Stephanie L. Dickinson

Background : Water turnover (rH ₂ O) is related to water balance including preformed water intake (WI), metabolic, inspired, and transcutaneous water. Literature is scarce on athletes. This study aimed to estimate and compare rH ₂ O and its components during one athletic season (preparatory and competition phases), adjusting for body composition and energy expenditure (EE). Methods : This longitudinal observational study included 112 athletes (19.8 ± 4.9 years, 39 females). Doubly labeled water determined total EE, rH ₂ O, and the remaining components through specific equations. Total body water was determined by deuterium dilution and fat-free mass by the four-compartment model. Resting EE was assessed by indirect calorimetry. Results : During the preparatory phase, male athletes showed higher rH ₂ O [5.03 (0.14) kg/day] compared with females [3.64 (0.19) kg/day, p < .001], even adjusting for body mass ( p = .024), but not for fat-free mass, total body water, and EE. Triathletes showed higher values of rH ₂ O after adjustments ( p < .05). Over the athletic season, no changes occurred for rH ₂ O or preformed WI within or between sexes or sports, even adjusting for body composition while some changes occurred adjusting for EE ( p < .05). Over the season, metabolic water increased ( p < .001), while inspired and transcutaneous water showed both increases and reductions ( p < .05). A small prevalence (∼16%) of low WI (WI ≤ 35 ml/kg of body mass/day) was persistent in both timepoints. Conclusion : While rH ₂ O and preformed WI did not differ over the season, cross-sectional differences were observed between sports but not between sexes, highlighting the variability of rH ₂ O and impact of contributing factors. Low preformed WI was present throughout the athletic season.

Background: US overdose deaths continue to exceed 77,000 per year, the majority of which involve opioids. One evidence-based response to this crisis is overdose education and naloxone distribution (OEND). There is a large national (US) network of citizens and first response agencies connected through an app called PulsePoint Respond , who are engaged in facilitating rapid layperson cardiopulmonary resuscitation administration in cases of public emergencies. Our goal is to recruit these first response agencies to provide targeted messaging about OEND to this large subpopulation of motivated layperson responders. This study focuses on the first step: the feasibility of our national efforts to recruit first response agencies to participate in our project. Objective: This study aimed to determine whether more first response agencies were successfully recruited using materials that included preemptive correction of misperceptions about overdose and naloxone than with standard recruitment materials and to investigate the recruitment parameters observed when agencies were successfully recruited. Methods: The overall study was a randomized controlled trial in which we randomly sampled 180 first response agencies from the total set of agencies subscribing to PulsePoint (n=773). Agencies were randomly allocated to 3 study arms (1:1:1) with stratification for rural status. Arm 1 received standard recruitment materials, arm 2 received similar materials that directly addressed common misperceptions about overdose and naloxone, and arm 3 was recruited to serve as a control arm for later parts of the study. The primary analysis of recruitment approaches used logistic regression, contrasting arms 1 and 2. Exploratory analyses included descriptive statistics and other logistic regression models. Results: A total of 40 agencies signed memoranda of understanding to participate in the project (n=176, 22.7% of contacted agencies; n=151, 26.5% of the agencies where a point of contact had been established). We did not find evidence that the messaging contained in arm 2 significantly affected recruitment success (odds ratio 0.754, 95% CI 0.298‐1.904; P =.55). Likewise, arm assignment (3-way comparison) did not significantly affect the likelihood of an agency agreeing to participate. The recruitment process took a mean of 159.08 (SD 104.74) days per agency and involved 8.38 emails, 1.98 voicemails, 0.83 phone calls, and 1.23 video calls. Conclusions: Recruiting first response agencies that subscribe to PulsePoint for participation in a national-level OEND project appears feasible, with an anticipated participation rate between 23% and 27% of agencies solicited. Successful recruitment timelines can be lengthy and involve extensive correspondence. Since the language used in our different study arms did not have a significant effect on agency recruitment, other factors (such as individual citizen responses to messaging) could reasonably be used to select the overall language used in subsequent project recruitment materials.

Background: While evidence suggests psychosocial support benefits well-being, physical health, and weight management, the impact of psychosocial health within digital behavioral weight management programs (compared to traditional in-person models) remains underexplored. Purpose: To evaluate the effectiveness of a digital commercial program (DCP) compared to standard nutrition guidance (SNG) on some weight-related psychosocial outcomes: weight-bias internalization (WBI), self-compassion, weight-related quality of life (WQOL), well-being, and body appreciation (BA). Methods: A 6-month randomized controlled trial (NCT05648344) was conducted among 376 US adults living with overweight/obesity. n = 187 were randomized to a DCP (WeightWatchers®), and n = 189 received SNG. Intention-to-treat analyses using analysis of covariance (ANCOVA), adjusted for sex, age, race, ethnicity, education, body mass index (BMI), and baseline values, were completed to assess changes in outcomes. Results: Mean ± SD age was 47.7 ± 12.2 years; 7.4% self-identified as Asian; 13.8% Black; 6.4% Other; 9.6% Hispanic; 20.7% male; 17.8% experienced food insecurity; BMI = 33.6 ± 4.7 kg/m2. At 6 months, DCP relative to SNG, participants lowered their WBI by a mean difference ± SE of −0.3 ± 0.1; and increased their self-compassion by 0.2 ± 0.1; BA by 0.2 ± 0.1; well-being by 6.4 ± 1.7, and WQOL by 5.6 ± 1.2, all P<.01. Conclusions: Relative to SNG, participants in the DCP showed increased self-compassion, BA, well-being, and WQOL, and decreased WBI, highlighting that DCPs may deliver favorable changes in psychosocial outcomes. These findings should be interpreted with caution due to the short follow-up period and the question of whether the observed differences are clinically meaningful.

Clustering effects, such as those introduced by housing animals in shared cages, are often overlooked in preclinical lifespan studies, despite their potential to distort variance estimates and inflate Type I error rates, leading to misleading conclusions. This methodological oversight reduces statistical rigor and may undermine the reliability of findings. To address this gap, the current study examines the impact of accounting for clustering and nesting effects on lifespan analyses by comparing the results of statistical models which both account for and ignore these effects. Using 2019 data from the Interventions Testing Program (ITP), a large-scale initiative evaluating the effects of compounds on lifespan in UM-HET3 mice as a case study, we illustrate how different modeling approaches influence statistical estimates and conclusions. Clustering and nesting effects were addressed using linear mixed effects, and Cox frailty models, both of which explicitly account for cage-level dependencies and different levels of data nesting. Comparisons were made between unadjusted lifespan analyses and those incorporating clustering and nesting adjustments. The results of this case study indicate that properly adjusting for clustering and nesting effects can change the conclusions drawn from statistical significance tests as compared to unadjusted model approaches, and so it remains best practice to properly account for clustering and nesting to reduce the potential for inflated Type I error rates. These findings highlight the importance of accounting for clustering and nesting in preclinical research to ensure valid and robust statistical inference. By demonstrating the practical application of clustering adjustments, this work underscores the broader implications for improving reproducibility and rigor in lifespan studies and other experimental designs.

Objective: Food noise has received attention in the media, although no validated questionnaires exist to measure it. This study developed and tested the reliability and validity of the Food Noise Questionnaire (FNQ).Methods: Participants (N = 400) successfully completed, the FNQ and a demographic questionnaire and self‐reported weight and height. A subsample (n = 150) completed the FNQ 7 days later for test–retest reliability, and this subsample's first FNQ data were subjected to exploratory factor analysis. The remaining subsample (n = 250) completed two preoccupation with food questionnaires to test convergent validity, along with mood, anxiety, and stress questionnaires to test for discriminant validity. Confirmatory factor analysis was conducted using this subsample's FNQ data.Results: Data from 396 participants were analyzed (4 participants did not complete all FNQ items). The FNQ had excellent internal consistency reliability (Cronbach α = 0.93) and high test–retest reliability (r = 0.79; p < 0.001; mean [SD] = 7.4 [1.0] days between administration). Factor analyses found that the five FNQ items loaded onto a single factor, with good fit indices (χ²[5] = 52.87, p < 0.001; root mean square error of approximation [RMSEA] = 0.20; comparative fit index [CFI] = 0.95; standardized root mean squared residual [SRMR] = 0.03). The FNQ showed good convergent (all r > 0.78; p < 0.001) and discriminant (all r < 0.39; p < 0.001) validity.Conclusions: The FNQ provides a psychometrically reliable and valid measure of food noise, although further research is needed to evaluate its clinical utility.

Background The credibility of nutritional research is dependent on the rigor with which studies are conducted and the ability for independent assessment to be performed. Despite the importance of these, more work is needed in the field of nutrition to buttress the trustworthiness of nutrition research. Objective To develop and apply a process for evaluating the rigor, reproducibility, and verifiability of nutritional research, using the relationship between potato consumption and Colorectal cancer (CRC) as a case study. Methods We updated existing systematic reviews to include studies on potatoes and CRC, assessing their design, execution, and reporting quality. We attempted to reproduce and verify the results of included studies by requesting raw data from authors and following statistical methods as described in the publications. Rigor was evaluated using four different tools: ROBINS-E, STROBE-Nut, Newcastle-Ottawa scale, and additional criteria related to transparency. Results Eighteen studies were included, none of which publicly share data. We managed to access data for only two studies, successfully reproducing and verifying the results for one. The majority of studies exhibited a high risk of bias, with significant limitations in reporting quality and methodological rigor. Conclusions Research on the relationship between potato consumption and CRC risk is insufficiently reproducible and verifiable, undermining the trustworthiness of its findings. This study highlights the need for improving transparency, data sharing, and methodological rigor in nutritional research. Our approach provides a model for assessing the credibility of research in other areas of nutrition.

Biological clocks and other molecular biomarkers of aging are difficult to implement widely in a clinical setting. In this study, we used routinely collected hematological markers to develop an aging clock to predict blood age and determine whether the difference between predicted age and chronologic age (aging gap) is associated with advanced aging in mice. Data from 2,562 mice of both sexes and three strains were drawn from two longitudinal studies of aging. Eight hematological variables and two metabolic indices were collected longitudinally (12,010 observations). Blood age was predicted using a deep neural network. Blood age was significantly correlated with chronological age, and aging gap was positively associated with mortality risk and frailty. Platelets were identified as the strongest age predictor by the deep neural network. An aging clock based on routinely collected blood measures has the potential to provide a practical clinical tool to better understand individual variability in the aging process.

Objective: The objective of this study was to investigate body composition changes with weight cycling (WC) among adult C57BL/6J mice with diet‐induced obesity.Methods: A total of 555 single‐housed mice were fed a high‐fat diet ad libitum (AL) from 8 to 43 weeks of age. The 200 heaviest mice of each sex were randomized to the following four groups: ever obese (EO, continued AL feeding); obese weight loser (OWL, calorie‐restricted); obese weight loser moderate (OWLM, body weight halfway between EO and OWL); and WC (diet restricted to OWL followed by AL refeeding cycles). Body weight and composition data were collected. Linear regression was used to calculate residuals between predicted and observed fat mass. Linear mixed models were used to compare diet groups.Results: Although weight loss and regain resulted in changes in body weight and composition, fat mass, body weight, and relative body fat were not significantly greater for the WC group compared with the EO group. During long‐term calorie restriction, males (but not females) in the OWLM group remained relatively fatter than the EO group.Conclusions: WC did not increase body weight or relative fat mass for middle‐aged, high‐fat diet‐fed adult mice. However, long‐term moderate calorie restriction resulted in lower body weight but greater “relative” fat in male mice.

Background: The use of naloxone, an opioid antagonist, is a critical component of the US response to fatal opioid-involved overdoses. The importance and utility of naloxone in preventing fatal overdoses have been widely declaimed by medical associations and government officials and are supported by strong research evidence. Still, there are gaps in the current US national strategy because many opioid-involved overdose fatalities have no evidence of naloxone administration. Improving the likelihood that naloxone will be used to prevent fatal overdoses is predicated on facilitating an environment wherein naloxone is available near each overdose and can be accessed by someone who is willing and able to use it. How to accomplish this on a national scale has been unclear. However, there exists a national network of >1 million cardiopulmonary resuscitation (CPR) layperson responders and 4800 emergency responder agencies linked through a mobile phone app called PulsePoint Respond. PulsePoint responders certify that they are trained to administer CPR and are willing to respond to possible cardiac events in public. When such an event occurs near their mobile phone’s location, they receive an alert to respond. These motivated citizens are ideally positioned to carry naloxone and reverse overdoses that occur in public. Objective: This randomized controlled trial will examine the feasibility of recruiting first responder agencies and layperson CPR responders who already use PulsePoint to obtain overdose education and carry naloxone. Methods: This will be a 3-arm parallel-group randomized controlled trial. We will randomly select 180 first responder agencies from the population of agencies contracting with the PulsePoint Foundation. The 3 study arms will include a standard recruitment arm, a misperception-correction recruitment arm, and a control arm (1:1:1 allocation, with random allocation stratified by zip code designation [rural or nonrural]). We will study agency recruitment and, among the agencies we successfully recruit, responder certification of receiving overdose and naloxone education, carrying naloxone, or both. Hypothesis 1 contrasts agency recruitment success between arms 1 and 2, and hypothesis 2 contrasts the ratios of layperson certification across all 3 arms. The primary analyses will be a logistic regression comparing the recruitment rates among the arms, adjusting for rural or nonrural zip code designation. Results: This study was reviewed by the Indiana University Institutional Review Board (20218 and 20219). This project was funded beginning September 14, 2023, by the National Institute on Drug Abuse. Conclusions: The hypotheses in this study will test whether a specific type of messaging is particularly effective in recruiting agencies and layperson responders. Although we hypothesize that arm 2 will outperform the other arms, our intention is to use the best-performing approach in the next phase of this study if any of our approaches demonstrates feasibility. Trial Registration: OSF Registries osf.io/egn3z; https://osf.io/egn3z International Registered Report Identifier (IRRID): PRR1-10.2196/57280