Web-Based Relationship Education and Pornography-Related Behaviors: A Single-Group Design During the COVID-19 Pandemic.

Research surrounding pornography and its impact on individual and relationship functioning is a frequent and ongoing debate in the current literature. However, recent meta-analyses and aggregated studies suggest that relationship distress is associated with higher levels of general pornography use. This may be a reason why a significant number of men and women view pornography and seek help for their use. In the present study, we explored whether participation in the OurRelationship program, a web-based relationship education program that has been empirically shown to reduce relationship distress but is not tailored to reduce general pornography use, was associated with reliable changes in pornography-related behaviors. In a sample of low-income and diverse couples (N = 314 couples; 628 individuals), we observed high completion rates (64.3%) as well as reliable, small-sized decreases in the frequency and duration of pornography use for the average couple (d = 0.12-0.13). Furthermore, post hoc analyses found that individuals who began the program viewing pornography daily reported reliability-larger decreases in pornography-related behaviors (d = 0.32-0.90) than those who viewed pornography less frequently. However, we did not see reliable changes in couples' arguments about pornography use or perceptions of problematic use. The findings were generally not moderated by gender or lifestyle changes due to the COVID-19 pandemic. Clinicians struggling to reduce their client's general pornography use may consider including a focus on improving general romantic relationship functioning.

Does coparenting improve during the OurRelationship program? Explorations within a low-income sample during the COVID-19 pandemic.

Low-income couples are at an increased risk for relationship instability and divorce, which can have residual impacts on coparenting between the two partners. Growing evidence suggests that brief online relationship education programs can be an effective tool for alleviating relationship distress among low-income couples. However, findings remain mixed when it comes to whether benefits from relationship-focused programs not explicitly addressing coparenting spillover to coparenting among those with children. This preregistered study sought to investigate whether couples participating in an evidence-based online relationship-focused intervention, the OurRelationship program, experienced improvements in coparenting during the coronavirus disease 2019 (COVID-19) pandemic. To expand on the existing literature, coparenting outcomes assessed included partners' gatekeeping behaviors in addition to coparenting satisfaction, given their important implications for partner involvement in parenting. We also examined the extent to which changes in coparenting were moderated by pre-post gains in relationship satisfaction, child gender, division of childcare, and pandemic disruptions. In a sample of 136 low-income couples (N = 272 individuals) and a one-group/pre-post design, we found medium-sized gains in relationship satisfaction (Cohen's d = .76) and small-sized improvements in all coparenting aspects assessed (|d|s = .29-.39). Couples with greater gains in relationship satisfaction experienced greater improvements in coparenting; further, coparenting changes were robust to other moderators. Taken together, findings suggested that brief online relationship education programs, such as the OurRelationship program, may be a promising option to improve coparenting among relationally distressed low-income couples with children during a global health crisis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Heterogeneity in COVID-19 Patients at Multiple Levels of Granularity: From Biclusters to Clinical Interventions

Several studies have shown that COVID-19 patients with prior comorbidities have a higher risk for adverse outcomes, resulting in a disproportionate impact on older adults and minorities that fit that profile. However, although there is considerable heterogeneity in the comorbidity profiles of these populations, not much is known about how prior comorbidities co-occur to form COVID-19 patient subgroups, and their implications for targeted care. Here we used bipartite networks to quantitatively and visually analyze heterogeneity in the comorbidity profiles of COVID-19 inpatients, based on electronic health records from 12 hospitals and 60 clinics in the greater Minneapolis region. This approach enabled the analysis and interpretation of heterogeneity at three levels of granularity (cohort, subgroup, and patient), each of which enabled clinicians to rapidly translate the results into the design of clinical interventions. We discuss future extensions of the multigranular heterogeneity framework, and conclude by exploring how the framework could be used to analyze other biomedical phenomena including symptom clusters and molecular phenotypes, with the goal of accelerating translation to targeted clinical care.

Efficacy and safety of s201086/GLPG1972, an ADAMTS-5 inhibitor, in patients with knee osteoarthritis: roccella, a 52-week, randomized, double-blind, dose-ranging phase 2 study

Purpose: To date, no disease-modifying osteoarthritis drugs (DMOADs) have been approved for the treatment of knee osteoarthritis (OA). S201086/GLPG1972 is a potent and selective inhibitor of ADAMTS-5 (a disintegrin and metalloproteinase with thrombospondin motif-5) in development as a DMOAD, hypothesized to reduce cartilage loss via inhibition of the enzymatic cleavage of aggrecan (a key component of cartilage). S201086/GLPG1972 has been shown to reduce cartilage degradation in preclinical models of OA. Therefore, we aimed to evaluate the efficacy and safety of S201086/GLPG1972 in patients with knee OA. Methods: ROCCELLA was a randomized, placebo-controlled, dose-ranging, phase 2 study comprising a 5-week screening period, a 52-week double-blind treatment period and a 2-week safety follow-up period (ClinicalTrials.gov ID: ). Patients aged 40-75 years with knee OA and pain severity in the target knee of 40-90 mm on a visual analog scale at screening and baseline were included. Target knees had predominant medial compartment disease, with Kellgren-Lawrence (KL) grade 2 or 3 and OARSI medial joint space narrowing (JSN) grade 1 or 2. Patients were randomized 1:1:1:1 to placebo or 75 mg, 150 mg or 300 mg S201086/GLPG1972 administered orally once daily. Concomitant analgesics (non-steroidal anti-inflammatory drugs and acetaminophen) were permitted. The primary endpoint was change from baseline to week 52 in cartilage thickness of the central medial femorotibial compartment (cMFTC) of the target knee, as measured by quantitative magnetic resonance imaging (qMRI) and analyzed by a central reading facility. Secondary efficacy endpoints included: change from baseline to week 52 in radiographic joint space width of the target knee (JSW;X-ray with central readout);patient-reported outcomes (including WOMAC scores, patient global assessment [PGA] score and pain score, both measured by visual analog scales);and safety outcomes. A mixed-effects model for repeated measures (using all longitudinal observations at each post-baseline visit) was used for the primary analysis. Results: Across 12 countries, 3319 patients were screened and 932 were included in the study. Patients had a mean age of 62.9 years and the majority (69.3%) were women. Baseline characteristics were similar across study groups (Table 1). Overall, 88.8% of knees were KL grade 3 and 67.3% were OARSI medial JSN grade 2. Patients experienced substantial cartilage loss;the mean (SD) change in cMFTC cartilage thickness was −0.12 (0.27) mm from baseline to week 52 in the placebo group. However, no statistically significant differences between treatment groups and placebo were observed for the primary endpoint of cMFTC cartilage thickness loss (placebo vs 75 mg, p = 0.165;vs 150 mg, p = 0.939;vs 300 mg, p = 0.682;Figure 1). These results were confirmed by sensitivity analyses assessing the management of missing data and delayed week 52 qMRI owing to the COVID-19 pandemic. No significant differences between treatment groups and the placebo group were observed at any time point in any of the secondary endpoints, including changes in WOMAC total score and subscores (Figure 2), radiographic JSW, PGA score or pain score. Treatment-emergent adverse events (TEAEs) and serious adverse events were experienced by similar proportions of patients in the placebo and S201086/GLPG1972 groups (Table 2). The most common TEAEs across all S201086/GLPG1972 treatment groups were arthralgia, nasopharyngitis and fall (Table 2). Tolerability was similar across the three S201086/GLPG1972 dose groups, with 6.8% (75 mg) to 8.6% (300 mg) of patients withdrawing from treatment owing to TEAEs, compared with 3.8% in the placebo group. Conclusions: The study successfully selected patients who experienced a substantial decrease in cartilage thickness over 52 weeks;a decrease that would be large enough to demonstrate a sizeable structural benefit of a DMOAD candidate. However, the study failed to meet its primary endpoint (change from baseline to week 52 in cartilage thickness of the cMFTC) and secondary endpoints, and there was no dose-response relationship. S201086/GLPG1972 had a good safety profile and was generally well tolerated. [Formula presented] [Formula presented] [Formula presented] [Formula presented]