Dietary energy density: a mediator of depressive symptoms and abdominal obesity or independent predictor of abdominal obesity?

BACKGROUND: In the U.S., Europe, and throughout the world, abdominal obesity prevalence is increasing. Depressive symptoms may contribute to abdominal obesity through the consumption of diets high in energy density. PURPOSE: To test dietary energy density ([DED]; kilocalories/gram of food and beverages consumed) for an independent relationship with abdominal obesity or as a mediator between depressive symptoms and abdominal obesity. METHODS: This cross-sectional study included 87 mid-life, overweight adults; 73.6% women; 50.6% African-American. Variables and measures: Beck Depression Inventory-II (BDI-II) to measure depressive symptoms; 3-day weighed food records to calculate DED; waist circumference, an indicator of abdominal obesity. Hierarchical regression tested if DED explained waist circumference variance while controlling for depressive symptoms and consumed food and beverage weight. Three approaches tested DED as a mediator. RESULTS: Nearly three-quarters of participants had abdominal obesity, and the mean waist circumference was 103.2 (SD 14.3) cm. Mean values: BDI-II was 8.67 (SD 8.34) which indicates most participants experienced minimal depressive symptoms, and 21.8% reported mild to severe depressive symptoms (BDI-II ≥ 14); DED was 0.75 (SD 0.22) kilocalories/gram. Hierarchical regression showed an independent association between DED and waist circumference with DED explaining 7.0% of variance above that accounted for by BDI-II and food and beverage weight. DED did not mediate between depressive symptoms and abdominal obesity. CONCLUSIONS: Depressive symptoms and DED were associated with elevated waist circumference, thus a comprehensive intervention aimed at improving depressive symptoms and decreasing DED to reduce waist circumference is warranted

Ursodeoxycholic acid to reduce adverse perinatal outcomes for intrahepatic cholestasis of pregnancy: the PITCHES RCT

Background: Intrahepatic cholestasis of pregnancy, characterised by maternal pruritus and raised serum bile acid concentrations, is associated with increased rates of stillbirth, preterm birth and neonatal unit admission. Ursodeoxycholic acid is widely used as a treatment, but without an adequate evidence base. / Objective: We aimed to evaluate whether or not ursodeoxycholic acid reduces adverse perinatal outcomes in affected women. / Design: Multicentre, masked, randomised, placebo-controlled, two-arm, parallel-group trial. / Setting: Thirty-three UK maternity units. / Participants: Women with intrahepatic cholestasis of pregnancy aged ≥ 18 years, between 20+0 and 40+6 weeks’ gestation with a singleton or twin pregnancy and no known lethal fetal anomaly. / Interventions: Women were randomly assigned (1 : 1 allocation ratio) to take ursodeoxycholic acid tablets or matched placebo tablets, at an equivalent dose of 1000 mg daily, titrated as needed. / Main outcome measures: The primary outcome was a composite of perinatal death (in utero fetal death after randomisation or known neonatal death up to 7 days) or preterm delivery (< 37 weeks’ gestation) or neonatal unit admission for at least 4 hours (from birth until hospital discharge). Each infant was counted once within this composite. Analyses were by intention to treat. / Results: Between 23 December 2015 and 7 August 2018, 605 women were randomised, with 305 women allocated to the ursodeoxycholic acid arm and 300 women to the placebo arm. There was no evidence of a significant difference in the incidence of the primary outcome between the groups: 23.0% (74 out of 322 infants) in the ursodeoxycholic acid group compared with 26.7% (85 out of 318 infants) in the placebo group; adjusted risk ratio 0.85 (95% confidence interval 0.62 to 1.15). There was no evidence of a significant difference in total costs (maternal, infant and the cost of ursodeoxycholic acid) between the two trial groups. There were two serious adverse events in the ursodeoxycholic acid group and six in the placebo group. / Limitations: Limitations include a primary outcome event rate in the control group that was lower than that estimated for the sample size calculation, but the lack of evidence of effect in all analyses suggests that it is unlikely that the trial had insufficient power. / Conclusions: In this clinical trial of ursodeoxycholic acid in women with intrahepatic cholestasis of pregnancy, there is no evidence that it is effective in reducing a composite of adverse perinatal outcomes. / Future work: Future research should aim to elucidate the aetiology and pathophysiology of adverse perinatal outcomes, particularly stillbirth, in women with intrahepatic cholestasis of pregnancy to assist the development of an effective preventative treatment. Further exploratory analyses may identify groups of women who might respond to ursodeoxycholic acid treatment. / Trial registration: Current Controlled Trials ISRCTN91918806. / Funding: This project was funded by the Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 7, No. 9. See the NIHR Journals Library website for further project information

Rationality in context: An analogical perspective

At times, human behavior seems erratic and irrational. Therefore, when modeling human decision-making, it seems reasonable to take the remarkable abilities of humans into account with respect to rational behavior, but also their apparent deviations from the normative standards of rationality shining up in certain rationality tasks. Based on well-known challenges for human rationality, together with results from psychological studies on decision-making and from previous work in the field of computational modeling of analogy-making, I argue that the analysis and modeling of rational belief and behavior should also consider context-related cognitive mechanisms like analogy-making and coherence maximization of the background theory. Subsequently, I conceptually outline a high-level algorithmic approach for a Heuristic Driven Theory Projection-based system for simulating context-dependent human-style rational behavior. Finally, I show and elaborate on the close connections, but also on the significant differences, of this approach to notions of "ecological rationality"

When almost is not even close: Remarks on the approximability of HDTP

A growing number of researchers in Cognitive Science advocate the thesis that human cognitive capacities are constrained by computational tractability. If right, this thesis also can be expected to have far-reaching consequences for work in Artificial General Intelligence: Models and systems considered as basis for the development of general cognitive architectures with human-like performance would also have to comply with tractability constraints, making in-depth complexity theoretic analysis a necessary and important part of the standard research and development cycle already from a rather early stage. In this paper we present an application case study for such an analysis based on results from a parametrized complexity and approximation theoretic analysis of the Heuristic Driven Theory Projection (HDTP) analogy-making framework

The JWST Hubble Sequence: The Rest-frame Optical Evolution of Galaxy Structure at 1.5 < z < 6.5

© 2023. The Author(s). Published by the American Astronomical Society. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/We present results on the morphological and structural evolution of a total of 3956 galaxies observed with JWST at 1.5 109 M ⊙ at z > 3 are not dominated by irregular and peculiar structures, either visually or quantitatively, as previously thought. We find a strong dominance of morphologically selected disk galaxies up to z = 6 in this mass range. We also find that the stellar mass and star formation rate densities are dominated by disk galaxies up to z ∼ 6, demonstrating that most stars in the Universe were likely formed in a disk galaxy. We compare our results to theory to show that the fraction of types we find is predicted by cosmological simulations, and that the Hubble Sequence was already in place as early as one billion years after the Big Bang. Additionally, we make our visual classifications public for the community.Peer reviewe

Serum Carotenoids and Fat-Soluble Vitamins in Women With Type 1 Diabetes and Preeclampsia: A longitudinal study

OBJECTIVE: Increased oxidative stress and immune dysfunction are implicated in preeclampsia (PE) and may contribute to the two- to fourfold increase in PE prevalence among women with type 1 diabetes. Prospective measures of fat-soluble vitamins in diabetic pregnancy are therefore of interest. RESEARCH DESIGN AND METHODS: Maternal serum carotenoids (α- and β-carotene, lycopene, and lutein) and vitamins A, D, and E (α- and γ-tocopherols) were measured at first (12.2 ± 1.9 weeks [mean ± SD], visit 1), second (21.6 ± 1.5 weeks, visit 2), and third (31.5 ± 1.7 weeks, visit 3) trimesters of pregnancy in 23 women with type 1 diabetes who subsequently developed PE (DM PE+) and 24 women with type 1 diabetes, matched for age, diabetes duration, HbA(1c), and parity, who did not develop PE (DM PE-). Data were analyzed without and with adjustment for baseline differences in BMI, HDL cholesterol, and prandial status. RESULTS: In unadjusted analysis, in DM PE+ versus DM PE-, α-carotene and β-carotene were 45 and 53% lower, respectively, at visit 3 (P < 0.05), before PE onset. In adjusted analyses, the difference in β-carotene at visit 3 remained significant. Most participants were vitamin D deficient (<20 ng/mL), and vitamin D levels were lower in DM PE+ versus DM PE- throughout the pregnancy, although this did not reach statistical significance. CONCLUSIONS: In pregnant women with type 1 diabetes, low serum α- and β-carotene were associated with subsequent development of PE, and vitamin D deficiency may also be implicated

Disparities in the frequency of fruit and vegetable consumption by socio-demographic and lifestyle characteristics in Canada

<p>Abstract</p> <p>Background</p> <p>The health benefits of adequate fruit and vegetable (F&V) consumption are significant and widely documented. However, many individuals self-report low F&V consumption frequency per day. This paper examines the disparities in the frequency of F&V consumption by socio-demographic and lifestyle characteristics.</p> <p>Method</p> <p>This study uses a representative sample of 93,719 individuals from the Canadian Community Health Survey (2007). A quantile regression model is estimated in order to capture the differential effects of F&V determinants across the conditional distribution of F&V consumption.</p> <p>Results</p> <p>The conditional and unconditional analyses reveal the existence of a socioeconomic gradient in F&V consumption frequency, in which the low income-education groups consume F&V less frequently than the high income-education groups. We also find significant disparities in F&V consumption frequency by demographic and lifestyle characteristics. The frequency of F&V consumption is relatively lower among: males, those in middle age, singles, smokers, individuals with weak social interaction and households with no children. The quantile regression results show that the association between F&V consumption frequency, and socio-demographic and lifestyle factors varies significantly along the conditional F&V consumption distribution. In particular, individual educational attainment is positively and significantly associated with F&V consumption frequency across different parts of the F&V distribution, while the income level matters only over the lower half of the distribution. F&V consumption follows a U-shaped pattern across the age categories. Those aged 30-39, 40-49 and 50-59 years consume F&V less frequently than those aged 18-29 years. The smallest F&V consumption is among the middle aged adults (40-49).</p> <p>Conclusions</p> <p>Understanding the socio-demographic and lifestyle characteristics of individuals with low F&V consumption frequency could increase the effectiveness of policies aimed at promoting F&V consumption. The differential effects of individual characteristics along the F&V consumption distribution suggest the need for a multifaceted approach to address the variation in F&V consumption frequency.</p

WILL (When to Induce Labour to Limit risk in pregnancy hypertension): a multicentre randomised controlled trial - adaptations to deliver a timing-of-birth trial during the COVID-19 international pandemic.

BACKGROUND: As a pragmatic randomised timing-of-birth trial, WILL adapted its trial procedures in response to the COVID-19 pandemic. These are reviewed here to inform post-pandemic trial methodology. METHODS: The trial (internal pilot) paused in March 2020, re-opened in July 2020, and is currently recruiting in 37 UK NHS consultant-led maternity units. We evaluated pandemic adaptations made to WILL processes and surveyed sites for their views of these changes (20 sites, videoconference). RESULTS: Despite 88% of sites favouring an electronic investigator site file (ISF), information technology requirements and clinical trial unit (CTU) operating procedures mandated the ongoing use of paper ISFs; site start-up delays resulted from restricted access to the CTU. Site initiation visits (SIVs) were conducted remotely; 50% of sites preferred remote SIVs and 44% felt that it was trial-dependent, while few preferred SIVs in-person as standard procedure. The Central team felt remote SIVs provided scheduling and attendance flexibility (for sites and trial staff), the option of recording discussions for missing or future staff, improved efficiency by having multiple sites attend, and time and cost savings; the negative impact on rapport-building and interaction was partially mitigated over time with more familiarity with technology and new ways-of-working. Two methods of remote consent were developed and used by 30/37 sites and for 54/156 recruits. Most (86%) sites using remote consenting felt it improved recruitment. For remote data monitoring (5 sites), advantages were primarily for the monitor (e.g. flexibility, no time constraints, reduced cost), and disadvantages primarily for the sites (e.g. document and access preparation, attendance at a follow-up meeting), but 81% of sites desired having the option of remote monitoring post-pandemic. CONCLUSIONS: COVID adaptations to WILL trial processes improved the flexibility of trial delivery, for Central and site staff, and participants. Flexibility to use these strategies should be retained post-pandemic. TRIAL REGISTRATION: ISRCTN77258279. Registered on 05 December 2018

The allure of otherness: transnational cult film fandom and the exoticist assumption

Academic scholarship addressing transnational cult fandom, particularly Western cult fans forming attachments to films outside their cultures, has frequently addressed the issue of exoticism. Much attention has been paid to how Western fans are problematically drawn to artefacts outside of their own cultures because of exotic qualities, resulting in a shallow and often condescending appreciation of such films. In this article, I critique a number of such articles for merely assuming such processes without proffering sufficient supporting evidence. In fact, I argue that a number of such exotic-oriented critiques of transnational cultism are actually guilty of practising what they preach against: an insufficient contextualization of fandom and a tendency to downplay the messiness of empirical data in favour of generalized abstractions. Further, I argue that the constant critique of fans as avoiding contextualization has not only been overstated but stringently used as a yardstick to denigrate fan engagements with texts as improper. As such, fans are often ‘othered’ within such articles, a process mirroring the ways they are accused of othering distant cultural artefacts