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Bacterial infections remain one of the main complications in cirrhosis and worsen patients' prognosis and quality of life. An increase in multidrug resistant microorganism (MDRM) infections among patients with cirrhosis, together with infection-related mortality rates, have been reported in recent years. Therefore, adaptation of the initial empiric antibiotic approach to different factors, particularly the local epidemiology of MDRM infections, has been recommended. We aim to describe the main features, outcomes and risk factors of MDRM infections in patients with cirrhosis.Prospective registry of all episodes of in-hospital infections occurring among cirrhotic patients admitted within a 2-year period at a single center. Clinical and microbiological data were collected at the time of infection diagnosis, and the in-hospital mortality rate of the infectious episode was registered.A total of 139 infectious episodes were included. The disease-causing microorganism was identified in 90 episodes (65%), of which 31 (22%) were caused by MDRM. The only two factors independently associated with MDRM infections were rectal colonization by MDRM and a nosocomial or healthcare-associated source. The infection-related mortality rate was 18.7%. MDRM infection and a past history of hepatic encephalopathy were independently associated with in-hospital mortality.Almost one fourth of bacterial infections occurring in admitted cirrhotic patients were due to MDRM. Rectal colonization was the most important risk factor for MDRM infections in decompensated cirrhosis. Screening for MDRM rectal colonization in patients admitted for decompensated cirrhosis should be assessed as a tool to improve local empiric antibiotic strategies.

Objective Automated digital interventions (ADIs) represent a potentially promising approach to enhance the outcomes of human coach-delivered weight loss interventions. However, the extent to which ADIs provide additive benefit is unclear. This study represents the first systematic review and meta-analysis of the effectiveness of ADIs for improving the outcomes of human coach-delivered weight loss treatment. Method Electronic database searches were used to identify trials that compared differences in weight change between (a) weight loss interventions that were delivered exclusively by coaches and (b) interventions supplementing this same human coaching with an ADI. Subgroup and moderator analyses examined the influence of intervention duration, duration of human coach contact, presence of tailored coaching, modality of the ADI and demographic variables on ADI effectiveness outcomes. Results Thirteen studies met inclusion criteria (1,471 participants). Random-effects meta-analysis revealed a mean difference in weight change between conditions of 2.18 kg at postintervention, representing a medium effect size of .54 (95% CI [.13, .95]). Subgroup analyses suggested that lower duration of coach contact was associated with improved additive effectiveness of ADIs. No other subgroup differences were found. Publication bias appeared to be a potential concern, though high levels of heterogeneity and a small number of included studies likely limited the ability to infer its presence. Conclusions Results support the use of ADIs to augment coach-delivered behavioral weight loss treatment, and also suggest that ADIs have the greatest impact when coaching is relatively low in frequency or duration. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Body dissatisfaction is ubiquitous in our society and leads to eating disorders. Longitudinal research suggests that higher body dissatisfaction predicts higher negative affect and unhealthy weight control behaviors over time. However, no study has assessed how body dissatisfaction impacts affect and weight control behaviors in the moment. In the current study, we examined the momentary relationships between body dissatisfaction, affect and weight control behaviors using ecological momentary assessment. Female college students (N = 67) completed measures of state body dissatisfaction, affect, and weight control behaviors across fourteen days using ecological momentary assessment. Greater body dissatisfaction significantly predicted lower subsequent positive affect and higher subsequent negative affect, but positive and negative affect did not predict subsequent body dissatisfaction. Daily average body dissatisfaction was not significantly associated with daily engagement in either healthy or unhealthy weight control behaviors. Short-term negative effects of body dissatisfaction on affect were apparent. Targeting body dissatisfaction may be important for improving affect. Level IV, multiple time series without intervention.

Higher trait mindfulness (i.e., bringing one’s attention to the present moment with an attitude of acceptance and non-judgment) is associated with lower eating disorder (ED) psychopathology. However, it is not yet clear how mindfulness results in lower ED psychopathology. One possibility is that mindfulness may decrease body checking, particularly in individuals who are high in ED psychopathology. The current study tests the relationships between mindfulness facets and body checking, and the extent to which these relationships are moderated by ED psychopathology. College students (N = 805, 76.7% female, mean age = 20.0) completed the Five-Facet Mindfulness Questionnaire, the Body Checking Questionnaire, and the Eating Disorder Examination Questionnaire electronically. Higher acting with awareness, non-judging, and non-reactivity were uniquely associated with lower body checking, whereas higher observing was uniquely associated with higher body checking. The relation between non-judging and body checking was stronger for individuals who were higher in ED psychopathology. All mindfulness facets, except describing, show potential as processes that can be altered to reduce body checking, particularly for individuals higher in ED psychopathology.

Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5years, 40.9% had hepatitis C, 75% had Child-Pugh A, and 85% were Barcelona Clinic Liver Cancer-C. The median time to first dose modification, treatment duration and overall survival rate were 2.4months (interquartile ranges [IQR], 0.8-3.8), 10.8months (IQR, 4.5-16.9), and 17.5months (95% CI, 7.2-24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group-Performance Status and diarrhoea. At the time of death or last follow-up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib-related, and 2 were non-sorafenib-related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non-dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis.

Objective Eating disorders (EDs) are characterized by significant anxiety during mealtime that contributes to food avoidance and weight loss. Individuals with EDs commonly use avoidance coping (e.g., distraction) to tolerate meals and comply with meal plans. Although this strategy may be effective short term, a large body of anxiety literature suggests that avoidance can lead to worsening of psychological symptoms long term. Method The current study (N = 66 individuals diagnosed with ED) used ecological momentary assessment (EMA) to examine the short-term and long-term associations of avoidance coping on ED symptoms. Results Distraction during meals predicted a reduction in anxiety in the short term, and both distraction and avoidance of emotions predicted increases in excessive exercise in the short term. Distraction and avoidance of emotions predicted increases in bulimic symptoms 1 month after completion of EMA. Discussion These results are consistent with prior literature on avoidance and suggest that avoidance coping during meals may contribute to the increase of ED behaviors in the long term. Coping strategies that encourage approach and tolerance of difficult thoughts and emotions (e.g., acceptance-based strategies) rather that avoidance coping may promote longer-term symptom reduction.

Altres ajuts: acords transformatius de la UAB Background & Aims: Alcoholic hepatitis (AH) is associated with a high incidence of infection and mortality. Rifaximin reduces bacterial overgrowth and translocation. We aimed to study whether the administration of rifaximin as an adjuvant treatment to corticosteroids decreases the number of bacterial infections at 90 days in patients with severe AH compared to a control cohort. Methods: This was a multicentre, open, comparative pilot study of the addition of rifaximin (1200 mg/day/90 days) to the standard treatment for severe AH. The results were compared with a carefully matched historical cohort of patients treated with standard therapy and matching by age and model of end-stage liver disease (MELD). We evaluated bacterial infections, liver-related complications, mortality and liver function tests after 90 days. Results: Twenty-one and 42 patients were included in the rifaximin and control groups respectively. No significant baseline differences were found between groups. The mean number of infections per patient was 0.29 and 0.62 in the rifaximin and control groups, respectively (p =.049), with a lower incidence of acute-on-chronic liver failure (ACLF) linked to infections within the treatment group. Liver-related complications were lower within the rifaximin group (0.43 vs. 1.26 complications/patient respectively) (p =.01). Mortality was lower in the treated versus the control groups (14.2% vs. 30.9, p =.15) without significant differences. No serious adverse events were associated with rifaximin treatment. Conclusions: Rifaximin is safe in severe AH with a significant reduction in clinical complications. A lower number of infections and a trend towards a lower ACLF and mortality favours its use in these patients.

Eating disorders are characterized by high levels of anxiety, especially while eating. However, little is known about anxiety experienced during meals and specifically what other variables may impact such anxiety. We sought to further quantify and understand the relationship between food anxiety, eating disorders, and related correlates (e.g., comorbid diagnoses, personality). In the current study [N = 42 participants diagnosed with an eating disorder (n = 36 participants with anorexia nervosa)], we quantified anxiety before, during, and after a meal using data from a food exposure session in a partial hospital eating disorder center. We examined diagnostic, personality, and clinical factors as correlates of food anxiety. Participants were more likely to experience higher food anxiety if they had a current diagnosis of major depression, obsessive–compulsive disorder, or post-traumatic stress disorder (PTSD). Concern over mistakes was the strongest and most consistent correlate of food anxiety regardless of time during the meal that anxiety was assessed. Other significant correlates were fear of positive evaluation, social appearance anxiety, BMI, and trust. These findings show how diagnoses, perfectionism (concern over mistakes), and other correlates relate to anxiety during meals. Food exposure interventions may benefit from personalizations that address these factors. IV Evidence from a randomized control trial, but from the first session before effects of the design would be present.

Background: The main pediatric liver tumors are hepatoblastoma (HB) and, to a lesser extent, pediatric hepatocellular carcinoma (HCC). HB appears at an early age (8 years) or adolescents and it is usually associated to underlying metabolic diseases. HEM-NOS (Hepatocellular malignant neoplasm, not otherwise specified) is a recent entity with histopathological features of HB and HCC. Due to the rarity of the disease ( Citation Format: Juan Carrillo-Reixach, Álvaro del Río-Álvarez, Laura Royo, Montserrat Domingo-Sàbat, Rita Alaggio, Ronald de Krijger, Christian Vokuhl, Marta Garrido, Laura Guerra, Constantino Sábado, Francisco Hernández, Manuel López-Santamaría, Viera Bajčiová, Rudolf Maibach, Margaret Childs, Piotr Czauderna, Keith Wheatley, Roland Kappler, Stefano Cairo, Bruce Morland, Margarita Sala, Maria Rosa Sarrias, Carolina Armengol. Molecular characterization of pediatric hepatocellular carcinoma: genomic, methylomic and transcriptomic analysis [abstract]. In: Proceedings of the AACR Special Conference: Advances in the Pathogenesis and Molecular Therapies of Liver Cancer; 2022 May 5-8; Boston, MA. Philadelphia (PA): AACR; Clin Cancer Res 2022;28(17_Suppl):Abstract nr PO010.

[Background & Aims] The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic., [Methods] An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave., [Results] Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37)., [Conclusions] The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making., [Lay summary] The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

INTRODUCTION: Obeticholic acid (OCA) and fibrates therapy results in biochemical improvement in placebo-controlled trials in patients with primary biliary cholangitis and insufficient response to ursodeoxycholic acid. There is scarce information outside of clinical trials. Therefore, we have assessed the effectiveness and adverse events of these treatments. METHODS: Data from patients included in the ColHai registry treated with OCA, fibrates, or both were recorded during a year, as well as adverse events and treatment discontinuation. RESULTS: Eighty-six patients were treated with OCA, 250 with fibrates (81% bezafibrate; 19% fenofibrate), and 15 with OCA plus fibrates. OCA group had baseline significantly higher alkaline phosphatase (ALP) (P = 0.01) and lower platelets (P = 0.03) than fibrates. Both treatments significantly decreased ALP, gamma-glutamyl transferase (GGT), and transaminases and improved Globe score. Albumin and immunoglobulin type M improved in the fibrates group. ALP decrease was higher under fibrates, whereas alanine aminotransferase decline was higher under OCA. Although baseline transaminases and GGT were higher in patients with OCA plus fibrates, significant ALP, GGT, alanine aminotransferase, and Globe score improvement were observed during triple therapy. Adverse events were reported in 14.7% of patients (21.3% OCA; 17.6% fenofibrate; 10.7% bezafibrate), mainly pruritus (10.1% with OCA). Discontinuation was more frequent in fenofibrate treatment mainly because of intolerance or adverse events. DISCUSSION: Second-line therapy with OCA or fibrates improves hepatic biochemistry and the GLOBE score in primary biliary cholangitis patients with suboptimal response to ursodeoxycholic acid. Simultaneous treatment with OCA and fibrates improved ALP as well.

Body dissatisfaction is ubiquitous in our society and leads to eating disorders. Longitudinal research suggests that higher body dissatisfaction predicts higher negative affect and unhealthy weight control behaviors over time. However, no study has assessed how body dissatisfaction impacts affect and weight control behaviors in the moment. In the current study, we examined the momentary relationships between body dissatisfaction, affect and weight control behaviors using ecological momentary assessment.Female college students (N = 67) completed measures of state body dissatisfaction, affect, and weight control behaviors across fourteen days using ecological momentary assessment.Greater body dissatisfaction significantly predicted lower subsequent positive affect and higher subsequent negative affect, but positive and negative affect did not predict subsequent body dissatisfaction. Daily average body dissatisfaction was not significantly associated with daily engagement in either healthy or unhealthy weight control behaviors.Short-term negative effects of body dissatisfaction on affect were apparent. Targeting body dissatisfaction may be important for improving affect.Level IV, multiple time series without intervention.

Objective Outcome variables gauging the frequency of specific disordered eating behaviors (e.g., binge eating, vomiting) are common in the study of eating and health behaviors. The nature of such data presents several analytical challenges, which may be best addressed through the application of underutilized statistical approaches. While zero-sensitive models are well-supported by methodologists, application of these models has yet to gain traction among a widespread audience of researchers who study eating-related behaviors. The current study examined several approaches to predicting count-based behaviors, including zero-sensitive (i.e., zero-inflated and hurdle) regression models. Method Exploration of alternative models to predict eating-related behaviors occurred in two parts. In Part 1, participants (N = 524; 54% female) completed the Eating Disorder Examination-Questionnaire and Daily Stress Inventory. We considered the theoretical basis and practical utility of several alternative approaches for predicting the frequency of binge eating and compensatory behaviors, including ordinary least squares (OLS), logistic, Poisson, negative binomial, and zero-sensitive models. In Part 2, we completed Monte Carlo simulations comparing negative binomial, zero-inflated negative binomial, and negative binomial hurdle models to further explore when these models are most useful. Results Traditional OLS regression models were generally a poor fit for the data structure. Zero-sensitive models, which are not limited to traditional distribution assumptions, were preferable for predicting count-based outcomes. In the data presented, zero-sensitive models were useful in modeling behaviors that were relatively rare (laxative use and vomiting, 9.7% endorsed) along with those that were somewhat common (binge eating, 33.4% endorsed; driven exercise, 40.7% endorsed). Simulations indicated missing data, sample size, and the number of zeros may impact model fit. Discussion Zero-sensitive approaches hold promise for answering key questions about the presence and frequency of common eating-related behaviors and improving the specificity of relevant statistical models. The current manuscript provides practical guidance to aid the use of these models when studying eating-related behaviors.

Resumen El carcinoma hepatocelular (CHC) es el sexto tumor mas frecuente con mas de 740.000 casos nuevos cada ano y constituye la tercera causa de muerte por neoplasia, habiendose descrito un aumento de su incidencia en los ultimos anos. Este tumor se desarrolla generalmente en pacientes con una enfermedad hepatica cronica subyacente. En las 2 ultimas decadas se ha producido un avance en su tratamiento: los pacientes de riesgo se incluyen en un programa de cribado, se ha desarrollado un sistema de estadificacion pronostica y finalmente han surgido nuevos tratamientos, sobre todo para aquellos pacientes con CHC avanzado. Este hecho ha motivado un mayor interes por este tumor y diversas sociedades cientificas han elaborado guias de practica clinica para el tratamiento de estos pacientes. En esta revision presentamos una vision actual y futura de este tumor.

Objective Stress is associated with the maintenance of eating disorders and exercise behaviors. However, it is unclear how stress is associated with exercise and vice-versa among individuals with higher levels of eating disorder symptoms in daily life. The current study tested the moderating effect of eating disorder symptoms on the relationships between: (1) daily stress and later exercise behavior and (2) daily exercise behavior and later stress. Method Female college students [N = 129, mean age = 19.19 (SD = 1.40)] completed the Eating Disorder Inventory-2. Participants then completed measures of stress and exercise four times daily across seven days using an automated telephone ecological momentary assessment system. Data were analyzed using multilevel models. Results Drive for thinness, bulimic symptoms, and body dissatisfaction significantly moderated the relationship between daily stress and later exercise (ps = .01–.05), such that higher daily stress predicted higher later exercise only in individuals who were low (but not average or high) in drive for thinness, bulimic symptoms, and body dissatisfaction symptoms. Discussion Stress is associated with exercise differentially depending on individuals’ eating disorder symptoms. Our findings suggest that only individuals with lower levels of eating disorder symptoms exercise when stressed.

Resumen Antecedentes y objetivo En 2010 publicamos que en Espana el 53% de los carcinomas hepatocelulares (CHC) se diagnostican fuera de programas de cribado, lo que conlleva una menor supervivencia. El objetivo del presente estudio es evaluar la situacion actual y las causas del diagnostico fuera de cribado. Material y metodos Registro prospectivo entre el 1 de octubre de 2014 y el 31 de enero de 2015 en 73 centros asistenciales espanoles de segundo/tercer nivel. Se registraron las caracteristicas basales y el primer tratamiento de los tumores primarios hepaticos incidentales de ese periodo. Resultados Se incluyeron 720 pacientes: CHC (n = 686), colangiocarcinoma intrahepatico (n = 29), hepatocolangiocarcinoma (n = 2), otros (n = 3). Los pacientes con CHC fueron varones en el 82% de los casos; media de 67 anos; cirrosis en el 87%; etiologia: alcohol 35%, VHC 30%, alcohol y VHC 15%, enfermedad hepatica por deposito de grasa 6%; estadio tumoral: BCLC-0 11%, A 43%, B 19%, C 16% y D 11%; tratamiento inicial: quimioembolizacion transarterial (23%), ablacion percutanea (22%), tratamiento sintomatico (20%), reseccion (11%), sorafenib (11%). Se diagnosticaron fuera de cribado 356 pacientes (53%). Los motivos principales fueron la ausencia de diagnostico previo de hepatopatia (76%) y la mala adherencia al cribado (18%). Estos pacientes eran predominantemente varones (p Conclusiones En Espana, la principal causa del diagnostico de CHC fuera del cribado es la ausencia de diagnostico previo de enfermedad hepatica, principalmente en varones con consumo de alcohol. La deteccion de hepatopatia en poblacion asintomatica y la mejora de la adherencia al cribado son los principales aspectos para mejorar la deteccion precoz.

Background & Aims: Hepatoblastoma (HB) is a rare disease. Nevertheless, it is the predominant pediatric liver cancer, with limited therapeutic options for patients with aggressive tumors. Herein, we aimed to uncover the mechanisms of HB pathobiology and to identify new biomarkers and therapeutic targets in a move towards precision medicine for patients with advanced HB. Methods: We performed a comprehensive genomic, transcriptomic and epigenomic characterization of 159 clinically annotated samples from 113 patients with HB, using high-throughput technologies. Results: We discovered a widespread epigenetic footprint of HB that includes hyperediting of the tumor suppressor BLCAP concomitant with a genome-wide dysregulation of RNA editing and the overexpression of mainly non-coding genes of the oncogenic 14q32 DLK1-DIO3 locus. By unsupervised analysis, we identified 2 epigenomic clusters (Epi-CA, Epi-CB) with distinct degrees of DNA hypomethylation and CpG island hypermethylation that are associated with the C1/C2/C2B transcriptomic subtypes. Based on these findings, we defined the first molecular risk stratification of HB (MRS-HB), which encompasses 3 main prognostic categories and improves the current clinical risk stratification approach. The MRS-3 category (28%), defined by strong 14q32 locus expression and Epi-CB methylation features, was characterized by CTNNB1 and NFE2L2 mutations, a progenitor-like phenotype and clinical aggressiveness. Finally, we identified choline kinase alpha as a promising therapeutic target for intermediate and high-risk HBs, as its inhibition in HB cell lines and patient-derived xenografts strongly abrogated tumor growth. Conclusions: These findings provide a detailed insight into the molecular features of HB and could be used to improve current clinical stratification approaches and to develop treatments for patients with HB. Lay summary: Hepatoblastoma is a rare childhood liver cancer that has been understudied. We have used cutting-edge technologies to expand our molecular knowledge of this cancer. Our biological findings can be used to improve clinical management and pave the way for the development of novel therapies for this cancer. (c) 2020 European Association for the Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)., This article was possible thanks to the inputs from the Instituto de Salud Carlos III, ISCIII (PI09/00751, PI10/02082, PI13/02340). The project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 668596 (ChiLTERN) and grant agreement No 826121 (iPC). JCR is supported by the Catalan Agency for Management of University and Research Grants (AGAUR, 2019 FI_B01024). LT is supported by an Accelerator Award (CRUCK, AECC, AIRC) (HUNTER, C9380/A26813). DS is supported by the Gilead Research Scholar in Liver Disease. JML is supported by the European Union's Horizon 2020 research and innovation programme (HEPCAR, 667273-2), Institucio Catalana de Recerca i Estudis Avancats (ICREA), U.S. Department of Defense (CA150272P3), an Accelerator Award (CRUCK, AECC, AIRC) (HUNTER, C9380/A26813), National Cancer Institute, Tisch Cancer Institute (P30-CA196521), Samuel Waxman Cancer Research Foundation, Spanish National Health Institute (SAF2016-76390) and AGAUR (SGR-1358). CA and MRS were supported by Ramon y Cajal (RYC-2010-07249) and Miguel Servet (CPII14/00021) programs of the Ministry of Science and Innovation of Spain and ISCIII, respectively. CA, MRS and MS received funding from CIBERehd (CB06/04/0033) and AGAUR (2017-SGR-490). IGTP is a member of the CERCA network of institutes. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Purpose The relationships between momentary affect and weight control behaviors have been extensively studied in samples of individuals with eating disorders, but we do not know that the established relationships translate to healthy college women. The current study examined the relationship between affect and weight control behaviors in healthy college women. Method Female college students (N = 67) completed measures of negative affect, positive affect, healthy weight control behaviors, and unhealthy weight control behaviors across fourteen days using ecological momentary assessment. Results Average daily negative affect was inversely associated with daily engagement in unhealthy weight control behaviors, but was not associated with healthy weight control behaviors. Average daily positive affect was not associated with daily engagement in healthy or unhealthy weight control behaviors. Conclusion Negative affect was inversely associated with engagement in unhealthy weight control behaviors in this female undergraduate sample. Future studies should continue to elucidate the differences in the relationships in samples of individuals with ED psychopathology vs. healthy samples.

Mindfulness is defined as bringing one's attention to present-moment experience with acceptance, and is associated with engagement in various health behaviours. To synthesise and evaluate this literature, we conducted a comprehensive meta-analytic review and examined (a) the associations between trait mindfulness and health behaviours and (b) the extent to which these associations were moderated by study and individual differences. A total of 125 independent samples were included (

Mindfulness is implicated in eating disorder (ED) psychopathology. However, this literature has not been synthesized to date. The current meta-analysis examined the associations between mindfulness and ED psychopathology.A total of 74 independent samples (effects = 576) were included. We used a multilevel random-effects model to estimate summary study-level effect sizes, and multilevel mixed-effects models to examine moderator effects.Mindfulness was negatively associated with ED psychopathology (r = -.25, p .001), both concurrently (r = -.25, p .001) and prospectively (rs = -.22 to -.24, ps .001). Associations were strongest for binge eating, emotional/external eating, and body dissatisfaction as well as the acting with awareness and nonjudging facets.Mindfulness may be an important process in ED psychopathology. Future research should prospectively and experimentally examine the relation between mindfulness and ED psychopathology.La atención plena (mindfulness) está implicada en la psicopatología de los trastornos de la conducta alimentaria (TCA). Sin embargo, esta literatura no ha sido sintetizada a la fecha. El presente meta-análisis examinó las asociaciones entre la atención plena y la psicopatología de los TCA. MÉTODOS: Se incluyeron un total de 74 muestras independientes (efectos = 576). Utilizamos un modelo de efectos aleatorios multinivel para estimar la síntesis de los tamaños de efecto por nivel de estudio, y los modelos de efecto mixto multinivel para examinar los efectos moderadores.La atención plena fue asociada negativamente con la psicopatología de TCA (r = −.25, p .001), tanto concurrentemente (r = −.25, p .001) como prospectivamente (rs = −.22-−.24, ps .001). Las asociaciones fueron más fuertes para trastorno por atracón, alimentación emocional/externa, e insatisfacción corporal, así como también el actuar con conciencia y sin juzgar las facetas. DISCUSIÓN: La atención plena (mindfulness) puede ser un proceso importante en la psicopatología de los TCA.

Marino, Z., Darnell, A., Lens, S., Sapena, V., Diaz, A., Belmonte, E., Perello, C., Calleja, J.L., Varela, M., Rodriguez, M., Rodriguez de Lope, C., Llerena, S., Torras, X., Gallego, A., Sala, M., Morillas, R.M., Minguez, B., Llaneras, J., Coll, S., Carrion, J.A., Inarrairaegui, M., Sangro, B., Vilana, R., Sole, M., Ayuso, C., Rios, J., Forns, X., Bruix, J., Reig, M.

Disinhibited eating (i.e., emotional and external eating), as well as associated features such as binge eating, bulimic symptoms, and eating concern are inversely associated with the mindfulness facets of acting with awareness, observing, and non-reactivity. However, it is unclear whether higher mindfulness is a precursor to lower disinhibited eating behaviors and symptoms or whether lower disinhibited eating behaviors and symptoms are a precursor to higher mindfulness (or both). The current study examined if acting with awareness, non-reactivity, and observing (describing and non-judging were not assessed) prospectively predicted several disinhibited eating features (emotional eating, external eating, bulimic symptoms, binge eating, and eating concern) and vice-versa across 6 months. Young adult women (N = 300) completed measures of these constructs at baseline and 6 months later. Non-reactivity inversely predicted binge eating and bulimic symptoms across 6 months. Observing predicted higher external and emotional eating across 6 months. In the opposite direction, disinhibited eating did not predict observing, non-reactivity, or acting with awareness. Interventions focusing on increasing non-reactivity could be effective in preventing and treating binge eating and bulimic symptoms.

Affective judgments of physical activity have emerged as important predictors of physical activity and interventions targeting affective judgments are a promising approach to improving regular physical activity. Currently, measures assessing a variety of potentially distinct constructs are treated as interchangeable assessments of affective judgments of physical activity. Moreover, little is known about the construct validity of the purported measures of this construct. We review several components of construct validity; highlighting their importance for health psychology research. Then, we examine the construct validity of a wide variety of affective judgment of physical activity measures in MTurk and student samples. Cronbach's alpha for the included measures was uniformly high; however, several scales contained excessively redundant items that ultimately lessen their construct validity. Moreover, dependability estimates for the majority of measures was poor, indicating high levels of transient measurement error. The included measures significantly predicted levels of physical activity; however, their relative predictive power was strongly associated with their dependability. In general, the affective judgment measures demonstrated poor convergent validity suggesting they are not interchangeable and best viewed as assessing distinct, albeit related, constructs. Another important limitation of these measures is that they exhibited poor discriminant validity from exercise self-efficacy, which represents an important theoretical and empirical issue for the field of health behavior research. Overall, the current findings indicate the available affective judgments of physical activity measures are suboptimal, have considerable construct validity limitations, and thereby prevent the further advancement of science, theory, and intervention development in this promising area of research. (PsycINFO Database Record

Chromium treatment has been shown to improve glucose regulation in some populations. The purpose of this study was to evaluate whether chromium picolinate (CrPic) supplementation improves glucose regulation in overweight individuals with binge-eating disorder (BED).In this double-blinded randomized pilot trial, participants (N = 24) were randomized to high (HIGH, 1000 mcg/day, n = 8) or moderate (MOD, 600 mcg/day, n = 9) dose of CrPic or placebo (PL, n = 7) for 6 months. Participants completed an oral glucose tolerance test (OGTT) at baseline, 3 months, and 6 months. Fixed effects models were used to estimate mean change in glucose area under the curve (AUC), insulinResults revealed a significant group and time interaction (p0.04) for glucoseAs anticipated, a moderate dose of CrPic was associated with improved glycemic control, whereas PL was associated with decreased glycemic control. It was unexpected that the improved glycemic control seen in the MOD dose group was not seen in the HIGH dose group. However, although participants randomized to the HIGH dose group did not have improved glycemic control, they had better glycemic control than participants randomized to the PL group. These findings support the need for larger trials.

© 2019 The Authors., [Background]: Chronic hepatic inflammation leads to liver fibrosis, which may progress to cirrhosis, a condition with high morbidity. Our aim was to assess the as yet unknown role of innate immunity protein CD5L in liver fibrosis. [Methods]: CD5L was measured by ELISA in plasma samples from cirrhotic (n = 63) and hepatitis (n = 39) patients, and healthy controls (n = 7), by immunohistochemistry in cirrhotic tissue (n = 12), and by quantitative RT-PCR in mouse liver cell subsets isolated by cell sorting. Recombinant CD5L (rCD5L) was administered into a murine model of CCl4-induced fibrosis, and damage, fibrosis and hepatic immune cell infiltration, including the LyC6hi (pro-fibrotic)-LyC6low (pro-resolutive) monocyte ratio were determined. Moreover, rCD5L was added into primary human hepatic stellate cells to study transforming growth factor β (TGFβ) activation responses. [Findings]: Cirrhotic patients showed elevated plasma CD5L concentrations as compared to patients with hepatitis and healthy controls (Mann-Whitney test p, This work was supported by grants from the Fundació la Marató de TV3 (MTV3 2013-3610), AGAUR (2016 PROD 00094, 2017-SGR-490) to MRS, CSIC (PIE-201720E092) and also from the Instituto de Salud Carlos III (ISCIII), and ERDFs from the EU, ‘Una manera de hacer Europa’, (PI10/01565, PI13/1906, PI16/0974, PI13/02340, PI09/00751 and PI17/00673 to MRS, CA, and PS-B, respectively and PI14/00703 to LK). MRS, PS-B, CA, and CB were supported by the Miguel Servet (CPII14/00021; CPII15/00041), Ramón y Cajal (RYC-2010-07249), and Juan de la Cierva (FJCI-2014-20,505) programs, respectively.

Background & Aims: Despite direct-acting antivirals being highly effective at eradicating hepatitis C virus infection, their impact on the development of hepatocellular carcinoma (HCC) remains controversial. We analyzed the clinical and radiological outcome of cirrhotic patients treated with interferon-free regimens to estimate the risk of developing HCC. Methods: This was a retrospective multicenter study focusing on cirrhotic patients treated with direct-acting antivirals until December 2016. Clinical and radiologic characteristics were collected before the start of antiviral therapy, at follow-up and at HCC development. Diagnosis of HCC was centrally validated and its incidence was expressed as HCC/100 person-years. Results: A total of 1,123 patients were included (60.6% males, 83.8% Child-Pugh A) and 95.2% achieved a sustained virologic response. Median time of follow-up was 19.6 months. Seventy-two patients developed HCC within a median of 10.3 months after starting antiviral treatment. HCC incidence was 3.73 HCC/100 person-years (95% CI 2.96-4.70). Baseline liver function, alcohol intake and hepatic decompensation were associated with a higher risk of HCC. The relative risk was significantly increased in patients with non-characterized nodules at baseline 2.83 (95% CI 1.55-5.16) vs. absence of non-characterized nodules. When excluding these patients, the risk remained increased. Conclusion: These data expose a clear-cut time association between interferon-free treatment and HCC. The mechanisms involved in the increased risk of HCC emergence in the short term require further investigation. Lay summary: In this cohort of cirrhotic patients, interferonfree therapies achieved a high rate of sustained virologic response (>95%); however, we reported a risk of de novo hepatocellular carcinoma of 3.73 per 100 person-years and a clearcut time association with antiviral therapy. The time association between starting direct-acting antivirals and developing hepatocellular carcinoma, together with the association with the presence of non-characterized nodules at baseline ultrasound, suggests that antiviral therapy elicits a mechanism (probably immune-related) that primes the growth and clinical recognition of hepatocellular carcinoma early during follow-up. As a result, short-term liver cancer risk is significantly increased. (C) 2019 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver.

Perceived satisfaction with health behavior change is defined as the overall assessment of the various positive and negative experiences and outcomes that result from engaging in the target behavior. Perceived satisfaction is theorized to be a critical predictor of health behavior change maintenance. It is therefore important to understand both (1) determinants of satisfaction and (2) the effect of satisfaction on health behavior change maintenance. This chapter reviews evidence across several different behavioral domains suggesting that perceived satisfaction is an important predictor of health behavior change maintenance. However, evidence to date is not yet clear on why people are satisfied with the changes they make or how best to intervene on this construct.

Background Repetitive negative thinking is a transdiagnostic process that occurs across several psychological disorders, including eating disorders. Individuals with eating disorders have higher levels of repetitive negative thinking than controls, and repetitive negative thinking is associated with eating disorder behaviors. However, no study has measured how momentary repetitive negative thinking may subsequently impact daily eating disorder behaviors and vice-versa. Method In the current study (N = 66, recently treated individuals recruited from an eating disorder treatment center), we examined the relationship between repetitive negative thinking and subsequent eating disorder behaviors and vice-versa using ecological momentary assessment. Results We found that higher momentary repetitive negative thinking predicted higher subsequent weighing and body checking. We also found that higher momentary meal-specific repetitive negative thinking predicted higher subsequent weighing and lower subsequent compensatory behavior. We also found that higher repetitive negative thinking predicted higher eating disorder symptoms at one-month follow-up. Conclusion There are short-term and long-term negative effects of repetitive negative thinking in the eating disorders. Targeting repetitive negative thinking may be important for decreasing eating disorder behaviors.

The aim of this study was to develop fotonovelas, a popular type of graphic novel in the Latino population, to raise awareness and educate about eating disorders (EDs). Four illustrated cartoons and scripts tailored for adults and adolescents of both sexes were presented in focus groups and an in-depth interview. Seventeen Latino adults (14 females; 3 males) and 10 adolescents (9 females; 1 male) participated in the study. Participants found the fotonovelas interesting, and eye-catching than traditional brochures. The use of Spanglish and clarification of differences across EDs were suggested by adolescent females. Male adults suggested changing the title to focus on the health consequences of EDs in order to catch the male attention in reading the story. Based on the receptivity we found in this study, fotonovela could be a promising avenue to raise awareness and to educate the Latino community in the United States about EDs.