Maternal and passionate love are both crucial for reproduction and involve attachment behaviors with high rewards. Neurobiological studies of attachment in animal and human neuroimaging studies have suggested that the coordination of oxytocinergic and vasopressinergic pathways, coupled with the dopaminergic reward system, contribute to the formation and maintenance of maternal and passionate love. In the present study, we carried out a quantitative meta-analysis of human neuroimaging to identify common and dissociable neural substrates associated with maternal and passionate love, using the activation likelihood estimation (ALE) approach. The ALE results showed significant activation of the brain regions in the left ventral tegmental area (VTA), right thalamus, left substantia nigra, and the left putamen for maternal love, but in the bilateral VTA for passionate love. The meta-analytic neuroimaging evidence suggests the greater involvement of cognitive–affective regulation in maternal attachment and the greater desire to combine liking and wanting in romantic love behaviors. The conjunction analysis highlights the functional convergence of the VTA across the two types of human love, indicating a shared neurobiological mechanism of maternal and passionate love with evolutionary roots. Our findings suggest that the processing of both maternal and passionate love involve the affective and motivational regulation associated with dopaminergic systems; our neuroimaging evidence supports the notion that maternal and passionate love share a common evolutionary origin and neurobiological basis in the human brain.

Before caring for patients, video instruction is commonly used for undergraduate medical students, and 360° virtual reality (VR) videos have gained increasing interest in clinical medical education. Therefore, the effect of immersive 360° VR video learning compared with two-dimensional (2D) VR video learning in clinical skills acquisition should be evaluated. This randomized, intervention-controlled clinical trial was aimed to assess whether immersive 360° VR video improves undergraduate medical students' learning effectiveness and reduces the cognitive load in history taking and physical examination (H&P) training. From May 1 2018 to October 30 2018, 64 senior undergraduate medical students in a tertiary academic hospital were randomized to receive a 10-min immersive 360° (360° VR video group; n = 32) or 2D VR instructional video (2D VR video group; n = 32), including essential knowledge and competency of H&P. The demographic characteristics of the two groups were comparable for age, sex, and cognitive style. The total procedure skill score, physical examination score, learner’s satisfaction score, and total cognitive load in the 360° VR video group were significantly higher than those in the 2D VR video group (effect sizes [95% confidence interval]: 0.72 [0.21–1.22], 0.63 [0.12–1.13], 0.56 [0.06–1.06], and 0.53 [0.03–1.03], respectively). This study suggested that a10-minute 360° VR video instruction helped undergraduate medical students perform fundamental H&P skills as effectively as 2D VR video. Furthermore, the 360° VR video might result in significantly better procedural metrics of physical examinations with higher learner satisfaction despite the higher cognitive load.

Entropy is a quantitative measure of signal uncertainty and has been widely applied to ultrasound tissue characterization. Ultrasound assessment of hepatic steatosis typically involves a backscattered statistical analysis of signals based on information entropy. Deep learning extracts features for classification without any physical assumptions or considerations in acoustics. In this study, we assessed clinical values of information entropy and deep learning in the grading of hepatic steatosis. A total of 205 participants underwent ultrasound examinations. The image raw data were used for Shannon entropy imaging and for training and testing by the pretrained VGG-16 model, which has been employed for medical data analysis. The entropy imaging and VGG-16 model predictions were compared with histological examinations. The diagnostic performances in grading hepatic steatosis were evaluated using receiver operating characteristic (ROC) curve analysis and the DeLong test. The areas under the ROC curves when using the VGG-16 model to grade mild, moderate, and severe hepatic steatosis were 0.71, 0.75, and 0.88, respectively; those for entropy imaging were 0.68, 0.85, and 0.9, respectively. Ultrasound entropy, which varies with fatty infiltration in the liver, outperformed VGG-16 in identifying participants with moderate or severe hepatic steatosis (p < 0.05). The results indicated that physics-based information entropy for backscattering statistics analysis can be recommended for ultrasound diagnosis of hepatic steatosis, providing not only improved performance in grading but also clinical interpretations of hepatic steatosis.

BackgroundElectronic learning (e-learning) through mobile technology represents a novel way to teach emergent otorhinolaryngology-head and neck surgery (ORL-HNS) disorders to undergraduate medical students. Whether a cognitive style of education combined with learning modules can impact learning outcomes and satisfaction in millennial medical students is unknown.ObjectiveThe aim of this study was to assess the impact of cognitive styles and learning modules using mobile e-learning on knowledge gain, competence gain, and satisfaction for emergent ORL-HNS disorders.MethodsThis randomized controlled trial included 60 undergraduate medical students who were novices in ORL-HNS at an academic teaching hospital. The cognitive style of the participants was assessed using the group embedded figures test. The students were randomly assigned (1:1) to a novel interactive multimedia (IM) group and conventional Microsoft PowerPoint show (PPS) group matched by age, sex, and cognitive style. The content for the gamified IM module was derived from and corresponded to the textbook-based learning material of the PPS module (video lectures). The participants were unblinded and used fully automated courseware containing the IM or PPS module on a 7-inch tablet for 100 min. Knowledge and competence were assessed using multiple-choice questions and multimedia situation tests, respectively. Each participant also rated their global satisfaction.ResultsAll of the participants (median age 23 years, range 22-26 years; 36 males and 24 females) received the intended intervention after randomization. Overall, the participants had significant gains in knowledge (median 50%, interquartile range [IQR]=17%-80%, P<.001) and competence (median 13%, IQR=0%-33%, P=.006). There were no significant differences in knowledge gain (40%, IQR=13%-76% vs 60%, IQR=20%-100%, P=.42) and competence gain (0%, IQR= −21% to 38% vs 25%, IQR=0%-33%, P=.16) between the IM and PPS groups. However, the IM group had a higher satisfaction score (8, IQR=6-9 vs 6, IQR=4-7, P=.01) compared with the PPS group. Using Friedman’s two-way nonparametric analysis of variance, cognitive styles (field-independent, field-intermediate, or field-dependent classification) and learning modules (IM or PPS) had significant effects on both knowledge gain (both adjusted P<.001) and satisfaction (both adjusted P<.001).ConclusionsMobile e-learning is an effective modality to improve knowledge of emergent ORL-HNS in millennial undergraduate medical students. Our findings suggest the necessity of developing various modules for undergraduate medical students with different cognitive styles.Trial RegistrationClinicaltrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV)