Experiences of loss of control eating in women after bariatric surgery: A qualitative study.

OBJECTIVE: Loss of control (LOC) eating following bariatric surgery remains insufficiently understood, reflected in a lack of clear conceptualization, valid measurements, and effective treatments. This study explored patients' perspectives on LOC eating post-bariatric surgery, focusing on the relevance of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) indicators of impaired control, and patients' experiences before (precipitating factors), during (eating patterns, perpetuating factors), and after the episodes (strategies used to stop eating). METHODS: This was a qualitative study using descriptive phenomenology. Participants were adults who have undergone gastric bypass or sleeve gastrectomy and self-reported recent LOC eating. Data were collected by semi-structured interviews and analyzed using a combined inductive and deductive approach. RESULTS: Participants were all women (N = 15; age: 34.5 ± 9.2 years). Results suggested that (1) except for feeling disgusted, guilty, or depressed after eating, other DSM-5 indicators did not seem to be highly relevant to this bariatric cohort; (2) LOC eating could occur across contexts, with food access, boredom, and food craving being consistent triggers; (3) the food amount consumed during a LOC episode was not necessarily considered excessive; (4) "mindlessness" and "satisfying hedonic, physiological, and mental needs" were the main perpetuating factors of LOC eating; and (5) self-talk and distracting attention were the most adopted strategies to stop eating. DISCUSSION: Study findings have implications concerning the conceptualization, measurement, and intervention of LOC eating among bariatric patients. For example, results suggested the need for more data to determine the appropriate indicators of LOC eating and the inclusion of boredom as an intervention target in bariatric patients. PUBLIC SIGNIFICANCE: Loss of control (LOC) eating is characterized by a sense of being unable to stop while eating. LOC eating is prevalent in patients who have undergone weight loss surgery and is associated with worse surgical outcomes. This qualitative study that explored post-bariatric surgery patients' experiences of LOC eating will inform efforts to better assess and intervene in this disordered eating behavior, thus ultimately optimizing patients' health following weight loss surgery.

Biological changes in the pregnancy-postpartum period and subsequent cardiometabolic risk-UPSIDE MOMS: A research protocol.

Multiple physiological changes occur in pregnancy as a woman's body adapts to support the growing fetus. These pregnancy-induced changes are essential for fetal growth, but the extent to which they reverse after pregnancy remains in question. For some women, physiological changes persist after pregnancy and may increase long-term cardiometabolic disease risk. The National Institutes of Health-funded study described in this protocol addresses a scientific gap by characterizing weight and biological changes during pregnancy and an extended postpartum period in relation to cardiometabolic risk. We use a longitudinal repeated measures design to prospectively examine maternal health from early pregnancy until 3 years postpartum. The aims are: (1) identify maternal weight profiles in the pregnancy-postpartum period that predict adverse cardiometabolic risk profiles three years postpartum; (2) describe immune, endocrine, and metabolic biomarker profiles in the pregnancy-postpartum period, and determine their associations with cardiometabolic risk; and (3) determine how modifiable postpartum health behaviors (diet, physical activity, breastfeeding, sleep, stress) (a) predict weight and cardiometabolic risk in the postpartum period; and (b) moderate associations between postpartum weight retention and downstream cardiometabolic risk. The proposed sample is 250 women. This study of mothers is conducted in conjunction with the Understanding Pregnancy Signals and Infant Development study, which examines child health outcomes. Biological and behavioral data are collected in each trimester and at 6, 12, 24, and 36 months postpartum. Findings will inform targeted health strategies that promote health and reduce cardiometabolic risk in childbearing women.

Continuous Preparation of 1:1 Haloperidol-Maleic Acid Salt by a Novel Solvent-Free Method Using a Twin Screw Melt Extruder.

Salts are generally prepared by acid-base reaction in relatively large volumes of organic solvents, followed by crystallization. In this study, the potential for preparing a pharmaceutical salt between haloperidol and maleic acid by a novel solvent-free method using a twin-screw melt extruder was investigated. The pH-solubility relationship between haloperidol and maleic acid in aqueous medium was first determined, which demonstrated that 1:1 salt formation between them was feasible (pHmax 4.8; salt solubility 4.7 mg/mL). Extrusion of a 1:1 mixture of haloperidol and maleic acid at the extruder barrel temperature of 60 °C resulted in the formation of a highly crystalline salt. The effects of operating temperature and screw configuration on salt formation were also investigated, and those two were identified as key processing parameters. Salts were also prepared by solution crystallization from ethyl acetate, liquid-assisted grinding, and heat-assisted grinding and compared with those obtained by melt extrusion by using DSC, PXRD, TGA, and optical microscopy. While similar salts were obtained by all methods, both melt extrusion and solution crystallization yielded highly crystalline materials with identical enthalpies of melting. During the pH-solubility study, a salt hydrate form was also identified, which, upon heating, converted to anhydrate similar to that obtained by other methods. There were previous reports of the formation of cocrystals, but not salts, by melt extrusion. 1H NMR and single-crystal X-ray diffraction confirmed that a salt was indeed formed in the present study. The haloperidol-maleic acid salt obtained was nonhygroscopic in the moisture sorption study and converted to the hydrate form only upon mixing with water. Thus, we are reporting for the first time a relatively simple and solvent-free twin-screw melt extrusion method for the preparation of a pharmaceutical salt that provides material comparable to that obtained by solution crystallization and is amenable to continuous manufacturing and easy scale up.

Validation of the Weight-Related Eating Questionnaire in pregnancy.

The Weight-Related Eating Questionnaire (WREQ), designed for assessing distinct constructs of dietary restraint and disinhibition-related eating behaviors, has not been validated in pregnancy. This secondary data analysis aimed to evaluate the WREQ's psychometrics in a diverse sample of pregnant women from the eMoms randomized controlled trial (N = 1399), randomly split for exploratory (EFA, n = 691) and confirmatory factor analysis (CFA, n = 708). Cronbach's alpha and corrected item-total correlation was used to examine internal consistency reliability. Sequential multiple regression analyses were used to assess criterion validity. EFA revealed three factors - dietary restraint, susceptibility to external cues, and emotional eating - accounting for 65.6 % of total variances. Parallel analysis confirmed a combination of two restraint subtypes (routine restraint and compensatory restraint). CFA showed that item 3 for assessing routine restraint had the lowest squared multiple correlation (0.22). The overall Cronbach's alpha of 0.87 demonstrated good internal consistency. Dietary restraint was negatively associated with the intake of energy (p = .03) and carbohydrates (p = .02), whereas susceptibility to external cues was positively associated with the intake of energy (p < .001), carbohydrates (p < .001), and total fat (p = .003). Additionally, emotional eating was positively associated with early-pregnancy body mass index (BMI) after adjustment for covariates (p < .001). These findings confirmed the reliability of the WREQ, the construct validity for susceptibility to external cues and emotional eating, and demonstrated its criterion validity regarding nutritional intake in pregnant women.

Crystallization of Form II Paracetamol with the Assistance of Carboxylic Acids toward Batch and Continuous Processes.

Form II paracetamol has captured the interest of researchers due to its improved compressibility. However, its low stability has made it difficult to be produced on a large scale with good reproducibility. In the present study, the selective polymorphic formation of paracetamol was carried out by cooling crystallization with four types of additives: adipic acid, fumaric acid, oxalic acid, and succinic acid. It was found that: (1) the more additives that were added, the higher the probability of forming Form II paracetamol; (2) Form II paracetamol could be induced by seeding the paracetamol aqueous solution with Form II paracetamol and fumaric acid crystals, and not the other three carboxylic acids; (3) a new solution complex of paracetamol-oxalic acid, evidenced by the solubility diagram, was responsible for the selective nucleation of Form II paracetamol in the oxalic acid aqueous solution; and (4) the range of the degree of supersaturation for nucleating Form II paracetamol was extended with the assistance of oxalic acid or fumaric acid. In large-scale crystallization, Form II paracetamol was produced by the continuous crystallization of 44 mg of paracetamol/mL in 50 wt% of fumaric acid aqueous solution with a flow rate of 150 mL/min.

Associations between Dietary Patterns and Inflammatory Markers during Pregnancy: A Systematic Review.

Elevated inflammation in pregnancy has been associated with multiple adverse pregnancy outcomes and potentially an increased susceptibility to future chronic disease. How maternal dietary patterns influence systemic inflammation during pregnancy requires further investigation. The purpose of this review was to comprehensively evaluate studies that assessed dietary patterns and inflammatory markers during pregnancy. This review was guided by the Preferred Reporting Items for Systematic Review and Meta-Analyses. Included studies were sourced from EMBASE, PubMed, Web of Science, and Scopus and evaluated using The Quality Assessment Tool for Quantitative Studies. Inclusion criteria consisted of human studies published in English between January 2007 and May 2020 that addressed associations between dietary patterns and inflammatory markers during pregnancy. Studies focused on a single nutrient, supplementation, or combined interventions were excluded. A total of 17 studies were included. Despite some inconsistent findings, maternal diets characterized by a higher intake of animal protein and cholesterol and/or a lower intake of fiber were shown to be associated with certain pro-inflammatory markers (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF- α), IL-8, serum amyloid A (SAA), and glycoprotein acetylation (GlycA)). Future studies that explore a broader range of inflammatory markers in the pregnant population, reduce measurement errors, and ensure adequate statistical adjustment are warranted.

A Novel Hydrate Form of Sodium Dodecyl Sulfate and Its Crystallization Process.

A novel hydrate form of sodium dodecyl sulfate (SDS) was firstly discovered through a hydrate screening with the use of organic solvents, while SDS is generally prepared solely in aqueous media. Surprisingly, a novel SDS hydrate form with needle-shaped crystals produced by adding acetonitrile to a 20 wt % SDS aqueous solution at a ratio of 3:1 (v/v) and further cooling to around 5 °C could be found with a trace amount in one of the two purchased SDS products that we examined. After comprehensive solid-state characterizations by powder X-ray diffraction (PXRD), thermogravimetric analysis (TGA), Fourier transform infrared (FTIR), Raman spectroscopy, dynamic vapor sorption (DVS), and elemental analysis (EA), it is also successfully made directly from the synthesis of SDS through esterification and saponification. Four times the equal proportion of acetone was added into the reaction solution at an interval of 5 min to separate the side product, sodium sulfate, from the mother liquor. The desired novel hydrate form of SDS was then obtained by cooling the filtered mother liquor to 5 °C and aged for 8 h for a preferential growth.

Influence of Appetite and Perceived Ability to Control Cravings on Excessive Gestational Weight Gain.

OBJECTIVE: To explore whether appetite is associated with gestational weight gain (GWG) and to assess the effect of perceived ability to control cravings on excessive GWG. DESIGN: Secondary data analysis. SETTING: Rochester, New York, United States. PARTICIPANTS: Women who were pregnant (N = 1,005) and participated in a randomized controlled trial to test the effect of electronically mediated interventions to prevent excessive GWG and postpartum weight retention. METHODS: We used two questions to assess appetite and perceived ability to control cravings before 28 weeks gestation: "How would you describe your appetite now compared to times when you are not pregnant?" and "How sure are you that you will be able to avoid overeating when you have cravings?" We conducted logistic regression to assess the relationships between appetite, perceived ability to control cravings, and excessive GWG. RESULTS: More than 47% of participants gained excessive weight during pregnancy. Approximately 62% of participants reported being hungrier, and more than 42% indicated that they were unsure they could avoid overeating with cravings. Participants who reported similar/less appetite than before pregnancy were less likely to gain excessive weight (p < .05). Participants who were sure they could control cravings were less likely to gain excessive weight (p = .02). CONCLUSION: Our results show that appetite and perceived ability to control cravings may affect GWG. Additional research is needed to assess if interventions targeting appetite and craving control could limit GWG.

Reproducible Crystallization of Sodium Dodecyl Sulfate·1/8 Hydrate by Evaporation, Antisolvent Addition, and Cooling.

Sodium dodecyl sulfate (SDS)·1/8 hydrate (NaC12H25SO4·1/8H2O) crystals were successfully produced by evaporation, antisolvent addition, cooling crystallization, and isothermal aging in a common stirred tank. A clear 33.3 wt % SDS aqueous solution was concentrated by evaporation to a 60 wt % coagel consisting of numerous SDS hydrates and water. The coagel was transformed to a clear solution when two times the volume of acetone relative to the water remaining were added. By this fluid property, a controlled crystallization was made possible in a homogeneous solution. Moreover, acetone with a water-to-acetone volume ratio of 1:15 was then added as an antisolvent to induce crystallization of SDS·1/8 hydrate by cubic addition. Finally, cooling crystallization and isothermal aging were carried out to further increase the yields and gave monodispersed particle size. The stability test showed that the produced SDS·1/8 hydrate could be stored at various relative humidity environments for at least 5 days.