Identifying behavioral links to neural dynamics of multifiber photometry recordings in a mouse social behavior network.

Objective.Distributed hypothalamic-midbrain neural circuits help orchestrate complex behavioral responses during social interactions. Given rapid advances in optical imaging, it is a fundamental question how population-averaged neural activity measured by multi-fiber photometry (MFP) for calcium fluorescence signals correlates with social behaviors is a fundamental question. This paper aims to investigate the correspondence between MFP data and social behaviors.Approach:We propose a state-space analysis framework to characterize mouse MFP data based on dynamic latent variable models, which include a continuous-state linear dynamical system and a discrete-state hidden semi-Markov model. We validate these models on extensive MFP recordings during aggressive and mating behaviors in male-male and male-female interactions, respectively.Main results:Our results show that these models are capable of capturing both temporal behavioral structure and associated neural states, and produce interpretable latent states. Our approach is also validated in computer simulations in the presence of known ground truth.Significance:Overall, these analysis approaches provide a state-space framework to examine neural dynamics underlying social behaviors and reveals mechanistic insights into the relevant networks.

Identifying behavioral links to neural dynamics of multifiber photometry recordings in a mouse social behavior network.

Distributed hypothalamic-midbrain neural circuits orchestrate complex behavioral responses during social interactions. How population-averaged neural activity measured by multi-fiber photometry (MFP) for calcium fluorescence signals correlates with social behaviors is a fundamental question. We propose a state-space analysis framework to characterize mouse MFP data based on dynamic latent variable models, which include continuous-state linear dynamical system (LDS) and discrete-state hidden semi-Markov model (HSMM). We validate these models on extensive MFP recordings during aggressive and mating behaviors in male-male and male-female interactions, respectively. Our results show that these models are capable of capturing both temporal behavioral structure and associated neural states. Overall, these analysis approaches provide an unbiased strategy to examine neural dynamics underlying social behaviors and reveals mechanistic insights into the relevant networks.

A Pilot Mixed-Methods Study to Establish the Clinical Usefulness of a Chronic Pain Profile (CPP) for Pain Management.

The Chronic Pain Profile (CPP) was developed as a tool for patients to document types and levels of use for all pain management strategies used. This pilot mixed-methods (quantitative and qualitative methods) study aimed to assess the perceived clinical usefulness of the CPP and identify potential areas of difficulty using the CPP among a sample of pharmacists. Data were obtained from an online survey of pharmacists licensed to practice in Arizona. Quantitative analysis included assessing the clinical usefulness of the CPP using 10 numerical items (scores ≥50% = useful), 5 ordinal items (scores ≥ 4 out of 5 = useful), and 11 open-response items. Qualitative analysis was conducted by two independent researchers who coded the comments and identified key themes through consensus. Data were collected for 33 individuals. Mean usefulness scores ranged from 66.6 ± 22.4 to 80.9 ± 23.5, and three of the five ordinal items had a median score ≥ 4. Three key themes (and subthemes) were identified: favorable features of the CPP, which included promoting patient advocacy and saving time when accessing pain information; using the CPP, which included evaluating of the effectiveness and appropriateness of the pain management approach and identifying gaps in patient knowledge; and limitations of the CPP, which included absence of customization, interpretation issues, complexity and wording issues, and concerns of internal consistency and reliability. This pilot study provides initial evidence of the CPP's clinical usefulness that could ultimately be used to help manage pain and improve health outcomes. Further analyses are needed to assess the CPP's validity and explore its use in wider populations of patients with pain.

Neural dynamics in the limbic system during male social behaviors.

Sexual and aggressive behaviors are vital for species survival and individual reproductive success. Although many limbic regions have been found relevant to these behaviors, how social cues are represented across regions and how the network activity generates each behavior remains elusive. To answer these questions, we utilize multi-fiber photometry (MFP) to simultaneously record Ca2+ signals of estrogen receptor alpha (Esr1)-expressing cells from 13 limbic regions in male mice during mating and fighting. We find that conspecific sensory information and social action signals are widely distributed in the limbic system and can be decoded from the network activity. Cross-region correlation analysis reveals striking increases in the network functional connectivity during the social action initiation phase, whereas late copulation is accompanied by a "dissociated" network state. Based on the response patterns, we propose a mating-biased network (MBN) and an aggression-biased network (ABN) for mediating male sexual and aggressive behaviors, respectively.

Abstraction of Reward Context Facilitates Relative Reward Coding in Neural Populations of the Macaque Anterior Cingulate Cortex.

The anterior cingulate cortex (ACC) is believed to be involved in many cognitive processes, including linking goals to actions and tracking decision-relevant contextual information. ACC neurons robustly encode expected outcomes, but how this relates to putative functions of ACC remains unknown. Here, we approach this question from the perspective of population codes by analyzing neural spiking data in the ventral and dorsal banks of the ACC in two male monkeys trained to perform a stimulus-motor mapping task to earn rewards or avoid losses. We found that neural populations favor a low dimensional representational geometry that emphasizes the valence of potential outcomes while also facilitating the independent, abstract representation of multiple task-relevant variables. Valence encoding persisted throughout the trial, and realized outcomes were primarily encoded in a relative sense, such that cue valence acted as a context for outcome encoding. This suggests that the population coding we observe could be a mechanism that allows feedback to be interpreted in a context-dependent manner. Together, our results point to a prominent role for ACC in context setting and relative interpretation of outcomes, facilitated by abstract, or untangled, representations of task variables.SIGNIFICANCE STATEMENT The ability to interpret events in light of the current context is a critical facet of higher-order cognition. The ACC is suggested to be important for tracking contextual information, whereas alternate views hold that its function is more related to the motor system and linking goals to appropriate actions. We evaluated these possibilities by analyzing geometric properties of neural population activity in monkey ACC when contexts were determined by the valence of potential outcomes and found that this information was represented as a dominant, abstract concept. Ensuing outcomes were then coded relative to these contexts, suggesting an important role for these representations in context-dependent evaluation. Such mechanisms may be critical for the abstract reasoning and generalization characteristic of biological intelligence.

Student pharmacists' perceptions of their professional identity.

INTRODUCTION: Professional identity describes the internal feeling of belonging to a community, such that someone "thinks, feels, and acts" like a member of a profession. Clear professional identity formation can improve the transition from school to work. However, there is limited knowledge about student pharmacists' perceptions of their professional identity. This research aimed to identify and compare student pharmacists' perceptions of their professional identity and to compare those perceptions across class cohorts. METHODS: Data were collected using an online questionnaire that incorporated professional identity labels drawn from previous research. The questionnaire was administered over four weeks to all student pharmacists at one United States pharmacy school. Data were analyzed using chi-square tests. RESULTS: One hundred sixteen responses were received (24% response rate) from the four graduating class years (2020-2023). Respondents were predominantly female (73%), Caucasian (43%), and had obtained at least a bachelor's degree (58%). "Medicine Adviser" was the most frequently selected professional identity (38%). "Business Person" was the least frequently selected professional identity (0%). There was no relationship between professional identities and cohorts of students. CONCLUSIONS: Student pharmacists in this study selected multiple professional identities, suggesting pharmacy students and the profession have yet to consolidate their own identity. There was no relationship between student pharmacists' professional identity selections and cohort, suggesting that professional identity formation did not change as a result of moving through the didactic curriculum. Additional training, curricular modification, and faculty support may be warranted to support student pharmacists with their professional identity development.

Assessing healthcare expenditures of older United States adults with pain and poor versus good mental health status: a cross-sectional study.

OBJECTIVES: This study aimed to determine if differences exist in healthcare expenditures of older United States (US) adults with pain based on self-reported mental health status, which is important to know given the prevalence of pain and poor mental health in the USA. DESIGN: This was a cross-sectional study. SETTING: US Medical Expenditure Panel Survey (MEPS) interviews. PARTICIPANTS: US adults aged ≥50 years, with self-reported pain in the past 4 weeks and positive healthcare expenditure in the 2018 Medical Expenditure Panel Survey (MEPS). The independent variable was poor versus good mental health status. PRIMARY AND SECONDARY OUTCOME MEASURES: Descriptive statistics compared demographic characteristics (using chi-square tests) and mean healthcare expenditures (using t-tests) between groups. Adjusted linear regression models with logarithmically-transformed expenditures compared differences in: total; inpatient; outpatient; emergency room; office-based; prescription medications and other expenditures. Analyses accounted for the complex MEPS design and were weighted to produce nationally-representative results. The a priori alpha level was 0.05. RESULTS: The weighted population included 57 134 711 older US adults with self-reported pain (14.4% poor mental health, 85.6% good mental health). Compared with individuals with good mental health, individuals with poor mental health had higher unadjusted total expenditures (US$20 231 vs US$13 379, p<0.0001), higher prescription medication expenditures (US$5924 vs US$3610, p<0.0001) and higher other expenditures (US$4833 vs US$2285, p<0.0001). In adjusted multivariable linear regression models, there were no differences in expenditures between those with poor mental health and those with good mental health status. CONCLUSIONS: There were no statistically significant differences in adjusted annual (2018) positive healthcare expenditures among older US adults with pain and poor versus good mental health status.

Comparison of Health Care Expenditures Among U.S. Older Adults With Pain Who Reported Frequent Exercise Versus Nonfrequent Exercise.

This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate-vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p = .007). There were no statistical differences between frequent exercise status for other health care expenditure types (p > .05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not.

Predictors of Mental Health Status among Older United States Adults with Pain.

Poor mental health is common among older adults with pain, resulting in high economic burden and impaired quality of life. This retrospective, cross-sectional database study aimed to identify characteristics associated with good mental health status among United States (US) adults aged ≥50 years with self-reported pain in the last four weeks using a weighted sample of 2017 Medical Expenditure Panel Survey data. Hierarchical multivariable logistic regression models were used to identify statistically significant predictors of good (versus poor) perceived mental health status. From a weighted population of 57,074,842 individuals, 85.5% (95% confidence interval (CI) = 84.4%, 86.7%) had good perceived mental health. Good mental health was associated most strongly with physical health status (adjusted odds ratio (AOR) = 9.216, 95% CI = 7.044, 12.058). Employed individuals were 1.7 times more likely to report good mental health versus unemployed (AOR = 1.715, 95% CI = 1.199, 2.452). Individuals who had completed less than high school education (AOR = 0.750, 95% CI = 0.569, 0.987) or who reported having a limitation (AOR = 0.513, 95% CI = 0.384, 0.684) were less likely to report good mental health. These key characteristics can be utilized to predict mental health status, which may be investigated to better manage concurrent pain and poor mental health.

Start low, go fast? Antipsychotic titration patterns at an inpatient psychiatric hospital.

INTRODUCTION: Antipsychotics are commonly used to treat psychotic symptoms and severe mental illnesses. Treatment guidelines recommend antipsychotics be titrated quickly to therapeutic effect in the acute setting but acknowledge that determining the optimal dose is complicated by a delay between treatment initiation and therapeutic response. The purpose of this study was to evaluate antipsychotic titration patterns in an inpatient psychiatric hospital. METHODS: This study is a retrospective chart review of adult patients admitted to a teaching hospital and initiated on an antipsychotic for treatment of psychosis between January and December 2018. Patients were excluded if they had substance-induced psychosis, delirium, were prescribed >1 antipsychotic, or had no antipsychotic dose changes. The primary outcome was the average titration rate of the newly initiated antipsychotic. Secondary outcomes included differences in titration rate between involuntary and voluntary admissions and other antipsychotic characteristics. RESULTS: Of 149 patients included, the majority had a primary diagnosis of schizophrenia. Antipsychotics were titrated on average every 2 days regardless of admission type. Eighteen percent of patients were titrated to guideline-recommended maximum doses, and it took, on average, 3 days for patients to reach their final dose during hospitalization. Average length of stay was 9 days, and 43.6% of patients were readmitted within 1 year. DISCUSSION: Antipsychotics are titrated rapidly in the inpatient setting despite a lack of evidence regarding the impact of titration rate on clinical outcomes. Further studies comparing slow versus rapid titration strategies are needed to elucidate the impact of this on patient outcomes.