetry in alpha oscillations is assumed to be associated with psychopathology and individual differences in emotional responding. Brain-activity-based feedback is a promising tool for the modulation of cortical activity. Here, we validated a neurofeedback protocol designed to change relative frontal asymmetry based on individual alpha peak frequencies, including real-time average referencing and eye-correction. Participants (N=60) were randomly assigned to a right, left or placebo neurofeedback group. Results show a difference in trainability between groups, with a linear change in frontal alpha asymmetry over time for the right neurofeedback group during rest. Moreover, the asymmetry changes in the right group were frequency and location specific, even though trainability did not persist at 1 week and 1 month follow-ups. On the behavioral level, subjective stress on the second test day was reduced in the left and placebo neurofeedback groups, but not in the right neurofeedback group. We found individual differences in trainability that were dependent on training group, with participants in the right neurofeedback group being more likely to change their frontal asymmetry in the desired direction. Individual differences in trainability were also reflected in the ability to change frontal asymmetry during the feedback. [ABSTRACT FROM AUTHOR]

Stress-induced changes in functional brain connectivity have been linked to the etiology of stress-related disorders. Resting state functional connectivity (rsFC) is especially informative in characterizing the temporal trajectory of glucocorticoids during stress adaptation. Using the imaging Maastricht Acute Stress Test (iMAST), we induced acute stress in 39 healthy volunteers and monitored the neuroendocrine stress levels during three runs of resting state functional magnetic resonance imaging (rs-fMRI): before (run 1), immediately following (run 2), and 30min after acute stress (run 3). The iMAST resulted in strong increases in cortisol levels. Whole-brain analysis revealed that acute stress (run 2 - 1) was characterized by changes in connectivity of the amygdala with the ventrolateral prefrontal cortex (vlPFC), ventral posterior cingulate cortex (PCC), cuneus, parahippocampal gyrus, and culmen. Additionally, cortisol responders were characterized by enhanced amygdala - medial prefrontal cortex (mPFC) connectivity. Stress recovery (run 3 - 2) was characterized by altered amygdala connectivity with the dorsolateral prefrontal cortex (dlPFC), ventral and dorsal anterior cingulate cortex (ACC), anterior hippocampal complex, cuneus, and presupplementary motor area (preSMA). Opposite to non-responders, cortisol responders were characterized by enhanced amygdala connectivity with the anterior hippocampal complex and parahippocampal gyrus, and reduced connectivity with left dlPFC, dACC, and culmen during early recovery. Acute stress responding and recovery are thus associated with changes in the functional connectivity of the amygdala network. Our findings show that these changes may be regulated via stress-induced neuroendocrine levels. Defining stress-induced neuronal network changes is pertinent to developing treatments that target abnormal neuronal activity. [ABSTRACT FROM AUTHOR]

Asymmetry in frontal electrical activity has been suggested to index tendencies in affective responding and thus may be associated with hormonal stress responses. To assess the functional role of frontal asymmetry (FA) in stress, we measured FA at rest and following exposure to acute stress induced with the Maastricht Acute Stress Task (MAST; N = 70) in the standard 8–13 Hz band as well as based on individual alpha frequency (IAF) band. IAF-based resting FA F4–F3 was associated with the stress-induced neuroendocrine response, such that left individual frontal activity predicted smaller total cortisol increases in response to the MAST. Like previous studies, we found resting left-sided FA F8–F7 to predict trait behavioural activation measured with the BIS/BAS scales. FA remained unaffected by stress-induced cortisol response. These findings suggest that individual FA might reflect a trait-like characteristic that moderates the stress response. Our results underscore the utility of IAF in studying individual differences in stress responding. [ABSTRACT FROM AUTHOR]

Stress initiates a cascade of (neuro)biological, physiological, and behavioral changes, allowing us to respond to a challenging environment. The human response to acute stress can be studied in detail in controlled settings, usually in a laboratory environment. To this end, many studies employ acute stress paradigms to probe stress-related outcomes in healthy and patient populations. Though valuable, these studies in themselves often have relatively limited sample sizes. We established a data-sharing and collaborative interdisciplinary initiative, the STRESS-NL database, which combines (neuro)biological, physiological, and behavioral data across many acute stress studies in order to accelerate our understanding of the human acute stress response in health and disease (www.stressdatabase.eu). Researchers in the stress field from 12 Dutch research groups of 6 Dutch universities created a database to achieve an accurate inventory of (neuro)biological, physiological, and behavioral data from laboratory-based human studies that used acute stress tests. Currently, the STRESS-NL database consists of information on 5529 individual participants (2281 females and 3348 males, age range 6–99 years, mean age 27.7 ± 16 years) stemming from 57 experiments described in 42 independent studies. Studies often did not use the same stress paradigm; outcomes were different and measured at different time points. All studies currently included in the database assessed cortisol levels before, during and after experimental stress, but cortisol measurement will not be a strict requirement for future study inclusion. Here, we report on the creation of the STRESS-NL database and infrastructure to illustrate the potential of accumulating and combining existing data to allow meta-analytical, proof-of-principle analyses. The STRESS-NL database creates a framework that enables human stress research to take new avenues in explorative and hypothesis-driven data analyses with high statistical power. Future steps could be to incorporate new studies beyond the borders of the Netherlands; or build similar databases for experimental stress studies in rodents. In our view, there are major scientific benefits in initiating and maintaining such international efforts. • This article describes a collaborative initiative combining data from human acute stress studies. • There are (neuro)biological, physiological, and behavioral data from 12 Dutch research groups. • The STRESS-NL database has data on 5529 participants stemming from 57 experiments. • The STRESS-NL database illustrates the potential of combining existing stress data. [ABSTRACT FROM AUTHOR]

Acute stress is associated with a shift from goal-directed to habitual behavior. This stress-induced preference for habitual behavior has been suggested as a potential mechanism by which binge eating disorder (BED) patients succumb to eating large amounts of high-caloric foods in an uncontrolled manner (i.e., binge episodes). While in healthy subjects the balance between goal-directed and habitual behavior is subserved by the anterior cingulate cortex (ACC), insular cortex, orbitofrontal cortex (OFC), anterior caudate nucleus, and posterior putamen, the brain mechanism that underlies this (possibly amplified) stress-induced behavioral shift in BED patients is currently unknown. In the current study, 76 participants (38 BED, 38 healthy controls (HCs)) learned six stimulus-response-outcome associations in a well-established instrumental learning task. Subsequently, three outcomes were selectively devalued, after which participants underwent either a stress induction procedure (Maastricht Acute Stress Test; MAST) or a no-stress control procedure. Next, the balance between goal-directed and habitual behavior was assessed during functional magnetic resonance imaging. Findings show that the balance between goal-directed and habitual behavior was associated with activity in the ACC, insula, and OFC in no-stress HCs. Although stress and BED did not modulate the balance between goal-directed and habitual behavior, BED participants displayed a smaller difference in putamen activation between trials probing goal-directed and habitual behavior compared with HCs when using a ROI approach. We conclude that putamen activity differences between BED and HC could reflect changes in monitoring of response accuracy or reward value, albeit perhaps not sufficiently to induce a measurable shift from goal-directed to habitual behavior. Future research could clarify potential boundary conditions of stress-induced shifts in instrumental behavior in BED patients. • Putamen activity differences in goal-directed action and habits was reduced in BED. • BED did not boost the shift in goal-directed to habitual responding. • Acute stress did not impact brain activity or behavior. [ABSTRACT FROM AUTHOR]

The article examines whether forkhead box class O (FoxO) transcription factors are differentially inactivated in rheumatoid arthritis (RA) synovial tissue and whether this inactivation correlates with laboratory and clinical parameters of disease activity. The study found that all 3 FoxO family members examined were phosphorylated in both RA and osteoarthritis (OA) synovial tissue, specifically, the inactivation of FoxO4 was enhanced in macrophages from RA synovial tissue.