Effect of Menstrual Cycle and Hormonal Contraception on Musculoskeletal Health and Performance: Protocol for a Prospective Cohort Design and Cross-Sectional Comparison.

BACKGROUND: Women of reproductive age experience cyclical variation in the female sex steroid hormones 17ß-estradiol and progesterone during the menstrual cycle that is attenuated by some hormonal contraceptives. Estrogens perform a primary function in sexual development and reproduction but have nonreproductive effects on bone, muscle, and sinew tissues (ie, ligaments and tendons), which may influence injury risk and physical performance. OBJECTIVE: The purpose of the study is to understand the effect of the menstrual cycle and hormonal contraceptive use on bone and calcium metabolism, and musculoskeletal health and performance. METHODS: A total of 5 cohorts of physically active women (aged 18-40 years) will be recruited to participate: eumenorrheic, nonhormonal contraceptive users (n=20); combined oral contraceptive pill (COCP) users (n=20); hormonal implant users (n=20); hormonal intrauterine system users (n=20); and hormonal injection users (n=20). Participants must have been using the COCP and implant for at least 1 year and the intrauterine system and injection for at least 2 years. First-void urine samples and fasted blood samples will be collected for biochemical analysis of calcium and bone metabolism, hormones, and metabolic markers. Knee extensor and flexor strength will be measured using an isometric dynamometer, and lower limb tendon and stiffness, tone, and elasticity will be measured using a Myoton device. Functional movement will be assessed using a single-leg drop to assess the frontal plane projection angle and the qualitative assessment of single leg loading. Bone density and macro- and microstructure will be measured using ultrasound, dual-energy x-ray absorptiometry, and high-resolution peripheral quantitative computed tomography. Skeletal material properties will be estimated from reference point indentation, performed on the flat surface of the medial tibia diaphysis. Body composition will be assessed by dual-energy x-ray absorptiometry. The differences in outcome measures between the hormonal contraceptive groups will be analyzed in a one-way between-group analysis of covariance. Within the eumenorrheic group, the influence of the menstrual cycle on outcome measures will be assessed using a linear mixed effects model. Within the COCP group, differences across 2 time points will be analyzed using the paired-samples 2-tailed t test. RESULTS: The research was funded in January 2020, and data collection started in January 2022, with a projected data collection completion date of August 2024. The number of participants who have consented at the point of manuscript submission is 66. It is expected that all data analysis will be completed and results published by the end of 2024. CONCLUSIONS: Understanding the effects of the menstrual cycle and hormonal contraception on musculoskeletal health and performance will inform contraceptive choices for physically active women to manage injury risk. TRIAL REGISTRATION: ClinicalTrials.gov NCT05587920; https://classic.clinicaltrials.gov/ct2/show/NCT05587920. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50542.

The magnitude of the testing effect is independent of retrieval practice performance.

Practicing retrieval is a potent learning enhancer. Theoretical accounts of the testing effect generally suggest that the magnitude of the testing effect is dependent on retrieval practice performance, such that conditions that promote better retrieval practice performance should result in a greater testing effect. Empirical evidence, however, has been mixed. Although some studies showed a positive association between retrieval practice performance and the testing effect, others have shown either no relation or the reverse. In the present study, we experimentally manipulated retrieval practice performance using a retrieval-based response deadline manipulation and an encoding-based study trial manipulation. Across six experiments, the magnitude of the testing effect was independent of retrieval practice performance. However, when we aggregated the data across the experiments, participants with superior retrieval practice performance showed a greater testing effect-an individual difference. This dissociation between experimental and correlational outcomes suggests that the positive relation between retrieval practice performance and the testing effect is not causal, and indeed, simulation data showed that the correlation between retrieval practice performance and testing effect was an artifact. We discuss the challenges these findings present to existing accounts of the testing effect. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Testing effects for self-generated versus experimenter-provided questions.

Given the finding that retrieval practice improves memory, it is frequently suggested that students test themselves while studying. This study examined whether participants benefit from testing if they create and use their own test questions. In Experiment 1, participants read passages, generated questions about the passages, and then either answered their questions as they created them (the procedure used in previous studies) or after a delay. In Experiments 2 and 3, participants either generated questions and answered them after a delay (i.e., self-testing), answered experimenter-provided questions, or reread the passages before taking a final test administered shortly after learning or following a 2-day delay. The experiments found no benefits of answering one's own questions after a delay. In fact, those who self-tested tended to have worse performance on a final assessment of learning than the other learning conditions. Exploratory analyses suggested that participants' questions often did not target material that was on the later criterion test, which may explain why self-testing was not beneficial. The present study suggests that testing may not benefit learning if students create their own test questions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Assessment of executive function in a rodent model of Type 1 diabetes.

This study examined the impact of Type 1 Diabetes Mellitus (T1DM) on executive function using a series of operant conditioning-based tasks in rats. Sprague Dawley rats were randomized to either non-diabetic (n = 12; 6 male) or diabetic (n = 14; 6 male) groups. Diabetes was induced using multiple low-dose streptozotocin injections. All diabetic rodents were insulin-treated using subcutaneous insulin pellet implants (9-15 mM). At week 14 of the study, rats were placed on a food restricted diet to induce 5-10 % weight loss. Rodents were familiarized and their set-shifting ability was tested on a series of tasks that required continuous adjustments to novel stimulus-reward paradigms in order to receive food rewards. Results showed no differences in the number of trials, nor number and type of errors made to successfully complete each task between groups. Therefore, we report no differences in executive function, or more specifically set-shifting abilities between non-diabetic and diabetic rodents that receive insulin.

Atrial cardiopathy and cognitive impairment.

Cognitive impairment involves complex interactions between multiple pathways and mechanisms, one of which being cardiac disorders. Atrial cardiopathy (AC) is a structural and functional disorder of the left atrium that may be a substrate for other cardiac disorders such as atrial fibrillation (AF) and heart failure (HF). The association between AF and HF and cognitive decline is clear; however, the relationship between AC and cognition requires further investigation. Studies have shown that several markers of AC, such as increased brain natriuretic peptide and left atrial enlargement, are associated with an increased risk for cognitive impairment. The pathophysiology of cognitive decline in patients with AC is not yet well understood. Advancing our understanding of the relationship between AC and cognition may point to important treatable targets and inform future therapeutic advancements. This review presents our current understanding of the diagnosis of AC, as well as clinical characteristics and potential pathways involved in the association between AC and cognitive impairment.

Does expressive writing or an instructional intervention reduce the impacts of test anxiety in a college classroom?

Test anxiety is a major concern in education because it causes uncomfortable feelings in test-anxious students and may reduce the validity of exam scores as a measure of learning. As such, brief and cost-effective interventions are necessary to minimize the negative impact of test anxiety on students' academic performance. In the present experiment, we examine two such interventions: expressive writing (Experiment 1) and an instructional intervention (Experiment 2), with the latter developed from a similar intervention for stereotype threat. Across four authentic exams in a psychology class, students alternated between completing the intervention and a control task immediately before completing the exams. Neither intervention was effective at reducing test anxiety or improving exam performance. The present results suggest that these interventions may not be successful in addressing the impacts of test anxiety in all classroom settings.

Judgments of learning (JOLs) selectively improve memory depending on the type of test.

JOL reactivity refers to the finding that making judgments of learning (JOLs) while studying material influences later memory for that material. Findings of JOL reactivity have been mixed, with some experiments reporting changes to memory when participants make JOLs and others finding no influence of JOLs. Soderstrom, Clark, Halamish, and Bjork (Journal of Experimental Psychology: Learning, Memory, and Cognition, 41(2), 553-558, 2015) proposed that JOL reactivity will only occur if the final test is sensitive to the same cues used to inform JOLs. The current study evaluated this account by manipulating the type of final test. In four experiments, participants studied mixed lists of related and unrelated word pairs and either made JOLs or did not make JOLs. Making JOLs generally enhanced memory for related word pairs when a cued-recall test was administered. However, during free recall, JOLs had no influence on memory for target information, likely because cue-target associations (which are used to inform JOLs) are less beneficial in the absence of cues. JOLs improved item recognition memory for words that were studied in related pairs, although the effect was small. Collectively, data from a meta-analysis of these experiments indicate that JOL reactivity depends on the type of final test, with reactivity most likely to occur when the final test is sensitive to the same cues used to inform JOLs. Future work should continue examining different tests and study materials in order to develop a comprehensive theory of JOL reactivity.