Michele Gelfand is the John H. Scully Professor of Cross-Cultural Management and Professor of Organizational Behavior at the Stanford Graduate School of Business School and Professor of Psychology by Courtesy. She was formerly a Distinguished University Professor of Psychology at the University of Maryland, College Park. Gelfand uses field, experimental, computational and neuroscience methods to understand the evolution of culture and its multilevel consequences. Her work has been published in outlets such as Science, the Proceedings of the National Academy of Sciences, Psychological Science, Nature Human behavior, the Journal of Personality and Social Psychology, Journal of Applied Psychology, Academy of Management Journal, among others. Gelfand is the founding co-editor of the Advances in Culture and Psychology series (Oxford University Press). Her book Rule Makers, Rule Breakers: How Tight and Loose Cultures Wire the World was published by Scribner in 2018. She is the Past President of the International Association for Conflict Management and co-founder of the Society for the Study of Cultural Evolution. She received the 2016 Diener award from SPSP, the 2017 Outstanding International Psychologist Award from the American Psychological Association, the 2019 Outstanding Cultural Psychology Award from the Society for Personality and Social Psychology, the 2020 Rubin Theory-to-Practice award from the International Association of Conflict Management, the 2021 Contributions to Society award from the Organizational Behavior Division of the Academy of Management, and the Annaliese Research Award from the Humboldt Foundation. Gelfand was elected to the American Academy of Arts and Sciences in 2019 and the National Academy of Sciences in 2021.
Professor, Organizational Behavior
Professor (By courtesy), Psychology
OB 581 (Win)
Independent Studies (5)
- Doctoral Practicum in Research
OB 699 (Aut, Win, Spr, Sum)
- Doctoral Practicum in Teaching
OB 698 (Aut, Win, Spr, Sum)
- Individual Research
GSBGEN 390 (Aut, Win, Spr)
- PhD Directed Reading
ACCT 691, FINANCE 691, MGTECON 691, MKTG 691, OB 691, OIT 691, POLECON 691 (Aut, Win, Spr, Sum)
- Special Laboratory Projects
PSYCH 195 (Aut, Win, Spr)
- Doctoral Practicum in Research
- Prior Year Courses
The Way They See Us: Examining the Content, Accuracy, and Bias of Metaperceptions Held by Syrian Refugees About the Communities That Host Them.
Personality & social psychology bulletin
Discourse about people seeking refuge from conflict varies considerably. To understand what components of this discourse reach refugees the most, we examined refugees' perceptions of how their host communities perceive them (i.e., intergroup metaperceptions). We sampled refugees who fled Syria to Jordan, Lebanon, Germany, and the Netherlands. Focus groups with 102 Syrian refugees revealed that the most prevalent metaperception discussed by refugees was that they thought their host communities saw them as threatening (Study 1). Surveys with 1,360 Syrian refugees and 1,441 members of the host communities (Study 2) found that refugees' metaperceptions tracked the perceptions held by their host communities (i.e., they were accurate), but there was also a significant mean difference, indicating that they were positively biased. Analyses further tested the roles of evaluative concern and group salience on metaperception accuracy, as well as differences in accuracy and bias across country and perception domain.
View details for DOI 10.1177/01461672231190222
View details for PubMedID 37571840
Social and moral psychology of COVID-19 across 69 countries.
2023; 10 (1): 272
The COVID-19 pandemic has affected all domains of human life, including the economic and social fabric of societies. One of the central strategies for managing public health throughout the pandemic has been through persuasive messaging and collective behaviour change. To help scholars better understand the social and moral psychology behind public health behaviour, we present a dataset comprising of 51,404 individuals from 69 countries. This dataset was collected for the International Collaboration on Social & Moral Psychology of COVID-19 project (ICSMP COVID-19). This social science survey invited participants around the world to complete a series of moral and psychological measures and public health attitudes about COVID-19 during an early phase of the COVID-19 pandemic (between April and June 2020). The survey included seven broad categories of questions: COVID-19 beliefs and compliance behaviours; identity and social attitudes; ideology; health and well-being; moral beliefs and motivation; personality traits; and demographic variables. We report both raw and cleaned data, along with all survey materials, data visualisations, and psychometric evaluations of key variables.
View details for DOI 10.1038/s41597-023-02080-8
View details for PubMedID 37169799
View details for PubMedCentralID PMC10173241
Multilevel cultural evolution: From new theory to practical applications.
Proceedings of the National Academy of Sciences of the United States of America
2023; 120 (16): e2218222120
Evolutionary science has led to many practical applications of genetic evolution but few practical uses of cultural evolution. This is because the entire study of evolution was gene centric for most of the 20th century, relegating the study and application of human cultural change to other disciplines. The formal study of human cultural evolution began in the 1970s and has matured to the point of deriving practical applications. We provide an overview of these developments and examples for the topic areas of complex systems science and engineering, economics and business, mental health and well-being, and global change efforts.
View details for DOI 10.1073/pnas.2218222120
View details for PubMedID 37036975
- Social norms and behavior change: The interdisciplinary research frontier JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION 2023; 205: A4-A7
From virility to virtue: the psychology of apology in honor cultures.
Proceedings of the National Academy of Sciences of the United States of America
2022; 119 (41): e2210324119
In honor cultures, relatively minor disputes can escalate, making numerous forms of aggression widespread. We find evidence that honor cultures' focus on virility impedes a key conflict de-escalation strategy-apology-that can be successfully promoted through a shift in mindset. Across five studies using mixed methods (text analysis of congressional speeches, a cross-cultural comparison, surveys, and experiments), people from honor societies (e.g., Turkey and US honor states), people who endorse honor values, and people who imagine living in a society with strong honor norms are less willing to apologize for their transgressions (studies 1-4). This apology reluctance is driven by concerns about reputation in honor cultures. Notably, honor is achieved not only by upholding strength and reputation (virility) but also through moral integrity (virtue). The dual focus of honor suggests a potential mechanism for promoting apologies: shifting the focus of honor from reputation to moral integrity. Indeed, we find that such a shift led people in honor cultures to perceive apologizing more positively and apologize more (study 5). By identifying a barrier to apologizing in honor cultures and illustrating ways to overcome it, our research provides insights for deploying culturally intelligent conflict-management strategies in such contexts.
View details for DOI 10.1073/pnas.2210324119
View details for PubMedID 36191220
Persuading republicans and democrats to comply with mask wearing: An intervention tournament.
Journal of experimental social psychology
2022; 101: 104299
Many people practiced COVID-19-related safety measures in the first year of the pandemic, but Republicans were less likely to engage in behaviors such as wearing masks or face coverings than Democrats, suggesting radical disparities in health practices split along political fault lines. We developed an "intervention tournament" which aimed to identify the framings that would promote mask wearing among a representative sample of Republicans and Democrats in the U.S. from Oct 14, 2020, to Jan 14, 2021 (N = 4931). Seven different conditions reflecting different moral values and factors specific to COVID-19-including protection from harm (self), protection from harm (community), patriotic duty, purity, reviving the economy, threat, and scientific evidence-were implemented to identify which framings would "win" in terms of promoting mask wearing compared to a baseline condition. We found that Republicans had significantly more negative attitudes toward masks, lower intentions to wear them, and were less likely to sign or share pledges on social media than Democrats, which was partially mediated by Republicans, compared to Democrats, perceiving that the threat of COVID-19 was lower. None of our framing conditions significantly affected Republicans' or Democrats' attitudes, intentions, or behaviors compared to the baseline condition, illustrating the difficulty in overcoming the strength of political polarization during COVID-19.
View details for DOI 10.1016/j.jesp.2022.104299
View details for PubMedID 35469190
Predicting attitudinal and behavioral responses to COVID-19 pandemic using machine learning.
2022; 1 (3): pgac093
At the beginning of 2020, COVID-19 became a global problem. Despite all the efforts to emphasize the relevance of preventive measures, not everyone adhered to them. Thus, learning more about the characteristics determining attitudinal and behavioral responses to the pandemic is crucial to improving future interventions. In this study, we applied machine learning on the multinational data collected by the International Collaboration on the Social and Moral Psychology of COVID-19 (N=51,404) to test the predictive efficacy of constructs from social, moral, cognitive, and personality psychology, as well as socio-demographic factors, in the attitudinal and behavioral responses to the pandemic. The results point to several valuable insights. Internalized moral identity provided the most consistent predictive contribution-individuals perceiving moral traits as central to their self-concept reported higher adherence to preventive measures. Similar results were found for morality as cooperation, symbolized moral identity, self-control, open-mindedness, and collective narcissism, while the inverse relationship was evident for the endorsement of conspiracy theories. However, we also found a non-neglible variability in the explained variance and predictive contributions with respect to macro-level factors such as the pandemic stage or cultural region. Overall, the results underscore the importance of morality-related and contextual factors in understanding adherence to public health recommendations during the pandemic.
View details for DOI 10.1093/pnasnexus/pgac093
View details for PubMedID 35990802
Religious Afterlife Beliefs Decrease Behavioral Avoidance of Symbols of Mortality.
Personality & social psychology bulletin
An astonishing cultural phenomenon is where, far away from or close to a city center, people in different societies localize cemeteries that function as both sites of memory of lost ones and symbols of mortality. Yet a psychological account of such differences in behavioral responses to symbols of mortality is lacking. Across five studies (N = 1,590), we tested a psychological model that religious afterlife beliefs decrease behavioral avoidance of symbols of mortality (BASM) by developing and validating a word-position task for quantifying BASM. We showed evidence that religious believers, including Christians, Muslims, Hindus, and Buddhists, exhibited decreased BASM relative to nonbelievers. We also provide evidence for a causal relationship between religious afterlife beliefs and reduced BASM. Our findings provide new insight into the functional role of religious afterlife beliefs in modulating human avoidance behavior in response to symbols of mortality.
View details for DOI 10.1177/01461672221096281
View details for PubMedID 35611400
Politicizing mask-wearing: predicting the success of behavioral interventions among republicans and democrats in the U.S.
2022; 12 (1): 7575
Scientists and policymakers seek to choose effective interventions that promote preventative health measures. We evaluated whether academics, behavioral science practitioners, and laypeople (N=1034) were able to forecast the effectiveness of seven different messages compared to a baseline message for Republicans and Democrats separately. These messages were designed to nudge mask-wearing attitudes, intentions, and behaviors. When examining predictions across political parties, forecasters predicted larger effects than those observed for Democrats compared to Republicans and made more accurate predictions for Republicans compared to Democrats. These results are partly driven by a lack of nudge effects on Democrats, as reported in Gelfand et al. (J Exp Soc Psychol, 2021). Academics and practitioners made more accurate predictions compared to laypeople. Although forecasters' predictions were correlated with the nudge interventions, all groups overestimated the observed results. We discuss potential reasons for why the forecasts did not perform better and how more accurate forecasts of behavioral intervention outcomes could potentially provide insight that can help save resources and increase the efficacy of interventions.
View details for DOI 10.1038/s41598-022-10524-1
View details for PubMedID 35534489
- Author Correction: National identity predicts public health support during a global pandemic. Nature communications 2022; 13 (1): 1949
The Importance of Being Unearnest: Opportunists and the Making of Culture
JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY
Opportunistic actors-who behave expediently, cheating when they can and offering minimal cooperation only when they have to-play an important role in producing some puzzling phenomena, including the flourishing of strong reciprocity, the peculiar correlation between positive and negative reciprocity within cultures of honor, and low levels of social capital within tight and collectivist cultures (that one might naively assume would produce high levels of social capital). Using agent-based models and an experiment, we show how Opportunistic actors enable the growth of Strong Reciprocators, whose strategy is the exact opposite of the Opportunists. Additionally, previous research has shown how the threat of punishment can sustain cooperation within a group. However, the present studies illustrate how stringent demands for cooperation and severe punishments for noncooperation can also backfire and reduce the amount of voluntary, uncoerced cooperation in a society. The studies illuminate the role Opportunists play in producing these backfire effects. In addition to highlighting other features shaping culture (e.g., risk and reward in the environment, "founder effects" requiring a critical mass of certain strategies at a culture's initial stage), the studies help illustrate how Opportunists create aspects of culture that otherwise seem paradoxical, are dismissed as "error," or produce unintended consequences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
View details for DOI 10.1037/pspa0000301
View details for Web of Science ID 000772150200001
View details for PubMedID 35324241
- The influence of cultural tightness-looseness on cross-border acquisition performance JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION 2022; 195: 1-15
The spatial representation of leadership depends on ecological threat: A replication and extension of Menon et al. (2010).
Journal of personality and social psychology
Since humanity's first steps, individuals have used nonverbal cues to communicate and infer leadership, such as walking ahead of others. Menon et al., (2010) showed that the use of spatial ordering as cue to leadership differs across cultures: Singaporeans were more likely than Americans to represent leaders behind rather than in front of groups. Furthermore, they showed that threat priming increases the representation of leaders at the back. We replicate and extend these findings. We draw on cultural tightness theory to explain variability in mental representations of leadership, advance the spatial precedence hypothesis that leaders are generally represented in the front, use a large cross-cultural sample to compare different cultural dimensions, and employ alternative operationalizations of threat. We show that leaders are generally represented in frontal spatial positions across 25 countries and in different types of teams. We also find that cultural tightness and ecological threat (pandemic, warfare, and predation) lead people to represent leaders at the back (Studies 1-5). Mediational models show that ecological threat triggers greater desire for tightness and norm-enforcing leaders, which in turn leads people to represent leaders at the back (Study 4). Likewise, in tightly regulated work-teams, leaders are thought of as being seated at the office's back desk (Study 5). Thus, we converge with Menon et al. that different cultures have different mental representations of leaders and individuals who face threats show greater preference for leaders at the back. Additionally, we demonstrate that cultural tightness is the key cultural predictor of mental representations of leadership. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
View details for DOI 10.1037/pspa0000304
View details for PubMedID 35201815
National identity predicts public health support during a global pandemic.
1800; 13 (1): 517
Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N=49,968 across 67 countries), we investigated self-reported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N=42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r=-0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics.
View details for DOI 10.1038/s41467-021-27668-9
View details for PubMedID 35082277
Concern with COVID-19 pandemic threat and attitudes towards immigrants: The mediating effect of the desire for tightness.
Current research in ecological and social psychology
1800; 3: 100028
Tightening social norms is thought to be adaptive for dealing with collective threat yet it may have negative consequences for increasing prejudice. The present research investigated the role of desire for cultural tightness, triggered by the COVID-19 pandemic, in increasing negative attitudes towards immigrants. We used participant-level data from 41 countries (N=55,015) collected as part of the PsyCorona project, a cross-national longitudinal study on responses to COVID-19. Our predictions were tested through multilevel and SEM models, treating participants as nested within countries. Results showed that people's concern with COVID-19 threat was related to greater desire for tightness which, in turn, was linked to more negative attitudes towards immigrants. These findings were followed up with a longitudinal model (N=2,349) which also showed that people's heightened concern with COVID-19 in an earlier stage of the pandemic was associated with an increase in their desire for tightness and negative attitudes towards immigrants later in time. Our findings offer insight into the trade-offs that tightening social norms under collective threat has for human groups.
View details for DOI 10.1016/j.cresp.2021.100028
View details for PubMedID 35098189
Predictors of adherence to public health behaviors for fighting COVID-19 derived from longitudinal data.
2022; 12 (1): 3824
The present paper examines longitudinally how subjective perceptions about COVID-19, one's community, and the government predict adherence to public health measures to reduce the spread of the virus. Using an international survey (N=3040), we test how infection risk perception, trust in the governmental response and communications about COVID-19, conspiracy beliefs, social norms on distancing, tightness of culture, and community punishment predict various containment-related attitudes and behavior. Autoregressive analyses indicate that, at the personal level, personal hygiene behavior was predicted by personal infection risk perception. At social level, social distancing behaviors such as abstaining from face-to-face contact were predicted by perceived social norms. Support for behavioral mandates was predicted by confidence in the government and cultural tightness, whereas support for anti-lockdown protests was predicted by (lower) perceived clarity of communication about the virus. Results are discussed in light of policy implications and creating effective interventions.
View details for DOI 10.1038/s41598-021-04703-9
View details for PubMedID 35264597
The Moral Foundations of Desired Cultural Tightness.
Frontiers in psychology
2022; 13: 739579
People vary on their desire for strict norms, and the moral underpinnings of these differences have yet to be explored. The current research examined whether and how moral beliefs held by individuals would affect the extent to which they want their country to be tight (i.e., having strict social norms) or loose (i.e., having more permissive social norms). In particular, the effects of the "binding" and "individualizing" foundations, which are moral beliefs focused on the importance of groups and individuals, respectively, were examined. We hypothesized that the binding foundations could predict people's desire for cultural tightness. We also hypothesized that the perception that one's society is threatened may drive this effect. Three studies were conducted using both cross-sectional (Studies 1 and 3) and two-wave (Study 2) designs. Demographic variables and participants' political orientation effects were controlled. In Study 1, only the binding foundations significantly predicted higher desired tightness. In Study 2, binding foundations predicted desired tightness measured at follow-up. In Study 3, the positive effect of perceived threat on desired tightness via the binding foundations was confirmed. From additional within-paper analyses we also have some evidence of significant relationships, albeit unstable across studies, between desired tightness and individualizing foundations.
View details for DOI 10.3389/fpsyg.2022.739579
View details for PubMedID 35519640
When danger strikes: A linguistic tool for tracking America's collective response to threats.
Proceedings of the National Academy of Sciences of the United States of America
1800; 119 (4)
In today's vast digital landscape, people are constantly exposed to threatening language, which attracts attention and activates the human brain's fear circuitry. However, to date, we have lacked the tools needed to identify threatening language and track its impact on human groups. To fill this gap, we developed a threat dictionary, a computationally derived linguistic tool that indexes threat levels from mass communication channels. We demonstrate this measure's convergent validity with objective threats in American history, including violent conflicts, natural disasters, and pathogen outbreaks such as the COVID-19 pandemic. Moreover, the dictionary offers predictive insights on US society's shifting cultural norms, political attitudes, and macroeconomic activities. Using data from newspapers that span over 100 years, we found change in threats to be associated with tighter social norms and collectivistic values, stronger approval of sitting US presidents, greater ethnocentrism and conservatism, lower stock prices, and less innovation. The data also showed that threatening language is contagious. In all, the language of threats is a powerful tool that can inform researchers and policy makers on the public's daily exposure to threatening language and make visible interesting societal patterns across American history.
View details for DOI 10.1073/pnas.2113891119
View details for PubMedID 35074911
- Cultural Evolutionary Mismatches in Response to Collective Threat CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2021
Integrating Evolutionary Game Theory and Cross-Cultural Psychology to Understand Cultural Dynamics
2021; 76 (6): 1054-1066
In this article, we show that an evolutionary game theoretic (EGT) modeling approach can be fruitfully integrated with research in cross-cultural psychology to provide insight into cultural dynamics. EGT was initially developed to model biological evolution, but has been increasingly used to study the evolution of human behavior. Through "virtual experimentation," EGT models can be used to test the effects of various factors on the trajectories of behavioral change at the population level. We illustrate how EGT models can provide new insights into processes of cultural adaptation, transmission, maintenance, and change. We conclude with the strengths and limitations of using EGT to study cultural dynamics and new frontiers that await investigation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
View details for DOI 10.1037/amp0000851
View details for Web of Science ID 000730412200021
View details for PubMedID 34914439
COVID-19 and the workplace: Implications, issues, and insights for future research and action.
The American psychologist
The impacts of COVID-19 on workers and workplaces across the globe have been dramatic. This broad review of prior research rooted in work and organizational psychology, and related fields, is intended to make sense of the implications for employees, teams, and work organizations. This review and preview of relevant literatures focuses on (a) emergent changes in work practices (e.g., working from home, virtual teamwork) and (b) emergent changes for workers (e.g., social distancing, stress, and unemployment). In addition, potential moderating factors (demographic characteristics, individual differences, and organizational norms) are examined given the likelihood that COVID-19 will generate disparate effects. This broad-scope overview provides an integrative approach for considering the implications of COVID-19 for work, workers, and organizations while also identifying issues for future research and insights to inform solutions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
View details for DOI 10.1037/amp0000716
View details for PubMedID 32772537
Using social and behavioural science to support COVID-19 pandemic response.
Nature human behaviour
The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.
View details for DOI 10.1038/s41562-020-0884-z
View details for PubMedID 32355299
Ambivalent stereotypes link to peace, conflict, and inequality across 38 nations
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
2017; 114 (4): 669-674
A cross-national study, 49 samples in 38 nations (n = 4,344), investigates whether national peace and conflict reflect ambivalent warmth and competence stereotypes: High-conflict societies (Pakistan) may need clearcut, unambivalent group images distinguishing friends from foes. Highly peaceful countries (Denmark) also may need less ambivalence because most groups occupy the shared national identity, with only a few outcasts. Finally, nations with intermediate conflict (United States) may need ambivalence to justify more complex intergroup-system stability. Using the Global Peace Index to measure conflict, a curvilinear (quadratic) relationship between ambivalence and conflict highlights how both extremely peaceful and extremely conflictual countries display lower stereotype ambivalence, whereas countries intermediate on peace-conflict present higher ambivalence. These data also replicated a linear inequality-ambivalence relationship.
View details for DOI 10.1073/pnas.1611874114
View details for Web of Science ID 000392597000038
View details for PubMedID 28069955
View details for PubMedCentralID PMC5278477
The Emergence of Sex Differences in Personality Traits in Early Adolescence: A Cross-Sectional, Cross-Cultural Study
JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY
2015; 108 (1): 171-185
Although large international studies have found consistent patterns of sex differences in personality traits among adults (i.e., women scoring higher on most facets), less is known about cross-cultural sex differences in adolescent personality and the role of culture and age in shaping them. The present study examines the NEO Personality Inventory-3 (McCrae, Costa, & Martin, 2005) informant ratings of adolescents from 23 cultures (N = 4,850), and investigates culture and age as sources of variability in sex differences of adolescents' personality. The effect for Neuroticism (with females scoring higher than males) begins to take on its adult form around age 14. Girls score higher on Openness to Experience and Conscientiousness at all ages between 12 and 17 years. A more complex pattern emerges for Extraversion and Agreeableness, although by age 17, sex differences for these traits are highly similar to those observed in adulthood. Cross-sectional data suggest that (a) with advancing age, sex differences found in adolescents increasingly converge toward adult patterns with respect to both direction and magnitude; (b) girls display sex-typed personality traits at an earlier age than boys; and (c) the emergence of sex differences was similar across cultures. Practical implications of the present findings are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
View details for DOI 10.1037/a0038497
View details for Web of Science ID 000348048200011
View details for PubMedID 25603371
View details for PubMedCentralID PMC4327943