Food Addiction Is Associated with Irrational Beliefs via Trait Anxiety and Emotional Eating.

Irrational beliefs (IB) are believed, in cognitive behavioral therapies, to be a prime cause of psychopathologies including anxiety, depression, problem eating, and alcohol misuse. "Food addiction" (FA), which has been modeled on diagnostic criteria for substance use disorder, and emotional eating (EE) have both been implicated in the rise in overweight and obesity. Both FA and EE are associated with anxiety. Thus, in the present study, the hypothesis that IB is associated with FA and with EE was tested. Furthermore, possible mediation of these relationships by trait anxiety and depression (and EE for IB and FA) was examined. The responses of 239 adult participants to questionnaires measuring FA, IB, EE, depression, trait anxiety, and anthropometrics were recorded. The results revealed that IB was significantly positively correlated with FA and EE (and depression and trait anxiety). Furthermore, only EE mediated the effect of IB on FA and this was not moderated by BMI. Finally, trait anxiety (but not depression) mediated the effect of IB on EE. Exploratory analysis revealed a significant serial mediation such that IB predicted higher FA via elevated trait anxiety and emotional eating in that order. The results of this study suggest that IB may be a source of the anxiety that is associated with EE and FA and suggest that clinicians may find IB a target for treatment of those persons who report experiences of EE and FA. IB may play a role in food misuse that leads to elevated BMI.

IL4Rα Signaling Abrogates Hypoxic Neutrophil Survival and Limits Acute Lung Injury Responses In Vivo.

Rationale: Acute respiratory distress syndrome is defined by the presence of systemic hypoxia and consequent on disordered neutrophilic inflammation. Local mechanisms limiting the duration and magnitude of this neutrophilic response remain poorly understood. Objectives: To test the hypothesis that during acute lung inflammation tissue production of proresolution type 2 cytokines (IL-4 and IL-13) dampens the proinflammatory effects of hypoxia through suppression of HIF-1α (hypoxia-inducible factor-1α)-mediated neutrophil adaptation, resulting in resolution of lung injury. Methods: Neutrophil activation of IL4Ra (IL-4 receptor α) signaling pathways was explored ex vivo in human acute respiratory distress syndrome patient samples, in vitro after the culture of human peripheral blood neutrophils with recombinant IL-4 under conditions of hypoxia, and in vivo through the study of IL4Ra-deficient neutrophils in competitive chimera models and wild-type mice treated with IL-4. Measurements and Main Results: IL-4 was elevated in human BAL from patients with acute respiratory distress syndrome, and its receptor was identified on patient blood neutrophils. Treatment of human neutrophils with IL-4 suppressed HIF-1α-dependent hypoxic survival and limited proinflammatory transcriptional responses. Increased neutrophil apoptosis in hypoxia, also observed with IL-13, required active STAT signaling, and was dependent on expression of the oxygen-sensing prolyl hydroxylase PHD2. In vivo, IL-4Ra-deficient neutrophils had a survival advantage within a hypoxic inflamed niche; in contrast, inflamed lung treatment with IL-4 accelerated resolution through increased neutrophil apoptosis. Conclusions: We describe an important interaction whereby IL4Rα-dependent type 2 cytokine signaling can directly inhibit hypoxic neutrophil survival in tissues and promote resolution of neutrophil-mediated acute lung injury.

The role of emotional eating and stress in the influence of short sleep on food consumption.

Short sleep duration is associated with elevated body mass index (BMI) and increased energy consumption. The present studies were conducted to determine what role emotional eating and stress might play in these relationships. The first was an exploratory questionnaire study in which sleep quality and duration were measured in conjunction with the Dutch Eating Behavior Questionnaire in 184 women. Emotional and external eating scores were significantly higher in those who reported poor sleep quality (but were not related to sleep duration). In a second study of 64 women who were provided with snacks in the laboratory under stressed and control conditions, elevated food consumption was observed in those who scored high on emotional eating and who reported short sleep (a significant stress × emotional eating × sleep duration interaction) but not in those who reported poor sleep quality. No effects were found in liking or wanting of food and few effects were found on appetite. BMI was not related to sleep duration or sleep quality in either study. The results suggest that the relationship between short sleep and elevated food consumption exists in those who are prone to emotional eating. An external stressor elevated consumption in normal sleepers to the level observed in short sleepers, however, it did not significantly elevate consumption in short sleepers. Future examinations of the effects of sleep duration and quality on food consumption should examine emotional eating status.

A prospective multicenter registry of laser therapy for degenerated saphenous vein graft stenosis: the COronary graft Results following Atherectomy with Laser (CORAL) trial.

PURPOSE: The primary aim of this study was to prospectively evaluate the safety and efficacy of Excimer laser atherectomy as a primary treatment strategy in consecutively eligible patients presenting for percutaneous coronary intervention (PCI) of degenerated saphenous vein graft (SVG) lesions using a multicenter registry. Prior single-center experience suggested that laser atherectomy may decrease acute procedural complications during treatment of degenerated SVGs, including lesions not amenable to distal protection devices (DPDs). METHODS AND MATERIALS: The COronary graft Results following Atherectomy with Laser investigators enrolled 98 patients at 18 centers between June 23, 2003, and October 4, 2004, with greater than 50% stenosis of an SVG who presented for PCI due to angina pectoris or objective evidence of myocardial ischemia in a concordant myocardial distribution. Laser atherectomy was planned. Patients were excluded if the operator planned to utilize a DPD. Inclusion and exclusion criteria were aligned to those in the Saphenous vein graft Angioplasty Free of Emboli Randomized (SAFER) trial. RESULTS: The primary end point [30-day major adverse cardiac events (MACE)] occurred in 18/98 (18.4%) patients driven primarily by non-q-wave myocardial infarction. Major procedural complications included no reflow (n=5) and major dissection (n=1). No perforations occurred. Univariate predictors of 30-day MACE included lesion length, vessel angulation, plaque burden, SVG degeneracy score, number of laser pulses used, and larger-sized laser catheters. CONCLUSIONS: This study demonstrated that Excimer laser atherectomy of diseased SVGs is feasible with results comparable to the 30-day MACE in the control population from the SAFER trial. Whether the addition of laser to embolic protection devices is of any clinical utility remains to be tested in future studies.

Payment reform: how should your organization prepare?

To prepare for payment reform, hospitals should: convene a permanent task force to monitor risk and lead performance improvement in the postreform era; identify the metrics linked to new and emerging incentive payments (e.g., readmission rates, prevention quality indicators); quantify their financial risk exposure and identify all performance improvement areas; pair a member of the finance team with either the CMO or CNO to monitor performance on a weekly basis.

New phenolic inhibitors of yeast homoserine dehydrogenase.

A relatively unexploited potential target for antimicrobial agents is the biosynthesis of essential amino acids. Homoserine dehydrogenase, which reduces aspartate semi-aldehyde to homoserine in a NAD(P)H-dependent reaction, is one such target that is required for the biosynthesis of Met, Thr, and Ile from Asp. We report a small molecule screen of yeast homoserine dehydrogenase that has identified a new class of phenolic inhibitors of this class of enzyme. X-ray crystal structural analysis of one of the inhibitors in complex with homoserine dehydrogenase reveals that these molecules bind in the amino acid binding region of the active site and that the phenolic hydroxyl group interacts specifically with the backbone amide of Gly175. These results provide the first nonamino acid inhibitors of this class of enzyme and have the potential to be exploited as leads in antifungal compound design.