Elucidating the role of procalcitonin as a biomarker in hospitalized COVID-19 patients.

Our objectives were to evaluate the role of procalcitonin in identifying bacterial co-infections in hospitalized COVID-19 patients and quantify antibiotic prescribing during the 2020 pandemic surge. Hospitalized COVID-19 patients with both a procalcitonin test and blood or respiratory culture sent on admission were included in this retrospective study. Confirmed co-infection was determined by an infectious diseases specialist. In total, 819 patients were included; 335 (41%) had an elevated procalcitonin (>0.5 ng/mL) and of these, 42 (13%) had an initial bacterial co-infection. Positive predictive value of elevated procalcitonin for co-infection was 13% while the negative predictive value was 94%. Ninety-six percent of patients with an elevated procalcitonin received antibiotics (median 6 days of therapy), compared to 82% with low procalcitonin (median 4 days of therapy) (adjusted OR:3.3, P < 0.001). We observed elevated initial procalcitonin in many COVID patients without concurrent bacterial co-infections which potentially contributed to antibiotic over-prescribing.

Post-severe Acute Respiratory Syndrome Coronavirus 2 Monoclonal Antibody Treatment Hospitalizations as a Sentinel for Emergence of Viral Variants in New York City.

We partnered with the US Department of Health and Human Services to treat high-risk, nonadmitted coronavirus disease 2019 (COVID-19) patients with bamlanivimab in the Bronx, New York per Emergency Use Authorization criteria. Increasing posttreatment hospitalizations were observed monthly between December 2020 and March 2021 in parallel to the emergence of severe acute respiratory syndrome coronavirus 2 variants in New York City.

Comparing stigmatizing attitudes toward anorexia nervosa, binge-eating disorder, avoidant-restrictive food intake disorder, and subthreshold eating behaviors in college students.

OBJECTIVE: The relative stigmatization of various eating disorders (ED) remains understudied, and there is no research examining stigma toward avoidant-restrictive food intake disorder (ARFID) or adult picky eating. The present study examined the relative stigmatization of various EDs and the subthreshold eating behaviors that are risk factors for their development, and the relation of gender differences to stigma. METHOD: A sample of 1147 college students was recruited and completed the study online. Participants were randomized and presented with a vignette representing a clinical ED [anorexia nervosa (AN), binge-eating disorder (BED), ARFID] or a subthreshold eating presentation (restrained eating, emotional eating, picky eating). Participants completed measures of stigma and perceived psychopathology. A 6 (target eating behavior) × 2 (target gender) × 2 (participant gender) MANOVA and subsequent ANOVAs were employed. RESULTS: Measures of stigma revealed significant main effects for eating presentation and participant gender. There were also significant interactions between eating presentation and participant gender. Men reported more stigmatizing views toward BED and AN compared to women. Overall, restraint was stigmatized less than the other targets, and AN received the greatest amount of stigma. Participants rated BED and AN as more pathological than all other targets, emotional eating and ARFID as more pathological than picky eating and restrained eating, and restrained eating as less pathological than all other targets. CONCLUSIONS: Future research should explore how the severity of eating behavior influences perceptions and at what level behaviors such as restriction are recognized as disordered.

An ecological momentary assessment of weight stigma among weight loss participants.

This investigation explored experiences of weight stigma using momentary, real-time diary assessments among adults seeking weight loss treatment. In total, 51 participants completed diary assessments of weight stigmatizing events and reported how they felt and coped with each incident. Experiencing stigma was significantly associated with fewer positive and greater negative emotions. There was a significant inverse relationship between using positive self-talk and feeling numb and a positive relationship between using isolation/avoidance coping and feeling depressed, ashamed, and less happy. The significant negative momentary impacts of weight stigma likely contribute to the long-term negative consequences of experiencing weight stigma.

A daily diary study of internalised weight bias and its psychological, eating and exercise correlates.

OBJECTIVE: The current investigation extends ecological momentary assessment (EMA) and daily diary weight stigma research in internalised weight bias (IWB). This investigation used daily diaries to examine the relationship between IWB, mood, coping, body appreciation, exercise behaviours and eating behaviours. DESIGN: The study sample consisted of individuals who were overweight or obese (85% female) with MBMI = 36.0, SDBMI = 6.2. Participants completed a daily diary each evening and wore a Fitbit for 30 days. MAIN OUTCOME MEASURES: Participants reported on IWB, mood, coping, body appreciation, exercise behaviours and eating behaviours. RESULTS: Both within- and between-subjects IWB were significantly related to positive affect, negative affect, several coping responses, body appreciation, eating behaviours and the urge to avoid exercise. Exploratory analyses indicated that positive and negative affect mediated many of the associations between IWB and coping responses, body appreciation, and eating and exercise behaviours. CONCLUSION: This investigation provides evidence that IWB experiences have daily impacts on psychological well-being, body appreciation, coping, eating and exercise behaviours. Also, this study raises awareness about IWB and its potential impact on psychological well-being and health behaviours.

A novel stepped-care approach to weight loss: The role of self-monitoring and health literacy in treatment outcomes.

OBJECTIVES: The aims of the current study were twofold: 1) examine the effectiveness of an innovative three-step, stepped-care behavioral weight loss treatment, and 2) examine factors that contribute to poor weight loss outcomes and the need for more intensive treatment. METHODS: The total sample for the study consisted of 53 individuals (87% female) with MBMI=35.6, SDBMI=6.4. A three-step, stepped-care treatment approach was implemented over six months. Step 1 included the Diabetes Prevention Program manual adapted for self-administration augmented with monitoring technology shown to facilitate weight loss and participant accountability and engagement. Participants who were unsuccessful at achieving established weight loss goals received stepped-up treatments in 2-month increments beginning at month 2. The stepped progression included the addition of meal replacement at Step 2 and individual counseling concurrent with meal replacement at Step 3. RESULTS: Un-stepped and once stepped participants lost a clinically significant amount of weight (i.e., >5%), while twice stepped participants lost an insignificant amount of weight. Twice stepped participants were significantly lower in health literacy and self-monitoring frequency. CONCLUSIONS: In this investigation, approximately 60% of the participants were able to lose a clinically significant amount of weight utilizing a minimally intensive intervention with little additional support. Regular self-monitoring and high health literacy proved to be significant correlates of success.

Facial attractiveness, weight status, and personality trait attribution: The role of attractiveness in weight stigma.

The current study examined the influence of facial attractiveness and weight status on personality trait attributions (e.g., honest, friendly) among more and less facially attractive as well as thin and overweight models. Participants viewed pictures of one of four types of models (overweight/less attractive, overweight/more attractive, thin/less attractive, thin/more attractive) and rated their attractiveness (facial, body, overall) and personality on 15 traits. Facial attractiveness and weight status additively impacted personality trait ratings. In mediation analyses, the facial attractiveness condition was no longer associated with personality traits after controlling for perceived facial attractiveness in 12 personality traits. Conversely, the thin and overweight condition was no longer associated with personality traits after controlling for perceived body attractiveness in only 2 personality traits. Post hoc moderation analysis indicated that weight status differently influenced the association between body attractiveness and personality trait attribution. Findings bear implications for attractiveness bias, weight bias, and discrimination research.

A randomized trial comparing two approaches to weight loss.

Weight loss programs evidence considerable variability in treatment outcomes, and weight regain is common, signaling the need for the refinement of effective treatments. This study compared the recently developed Transforming Your Life program to the Diabetes Prevention Program, considered the "Gold Standard" in behavioral weight loss treatment. A total of 98 participants (Transforming Your Life = 51; Diabetes Prevention Program = 47) were randomized to the two weight loss interventions. The Transforming Your Life program and Diabetes Prevention Program produced comparable weight loss and maintenance outcomes. Individuals may benefit from engagement in the Transforming Your Life program, if they are searching for a somewhat novel approach to losing weight other than that offered by the Diabetes Prevention Program.

Changes in weight bias and perceived employability following weight loss and gain.

BACKGROUND: The present weight stigma study examined whether attitudes toward and employability of a normal weight person can change after learning that the person had been obese. METHODS: Participants (N = 154) viewed an image of a normal weight woman and rated their impression of her. Next, participants rated their impression of her overweight image after learning how she had previously gained and subsequently lost weight. RESULTS: Participants rated the model far less favorably including perceived employability if they thought the once overweight model lost weight through surgery vs. diet and exercise. How the model initially gained the weight had little impact on participant ratings. CONCLUSIONS: Surgical weight loss had a significant impact on personality judgments. These negative views extended to hiring decisions.

The moderating effect of gender on ideal-weight goals and exercise dependence symptoms.

Background and aims Exercise dependence is implicated in the development of eating disorders and muscle dysmorphic disorder. Although conceptually these disorders represent similar pathologies they largely affect different genders and result in opposite body composition, appearance, and ideal-weight goals (i.e., to gain or lose/maintain weight). Therefore, understanding individuals' ideal-weight goals related to engaging in exercise while simultaneously examining gender differences in exercise dependence symptoms may help to identify those whom may be most at-risk for eating disorders and muscle dysmorphic disorder. The purpose of our study was to examine the moderating effect of gender for exercise dependence symptoms in relation to weight gain, loss, or maintenance goals. Methods Self-reported exercise behavior and exercise dependence symptoms (i.e., Exercise Dependence Scale) were assessed in 513 undergraduate students. Results Our analysis revealed a moderating effect for gender on ideal-weight goals and a gender difference in exercise dependence symptoms. Specifically, men who were dissatisfied with their current weight reported more exercise dependence symptoms than women. Conclusions These results support a growing body of research and extend our understanding of the relationships among exercise dependence and gender specific body-focused psychiatric disorders.

Biosynthetic pathway and gene cluster analysis of curacin A, an antitubulin natural product from the tropical marine cyanobacterium Lyngbya majuscula.

Curacin A (1) is a potent cancer cell toxin obtained from strains of the tropical marine cyanobacterium Lyngbya majuscula found in Curaçao. Its structure is unique in that it contains the sequential positioning of a thiazoline and cyclopropyl ring, and it exerts its potent cell toxicity through interaction with the colchicine drug binding site on microtubules. A series of stable isotope-labeled precursors were fed to cultures of curacin A-producing strains and, following NMR analysis, allowed determination of the metabolic origin of all atoms in the natural product (one cysteine, 10 acetate units, two S-adenosyl methionine-derived methyl groups) as well as several unique mechanistic insights. Moreover, these incorporation experiments facilitated an effective gene cloning strategy that allowed identification and sequencing of the approximately 64 kb putative curacin A gene cluster. The metabolic system is comprised of a nonribosomal peptide synthetase (NRPS) and multiple polyketide synthases (PKSs) and shows a very high level of collinearity between genes in the cluster and the predicted biochemical steps required for curacin biosynthesis. Unique features of the cluster include (1) all but one of the PKSs are monomodular multifunctional proteins, (2) a unique gene cassette that contains an HMG-CoA synthase likely responsible for formation of the cyclopropyl ring, and (3) a terminating motif that is predicted to function in both product release and terminal dehydrative decarboxylation.