Are drinkers implicitly positive about drinking alcohol? Personalizing the alcohol-IAT to reduce negative extrapersonal contamination

AIMS: The advent of indirect measures, such as the Implicit Association test (IAT), has stimulated interest in implicit cognitions that may automatically steer addictive behaviours such as alcohol abuse. Counter-intuitively, recent IAT research has demonstrated that alcohol is implicitly associated with negative valence, regardless of the level of alcohol consumption. However, because the IAT is susceptible to extrapersonal contamination, this study examined whether previous findings reflect contamination of IAT effects by negative extrapersonal knowledge rather than personal associations with alcohol. METHODS: Implicit alcohol associations were measured with a personalized alcohol-IAT, designed to reduce extrapersonal contamination. Whether alcohol associations measured with the personalized IAT would predict drinking behaviour above the variance explained by self-reported alcohol-related expectancies and attitude was examined. RESULTS: In contrast to previous findings with the IAT, the personalized IAT yielded positive associations. Moreover, positive alcohol associations predicted drinking behaviour above self-reported alcohol expectancies and attitudes, demonstrating the incremental validity of the personalized IAT. CONCLUSIONS: The present findings support the hypothesis that previous findings with the alcohol-IAT at least partly reflect negative extrapersonal alcohol-related knowledge, and that implicit alcohol associations are positive rather than negative.     

Preexisting Insulin Autoantibodies Predict Efficacy of Otelixizumab in Preserving Residual β-Cell Function in Recent-Onset Type 1 Diabetes

OBJECTIVE

Immune intervention trials in recent-onset type 1 diabetes would benefit from biomarkers associated with good therapeutic response. In the previously reported randomized placebo-controlled anti-CD3 study (otelixizumab; GlaxoSmithKline), we tested the hypothesis that specific diabetes autoantibodies might serve this purpose.

RESEARCH DESIGN AND METHODS

In the included patients (n = 40 otelixizumab, n = 40 placebo), β-cell function was assessed as area under the curve (AUC) C-peptide release during a hyperglycemic glucose clamp at baseline (median duration of insulin treatment: 6 days) and every 6 months until 18 months after randomization. (Auto)antibodies against insulin (I[A]A), GAD (GADA), IA-2 (IA-2A), and ZnT8 (ZnT8A) were determined on stored sera by liquid-phase radiobinding assay.

RESULTS

At baseline, only better preserved AUC C-peptide release and higher levels of IAA were associated with better preservation of β-cell function and lower insulin needs under anti-CD3 treatment. In multivariate analysis, IAA (P = 0.022) or the interaction of IAA and C-peptide (P = 0.013) independently predicted outcome together with treatment. During follow-up, good responders to anti-CD3 treatment (i.e., IAA⁺ participants with relatively preserved β-cell function [≥25% of healthy control subjects]) experienced a less pronounced insulin-induced rise in I(A)A and lower insulin needs. GADA, IA-2A, and ZnT8A levels were not influenced by anti-CD3 treatment, and their changes showed no relation to functional outcome.

CONCLUSIONS

There is important specificity of IAA among other diabetes autoantibodies to predict good therapeutic response of recent-onset type 1 diabetic patients to anti-CD3 treatment. If confirmed, future immune intervention trials in type 1 diabetes should consider both relatively preserved functional β-cell mass and presence of IAA as inclusion criteria.     

Spontaneous extradural hematoma as a presentation of sinusitis: case report and literature review

Spontaneous extradural hematoma is rarely mentioned in literature as intracranial complications of sinusitis. The authors presented a girl with spontaneous extradural hematoma secondary to pansinusitis and reviewed the literature. In a child with spontaneous extradural hematoma without a history of head trauma, sinusitis should be excluded.     

Specificity of the failure to inhibit responses in overweight children

Poor response inhibition has been associated with obesity, excessive food intake, and other consumptive behaviours, including alcohol use. However, the correlation between obesity and addictive behaviours like alcoholism is low: people who are obese appear to have a specific problem in restraining food intake. This would imply that obese people have more difficulties in inhibiting responses towards food, compared to other rewarding stimuli. In the present study 89 children (ages 7-9) were tested with the stop signal task, in which responses towards food pictures or toy pictures had to be inhibited. Results showed that children were less effective in inhibiting responses towards food and percentage overweight predicted a lower ability to inhibit responses in general. When dichotomizing the sample in overweight and lean children, it appeared that overweight children were specifically less effective in inhibition towards food cues, compared to lean children. In conclusion: The results confirm weight related inhibitory problems and might explain the increased overeating to food cues in overweight children, as reported in the literature.     

A delicious fly in the soup. The relationship between disgust, obesity, and restraint

Disgust is a core emotion that serves to protect one from engaging in activities that promote contamination and contracting disease. Since disgust is intimately connected to ingesting food, disgust sensitivity is probably also associated with dietary habits. The aim of the present study was to examine the relationship between obesity and disgust and between restraint and disgust. Participants (n=135, all female) were recruited and tested via the Internet. They indicated their desire to eat high-calorie foods and filled out several questionnaires assessing restrained eating and disgust sensitivity. We hypothesized that more restrained eaters would show increased disgust and that women with a higher BMI would show decreased disgust, which is what we found; that is, more restrained eaters showed increased core disgust and contamination disgust, whereas women with a higher BMI showed decreased core disgust and contamination disgust. Hence, feeling disgusted by food may be a strategy to uphold restraint, whereas relatively decreased disgust could encourage overeating.     

Influence of CYP2C19 genotype on the pharmacokinetics of R483, a CYP2C19 substrate, in healthy subjects and type 2 diabetes patients

Objectives  

R483 is a thiazolidinedione peroxisome proliferator-activated receptor gamma (PPARγ) agonist with anti-diabetic properties and also a cytochrome P450 2C19 (CYP2C19) substrate. The aim of the clinical studies reported here was to investigate the influence of the CYP2C19 genotype on the pharmacokinetics (PK) of R483 in healthy subjects and in type 2 diabetes mellitus (T2DM) patients.     

Prenatal anatomical imaging in fetuses with congenital diaphragmatic hernia

The role of prenatal ultrasound and magnetic resonance imaging in the diagnosis and management of congenital diaphragmatic hernia (CDH) is reviewed. Topics include morphologic imaging and vascular assessment of the developing lung, the value of imaging parameters as prognostic predictors in CDH and the role of imaging following percutaneous fetoscopic endoluminal tracheal occlusion.     

Response Inhibition Moderates the Relationship Between Implicit Associations and Drinking Behavior

Background:  Contemporary dual-process models of alcohol abuse propose that alcohol abuse develops because of dysfunctions in the impulsive system, which generates automatic impulses to drink alcohol, and disruptions in the reflective system, which becomes unable to inhibit the influence of these automatic impulses. Based on these insights, this study investigated whether individual differences in the ability of the reflective system to exert response inhibition moderate the relationship between automatic cognitive processes and drinking behavior. Specifically, it was examined whether the interaction between implicit alcohol-related associations and response inhibition predicted drinking behavior.
Methods:  Seventy-one university students completed the study online via the Internet. Implicit alcohol associations with positive affect and with arousal were assessed with variants of the Implicit Association Test. Response inhibition was measured using the original Stroop task. Participants also reported their weekly alcohol use and alcohol-related problems.
Results:  As predicted, implicit associations were unrelated to drinking behavior when response inhibition was high. In contrast, when response inhibition was low, stronger implicit associations between alcohol and positive affect predicted increased alcohol use and alcohol-related problems.
Conclusions:  These findings indicate that the relationship between automatic cognitive processes, originating in the impulsive system, and drinking behavior depends on individual differences in response inhibition exerted by the reflective system. As prolonged alcohol abuse is known to impair response inhibition, alcohol abusers may benefit from interventions that increase response inhibition, thereby restoring inhibitory control over automatic impulses.     

Fungal β-1,3-Glucan Increases Ofloxacin Tolerance of Escherichia coli in a Polymicrobial E. coli/Candida albicans Biofilm

In the past, biofilm-related research has focused mainly on axenic biofilms. However, in nature, biofilms are often composed of multiple species, and the resulting polymicrobial interactions influence industrially and clinically relevant outcomes such as performance and drug resistance. In this study, we show that Escherichia coli does not affect Candida albicans tolerance to amphotericin or caspofungin in an E. coli/C. albicans biofilm. In contrast, ofloxacin tolerance of E. coli is significantly increased in a polymicrobial E. coli/C. albicans biofilm compared to its tolerance in an axenic E. coli biofilm. The increased ofloxacin tolerance of E. coli is mainly biofilm specific, as ofloxacin tolerance of E. coli is less pronounced in polymicrobial E. coli/C. albicans planktonic cultures. Moreover, we found that ofloxacin tolerance of E. coli decreased significantly when E. coli/C. albicans biofilms were treated with matrix-degrading enzymes such as the β-1,3-glucan-degrading enzyme lyticase. In line with a role for β-1,3-glucan in mediating ofloxacin tolerance of E. coli in a biofilm, we found that ofloxacin tolerance of E. coli increased even more in E. coli/C. albicans biofilms consisting of a high-β-1,3-glucan-producing C. albicans mutant. In addition, exogenous addition of laminarin, a polysaccharide composed mainly of poly-β-1,3-glucan, to an E. coli biofilm also resulted in increased ofloxacin tolerance. All these data indicate that β-1,3-glucan from C. albicans increases ofloxacin tolerance of E. coli in an E. coli/C. albicans biofilm.     

Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy

This review provides an overview of results found in literature on objective measurements of upper limb movements in children with hemiplegic cerebral palsy (HCP). Seventeen articles were selected following a systematic search. Analysed tasks varied from simple reaching and gross motor functions to complex, fine motor tasks. Spatiotemporal characteristics have been extensively studied and longer movement durations, slower movement speed and reduced trajectory straightness at the affected upper limb, compared to the non-affected side or healthy children, were most frequently reported. Joint kinematics has been far less studied. The limited data confirm the clinical impression of children with HCP using less elbow extension and supination to reach for an object, which is compensated by increased trunk flexion. Increased trunk involvement was also reported during gross motor functions. Although three-dimensional (3D) movement analysis seems promising to provide additional insights in the pathological upper limb movements observed in HCP, future standardisation of the entire protocol is crucial. No consensus exists on the procedures for data collection, processing, analysing and reporting of results, or what upper limb tasks should be assessed. The International Society of Biomechanics recently proposed recommendations on the definition of upper limb joint coordinate systems and rotation sequences. These guidelines were not yet applied in these studies. Although the diverse methodological approaches used in the studies complicate the comparison of published results, some general conclusions could be drawn. A further standardisation of the protocol for 3D upper limb movement analysis will provide the foundation for comparable and repeatable results and eventually facilitate the selection and planning of treatment interventions.