395 research outputs found

    A serial mediation model of the relationship between alexithymia and BMI: The role of negative affect, negative urgency and emotional eating

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    Difficulty identifying and describing emotions (alexithymia) has been related to impulsiveness and negative affect, emotional eating and obesity. However, previous research findings concerning the relationship between alexithymia and obesity have been mixed and inconsistent, raising the possibility that the relationship is indirect and mediated by multiple unknown factors. The aim of the study was to comprehensively explore the potential pathways between alexithymia and obesity via a novel theoretical model, and for the first time, incorporate negative affect, impulsiveness and emotional eating as potential mediating factors. Two questionnaire-based studies were conducted; the first as an exploratory analysis within a student sample (N=125), and the second as a self-replication within a more representative general population sample (N=342). Study One revealed that difficulty identifying feelings predicted Body Mass Index (BMI) both directly (B = .1694, CI = .0194-.3194) and indirectly via impulsiveness and emotional eating (B = .0074, CI = .0001-.0315). In contrast, Study Two revealed that alexithymia predicted BMI indirectly via negative affect (when depression was included in the model; B = .0335, CI = .0019-.0660) or impulsiveness (when anxiety was included in the model; B = .0021, CI = .0001-.0066). Our findings provide partial support for the hypothesised model and offer original insight into the relationship between alexithymia and obesity. Additionally, our findings highlight important methodological considerations for future research and suggest that ways to address an individual’s ability to identify, describe and regulate emotions should be considered when designing interventions to assist weight loss and management

    Research priorities in cardiovascular imaging.

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    AIM: A modified Delphi approach was used to develop consensus opinion among British Society for Cardiac Imaging/British Society of Cardiac CT (BSCI/BSCCT) members in order to prioritise research questions in cardiovascular imaging. METHODS: All members of the BSCI/BSCCT were invited to submit research questions that they considered to be of the highest clinical and/or academic priority in the field of cardiovascular imaging (phase 1). Subsequently a steering committee removed duplicate questions and combined questions of a similar theme by consensus agreement where appropriate. BSCI/BSCCT members were invited to rank the resulting research questions in two further iterative rounds (phases 2 and 3) to determine a final list of high-priority research questions. RESULTS: A total of 111 research questions were submitted in phase 1 by 30 BSCI/BSCCT members. While there was a broad range of topics, from determining the optimal features/markers of the vulnerable plaque to investigating how cardiac imaging can best be used to maximise clinical outcomes and economic costs, multimodality imaging-related (n=44, 40%) questions dominated the categories and coronary artery imaging (n=40, 36%) was the most common topic. Over two iterative rounds of prioritisation of these research questions, the original 111 were reduced to 75 questions in round 2, and 25 in round 3. From these 25 a final Top 10 list was distilled by consensus grouping. CONCLUSION: This study has identified and ranked the top research priorities in cardiovascular imaging, as identified by the BSCI/BSCCT membership. This is a first step towards identifying the cardiovascular imaging research priorities within the UK and may assist researchers and funding bodies alike in setting priorities

    External validation of novel clinical likelihood models to predict obstructive coronary artery disease and prognosis

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    Objectives The risk factor-weighted and coronary artery calcium score-weighted clinical likelihood (RF-CL and CACS-CL, respectively) models improve discrimination of patients with suspected obstructive coronary artery disease (CAD). However, external validation is warranted. Compared to the 2019 European Society of Cardiology pretest probability (ESC-PTP) model, the aims were (1) to validate the RF-CL and CACS-CL models for identification of obstructive CAD and revascularisation, and (2) to investigate prognosis by CL thresholds. Methods Stable de novo chest pain patients (n=1585) undergoing coronary CT angiography (CTA) were investigated. Obstructive CAD was defined as &gt;70% diameter stenosis in a major epicardial vessel on CTA. Decision of revascularisation within 120 days was based on onsite judgement. The endpoint was non-fatal myocardial infarction or cardiovascular death. The ESC-PTP was calculated based on age, sex and symptom typicality, the RF-CL additionally included number of risk factors, and the CACS-CL incorporated CACS to the RF-CL. Results Obstructive CAD was present in 386/1585 (24.4%) patients, and 91/1585 (5.7%) patients underwent revascularisation. Both the RF-CL and CACS-CL classified more patients to very-low CL (&lt;5%) of obstructive CAD compared with the ESC-PTP model (41.4% and 52.2% vs 19.2%, p&lt;0.001). In very-low CL patients, obstructive CAD and revascularisation prevalences (≤6% and &lt;1%) remained similar combined with low event risk during 5.0 years follow-up. Conclusion In an external validation cohort, the novel RF-CL and CACS-CL models improve categorisation to a very-low CL group with preserved prevalences of obstructive CAD, revascularisation and favourable prognosis.</p

    Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups

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    Objectives To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture. Design Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams. Setting North Wales. Participants Surveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13). Results The realist review provided understanding of how rehabilitation interventions work in the realworld context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring. Conclusions A realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III)

    Emerging tuberculosis pathogen hijacks social communication behavior in the group-living banded mongoose (Mungos mungo)

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    An emerging Mycobacterium tuberculosis complex (MTC) pathogen, M. mungi, infects wild banded mongooses (Mungos mungo) in Northern Botswana, causing significant mortality. This MTC pathogen did not appear to be transmitted through a primary aerosol or oral route. We utilized histopathology, spoligotyping, mycobacterial interspersed repetitive unitsvariable number of tandem repeats (MIRU-VNTR), quantitative PCR (qPCR), and molecular markers (regions of difference [RDs] from various MTC members, including region of difference 1 [RD1] from M. bovis BCG [RD1BCG], M. microti [RD1mic], and M. pinnipedii [RD1seal], genes Rv1510 [RD4], Rv1970 [RD7], Rv3877/8 [RD1], and Rv3120 [RD12], insertion element IS1561, the 16S RNA gene, and gene Rv0577 [cfp32]), including the newly characterized mongoose-specific deletion in RD1 (RD1mon), in order to demonstrate the presence of M. mungi DNA in infected mongooses and investigate pathogen invasion and exposure mechanisms. M. mungi DNA was identified in 29% of nasal planum samples (n 52), 56% of nasal rinses and swabs (n 9), 53% of oral swabs (n 19), 22% of urine samples (n 23), 33% of anal gland tissue (n 18), and 39% of anal gland secretions (n 44). The occurrence of extremely low cycle threshold values obtained with qPCR in anal gland and nasal planum samples indicates that high levels of M. mungi can be found in these tissue types. Histological data were consistent with these results, suggesting that pathogen invasion occurs through breaks in the nasal planum and/or skin of the mongoose host, which are in frequent contact with anal gland secretions and urine during olfactory communication behavior. Lesions in the lung, when present, occurred only with disseminated disease. No environmental sources of M. mungi DNA could be found. We report primary environmental transmission of an MTC pathogen that occurs in association with social communication behavior.Data Set S1, XLSX file, 0.1 MB.Data Set S2, XLSX file, 0.1 MB.This work was supported in part by Morris Animal Foundation grant number D14ZO-083 and by National Science Foundation grant number 1518663 as part of the joint NSF-NIH-USDA Ecology and Evolution of Infectious Diseases program. K. A. Alexander was also supported in part through the National Institute of General Medical Sciences of the National Institutes of Health under award number U01GM110748.http://www.sherpa.ac.uk/romeo/issn/2150-7511/am2016Veterinary Tropical Disease

    Sequence-dependent off-target inhibition of TLR7/8 sensing by synthetic microRNA inhibitors

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    Anti-microRNA (miRNA) oligonucleotides (AMOs) with 2\u27-O-Methyl (2\u27OMe) residues are commonly used to study miRNA function and can achieve high potency, with low cytotoxicity. Not withstanding this, we demonstrate the sequence-dependent capacity of 2\u27OMe AMOs to inhibit Toll-like receptor (TLR) 7 and 8 sensing of immunostimulatory RNA, independent of their miRNA-targeting function. Through a screen of 29 AMOs targeting common miRNAs, we found a subset of sequences highly inhibitory to TLR7 sensing in mouse macrophages. Interspecies conservation of this inhibitory activity was confirmed on TLR7/8 activity in human peripheral blood mononuclear cells. Significantly, we identified a core motif governing the inhibitory activity of these AMOs, which is present in more than 50 AMOs targeted to human miRNAs in miRBaseV20. DNA/locked nucleic acids (LNA) AMOs synthesized with a phosphorothioate backbone also inhibited TLR7 sensing in a sequence-dependent manner, demonstrating that the off-target effects of AMOs are not restricted to 2\u27OMe modification. Taken together, our work establishes the potential for off-target effects of AMOs on TLR7/8 function, which should be taken into account in their therapeutic development and in vivo application
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