Gut peptides before and following Roux-En-Y gastric bypass: A systematic review and meta-analysis

A systematic search was conducted in Medline Ovid, Embase, Scopus, and Cochrane Central Register of Controlled Trials up until March 2021 following PRISMA guidelines. Studies included evaluated ghrelin, GLP-1, PYY or appetite sensation via visual analogue scales (VASs) before and after Roux-en-Y gastric bypass (RYGB) in adults. A multilevel model with random effects for study and follow-up time points nested in study was fit to the data. The model included kcal consumption as a covariate and time points as moderators. Among the 2559 articles identified, k = 47 were included, among which k = 19 evaluated ghrelin, k = 40 GLP-1, k = 22 PYY, and k = 8 appetite sensation. Our results indicate that fasting ghrelin levels are decreased 2 weeks post-RYGB (p = 0.005) but do not differ from baseline from 6 weeks to 1-year post-RYGB. Postprandial ghrelin and fasting GLP-1 levels were not different from pre-surgical values. Postprandial levels of GLP-1 increased significantly from 1 week (p < 0.001) to 2 years post-RYGB (p < 0.01) compared with pre-RYGB. Fasting PYY increased at 6 months (p = 0.034) and 1 year (p = 0.029) post-surgery; also, postprandial levels increased up to 1 year (p < 0.01). Insufficient data on appetite sensation were available to be meta-analyzed.

Meta-Analytic Findings of the Self-Controlled Motor Learning Literature: Underpowered, Biased, and Lacking Evidential Value

The self-controlled motor learning literature consists of experiments that compare a group of learners who are provided with a choice over an aspect of their practice environment to a group who are yoked to those choices. A qualitative review of the literature suggests an unambiguous benefit from self-controlled practice. A meta-analysis was conducted on the effects of self-controlled practice on retention test performance measures with a focus on assessing and potentially correcting for selection bias in the literature, such as publication bias and p-hacking. First, a naïve random effects model was fit to the data and a moderate benefit of self-controlled practice, g = .44 (k = 52, N = 2061, 95% CI [.31, .56]), was found. Second, publication status was added to the model as a potential moderator, revealing a significant difference between published and unpublished findings, with only the former reporting a benefit of self-controlled practice. Third, to investigate and adjust for the impact of selectively reporting statistically significant results, a weight-function model was fit to the data with a one-tailed p-value cutpoint of .025. The weight-function model revealed substantial selection bias and estimated the true average effect of self- controlled practice as g = .107 (95% CI [.047, .18]). P-curve analyses were conducted on the statistically significant results published in the literature and the outcome suggested a lack of evidential value. Fourth, a suite of sensitivity analyses were conducted to evaluate the robustness of these results, all of which converged on trivially small effect estimates. Overall, our results suggest the benefit of self-controlled practice on motor learning is small and not currently distinguishable from zero.

Testifying after an Investigation: Shaping the Mental Health of Public Safety Personnel

In this editorial, we draw on two Canadian cases to interrogate how mass causality events and investigations consume many responders before (e.g., public safety communicators, detachment service assistants), during (e.g., police, fire, paramedics), and after the incident (e.g., coroners, correctional workers, media coverage). Their well-being may suffer from the associated processes and outcomes. In the current article, we focus on the mass causality incident of 2020 in Nova Scotia, Canada, and the investigation following a prisoner death in 2019 in Newfoundland, Canada, to explore how testifying post-incident can be made more palatable for participating public safety personnel (PSP). Specifically, we study how testifying after an adverse event can affect PSP (e.g., recalling, vicarious trauma, triggers) and how best to mitigate the impact of testimony on PSP well-being, with a lens to psychological "recovery" or wellness. We focus here on how to support those who may have to testify in a judicial proceeding or official inquiry, given being investigated for best-intended actions can result in moral injury or a posttraumatic stress injury, both exacerbated by judicial review, charge, accusation, or inquiry.

Autonomy Support via Instructionally Irrelevant Choice Not Beneficial for Motor Performance or Learning

Purpose: The Optimizing Performance Through Motivation and Attention for Learning (OPTIMAL) theory predicts that providing learners with choices during skill acquisition will enhance their acquisition performance, motor learning, and expectancies. Based on this theory, it is recommended that instructors ask learners to choose which tasks to practice in applied settings. This experiment tested these predictions and recommendation by crossing autonomy support with practice schedule in a 2 × 2 factorial design. Method: Participants (N = 128) practiced a novel non-dominant hand dart-throwing task either with choice over the color of the dart flights (autonomy) or yoked to a counterpart's choices (yoked). Further, participants either practiced throwing darts to three different targets in equal amounts (variable) or throwing to the same target for all practice trials (constant). All participants completed a pretest, acquisition phase, 24-hr delayed retention and transfer tests, as well as baseline and post-acquisition autonomy, and self-efficacy measures. Data were analyzed according to a pre-registered analysis plan that included pretest and gender as covariates. Results: The autonomy groups reported significantly greater perceived autonomy at the end of acquisition. There were no significant effects of autonomy on self-efficacy, or motor performance uniquely during acquisition, or uniquely on the delayed transfer test. The autonomy groups, however, performed with significantly greater error across acquisition and transfer. Practice schedule interacted with the time of testing such that the constant groups performed significantly more accurately during acquisition but non-significantly less accurately during transfer than the variable groups. Conclusions: These results are inconsistent with OPTIMAL theory.

The recommendation for learners to be provided with control over their feedback schedule is questioned in a self-controlled learning paradigm

Evidence that self-controlled feedback schedules are more effective for motor learning than yoked or predetermined schedules has been used to forward the recommendation that practitioners should provide choice to learners over when they would like to receive feedback. This recommendation can be questioned because the typical comparison groups in such experimentation do not well represent the applied setting. Consequently, comparison groups that better map onto the applied setting are needed. To this end, three groups learned a golf putting task: (1) self-controlled, (2) traditional-yoked, and (3) a group who were led to believe their KR schedule was being controlled by a golf coach. Participants (N = 60) completed a pre-test, acquisition phase, and delayed post-tests (retention/transfer). No group differences during the post-tests for mean radial error, F(2, 54) = 2.71, p = .075, or bivariate variable error, F(2, 56) = 0.11, p = .896, were found. Thus, the typical self-controlled learning advantage was not observed. Given the failure to replicate self-controlled benefits, combined with the fact there is little research that has directly compared self-controlled feedback schedules to coach-controlled schedules, we argue more evidence is needed before advocating that learners be provided choice over their feedback schedule.

The self: Your own worst enemy? A test of the self-invoking trigger hypothesis

The self-invoking trigger hypothesis was proposed by Wulf and Lewthwaite [Wulf, G., & Lewthwaite, R. (2010). Effortless motor learning? An external focus of attention enhances movement effectiveness and efficiency. In B. Bruya (Ed.), Effortless attention: A new perspective in attention and action (pp. 75–101). Cambridge, MA: MIT Press] as a mechanism underlying the robust effect of attentional focus on motor learning and performance. One component of this hypothesis, relevant beyond the attentional focus effect, suggests that causing individuals to access their self-schema will negatively impact their learning and performance of a motor skill. The purpose of the present two studies was to provide an initial test of the performance and learning aspects of the self-invoking trigger hypothesis by asking participants in one group to think about themselves between trial blocks—presumably activating their self-schema—to compare their performance and learning to that of a control group. In Experiment 1, participants performed 2 blocks of 10 trials on a throwing task. In one condition, participants were asked between blocks to think about their past throwing experience. While a control group maintained their performance across blocks, the self group's performance was degraded on the second block. In Experiment 2, participants were asked to practice a wiffleball hitting task on two separate days. Participants returned on a third day to perform retention and transfer tests without the self-activating manipulation. Results indicated that the self group learned the hitting task less effectively than the control group. The findings reported here provide initial support for the self-invoking trigger hypothesis.

Enhanced expectancies improve performance under pressure

Beyond skill, beliefs in requisite abilities and expectations can affect performance. This experiment examined effects of induced perceptions of ability to perform well under generic situations of challenge. Participants (N = 31) first completed one block of 20 trials on a throwing accuracy task. They then completed questionnaires ostensibly measuring individual differences in the ability to perform under pressure. Enhanced-expectancy group participants were told that they were well-suited to perform under pressure, while the control group received neutral information. Subsequently, all participants completed another block of 20 trials on the throwing task, with their performance videotaped and under the assumption that they could secure a prize for themselves and a paired participant with successful performance. Both groups had similar accuracy scores on the first trial block. The enhanced-expectancy group significantly increased their throwing accuracy in the higher-pressure situation (second block), whereas the control group showed no change in performance. Furthermore, beliefs regarding performance under challenge predicted throwing accuracy on the second block. The present findings provide evidence that enhancing individuals’ generic expectancies regarding performance under pressure can affect their motor performance.

High resolution chromosome 3p allelotyping of human lung cancer and preneoplastic/preinvasive bronchial epithelium reveals multiple, discontinuous sites of 3p allele loss and three regions of frequent breakpoints

Allele loss involving chromosome arm 3p is one of the most frequent and earliest known genetic events in lung cancer pathogenesis and may affect several potential tumor suppressor gene regions. To further study the role of chromosome 3p allele loss in the pathogenesis of lung cancer, we performed high resolution loss of heterozygosity (LOH) studies on 97 lung cancer and 54 preneoplastic/preinvasive microdissected respiratory epithelial samples using a panel of 28 3p markers. Allelic losses of 3p were detected in 96% of the lung cancers and in 78% of the preneoplastic/preinvasive lesions. The allele losses were often multiple and discontinuous, with areas of LOH interspersed with areas of retention of heterozygosity. Most small cell lung carcinomas (91%) and squamous cell carcinomas (95%) demonstrated larger 3p segments of allele loss, whereas most (71%) of the adenocarcinomas and preneoplastic/preinvasive lesions had smaller chromosome areas of 3p allele loss. There was a progressive increase in the frequency and size of 3p allele loss regions with increasing severity of histopathological preneoplastic/preinvasive changes. In analyses of the specific parental allele lost comparing 42 preneoplastic/preinvasive foci with those lost in the lung cancer in the same patient (n = 10), the same parental allele was lost in 88% of 244 comparisons for 28 3p markers (P = 1.2 x 10(-36) for this occurring by chance). This indicates the occurrence of allele-specific loss in these foci similar to that seen in the tumor by a currently unknown mechanism. Analysis of all of the data indicated multiple regions of localized 3p allele loss including telomere-D3S1597, D3S1111-D3S2432, D3S2432-D3S1537, D3S1537, D3S1537-D3S1612, D3S4604/Luca19.1-D3S4622/Luca4.1, D3S4624/Luca2.1, D3S4624/Luca2.1-D3S1582, D3S1766, D3S1234-D3S1300 (FHIT/FRA3B region centered on D3S1300), D3S1284-D3S1577 (U2020/DUTT1 region centered on D3S1274), and D3S1511-centromere. A panel of six markers in the 600-kb 3p21.3 deletion region showed loss in 77% of the lung cancers, 70% of normal or preneoplastic/preinvasive lesions associated with lung cancer, and 49% of 47 normal, mildly abnormal, or preneoplastic/preinvasive lesions found in smokers without lung cancer; however, loss was seen in 0% of 18 epithelial samples from seven never smokers. The 600-kb 3p21.3 region and the 3p14.2 (FHIT/FRA3B) and 3p12 (U2020/DUTT1) regions were common, independent sites of breakpoints (retention of heterozygosity by some markers and LOH by other markers in the immediate region). We conclude that 3p allele loss is nearly universal in lung cancer pathogenesis; involves multiple, discrete, 3p LOH sites that often show a "discontinuous LOH" pattern in individual tumors; occurs in preneoplastic/preinvasive lesions in smokers with and without lung cancer (multiple lesions often lose the same parental allele); frequently involves breakpoints in at least three very small defined genomic regions; and appears to have allele loss and breakpoints first occurring in the 600-kb 3p21.3 region. These findings are consistent with previously reported LOH studies in a variety of tumors showing allele loss occurring by mitotic recombination and induced by oxidative damage.

Empowerment in general practice. The trilogies of caring

The authors examine the way in which the doctor-patient interaction often varies between an oppressive caring mode and an oppressed caring mode, both of which apply pressures to the participants and prevent good quality care. A model for the trilogy of oppressive, oppressed, and empowerment caring is examined and it is explained how the process of empowerment caring can enhance the general practitioners' quality of care and improve their practice, their home life and their personal wellbeing.

Does non-clinical decompression stress lead to brain damage in abalone divers?

Abalone divers are subject to considerable decompression stresses and could be at risk of progressive cognitive impairment. A sample of abalone divers was compared with a sample of fishermen, by means of a battery of neuropsychological tests. No evidence of cognitive impairment was found in the divers, in spite of evidence of their exposure to decompression stress. The implications for other professional divers and for recreational underwater divers who follow standard decompression protocols are reassuring.

Results of large scale media antismoking campaign in Australia: North Coast "Quit for Life" programme

A three community study was carried out in northern New South Wales, Australia, to determine the effectiveness of interventions via media and media plus community programmes in altering behaviours of life style, including smoking, dietary fat intake, and exercise. Results were analysed of one aspect of the "North Coast Healthy Lifestyle Programme" entitled "Quit for Life," which aimed at reducing cigarette smoking over a two year period. There was a significant decline in the prevalence of smoking in both test towns, ranging from 16% in younger men to 6% in older women. These were significantly greater than the declines in the control town. The declines were more sustained over the two year period in the town subjected to media plus community programmes.