Areca catechu-(Betel-nut)-induced whole transcriptome changes in a human monocyte cell line that may have relevance to diabetes and obesity; a pilot study.

BACKGROUND: Betel-nut consumption is the fourth most common addictive habit globally and there is good evidence linking the habit to obesity, type 2 diabetes (T2D) and the metabolic syndrome. The aim of our pilot study was to identify gene expression relevant to obesity, T2D and the metabolic syndrome using a genome-wide transcriptomic approach in a human monocyte cell line incubated with arecoline and its nitrosated products. RESULTS: The THP1 monocyte cell line was incubated separately with arecoline and 3-methylnitrosaminopropionaldehyde (MNPA) in triplicate for 24 h and pooled cDNA indexed paired-end libraries were sequenced (Illumina NextSeq 500). After incubation with arecoline and MNPA, 15 and 39 genes respectively had significant changes in their expression (q < 0.05, log fold change 1.5). Eighteen of those genes have reported associations with T2D and obesity in humans; of these genes there was most marked evidence for CLEC10A, MAPK8IP1, NEGR1, NQ01 and INHBE genes. CONCLUSIONS: Our preliminary studies have identified a large number of genes relevant to obesity, T2D and metabolic syndrome whose expression was changed significantly in human TPH1 cells following incubation with betel-nut derived arecoline or with MNPA. These findings require validation by further cell-based work and investigation amongst betel-chewing communities.

Changes over time in the relationship between weight, body fat, motivation, impulsivity and eating behaviour.

BACKGROUND: University students are at a greater risk of gaining weight compared to others. We explored associations between changes in weight and a set of dispositional constructs related to eating behaviour: motivation, impulsivity, social comparison, and eating styles. We predicted that increases in controlled motivation, impulsivity, uncontrolled eating, emotional eating, and physical appearance comparison would be related to increased weight and body fat. METHODS: First year students at a British university completed baseline (n = 196) and three-month (n = 163) measures of impulsivity, physical appearance comparison, motivation for following a healthy diet, eating styles, weight and body fat. Baseline-follow-up changes in these constructs were computed and subjected to cluster analysis. RESULTS: Four participant groups were identified according to similarities in the way these constructs evolved over time. The Losing and Gaining groups tended to show opposing changes in key variables (physical appearance comparison, uncontrolled eating, motivation, weight, and percentage of body fat). Interestingly, two groups showed no change in weight and body fat but evidenced unique changes in key variables, indicating that individuals can have different psychological profiles but still maintain their weight. CONCLUSIONS: The study highlighted how stable weight maintenance arises from sets of interdependent constructs rather than variables in isolation, as well as emphasizing a need to take a person-centred approach to examining those at risk of weight gain and in developing interventions.

Mate preference priorities in the East and West: A cross-cultural test of the mate preference priority model.

OBJECTIVE: Mate choice involves trading-off several preferences. Research on this process tends to examine mate preference prioritization in homogenous samples using a small number of traits and thus provide little insight into whether prioritization patterns reflect a universal human nature. This study examined whether prioritization patterns, and their accompanying sex differences, are consistent across Eastern and Western cultures. METHOD: In the largest test of the mate preference priority model to date, we asked an international sample of participants (N = 2,477) to design an ideal long-term partner by allocating mate dollars to eight traits using three budgets. Unlike previous versions of the task, we included traits known to vary in importance by culture (e.g., religiosity and chastity). RESULTS: Under low budget conditions, Eastern and Western participants differed in their mate dollar allocation for almost every trait (average d = 0.42), indicating that culture influences prioritization. Despite these differences, traits fundamental for the reproductive success of each sex in the ancestral environment were prioritized by both Eastern and Western participants. CONCLUSION: The tendency to prioritize reproductively fundamental traits is present in both Eastern and Western cultures. The psychological mechanisms responsible for this process produce similar prioritization patterns despite cross-cultural variation.

Maternal gestational diabetes is associated with genome-wide DNA methylation variation in placenta and cord blood of exposed offspring.

Exposure of a developing foetus to maternal gestational diabetes (GDM) has been shown to programme future risk of diabetes and obesity. Epigenetic variation in foetal tissue may have a mechanistic role in metabolic disease programming through interaction of the pregnancy environment with gene function. We aimed to identify genome-wide DNA methylation variation in cord blood and placenta from offspring born to mothers with and without GDM. Pregnant women of South Asian origin were studied and foetal tissues sampled at term delivery. The Illumina HumanMethylation450 BeadChip was used to assay genome-wide DNA methylation in placenta and cord blood from 27 GDM exposed and 21 unexposed offspring. We identified 1485 cord blood and 1708 placenta methylation variable positions (MVPs) achieving genome-wide significance (adjusted P-value <0.05) with methylation differences of >5%. MVPs were disproportionately located within first exons. A bioinformatic co-methylation algorithm was used to detect consistent directionality of methylation in 1000 bp window around each MVP was observed at 74% of placenta and 59% of cord blood MVPs. KEGG pathway analysis showed enrichment of pathways involved in endocytosis, MAPK signalling and extracellular triggers to intracellular metabolic processes. Replication studies should integrate genomics and transcriptomics with longitudinal sampling to elucidate stability, determine causality for translation into biomarker and prevention studies.

Heterosexual Men's Ratings of Sexual Attractiveness of Adolescent Girls: A Cross-Cultural Analysis.

Following an identical procedure to the one we previously reported (O'Donnell, Lowe, Brotherton, & Bennett, 2014), we examined ratings of sexual attraction to photographs of (the same) adolescent girls (Tanner stages 3-4) labelled as either 14-15 years or 16-17 years old, women, and men. Ratings were made by Bulgarian heterosexual men by pressing buttons on a response box which recorded the ratings made and the time in milliseconds taken to respond. Despite the age of sexual consent in Bulgaria being 14 years, the pattern of findings did not differ from those found in the UK, where the age of consent is 16 years. That is, mean ratings of the sexual attractiveness of the girls labelled as younger were lower than those of the (same) girls labelled as older, and those of the women. In addition, correlations revealed significantly longer responding times when younger girls (and men) were rated as more highly sexually attractive. These associations were reversed in response to the photographs of women. We take these findings to indicate an inhibitory effect arising from generalized sexual norms relating to the inappropriateness of sexual attraction to young girls; the greater the attraction, the higher the inhibition. This second replication of our initial findings suggests a robust effect that may be of benefit in exploration of pedophile or sex offender groups.

Heterosexual men's ratings of sexual attractiveness of pubescent girls: Effects of labeling the target as under or over the age of sexual consent.

The study aimed to identify implicit and explicit processes involved in reporting the sexual attractiveness of photographs of the same pubescent girls labeled as either under or within the age of sexual consent in the UK, women, and men. In two studies, 53 and 70 heterosexual men (M age 25.2 and 31.0 years) rated the sexual attractiveness of photographs in each category presented via computer [seeing target photographs of girls labeled as either under- (14-15 years) or within the age of consent (16-17 years)], using a 7-point response box. Ratings in Study 1 were in response to a question asking participants to rate how sexually attractive the person in each photograph was. In Study 2, participants rated how sexually attractive they personally found the target. Response times were also recorded. Several findings were replicated in both studies (although the strength of findings differed). Mean ratings of the sexual attractiveness of the underage girls were lower than those of overage girls and women. In addition, correlations revealed significantly longer responding times when "underage" girls (and men) were rated as more highly sexually attractive. No such relationship emerged with the same girls labeled within the age of consent or women. Overall, these data suggest that men find pubescent girls identified as being under the age of consent sexually attractive, but inhibit their willingness to report this; the greater the attraction, the greater the inhibition.

CT coronary angiography first prior to rapid access chest pain clinic review: a retrospective feasibility study.

OBJECTIVES: Since rapid access chest pain clinics (RACPC) were established to streamline stable chest pain assessment, CT coronary angiography (CTCA) has become the recommended investigation for patients without known coronary artery disease (CAD), with well-defined indications. This single-centre retrospective study assessed the feasibility of General Practice (GP)-led CTCA prior to RACPC. METHODS: RACPC pathway patients without pre-existing CAD electronic records were reviewed (September-October 2019). Feasibility assessments included appropriateness for RACPC, referral clinical data vs RACPC assessment for CTCA indication and safety, and a comparison of actual vs hypothetical pathways, timelines and hospital encounters. RESULTS: 106/172 patients screened met inclusion criteria (mean age 61 ± 14, 51% female). 102 (96%) referrals were 'appropriate'. No safety concerns were identified to preclude a GP-led CTCA strategy. The hypothetical pathway increased CTCA requests vs RACPC (84 vs 71), whilst improving adherence to guidelines and off-loading other services. 22% (23/106) had no CAD, representing cases where one hospital encounter may be sufficient. The hypothetical pathway would have reduced referral-to-diagnosis by at least a median of 27 days (interquartile range 14-33). CONCLUSION: A hypothetical GP-led CTCA pathway would have been feasible and safe in a real-world RACPC patient cohort without pre-existing CAD. This novel strategy would have increased referrals for CTCA, whilst streamlining patient pathways and improved NICE guidance adherence. ADVANCES IN KNOWLEDGE: GP-led CTCA is a feasible and safe pathway for patients without pre-existing CAD referred to RACPC, reducing hospital encounters required and may accelerate time to diagnosis. This approach may have implications and opportunities for other healthcare pathways.

An integrative epi-transcriptomic approach identifies the human cartilage chitinase 3-like protein 2 (CHI3L2) as a potential mediator of B12 deficiency in adipocytes.

Vitamin B12 has multiple biochemical functions including in the one-carbon cycle generating a methyl group for DNA methylation, and metabolism of fatty acids and amino acids to generate energy via the citric acid cycle. The aim of our study was to use a combined epigenomic and transcriptomic approach to identify novel genes mediating the effect of B12 on adipogenesis.Human pre-adipocytes (CHUB-S7) were treated with a range of B12 (0-500 nM) concentrations from the day of cell seeding until harvesting in discovery and validation experiments prior to genome-wide methylation analysis using the Illumina HumanMethylation 450Beadchip. For transcriptomic analysis, RNA-seq libraries were run on the Illumina HiSeq 2500. To further investigate the expression of any genes on human adipogenesis, a second human preadipocyte strain was studied (SGBS) by real-time quantitative PCR (qRT-PCR).A combined epigenetic and transcriptomic approach in differentiated human pre-adipocyte cell line, CHUB-S7, identified that the Human cartilage chitinase 3-like protein 2 (CHI3L2) gene was hypo-methylated and had increased expression in low B12 conditions. Furthermore, there was an approximately 1000-fold increase in CHI3L2 expression in the early days of adipocyte differentiation, which paralleled an increase of lipid droplets in differentiated SGBS cells and an increased expression level of markers of mature adipocytes.In summary, we have identified a potential role of the human cartilage chitinase 3-like protein 2 (CHI3L2) in adipocyte function in the presence of low B12 levels.

Associations Between Mental Health, Interoception, Psychological Flexibility, and Self-as-Context, as Predictors for Alexithymia: A Deep Artificial Neural Network Approach.

Background: Alexithymia is a personality trait which is characterized by an inability to identify and describe conscious emotions of oneself and others. Aim: The present study aimed to determine whether various measures of mental health, interoception, psychological flexibility, and self-as-context, predicted through linear associations alexithymia as an outcome. This also included relevant mediators and non-linear predictors identified for particular sub-groups of participants through cluster analyses of an Artificial Neural Network (ANN) output. Methodology: Two hundred and thirty participants completed an online survey which included the following questionnaires: Toronto alexithymia scale; Acceptance and Action Questionnaire 2 (AQQII); Positive and Negative Affect Scale (PANAS-SF), Depression, Anxiety, and Stress Scale 21 (DAS21); Multidimensional Assessment of Interoceptive Awareness (MAIA); and the Self-as-Context (SAC) scale. A stepwise backwards linear regression and mediation analysis were performed, as well as a cluster analysis of the non-linear ANN upper hidden layer output. Results: Higher levels of alexithymia were associated with increased psychological inflexibility, lower positive affect scores, and lower interoception for the subscales of "not distracting" and "attention regulation." SAC mediated the relation between emotional regulation and total alexithymia. The ANNs accounted for more of the variance than the linear regressions, and were able to identify complex and varied patterns within the participant subgroupings. Conclusion: The findings were discussed within the context of developing a SAC processed-based therapeutic model for alexithymia, where it is suggested that alexithymia is a complex and multi-faceted condition, which requires a similarly complex, and process-based approach to accurately diagnose and treat this condition.

Emotions and their cognitive precursors: responses to spontaneously identified stressful events among hospital nurses.

This study used Smith and Lazarus's appraisal model to explore nurses' emotional reactions to self-identified distressing work situations. Key situations reported typically involved time or interpersonal pressure, coping with errors at work, difficulties with patients, and managerial conflict. The strongest emotions experienced were anger and frustration. Anxiety and sadness were less endorsed. Most nurses felt able to cope emotionally and problem-solve solutions to the problems they faced. The findings were generally supportive of Smith and Lazarus's theory, with the exception of the emotion of sadness. The implications of the results are discussed.

Information processing in illness representation: Implications from an associative-learning framework.

OBJECTIVE: The common-sense model (Leventhal, Meyer, & Nerenz, 1980) outlines how illness representations are important for understanding adjustment to health threats. However, psychological processes giving rise to these representations are little understood. To address this, an associative-learning framework was used to model low-level process mechanics of illness representation and coping-related decision making. METHOD: Associative learning was modeled within a connectionist network simulation. Two types of information were paired: Illness identities (indigestion, heart attack, cancer) were paired with illness-belief profiles (cause, timeline, consequences, control/cure), and specific illness beliefs were paired with coping procedures (family doctor, emergency services, self-treatment). To emulate past experience, the network was trained with these pairings. As an analogue of a current illness event, the trained network was exposed to partial information (illness identity or select representation beliefs) and its response recorded. RESULTS: The network (a) produced the appropriate representation profile (beliefs) for a given illness identity, (b) prioritized expected coping procedures, and (c) highlighted circumstances in which activated representation profiles could include self-generated or counterfactual beliefs. CONCLUSIONS: Encoding and activation of illness beliefs can occur spontaneously and automatically; conventional questionnaire measurement may be insensitive to these automatic representations. Furthermore, illness representations may comprise a coherent set of nonindependent beliefs (a schema) rather than a collective of independent beliefs. Incoming information may generate a "tipping point," dramatically changing the active schema as a new illness-knowledge set is invoked. Finally, automatic activation of well-learned information can lead to the erroneous interpretation of illness events, with implications for [inappropriate] coping efforts. (PsycINFO Database Record

Milieu matters: Evidence that ongoing lifestyle activities influence health behaviors.

Health behaviors occur within a milieu of lifestyle activities that could conflict with health actions. We examined whether cognitions about, and performance of, other lifestyle activities augment the prediction of health behaviors, and whether these lifestyle factors are especially influential among individuals with low health behavior engagement. Participants (N = 211) completed measures of past behavior and cognitions relating to five health behaviors (e.g., smoking, getting drunk) and 23 lifestyle activities (e.g., reading, socializing), as well as personality variables. All behaviors were measured again at two weeks. Data were analyzed using neural network and cluster analyses. The neural network accurately predicted health behaviors at follow-up (R2 = .71). As hypothesized, lifestyle cognitions and activities independently predicted health behaviors over and above behavior-specific cognitions and previous behavior. Additionally, lifestyle activities and poor self-regulatory capability were more influential among people exhibiting unhealthy behaviors. Considering ongoing lifestyle activities can enhance prediction and understanding of health behaviors and offer new targets for health behavior interventions.

The Impact of Mindfulness and Perspective-Taking on Implicit Associations Toward the Elderly: a Relational Frame Theory Account.

Perspective-taking interventions have been shown to improve attitudes toward social outgroups. In contrast, similar interventions have produced opposite effects (i.e., enhanced negativity) in the context of attitudes toward elderly groups. The current study investigated whether a brief perspective-taking intervention enhanced with mindfulness would be associated with less negativity than perspective-taking alone. One hundred five participants were randomly assigned to 1 of 4 conditions which comprised of an active or control perspective-taking component and an active or control mindfulness component. Participants were then administered an Implicit Associated Test to assess implicit biases toward the elderly. Results supported previous findings in that the condition in which perspective-taking was active but mindfulness was inactive was associated with greater negative implicit bias toward the elderly; however, some of this negativity decreased in the active perspective-taking and active mindfulness condition. The current findings and other mixed effects that have emerged from perspective-taking interventions are discussed from a Relational Frame Theory perspective.

Characteristics attributed to individuals with dental fluorosis.

BACKGROUND: Previous investigations of the public perception of dental fluorosis have focused mainly on aesthetics. Other characteristics which could potentially be ascribed to fluorosis, such as perceived personality traits, have not been examined. OBJECTIVES: This study aimed to identify personal characteristics (descriptors) attributed to people with fluorosis of varying degrees of severity, as depicted in standardised photographs viewed from different perspectives. METHOD: Extra-oral (full face) and intra-oral images of male and female subjects were digitally manipulated to represent normal dental enamel, mild, moderate, and severe fluorosis. The images were then scored by 90 members of the public (45M, 45F), under different experimental conditions, which varied the level of cueing to the teeth. Participants were asked (i) to record their spontaneous descriptors, (ii) select relevant descriptors from a predefined list of 50 descriptors and traits. RESULTS: 170 different word or phrase descriptors were spontaneously attributed to the images. Characteristics used to describe fluorosis varied with the degree of severity. However, endorsements were significantly influenced by whether participants viewed extra or intraoral images and the degree of cueing. Conditions which most accurately mirrored everyday social interactions, that is viewing extraoral images without cueing to pay particular attention to the mouth, were least likely to result in the attribution of characteristics that varied with levels of fluorosis. CONCLUSIONS: While characteristics varying with severity of dental fluorosis were ascribed, more sophisticated attitudinal measures are required to ascertain the wider social impact of fluorosis beyond the aesthetic.

Living with an implantable cardioverter defibrillator: The patients' experience.

OBJECTIVES: To explore the lived experiences of implantable cardioverter defibrillator (ICD) recipients. BACKGROUND: Previous research suggests ICD recipients experience significant psychological distress with a focus on shock anxiety. In response, avoidant behaviors are often used which can lead to reduced quality of life, cardiac fitness and increased risk of arrhythmia. METHODS: A qualitative study using semi-structured interviews with a purposive sample of 18 recipients who had either received or not received an ICD shock was conducted. Data were analyzed using a thematic approach. RESULTS: Three themes with sub-themes were defined: (i) physical consequences; (ii) emotional consequences (feeling vulnerable and uncertain; anxiety and depression); and (iii) coping with the ICD (avoidance/restrictive behaviors; acceptance; concealment). CONCLUSION: ICD recipients might be helped by a psycho-social intervention that corrects false beliefs about exercise and offers some simple stress management techniques. Additional elements might include helping recipients to re-evaluate goals and find a valued sense of self which this study found aided ICD acceptance.

Passive stent coatings in the drug-eluting era.

Advances in coronary stent technology, both in terms of stent design and function, have significantly improved the safety and efficacy of percutaneous coronary intervention, including marked reduction in restenosis. This has led to its use in increasingly challenging clinical and lesional subsets, with potential for increased risk of stent-associated thrombosis. In this article we outline the development of passive stent coatings, and evaluate the ongoing role of such coatings in the contemporary era of antiproliferative drug-eluting stents.

A connectionist implementation of the theory of planned behavior: association of beliefs with exercise intention.

The theory of planned behavior suggests attitudes are a product of salient beliefs. This study examined whether aggregating salient beliefs was plausible within a more biologically centered information-processing environment. A neural network was used to examine associations among beliefs relating to exercise intention. Data on intentions and behavioral, normative, and control beliefs from 114 respondents were used to train (by error backpropagation) a neural network to associate beliefs with intention. The R-sup-2 between the network's estimated and self-reported intention was.66. The network's representation comprised 6 belief profiles associated with high, moderate, or low behavioral intention. The neural network accommodated complex relationships among beliefs and belief-intention associations and indicated how high-level constructs such as attitudes may be viewed as the best fit (compromise state) between aroused beliefs.

Emotion-related primary and secondary appraisals, adjustment and coping: associations in women awaiting breast disease diagnosis.

OBJECTIVE: Different emotions are to some extent associated with different ways of coping. Cognitive processes involved in determining emotional reactions may influence coping (perhaps through directing attention or generating salient information). This study explored possible appraisal-coping associations by examining whether a set of appraisal components identified in emotion theory were also associated with coping. DESIGN: The study examined concurrent associations between appraisal components, emotional adjustment, and coping in 148 women with suspected breast disease. METHOD: Questionnaire measures of primary and secondary appraisal components identified in emotion theory, anxiety, depression, and coping were sent to women during the waiting period between GP referral and attendance at a 'one-stop' breast-disease diagnosis clinic. RESULTS: Consistent with expectations, appraisal components were associated with both emotions and coping. Elevated anxiety was associated with appraisals of low emotion-focused coping potential; avoidance coping was associated with motivational incongruence, self-accountability, and pessimistic appraisal of emotion-focused coping potential; acceptance/resignation coping was associated with self-accountability and pessimistic appraisals of both future expectancy and emotion-focused coping potential. CONCLUSION: This study presents a theoretically driven approach to exploring associations between emotions and adjustment efforts. In keeping with expectations, a number of appraisal components identified in emotion theory were found to be associated with both emotion and coping.

BRIEF REPORT.

Two studies are reported. In the first, 69 undergraduate students were asked to complete a questionnaire in which they reported one stressful incident they had experienced in the previous four weeks, and the appraisals, core relational themes, and emotions they experienced at the time. Without warning, one week later they were asked to consider the same incident and report their appraisals and emotions. Only scores on two of 41 variables differed across occasions. Data from the first time of completion were added to those of another group of students to form a total sample of 156 participants. These data were then used to test the model of appraisals, core relational themes, and emotion of Smith and colleagues (e.g. Smith and Lazarus, 1993). The model was tested on four emotions: anger, guilt, anxiety, and sadness, and accounted for between eighteen and forty eight percent of the explained variance of each measure. Contrary to the study's hypotheses, emotion-focussed coping potential added to the variance explained in measures of guilt and anger. The results are discussed in the context of the cognition-emotion literature.

The association between illness representation profiles and use of unscheduled urgent and emergency health care services.

OBJECTIVES: Provision of unscheduled health care (e.g., emergency department, family doctor consultations, pharmacist) is aided by matching patients with the 'right service, first time'. However, service choice is usually made by patients and carers rather than service providers. The self-regulation model (SRM) posits that people cope in ways consistent with their illness understanding. The SRM was used to examine differences in people's use of primary, secondary, and community health care services according to their illness representation, whilst also examining associations with chronic illness. Research historically treats illness representations at the level of independent components; this research focused on components as sets (profiles). DESIGN AND METHODS: A general population postal survey obtained usable data from 588 respondents on service usage and illness representation. RESULTS: Cluster analysis detected three illness representation profiles (participant groups) comprising people who regarded their illness as serious, unambiguous, distressing, and difficult to manage (group 1); chronic and concerning, but believing they understood and could manage it (group 2); short-term, of limited impact or concern but ambiguous in nature (group 3). Overall, group 1 used secondary care more than the other groups. When considering illness chronicity, group 1 showed more use of primary care with non-chronic conditions and secondary care with chronic conditions. CONCLUSIONS: Findings highlighted differences in use of unscheduled services that were related to illness representation profiles. Interventions for moderating service use such as patient information campaigns may need to be tuned towards specific groups of service users to optimize impact.