Evaluation of weight loss counsel for Osteoarthritis patients: A cross-sectional analysis of NHANES 2011-2018.

OBJECTIVE: Though health care providers (HCPs) know the importance of weight loss counsel for Osteoarthritis (OA), little is known about how frequently it is practiced and even less of its effectiveness. Thus, we analyzed the prevalence and effectiveness of weight counsel receipt in overweight/obese OA patients. DESIGN: Using 2011-2018 National Health and Nutrition Examination Survey data, we cross-sectionally analyzed overweight/obese patients in the United States to determine the prevalence of receipt of HCP weight counsel in those with OA and among other variables. We used multivariate logistic regression models to calculate odds ratios of being counseled and of achieving ten percent weight loss in groups with and without counsel. Mean weight losses were also compared among groups. RESULTS: 39,156 patients were identified, of whom 1948 met inclusion criteria. Overall, 51.89% of overweight/obese OA patients received weight counseling. The odds of receiving counsel varied with several demographic variables. The odds of achieving 10% weight loss in those counseled was 1.84 times (95% confidence interval: 1.028, 3.299) that of those not counseled (p = 0.04). In contrast, patients counseled lost a mean of 0.49 pounds while those not counseled gained a mean of 0.03 pounds, a difference which was not statistically significant (p = 0.59). CONCLUSION: Prevalence of weight counsel receipt for OA has not changed significantly between 2011 and 2018. Though counsel for weight more frequently leads to adequate weight loss in those with OA, the average weight loss is minimal regardless of counsel. Thus, refinement of this intervention may be needed to bolster weight loss.

The thief of (bed)time: Examination of the daily associations between bedtime procrastination and multidimensional sleep health.

OBJECTIVES: Sleep insufficiency is associated with increased risk of morbidity and mortality. Bedtime procrastination, or the needless and voluntary delay in sleep, is a sleep-related behavior which may interfere with sleep health. The objective of this study is to comprehensively examine the daily associations among bedtime procrastination and measures of sleep regularity, satisfaction, timing, efficiency, and duration. METHODS: Two hundred and eighty young adult participants (79% female; Mage=24.4) completed daily sleep diaries and measures of bedtime procrastination and sleep restoration over 14days, in addition to measures of chronotype. Multilevel models were constructed to examine the associations between bedtime procrastination and sleep health. RESULTS: Greater bedtime procrastination was associated with poorer sleep health, including poorer self-reported sleep restoration, later sleep timing, less efficient sleep, and shorter sleep duration. These associations were significant at both within- and between-person levels, and persisted after statistically adjusting for individuals' chronotypes. CONCLUSIONS: This study offers bedtime procrastination as a putative mechanism for poor sleep health and finds that the associated risk of poor sleep from bedtime procrastination is independent of chronotype. Results presented here suggest that bedtime procrastination may be a relevant behavior in the development or maintenance of sleep and sleep-related disorders.

Analyzing the Quality and Readability of Online Hyaluronic Acid Knee Injection Resources.

INTRODUCTION: We analyzed the quality of information about Hyaluronic acid (HA) knee injections for osteoarthritis using DISCERN, a tool that grades the quality of websites. We also analyzed readability with Flesch-Kincaid grade reading levels (FKGRL). METHODS: Lists of the top ten included sites from Google searches about HA injections were evaluated using DISCERN to determine their quality. Additional variables collected were site category, Health on Net (HON) certification, search result rank, and FKGRL. DISCERN scores were compared and grouped by these variables. RESULTS: Most sites were measured as fair in quality. Greater DISCERN scores were produced from searches using general terminology, sites with HON labels, and academic journal publications. CONCLUSION: This study indicates information quality for HA injections online is fair. The data also indicates that patients can best educate themselves using HON labels, general search terms, and information from academic journals when possible.

Using emotion to guide decisions: the accuracy and perceived value of emotional intensity forecasts.

Forecasts about future emotion are often inaccurate, so why do people rely on them to make decisions? People may forecast some features of their emotional experience better than others, and they may report relying on forecasts that are more accurate to make decisions. To test this, four studies assessed the features of emotion people reported forecasting to make decisions about their careers, education, politics, and health. In Study 1, graduating medical students reported relying more on forecast emotional intensity than frequency or duration to decide how to rank residency programs as part of the process of being matched with a program. Similarly, participants reported relying more on forecast emotional intensity than frequency or duration to decide which universities to apply to (Study 2), which presidential candidate to vote for (Study 3), and whether to travel as Covid-19 rates declined (Study 4). Studies 1 and 3 also assessed forecasting accuracy. Participants forecast emotional intensity more accurately than frequency or duration. People make better decisions when they can anticipate the future. Thus, people's reports of relying on forecast emotional intensity to guide life-changing decisions, and the greater accuracy of these forecasts, provide important new evidence of the adaptive value of affective forecasts.

A daily examination of executive functioning and chronotype in bedtime procrastination.

STUDY OBJECTIVES: Bedtime procrastination, or delays in bedtime not attributable to external obligations, is a behavioral tendency that undermines sleep and is conceptualized as a consequence of poor self-regulation. Prior studies investigating the mechanistic role of self-regulation in bedtime procrastination relied on cross-sectional methods and self-reported self-regulation. The present study examined the association between bedtime procrastination and both objective and self-reported executive functioning (EF) as indices of self-regulation, as well as the moderating role of chronotype, using methods that examined these associations at the daily level. METHODS: A total of 273 young adult participants (78% female; Mage = 24.4) completed daily measures of objective EF (i.e., Stroop task), self-reported EF (i.e., self-reported cognitive, behavioral, and emotional regulation difficulties), and bedtime procrastination over 14 days, in addition to measures of chronotype. Multilevel models were constructed to examine the associations between bedtime procrastination and EF, as well as EF-chronotype interactions. RESULTS: Poorer daily objective EF and self-reported behavioral regulation were associated with greater same-night bedtime procrastination. Additionally, poorer subjective cognitive and emotional regulation were associated with greater average bedtime procrastination across 14 days. Later chronotypes reported greater bedtime procrastination than early chronotypes. CONCLUSIONS: The present study provides support for the association between EF and bedtime procrastination, but finds no evidence for the moderating role of chronotype in this association. Results suggest that some EF processes may be more relevant to bedtime procrastination than others. Current findings have implications for assessment and intervention for this consequential sleep-relevant behavioral tendency.

Good, bad, and beyond: Perils of partialing positive and negative couple variables within individuals.

Partialing correlated predictors to test independent effects is an essential tool in couple research. In actor-partner models, partners' parallel scores are partialed in tests of unique associations with outcomes. Correlated aspects of couple functioning are also often partialed within individuals to examine separate effects. Partialed versions of measures are typically interpreted as assessing the same construct as original unadjusted variables, but in fact their meaning can change. Extending a prior report on changes in construct validity resulting from partialing partners' parallel scores, the present analyses examined effects of partialing measures of positive and negative relationship variables within individuals, specifically perceived support from the partner and relationship conflict. In 300 middle-aged and older couples, we utilized participants' interpersonal circumplex ratings of their partner's typical behavior during marital interactions to compare interpersonal correlates of unadjusted and within-person partialed forms of the Quality of Relationships Inventory Support and Conflict scales. Compared to unadjusted scores, partialed support scores (i.e., adjusted for conflict) were substantially less closely associated with ratings of partner's warmth, and were associated with a less submissive (i.e., less agreeable, cooperative) form of warmth. Compared to unadjusted scores, partialed conflict scores (i.e., adjusted for support) were substantially less closely correlated with ratings of the partner's hostility, and were associated with a more controlling (i.e., critical, coercive) form of hostility. Results were nearly identical for wives and husbands. Partialing correlated scores within individuals can alter the construct validity of relationship measures, suggesting the need for careful reporting and interpretation in couple research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Nonsuicidal self-injury, sleep quality, and shame response to a laboratory stress task.

OBJECTIVE: Nonsuicidal self-injury (NSSI) frequently functions to regulate shame-based emotions and cognitions in the context of interpersonal stress. The present study sought to examine how sleep quality (SQ) may influence this process in a laboratory setting. METHODS: Participants included 72 adults (Mage = 24.28; 36 with a lifetime history of NSSI) who completed a self-report measure of prior month SQ and engaged in a modified Trier social stress task (TSST). State shame ratings were collected immediately before and following the TSST, as well as 5 min post-TSST, to allow for the measurement of shame reactivity and recovery. RESULTS: No significant results emerged for NSSI history and SQ as statistical predictors of shame reactivity. However, NSSI history was significantly associated with heightened shame intensity during the recovery period of the task, and this was moderated by SQ. Simple slopes analyses revealed a conditional effect whereby poorer SQ (1SD above the mean) was associated with greater intensity of shame during recovery, but only for those with a history of NSSI. CONCLUSION: Poor SQ may contribute to worrisome emotional responses to daytime stressors in those at risk for NSSI.

Partialing alters interpersonal correlates of negative affective symptoms and traits: A circumplex illustration.

INTRODUCTION: Negative affective symptoms (e.g., anxiety, depression, and anger) are correlated and have parallel associations with outcomes, as do related personality traits (i.e., facets of neuroticism), often prompting statistical control (i.e., partialing) to determine independent effects. However, such adjustments among predictor variables can alter their construct validity. In three studies, the interpersonal circumplex (IPC) and a related analytic approach (i.e., Structural Summary Method) were used to evaluate changes in interpersonal correlates of negative affective characteristics resulting from partialing. METHODS: Samples of undergraduates (Sample 1 n = 3283; Sample 2 = 688) and married couples (n = 300 couples) completed self-report (three samples) and partner rating (sample 3) measures of anxiety, depression and anger, and IPC measures of interpersonal style. RESULTS: Anxiety, depression, and anger had expected interpersonal correlates across samples. Partialing depression eliminated interpersonal correlates of anxiety. When anxiety was controlled, depression measures were more strongly associated with submissiveness and less closely associated with low warmth. Adjustments involving anger magnified differences in dominance versus submissiveness associated with the negative affects. DISCUSSION: Removal of overlap among negative affective measures via partialing alters their interpersonal correlates, potentially complicating interpretation of adjusted associations.

To put asunder: Are there perils of partialing in actor-partner interdependence models?

In research on couples, statistical adjustment (i.e., partialing) for correlations between partners' parallel scores is common and useful, as in the actor-partner interdependence model. Original and partialed scores are typically interpreted as assessing the same construct, but this may not be a valid assumption. Other approaches to nonindependence-such as common fate modeling-may better represent some couple constructs. This study of 300 couples utilized participants' interpersonal circumplex ratings of partners' typical behavior during marital interactions to evaluate the interpersonal meaning of unadjusted and partialed forms of the Marital Adjustment Test (MAT), a measure of overall relationship quality, and the Quality of Relationships Inventory-Support (QRI-S) and Conflict (QRI-C) scales, which measured perceived support from and conflict with the partner. After partialing partners' scores, MAT and QRI-S scores were substantially less closely associated with ratings of partners' warmth, their primary expected interpersonal correlates. Partner-partialed QRI-C scores were substantially less closely correlated with ratings of partners' hostility and were associated with a somewhat more controlling form of hostility. In contrast, partialing partners' trait optimism scores resulted in minimal changes in interpersonal correlates of this personality characteristic. Couple-level MAT, QRI-S, and QRI-C variables representing overlapping variance across partners while partialing unshared variance in spouses' scores (i.e., common fate scores) had highly similar interpersonal correlates when compared to unadjusted versions. Potential alterations in construct validity resulting from partialing partners' scores warrant interpretive caution, and alternative analytic frameworks (e.g., the common fate model) may better maintain the construct validity of some dyadic measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The role of pre-sleep arousal in the connection between insomnia and suicide risk.

Insomnia is a risk factor for suicidal thoughts and behaviors. The present study examined the role of pre-sleep arousal in this association. Seventy-eight adults (Mage = 24.28, 56% had recent history of suicidal thoughts and behaviors) attended two lab visits over four consecutive days. We tested if generally experienced self-reported pre-sleep arousal explained the association between self-report insomnia symptoms experienced over the past two weeks and past week-suicidal ideation. Results indicated full mediation for pre-sleep cognitive arousal, but not somatic arousal. Pre-sleep cognitive arousal could be a key variable linking insomnia symptoms to suicide risk.

Moving Toward, Moving Against, and Moving Away: An Interpersonal Approach to Construct Validation of the Horney-Coolidge Type Inventory.

Karen Horney's interpersonal theory of adjustment defined three different neurotic trends involving characteristic social behavior and motives: compliant (moving toward people), aggressive (moving against people), and detached (moving away from people). The Horney-Coolidge Type Inventory (HCTI) was developed to assess these trends, but has not been validated using standard methods in the interpersonal perspective. The studies reported here refined the structure of the HCTI, and utilized the structural summary method (SSM) to identify relationships of the three shortened HCTI trend scales with the interpersonal circumplex (IPC) in single university (n = 514) and multisite university (n = 3,283) samples. Results across both studies confirmed predicted interpersonal characteristics of each trend: Compliance was associated with warm submissiveness, aggression was associated with hostile dominance, and detachment was associated with hostile or cold submissiveness. However, analyses of facets within the three HCTI trend domains revealed significant differences. Results are discussed as a potential guide to further refinement of assessments of the Horney maladaptive trends, and support inclusion of Horney's model in current interpersonal theory.

Transcriptome of HPßCD-treated Niemann-Pick disease type C1 cells highlights GPNMB as a biomarker for therapeutics.

The rare, fatal neurodegenerative disorder Niemann-Pick disease type C1 (NPC1) arises from lysosomal accumulation of unesterified cholesterol and glycosphingolipids. These subcellular pathologies lead to phenotypes of hepatosplenomegaly, neurological degeneration and premature death. The timing and severity of NPC1 clinical presentation is extremely heterogeneous. This study analyzed RNA-Seq data from 42 NPC1 patient-derived, primary fibroblast cell lines to determine transcriptional changes induced by treatment with 2-hydroxypropyl-ß-cyclodextrin (HPßCD), a compound currently under investigation in clinical trials. A total of 485 HPßCD-responsive genes were identified. Pathway enrichment analysis of these genes showed significant involvement in cholesterol and lipid biosynthesis. Furthermore, immunohistochemistry of the cerebellum as well as measurements of plasma from Npc1m1N null mice treated with HPßCD and adeno-associated virus gene therapy suggests that one of the identified genes, GPNMB, may serve as a useful biomarker of treatment response in NPC1 disease. Overall, this large NPC1 patient-derived dataset provides a comprehensive foundation for understanding the genomic response to HPßCD treatment.

Mechanisms of disease-modifying effect of saracatinib (AZD0530), a Src/Fyn tyrosine kinase inhibitor, in the rat kainate model of temporal lobe epilepsy.

We have recently demonstrated the role of the Fyn-PKCδ signaling pathway in status epilepticus (SE)-induced neuroinflammation and epileptogenesis in experimental models of temporal lobe epilepsy (TLE). In this study, we show a significant disease-modifying effect and the mechanisms of a Fyn/Src tyrosine kinase inhibitor, saracatinib (SAR, also known as AZD0530), in the rat kainate (KA) model of TLE. SAR treatment for a week, starting the first dose (25 mg/kg, oral) 4 h after the onset of SE, significantly reduced spontaneously recurring seizures and epileptiform spikes during the four months of continuous video-EEG monitoring. Immunohistochemistry of brain sections and Western blot analyses of hippocampal lysates at 8-day (8d) and 4-month post-SE revealed a significant reduction of SE-induced astrogliosis, microgliosis, neurodegeneration, phosphorylated Fyn/Src-419 and PKCδ-tyr311, in SAR-treated group when compared with the vehicle control. We also found the suppression of nitroxidative stress markers such as iNOS, 3-NT, 4-HNE, and gp91phox in the hippocampus, and nitrite and ROS levels in the serum of the SAR-treated group at 8d post-SE. The qRT-PCR (hippocampus) and ELISA (serum) revealed a significant reduction of key proinflammatory cytokines TNFα and IL-1ß mRNA in the hippocampus and their protein levels in serum, in addition to IL-6 and IL-12, in the SAR-treated group at 8d in contrast to the vehicle-treated group. These findings suggest that SAR targets some of the key biomarkers of epileptogenesis and modulates neuroinflammatory and nitroxidative pathways that mediate the development of epilepsy. Therefore, SAR can be developed as a potential disease-modifying agent to prevent the development and progression of TLE.

Optimistic expectations have benefits for effort and emotion with little cost.

The present investigation examined the potential benefits and costs of optimistic expectations about future events through the lens of error management theory (EMT). Decades of evidence have shown that optimism about the likelihood of future events is pervasive and difficult to correct. From an EMT perspective, this perpetuation of inaccurate beliefs is possible because optimism offers benefits greater than the costs. The present investigation examined this possibility for controllable important life events with a known time at which they would occur. College students taking their first exam (n = 1,061) and medical students being matched with residency placements (n = 182) reported their expectations and emotions weeks before the event and their responses after they knew the outcome of the event. Optimistic expectations predicted the quality of effort investment before an event occurred-students were more satisfied with their studying, medical students were more satisfied with their decision making, and optimism predicted better performance. Optimistic expectations also predicted less emotional distress before the event. There was no evidence that optimistic expectations related to longer-term greater distress when participants experienced an unexpected negative outcome; the valence of the outcome itself predicted distress. These results are consistent with the EMT-derived hypothesis that optimistic expectations have benefits for effort and emotion before an event occurs, with little cost after the outcome occurs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Prospective association between suicide cognitions and emotional responses to a laboratory stressor: The mediating role of nightly subjective sleep quality.

BACKGROUND: Sleep is a reliable correlate of suicidal thoughts and behaviors (STBs), yet few studies have directly examined negative affect in the context of this association. The present study combined daily experience methods with a laboratory paradigm to investigate suicide cognitions as a predictor of emotional responses to environmental stressors, and tested the role of nightly sleep parameters. METHOD: 72 participants (Mage = 24.25; 41 with a recent history of suicide ideation and 31 without a history of STBs) completed a four-day study. Suicide cognitions were measured on the first day, and actigraphy-based sleep duration and fragmentation, and morning ratings of prior night subjective sleep quality (SSQ) were subsequently measured over three consecutive nights. Participants returned on the fourth day to complete the Trier Social Stress Task, where self-report changes in negative affect immediately post-task (i.e., reactivity) and five minutes post-task (i.e., recovery) were observed. RESULTS: Regression analyses indicated that suicide cognitions predicted negative affect reactivity and recovery. Simple mediation analyses revealed that SSQ partially mediated the relation between suicide cognitions and negative affect recovery (especially shame), but not reactivity. No significant associations were observed for the actigraphy-based sleep parameters. LIMITATIONS: Just three nights of actigraphy-based data collection. A single item was used to measure SSQ. CONCLUSIONS: Suicide cognitions predict negative affective responses to situational stressors and SSQ may have a key role in this effect, especially the duration of negative emotional reactions. Hence, sleep and emotional reactivity may be potential targets for suicide prevention efforts.

Safety and feasibility of combined atrial fibrillation ablation and left atrial appendage occlusion after left atrial appendage electrical isolation.

OBJECTIVE: To demonstrate the feasibility of combining left atrial appendage electrical isolation (LAAEI) with left atrial appendage occlusion (LAAO) to increase efficacy of persistent/longstanding atrial fibrillation (PLAF) catheter ablation (CA) while mitigating risk of left atrial appendage (LAA) thrombus. BACKGROUND: CA for atrial fibrillation (AF) plus LAAO is safe and feasible. LAAEI may improve freedom from recurrence in PLAF but may increase LAA thrombus. METHODS: We performed 42 concomitant procedures in patients with PLAF. After standard lesions, LAAEI was performed. LAAO immediately followed ablation. If 3-month transesophageal echocardiogram (TEE) was benign, oral anticoagulation (OAC) was transitioned to dual antiplatelet therapy for 3 more months. RESULTS: Patients were 71.1 ± 8.5 years old, with CHADS2-VASc of 3.3 ± 1.1 and HAS-BLED of 2.5 ± 1.4. Twenty-eight of 42 patients (66.7%) were completely AF free over an average follow-up of 18.6 ± 8.6 months. The AF-free survival estimate was 94.5% at 1 year. There was no thromboembolism (TE) during the follow-up. There were six non-significant leaks acutely and six non-significant leaks at 6 months. There were three device-related thrombi, although 2/3 stopped OAC prematurely. CONCLUSION: A combined procedure is feasible and effective in treating arrhythmia and stroke risk associated with PLAF. The risk of TE despite OAC after LAAEI supports simultaneous LAAO.