Persistence of poor sleep predicts the severity of the clinical condition after 6months of standard treatment in patients with eating disorders

Clinical evidence suggests that eating disorder (ED) patients experience poor sleep even if they rarely complain of it. However, direct empirical evidence supporting this relationship is still sparse. In order to provide direct evidence, poor sleep, severity of the ED symptoms and depression were obtained in 562 ED patients at treatment admission (T0). For 271 patients out of them, data were also available after 6 months of standard treatment (T1). Results evidence that at T0 poor sleep predicts severity of ED symptoms through the mediation of depression. Persistence of poor sleep at T1 directly predicts the severity of the ED symptoms both directly and through the mediation of depression. These findings suggest that the treatment of ED may benefit from addressing poor sleep since its presence and persistence increase comorbidity and attrition to the standard treatment

Systematic study of effect of cross-drafts and nozzle diameter on shield gas coverage

A shield gas flow rate of 15–20 L min21 is typically specified in metal inert gas welding, but is often adjusted to as high as 36 L min21 by welders in practice. Not only is this overuse of shield gas wasteful, but uncontrolled high gas flows can lead to significant turbulence induced porosity in the final weld. There is therefore a need to understand and control the minimum shield gas flow rate used in practical welding where cross-drafts may affect the coverage. Very low gas coverage or no shielding leads to porosity and spatter development in the weld region. A systematic study is reported of the weld quality achieved for a range of shield gas flow rates, cross-draft speeds and nozzle diameters using optical visualisation and numerical modelling to determine the shield gas coverage. As a consequence of the study, the shield gas flow has been reduced to 12 L min21 in production welding, representing a significant process cost saving and reduced environmental impact with no compromise to the final weld quality

Evaluation of anti-insulin receptor antibodies as potential novel therapies for human insulin receptoropathy using cell culture models.

AIMS/HYPOTHESIS: Bi-allelic loss-of-function mutations in the INSR gene (encoding the insulin receptor [INSR]) commonly cause extreme insulin resistance and early mortality. Therapeutic options are limited, but anti-INSR antibodies have been shown to activate two mutant receptors, S323L and F382V. This study evaluates four well-characterised murine anti-INSR monoclonal antibodies recognising distinct epitopes (83-7, 83-14, 18-44, 18-146) as surrogate agonists for potential targeted treatment of severe insulin resistance arising from insulin receptoropathies. METHODS: Ten naturally occurring mutant human INSRs with defects affecting different aspects of receptor function were modelled and assessed for response to insulin and anti-INSR antibodies. A novel 3T3-L1 adipocyte model of insulin receptoropathy was generated, permitting conditional knockdown of endogenous mouse Insr by lentiviral expression of species-specific short hairpin (sh)RNAs with simultaneous expression of human mutant INSR transgenes. RESULTS: All expressed mutant INSR bound to all antibodies tested. Eight mutants showed antibody-induced autophosphorylation, while co-treatment with antibody and insulin increased maximal phosphorylation compared with insulin alone. After knockdown of mouse Insr and expression of mutant INSR in 3T3-L1 adipocytes, two antibodies (83-7 and 83-14) activated signalling via protein kinase B (Akt) preferentially over signalling via extracellular signal-regulated kinase 1/2 (ERK1/2) for seven mutants. These antibodies stimulated glucose uptake via P193L, S323L, F382V and D707A mutant INSRs, with antibody response greater than insulin response for D707A. CONCLUSIONS/INTERPRETATION: Anti-INSR monoclonal antibodies can activate selected naturally occurring mutant human insulin receptors, bringing closer the prospect of novel therapy for severe insulin resistance caused by recessive mutations

Roles of Candida albicans Mig1 and Mig2 in glucose repression, pathogenicity traits, and SNF1 essentiality.

Metabolic adaptation is linked to the ability of the opportunistic pathogen Candida albicans to colonize and cause infection in diverse host tissues. One way that C. albicans controls its metabolism is through the glucose repression pathway, where expression of alternative carbon source utilization genes is repressed in the presence of its preferred carbon source, glucose. Here we carry out genetic and gene expression studies that identify transcription factors Mig1 and Mig2 as mediators of glucose repression in C. albicans. The well-studied Mig1/2 orthologs ScMig1/2 mediate glucose repression in the yeast Saccharomyces cerevisiae; our data argue that C. albicans Mig1/2 function similarly as repressors of alternative carbon source utilization genes. However, Mig1/2 functions have several distinctive features in C. albicans. First, Mig1 and Mig2 have more co-equal roles in gene regulation than their S. cerevisiae orthologs. Second, Mig1 is regulated at the level of protein accumulation, more akin to ScMig2 than ScMig1. Third, Mig1 and Mig2 are together required for a unique aspect of C. albicans biology, the expression of several pathogenicity traits. Such Mig1/2-dependent traits include the abilities to form hyphae and biofilm, tolerance of cell wall inhibitors, and ability to damage macrophage-like cells and human endothelial cells. Finally, Mig1 is required for a puzzling feature of C. albicans biology that is not shared with S. cerevisiae: the essentiality of the Snf1 protein kinase, a central eukaryotic carbon metabolism regulator. Our results integrate Mig1 and Mig2 into the C. albicans glucose repression pathway and illuminate connections among carbon control, pathogenicity, and Snf1 essentiality

Interventions for preventing oral mucositis for patients with cancer receiving treatment

Background: Treatment of cancer with chemotherapy is becoming increasingly more effective but is associated with short and long-term side effects. Oral side effects remain a major source of illness despite the use of a variety of agents to prevent them. Objectives: To evaluate the effectiveness of oral (and topical) prophylactic agents for oral mucositis and oral candidiasis in patients with cancer (excluding head and neck cancer), compared with placebo or no treatment. Search Strategy: Computerised MEDLINE, EMBASE, CINAHL, CANCERLIT, the Cochrane Controlled Trials Register and the Cochrane Oral Health Group Specialist Register search up to July 1999. Reference lists from relevant articles were scanned and the authors of eligible studies were contacted to identify trials and obtain additional information. Selection Criteria: Studies were selected if they met the following criteria: design - random or quasi-random allocation of participants; participants - anyone with cancer receiving chemotherapy (excluding head and neck cancer); interventions - prophylactic agents prescribed to reduce oral conditions arising from cancer or its treatment; outcomes - mucositis and oral candidiasis. Data Collection and Analysis: Information regarding methods, participants, interventions and outcome measures and results were independently extracted, in duplicate, by two reviewers (JC &amp; HW). Specialist advice was sought to categorise interventions. Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out using the Jadad criteria (Jadad 1998). The Cochrane Oral Health Group statistical guidelines were followed and relative risk values calculated using random effects models where significant heterogeneity was detected (P &lt; 0.1). Main Results: Thirty-eight reports of trials were initially included. Two were duplicate reports and nine were excluded as there was no useable information. Of the 27 useable studies 14 had data for mucositis comprising 945 randomised patients and 15 included data for oral candidiasis with 1164 randomised patients. Of the eight prophylactic agents used for mucositis only one, ice chips, was effective (Relative risk 0.57, 95% CI 0.43 to 0.77, chi-square for heterogeneity = 0.26 (df = 1), p = 0.61). The NNT to prevent one extra case of mucositis over the baseline incidence using ice chips was 4 (95%CI: 3 to 7). The NNT for when the baseline incidence of mucositis in the population ranges from 50% to 80% are 5 to 4 respectively. There is evidence that antifungal agents which are partially or fully absorbed from the gastrointestinal tract prevent oral candidiasis and that the partially absorbed agents may be more effective than the fully absorbed agents. The RR for partially absorbed agents was 0.13 (95% CI 0.06 to 0.27, chi-square for heterogeneity = 5.3 (df = 3), P = 0. 15). The NNT to prevent one extra case of oral candidiasis over the baseline incidence using partially absorbed drugs was 3 (95% CI: 3 to 5). The NNT for when the baseline incidence of oral candidiasis in the population ranges from 30% to 70% are 4 to 2 respectively. The general reporting of RCT's was poor however the median Jadad score was acceptable and improved further when the authors provided additional information. The sensitivity analysis confirmed the findings for oral candidiasis. Reviewer's Conclusions: There is some evidence that ice chips prevent mucositis. None of the other prophylactic agents included in this review prevented mucositis. There is evidence that prophylactic use of antifungal agents which are absorbed or partially absorbed from the gastrointestinal tract reduce the clinical signs of oral candidiasis, and the partially absorbed drugs may be more effective. Future trials in this area should address the link between oral and general health including outcomes relevant to the patient. Collaboration between medical and dental teams is indicated.</p

Person Perception Aspects of Judgments of Truthfulness in Public Appeals

Although detection of deception accuracy rate has been researched extensively, the person perception components that are the basis for these judgments remain unclear. To explore this, 30 academics' person perceptions, as well as truthfulness judgment, of the individual presenting a televised appeal were measured using a 14-item scale. Twelve appeals (6 genuine and 6 false) for information regarding the whereabouts of a missing relative, or for information to apprehend the person who murdered their relative, were used. The person perception scale consisted of (1) global, abstract judgments (open, deceptive, genuine, trustworthy, and emotional) and (2) behavioural indices (facial pleasantness, facial animation, arousal, tension, involvement, verbal; consistency, plausibility and directness, and vocal certainty). Multiple regression identified person perceptions of openness, (non)deceptiveness, genuineness, trustworthiness, and verbal plausibility as significant predictors of truthfulness judgments. Future research should now explore the relationship of these person perception components of truth judgments to the accuracy

An ‘app’ropriate resource? Using mobile apps to provide feeding advice and support to parents

Feeding problems in children are extremely common and can affect long-term physical health, in addition to being acutely stressful for both the parent and child. Despite this, advice on child feeding is still poorly communicated to parents and many struggle to find professional support and advice when they experience problems feeding their child. The purpose of this research was to develop a resource to address this; one which allows for wide and cost-effective dissemination of expert advice and avoids traditional barriers to healthcare access. To this end, we developed a free-to-download mobile app for smartphones (and website version for non-app users). Following a review of the literature on infant feeding problems, the resource was developed to offer: (1) education on the most prevalent feeding difficulties; (2) interactive, tangible tools and tips to implement suggested strategies; and (3) assessment tools to monitor problem severity and parent/child subjective wellbeing. Mothers (N = 18) discussed their feeding experiences and appraised the mobile app and website prototypes. Feedback confirmed that feeding problems were common, guidance was inadequate, and that this resource was viewed as extremely helpful, novel, and contained a depth of information beyond anything previously seen. Importantly, mothers welcomed the possibility of using a mobile app to access feeding-related guidance. Overall, this resource represents a novel way to deliver education and guidance in an easy-to-use, highly accessible way that fits with modern parents’ lifestyles. Further evaluation activities are planned to test the efficacy of the resource as an intervention tool

Development and preliminary evaluation of the Child Feeding Guide website and app: a tool to support caregivers with promoting healthy eating in children.

Development and preliminary evaluation of the Child Feeding Guide website and app: a tool to support caregivers with promoting healthy eating in children

Milk feeding, solid feeding and obesity risk: a review of the relationships between early life feeding practices and later adiposity

Childhood obesity is a major health issue with associated ill-health consequences during childhood and into later adolescence and adulthood. Given that eating behaviours are formed during early childhood, it is important to evaluate the relationships between early life feeding practices and later child adiposity. This review describes and evaluates recent literature exploring associations between child weight and the mode of milk feeding, the age of introducing solid foods and caregivers’ solid feeding practices. There are many inconsistencies in the literature linking early life feeding to later obesity risk and discrepancies may be related to inconsistent definitions, or a lack of control for confounding variables. This review summarises the literature in this area and identifies the need for large scale longitudinal studies to effectively explore how early life feeding experiences may interact with each other and with nutritional provision during later childhood to predict obesity risk

Investigating the association between children’s screen media exposure and vocabulary size in the UK

Children are growing up in a digital age with increasing exposure to television and touchscreen devices. We tested whether exposure to screen media is associated with children’s early language development. One hundred and thirty-one highly educated caregivers of UK children aged 6–36 months completed a media exposure questionnaire and vocabulary measure. 99% of children were read to daily, 82% watched television, and 49% used mobile touchscreen devices daily. Regression analyses revealed that time spent reading positively predicted vocabulary comprehension and production scores at 6–18 months, but time spent engaging with television or mobile touchscreen devices was not associated with vocabulary scores. Critically, correlations revealed that time spent reading or engaging with other non-screen activities was not offset by time spent engaging with television or mobile touchscreen devices. Thus, there was no evidence to suggest that screen media exposure adversely influenced vocabulary size in our sample of highly educated families with moderate media use