Fatores de risco de transtornos alimentares: revisão guarda-chuva de metanálises publicadas

Objetivo: Graduar as evidências sobre fatores de risco de transtornos alimentares (anorexia nervosa, bulimia nervosa e transtorno de compulsão alimentar periódica) com o método de revisão guarda-chuva. Métodos: Trata-se de revisão sistemática de estudos observacionais sobre fatores de risco de transtornos alimentares publicados no PubMed, PsycInfo, e Embase até 11 de dezembro de 2019. Recalculamos metanálises de efeitos aleatórios, heterogeneidade, efeito de estudo pequeno, viés de excesso de significância e intervalo de confiança de 95% e graduamos evidências significativas (p < 0,05) de convincentes a fracas, conforme os critérios estabelecidos. A qualidade foi avaliada com a ferramenta Assessment of Multiple Systematic Reviews 2 (AMSTAR-2). Resultados: Foram incluídas 9 das 2.197 metanálises, as quais apresentavam evidências de 50 fatores de risco, 29.272 sujeitos com transtornos alimentares e 1.679.385 controles. Embora não houvesse associação com evidências convincentes, evidências altamente sugestivas apoiaram a associação entre abuso sexual infantil e bulimia nervosa (k = 29, 1.103 casos com distúrbios alimentares, 8.496 controles, RC, 2,73, IC95% 1,96-3.79, p = 2,1x10-9, qualidade AMSTAR-2 moderada) e entre vitimização por provocação relacionada à aparência e quaisquer transtornos alimentares (k = 10, 1.341 casos com transtornos alimentares, 3.295 controles, RC 2,91, IC95% 2,05-4,12, p = 1,8x10-9, qualidade AMSTAR-2 moderada). Evidências sugestivas, fracas ou nenhuma evidência sustentaram 11, 29 e 8 associações, respectivamente. Conclusões: Evidência mais confiáveis indicam que eventos traumáticos e estressantes precoces são fatores de risco de transtornos alimentares. São necessários estudos de coorte colaborativos prospectivos maiores para identificar fatores de risco de transtornos alimentares, especialmente a anorexia nervos

The impact of COVID-19 lockdown and of the following "re-opening" period on specific and general psychopathology in people with Eating Disorders: the emergent role of internalizing symptoms

BACKGROUND: We assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on specific Eating Disorder (ED) and general psychopathology in people with an ED diagnosis during the lockdown period and after the end of the related containment measures.METHODS: People with clinically defined diagnosis and undergoing treatment for an ED completed an online survey, which included adapted questions from standardized psychometric scales. Data relative to three different time periods (before, during and after the end of lockdown) were collected. Psychopathological changes over these periods were investigated and compared through one-way analysis of variance or covariance with repeated measures.RESULTS: Three hundred twelve people completed the survey (57.4% diagnosed with Anorexia Nervosa (AN) or atypical AN, 20.2% with Bulimia Nervosa, 15.4% with Binge Eating Disorder, 7.05% with Other Specified Feeding or Eating Disorders). The severity of both specific and general psychopathology increased during the lockdown and the rise of general symptoms persisted in the following re-opening phase, except for suicide ideation. Almost all of these findings were not affected by ED diagnosis, participants' age and illness duration.LIMITATIONS: The retrospective nature of data collection is the main limitation of the study.CONCLUSIONS: People with EDs showed a COVID-19 emergency-induced worsening of both general and specific psychopathology. The effect on general psychopathology persisted in the re-opening period. These findings suggest a high stress vulnerability of ED individuals with important effects on internalizing symptoms, which are worth of attention by clinicians

Pathways to eating disorder care: a European multicenter study

Background: The aim of this study was to assess barriers and facilitators in the pathways toward specialist care for eating disorders (EDs). Methods: Eleven ED services located in seven European countries recruited patients with an ED. Clinicians administered an adapted version of the World Health Organization "Encounter Form," a standardized tool to assess the pathways to care. The unadjusted overall time needed to access the ED unit was described using the Kaplan-Meier curve. Results: Four-hundred-nine patients were recruited. The median time between the onset of the current ED episode and the access to a specialized ED care was 2 years. Most of the participants did not directly access the specialist ED unit: primary "points of access" to care were mental health professionals and general practitioners. The involvement of different health professionals in the pathway, seeking help for general psychiatric symptoms, and lack of support from family members were associated with delayed access to ED units. Conclusions: Educational programs aiming to promote early diagnosis and treatment for EDs should pay particular attention to general practitioners, in addition to mental health professionals, and family members to increase awareness of these illnesses and of their treatment initiation process

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Effect of postweaning feeding on the performance and energy balance of female rabbits at different physiological states

The feeding of a high-fiber and lowenergy diet to young rabbit does from weaning to the first kindling was used to modify their body reserves, stimulate their energy intake, and reduce the energy deficit during the first lactation. Rabbits (53 per group) were given ad libitum access to either a control or high-fiber diet (CP, 17.6 vs 15.8% of DM; crude fiber, 15.5 vs 19.9% of DM; digestible energy, 2,565 vs 2,261 kcal/kg of DM, respectively) from weaning to their first kindling. During lactation, both groups received the same diet, which contained 19.3% CP, 16.5% crude fiber, and 2,634 kcal/kg digestible energy (dry matter basis). Four comparative slaughters were performed to estimate the chemical and energy balance of rabbit does at different physiological states: at the beginning of the trial (12 rabbits, 45 d of age), at mating (10 rabbits per group, 136 d), at kindling (10 rabbits per group, 167 d), and at the end of lactation (12 and 11 rabbits for the control and the high-fiber group, 197 d). Large changes in body weight and composition were observed between slaughters. From 45 d to mating, doe body fat and energy increased 7.93 and 4.64 times the initial content, respectively. During pregnancy, body protein concentration decreased from 203 to 186 g/kg. At the end of lactation, body fat and energy concentration were reduced to values close to those measured at 45 d of age. Dietary treatment affected body chemical and energy balance during pregnancy and lactation but not reproductive and lactational performance. The high-fiber diet stimulated feed intake from weaning to the first kindling but not dietary energy intake. During lactation, the rabbits fed the high-fiber diet ate 10 kcal\u2022d-1\u2022kg live weight\uf02d.75 more and lost less body fat ( -405 vs --504 g) and body energy ( -3,628 vs -4,294 kcal) than the does fed the control diet ( P < .001). In the same period, all does showed water and protein retention (185 and 45 g, on average) regardless of dietary treatment. In conclusion, feeding young does a high-fiber diet until their first kindling reduced the chemical and energy body deficit at the end of the first lactatio

New approaches to selecting a scan-sampling method for chicken behavioral observations and their practical implications

The use of the scan-sampling method, especially when a large amount of data is collected, has become widespread in behavioral studies. However, there are no specific guidelines regarding the choice of the sampling interval in different conditions. Thus, establishing a standard approach for video analysis represents an important step forward within the scientific community. In the present work, we hypothesized that the length of the sampling interval could influence the results of chicken behavioral study, for which we evaluated the reliability, accuracy, and validity of three different sampling intervals (10, 15 and 30 min). The Bland-Altman test was proposed as an innovative approach to compare sampling intervals and support researcher choices. Moreover, these sampling intervals were applied to compare the behavior of 4 chicken genotypes kept under free-range conditions. The Bland-Altman plots suggested that sampling intervals greater than 10 min lead to biases in the estimation of rare behaviors, such as "Attacking". In contrast, the 30-min sampling interval was able to detect differences among genotypes in high-occurrence behaviors, such as those associated with locomotory activity. Thus, from a practical viewpoint, when a broad characterization of chicken genotypes is required, the 30-min scan-sampling interval might be suggested as a good compromise between resources and results

Optimizing reliability, accuracy, and validity of three scan sampling intervals in the behavioral observations of slow growing broiler chickens

In the present study, we hypothesized that the length of the sampling interval could affect the results and, consequently, the conclusions drawn and the interpretations made about poultry behavior. Therefore, we evaluated the reliability, accuracy, and validity of three different sampling intervals (i.e., 10, 15, and 30 minutes) for the behavioral observations of broiler chickens

Facial Expression Recognition for Measuring Jurors’ Attention in Acoustic Jury Tests

The perception of sound greatly impacts users’ emotional states, expectations, affective relationships with products, and purchase decisions. Consequently, assessing the perceived quality of sounds through jury testing is crucial in product design. However, the subjective nature of jurors’ responses may limit the accuracy and reliability of jury test outcomes. This research explores the utility of facial expression analysis in jury testing to enhance response reliability and mitigate subjectivity. Some quantitative indicators allow the research hypothesis to be validated, such as the correlation between jurors’ emotional responses and valence values, the accuracy of jury tests, and the disparities between jurors’ questionnaire responses and the emotions measured by FER (facial expression recognition). Specifically, analysis of attention levels during different statuses reveals a discernible decrease in attention levels, with 70 percent of jurors exhibiting reduced attention levels in the ‘distracted’ state and 62 percent in the ‘heavy-eyed’ state. On the other hand, regression analysis shows that the correlation between jurors’ valence and their choices in the jury test increases when considering the data where the jurors are attentive. The correlation highlights the potential of facial expression analysis as a reliable tool for assessing juror engagement. The findings suggest that integrating facial expression recognition can enhance the accuracy of jury testing in product design by providing a more dependable assessment of user responses and deeper insights into participants’ reactions to auditory stimuli

Table_1_Evaluating methods for determining mercury concentrations in ancient marine fish and mammal bones as an approach to assessing millennial-scale fluctuations in marine ecosystems.pdf

Millennial-scale datasets of heavy metals in biota are difficult to obtain but are important for determining patterns and underlying drivers of toxicant concentrations. This is particularly important to better discriminate contemporary natural and anthropogenic sources. Globally mercury is a contaminant of concern. Post-industrial increases in mercury in arctic biota have been documented and monitoring of Steller sea lions (Eumetopias jubatus) in the Aleutian Islands, Alaska, has revealed a high proportion of pups with fur mercury concentrations above thresholds of concern in some regions. As bone is a tissue that is well preserved in archeological middens, it may prove useful for developing long-term mercury data sets under appropriate conditions. The goal of this study was to evaluate methodologies for measuring mercury concentration in Steller sea lion bone using a direct mercury analyzer, considering sample preparation methods and variability among bone tissue types (e.g., compact versus spongy bone). Finally, we directly compare sensitivity and precision of two different direct mercury analyzer models. Based on the methods presented here, direct mercury analysis using the Nippon MA-3000 can quantify small (ppb) quantities of Hg accurately and precisely in 20 to 60mg of bone with minimal specimen processing. The described method is efficient, relatively inexpensive, and requires minimal bone, conserving rare and valuable specimens. Hydrogen peroxide cleaning and collagen extraction were not required, and may be detrimental for optimal Hg quantification in bone. Further, while homogenization of distinct compact and spongy bone did not impact concentration determination, variance of technical replicates was lower improving quantitation precision. Most importantly, significant differences between compact and spongy bone exist within some individual specimen; however, the difference is not consistent and may indicate differential Hg exposure windows influenced by turnover rate of bone types. We conclude bone provides a natural archive for mercury ecosystem dynamics over millennial time scales in regions where appropriate samples are available. Compact bone has lower and less variable [THg] simplifying analysis and interpretation of data; however, the more dynamic concentrations observed in spongy bone should not be dismissed as invaluable due to their variability in [THg]. Comparisons of [THg] between bone type within individual may provide insight into more acute changes in mercury exposure within an individual’s lifetime.</p