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Mixed martial arts' popularity has increased in recent years, alongside descriptive research and evidence-based performance recommendations. Guidelines for (both chronic and acute) weight making exist; however, how these translate in real-life scenarios and detailed investigations on practices in larger groups deserve attention. The present study examined the body mass (BM) and composition of 33 professional mixed martial arts athletes preparing for 80 fights. Athletes were supported by on-site dietitians, who encouraged evidence-based practices. Fasted BM was measured throughout the last ∼10 days before all bouts (acute weight management phase). A subset of athletes had body composition assessed before and after the chronic weight loss phase for 40 fights. Most athletes engaged in chronic BM loss, and all engaged in acute weight loss. Many lost fat-free mass (FFM) during the chronic phase, with rates of BM loss <0.5% best preserving FFM. Regardless of losses, the present athletes possessed greater FFM than other combat sport athletes and engaged in greater acute weight loss. Dehydration in the 24–48 hr before the weigh-in was not reflective of weight regain after the weigh-in, rather BM 7–10 days before the weigh-in was most reflective. These findings suggest that many mixed martial arts athletes could increase FFM at the time of competition by maintaining leaner physiques outside of competition and/or allowing increased time to reduce BM chronically. Acutely, athletes can utilize evidence-based protocols, eliminating carbohydrates, fiber, sodium, and finally fluid in a staged approach, before the weigh-in, reducing the amount of sweating required, thus theoretically better protecting health and preserving performance. [ABSTRACT FROM AUTHOR]

Background: Women with higher body mass index report low rates of and face unique barriers to exercise. Increasing exercise participation can improve mental and physical health independent of weight loss; however, most exercise programs targeting this population focus predominately on losing weight. This paper aims to describe the development of Fit&Fab, a community-based exercise intervention focused on increasing exercise participation and enjoyment for women with obesity. Methods: In partnership with the YMCA, we recruited women ages 35–64 years (body mass index ≥ 30) to participate in 4 focus groups to understand exercise preferences. Formative work was used to identify theory constructs and associated intervention components. Women from the focus groups were recruited for a community advisory board that finalized the intervention design, recruitment, and evaluation plan. Results: Focus groups participants (N = 29) preferred to exercise without men and wanted a cohort-style class that included women of similar exercise levels and body types, incorporated social support, fun activities, and broke exercise into smaller bouts. They wanted a supportive instructor who was fit but understood weight-related challenges. The community advisory board and research team used focus group findings to inform design of the final intervention including group exercise classes, psychosocial support sessions, personalized training, exercise tracking, outcome monitoring, and rewards. Conclusions: Our findings emphasize the need to focus on exercise enjoyment and benefits other than losing weight to improve exercise participation among women with higher body mass index. In addition to having outcomes other than weight loss, exercise interventions with this population should also consider group composition, instructor, and class format. [ABSTRACT FROM AUTHOR]

Pursuing a self-regulatory goal, such as weight loss, motivates consumers to forego pleasure seeking, typically by selecting virtue over vice. We propose that in the absence of virtuous options, consumers with a self-regulatory goal will instead choose less variety in choice sets of exclusively vice options because the extra pleasure that variety affords seems incompatible with the goal. We find converging evidence for the decrease in variety seeking in vice categories across five studies (and three supplementary studies in the web appendix , N  = 6,066), using both scenario-based and actual consumption contexts. We also demonstrate the underlying process: consumers are motivated to curtail pleasure seeking when pursuing a weight-loss goal and that leads them to choose less variety in vice categories when there is no virtue alternative available. [ABSTRACT FROM AUTHOR]

Youth with intellectual disabilities engage in low levels of physical activity (PA). An aim of this family-based weight-loss behavioral intervention (FBBI) trial was to increase and sustain PA in these youth. Accelerometry data were available from 21 individuals with intellectual disabilities, age 14–22 years. Each completed the 6-month FBBI, after which 10 completed a 6-month maintenance intervention (FBBI-M), and 11 received no further intervention (FBBI-C). Twenty participated in a further 6-month follow-up. Accelerometry data were analyzed using linear mixed models. During FBBI, mean (SE) moderate to vigorous PA increased by 4.1 (2.5) min/day and light PA by 24.2 (13.5) min/day. Mean (SE) difference in moderate to vigorous PA between participants in FBBI-M and FBBI-C at 18 months was 14.0 (5.1) min/day (p =.005); mean (SE) difference in light PA was 47.4 (27.4) min/day (p =.08). Increasing PA through behavioral intervention is possible in youth with intellectual disabilities. [ABSTRACT FROM AUTHOR]

This mixed methods study aimed to investigate weight cutting practices of female taekwon-do athletes internationally and explore their experiences of "making weight." A survey of weight loss practices and eating behaviors was completed by 103 taekwon-do athletes from 12 countries, which illustrated that 72.5% of athletes engage in both acute and chronic weight loss practices prior to competition and that there were higher levels of disordered eating within this athletic population than nonweight cutting athletes. Semistructured interviews were conducted with five international-level competitors; thematic analysis of the interviews identified that the women in general felt weight cutting was "horrible—but worth it" and the women believed that (a) weight cutting is unpleasant, difficult, and challenging; and (b) weight cutting provides a competitive advantage. The implications of this study are that weight cutting is widespread among high-level competitive female taekwon-do athletes and this is unlikely to change given the perceived advantages. Efforts are needed to make sure that the women are knowledgeable of the risks and are provided with safe and effective means of making weight. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of bulb thickness on the weight of obturator prostheses and masticatory performance in edentulous hemimaxillectomy patients.Materials and Methods: A randomized, single-blind, three-period crossover trial was conducted with 17 edentulous patients. All patients were provided with three definitive 3D-printed obturator prostheses each. Obturators were divided into three groups: (1) group 1 (G1; 1-mm bulb); (2) group 2 (G2; 2-mm bulb); and (3) group 3 (G3; 3-mm bulb). After fabrication, the weight of each obturator was measured using a digital analytical balance. The patients used each obturator for a period of 2 weeks without a passive period (ie, they did not stop using the obturator). After using each obturator, masticatory function was evaluated with an adapted Sato questionnaire and the sieve test. Data were analyzed using one-way ANOVA and Pearson correlation analysis (α = .05).Results: According to the results of the Sato questionnaire and sieve test, G1 demonstrated the highest masticatory function scores (70.88 ± 9.39; 1.06 ± 0.06), while G3 exhibited the lowest scores (48.23 ± 7.69; 0.92 ± 0.05) (P < .001). The weight of the obturators was significantly different between groups (G1 = 31.58 ± 1.09 g; G2 = 33.99 ± 1.21 g; G3 = 36.57 ± 1.13 g) (P < .001). The correlation between masticatory function and the weight of the obturator was significant (P < .05).Conclusion: This study revealed that using 1-mm obturator bulb thickness was an effective fabrication method for improving masticatory function and reducing the weight of obturator prostheses in edentulous hemimaxillectomy patients. [ABSTRACT FROM AUTHOR]

Background: Off-label use of semaglutide for non-diabetic weight loss (which regulators have linked to social media promotion) created worldwide supply shortages. We evaluated worldwide semaglutide interest measured by online search behavior to gauge social media and conventional print media reporting's effect on search interest. Methods: Using Google Trends Extended for Health (GTEH) multiple sampling, we retrieved regional online interest (ROI) for all countries and extracted timelines and top search queries for January 2021–August 2023 for countries with median ROI ≥ 20 using the "semaglutide" topic. We obtained semaglutide media reporting from the ProQuest database. We estimated the effect of media and within-country semaglutide interest on between-country interest with Granger causality analysis. We determined changepoints for trends within each country with joinpoint regression. We determined prominent themes in search queries for each country with natural language processing thematic analysis. Results: Twenty-seven countries were included. Most countries showed an increase in semaglutide interest over time, with Canada and the USA showing the largest sustained interest. Most of the search interest arose from 2022 onwards. Granger's analysis showed that media coverage could only partially explain interest, and interest in some countries partially preceded interest in others, with the UK and Germany showing strong relationships between news reports and lagged search interest. Joinpoint analysis identified up to four significant within-country changepoints. Most countries showed significant positive weekly trends in 2021–2022, although uptrends in search interest varied considerably between countries. One episode of the Dr. Oz show (TV media event) coincided with strong peaks in numerous countries. Natural language processing of top search queries showed some agreement between countries and country-specific themes. Weight loss was a major theme in most countries, while a diabetes theme was generally absent or weak. Some countries (Australia, Chile, South Africa, UK) had themes for buying Ozempic from (named) local retailers, and Germany had a theme related to buying Ozempic without a script. Conclusions: GTEH data provided insights into global search interest in semaglutide and regional variation. Studies focusing on specific countries which include social media data can elucidate specific drivers behind the surge in off-label use of semaglutide. [ABSTRACT FROM AUTHOR]

Background: Most of the worldwide population is overweight and suffers from the resulting musculoskeletal comorbidities such as knee osteoarthritis or back pain. Practice guidelines recommend weight loss interventions for individuals suffering from these conditions. This systematic review investigated whether including a weight loss intervention in the musculoskeletal therapy of these individuals was cost-effective compared to administering the musculoskeletal therapy alone. Methods: This study followed the PRISMA guidelines to systematically and independently search six databases and select full health economic evaluations published up to May 2024 from health care or societal perspectives according to predefined eligibility criteria. Cost data were standardised to 2023 Belgium Euros. The methodological quality was assessed using two health economic-specific checklists. Results: The searches produced 5′305 references, of which 8 studies were selected for a total of 1′726 participants. The interventions consisted of different exercise plans and nutritional targets. Six values were in the north-eastern; leading to increased quality-adjusted life year (QALY) and higher costs; and two in the south-eastern quadrant of the cost-utility plane; leading to increased QALYs and lower costs. Two studies observed no differences in QALYs. Incremental cost utility ratios (ICUR) ranged from €13′580.10 to €34′412.40 per additional QALY from a healthcare perspective. From a societal perspective, the ICUR was €30′274.84. The included studies fulfilled 86 percent of the criteria in trial-based economic evaluations and 57 percent in model-based economic evaluations. The most common limitations of the studies were related to appropriate cost measures' specifications, research questions, time horizon choices, and sensitivity analyses. Conclusions: This systematic review showed weak but consistent evidence of cost-effectiveness for adding a weight loss intervention to musculoskeletal therapy for individuals with overweight, from either perspective. Further economic evaluations should evaluate the long-term cost-effectiveness of the intervention. Trial registration: International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY (2022,110,122). [ABSTRACT FROM AUTHOR]

Obesity is a major public health problem worldwide. Different approaches are known to face this problem, for example, dieting, surgery, or drug interventions. It has also been shown that placebos may help to reduce weight and hunger feelings, but the use of placebos is linked to problems with respect to the patient-healthcare-provider relationship. However, recent studies demonstrated that even placebos without deception (open-label placebos) affect symptoms such as pain, anxiety, or emotional distress. Here we aimed to examine whether an open-label placebo may help to lose weight in obesity. Our study included fifty-seven overweight and obese patients who aimed to lose weight using a combination of diet and sports. Patients were randomly divided into two groups. Participants in the open-label placebo group received two placebos each day. A treatment-as-usual group received no pills. Primary outcome included changes of body weight. Secondary outcomes were change of eating behavior and self-management abilities. After 4 weeks we found that participants in the open-label placebo condition lost more weight than the treatment-as-usual group. Furthermore, OLP treatment affected eating behavior. No effects for self-management abilities were found. Although further research is necessary, open-label placebos might help individuals to lose weight. [ABSTRACT FROM AUTHOR]

Obesity presents a significant public health challenge, demanding effective dietary interventions. This study employed a high-fat diet-induced obesity mouse model to explore the impacts of inulin with different polymerization degrees on obesity management. Our analysis reveals that high-degree polymerization inulin (HDI) exhibited a significantly higher oil binding capacity and smaller particle size compared to low-degree polymerization inulin (LDI) (p  <  0.05). HDI was more effective than LDI in mitigating body weight gain in high-diet induced obese mice, although neither LDI nor HDI affected blood sugar levels when compared to the high-fat diet control group (p  <  0.05). Both HDI and LDI administrations reduced liver weight and enhanced brown adipose tissue thermogenesis compared to the high-fat diet induced control group (p  <  0.05). Additionally, HDI suppressed hepatic lipogenesis, resulting in a further reduction in liver triglycerides compared to the high-fat diet-induced obese mice (p  <  0.05). Notably, HDI improved gut health by enhancing intestinal morphology and modulating gut microbiota structure. HDI administration notably increased the relative abundance of cecal Akkermansia, a gut microbe associated with improved metabolic health, while LDI showed limited efficacy (p  <  0.05 and p  >  0.05, respectively). These findings underscore the importance of the structural properties of inulin in its potential to combat obesity and highlight the strategic use of inulin with varying polymerization degrees as a promising dietary approach for obesity management, particularly in its influence on gut microbiota composition and hepatic lipid metabolism regulation. [ABSTRACT FROM AUTHOR]

Postprandial IL-1β surges are predominant in the white adipose tissue (WAT), but its consequences are unknown. Here, we investigate the role of IL-1β in WAT energy storage and show that adipocyte-specific deletion of IL-1 receptor 1 (IL1R1) has no metabolic consequences, whereas ubiquitous lack of IL1R1 reduces body weight, WAT mass, and adipocyte formation in mice. Among all major WAT-resident cell types, progenitors express the highest IL1R1 levels. In vitro, IL-1β potently promotes adipogenesis in murine and human adipose-derived stem cells. This effect is exclusive to early-differentiation-stage cells, in which the adipogenic transcription factors C/EBPδ and C/EBPβ are rapidly upregulated by IL-1β and enriched near important adipogenic genes. The pro-adipogenic, but not pro-inflammatory effect of IL-1β is potentiated by acute treatment and blocked by chronic exposure. Thus, we propose that transient postprandial IL-1β surges regulate WAT remodeling by promoting adipogenesis, whereas chronically elevated IL-1β levels in obesity blunts this physiological function. The consequences of postprandial IL-1β surges in white adipose tissue are unknown. Here the authors show IL-1β regulates WAT remodelling by promoting adipogenesis and energy storage, which is blocked by chronic elevation of this cytokine (as in obesity). [ABSTRACT FROM AUTHOR]

Background: Addressing the shortage of high-quality protein resources, this study was conducted to investigate the effects of replacing soybean meal (SBM) with different levels of enzymolysis-fermentation compound protein feed (EFCP) in the diets of growing-finishing pigs, focusing on growth performance, nutrients digestibility, carcass traits, and meat quality. Methods: Sixty DLY (Duroc × Landrace × Yorkshire) pigs with an initial body weight of 42.76 ± 2.05 kg were assigned to 5 dietary treatments in a 2 × 2 + 1 factorial design. These dietary treatments included a corn-soybean meal diet (CON), untreated compound protein feed (UCP) substitution 50% (U50) and 100% SBM (U100) diets, and EFCP substitution 50% (EF50) and 100% SBM (EF100) diets. Each treatment had 6 pens (replicates) with 2 pigs per pen, and the experiment lasted 58 d, divided into phase I (1–28 d) and phase II (29–58 d). Following phase I, only the CON, U50, and EF50 groups were continued for phase II, each with 5 replicate pens. On d 59, a total of 15 pigs (1 pig/pen, 5 pens/treatment) were euthanized. Results: During phase I, the EF50 group had a higher average daily gain (ADG) in pigs (P < 0.05) compared to the CON group, whereas the U50 group did not have a significant difference. As the substitution ratio of UCP and EFCP increased in phase I, there was a noticeable reduction in the final body weight and ADG (P < 0.05), along with an increase in the feed-to-gain ratio (F/G) (P < 0.05). In phase II, there were no significant differences in growth performance among the treatment groups, but EF50 increased the apparent digestibility of several nutrients (including dry matter, crude protein, crude fiber, acid detergent fiber, ash, gross energy) compared to U50. The EF50 group also exhibited significantly higher serum levels of neuropeptide Y and ghrelin compared to the CON and U50 groups (P < 0.05). Moreover, the EF50 group had higher carcass weight and carcass length than those in the CON and U50 groups (P < 0.05), with no significant difference in meat quality. Conclusions: The study findings suggest that replacing 50% SBM with EFCP during the growing-finishing period can improve the growth performance, nutrient digestibility, and carcass traits of pigs without compromising meat quality. This research offers valuable insights into the modification of unconventional plant protein meals and developing alternatives to SBM. [ABSTRACT FROM AUTHOR]

Preclinical mouse models are critical for understanding the pathophysiological response to infections and developing treatment strategies for sepsis. In keeping with ethical values, researchers follow guidelines to minimize the suffering of the mice. Weight loss is a criteria used as a humane end point, but there is no official recommendation for a maximum weight loss leading to euthanasia. To evaluate whether the thresholds used in daily practice are optimal, we performed a comprehensive retrospective analysis of data generated over 10 years with > 2300 mice used in models of infection with Listeria monocytogenes, Streptococcus pneumoniae, Candida albicans and H1N1 influenza virus. Weight loss segregated mice that survived from those that did not. Statistical analyses revealed that lowering the weight loss thresholds used (none, 30% or 20%) would have increased mortality rates due to the sacrifice of mice that survived infections (p < 0.01–0.001). Power calculations showed high variability and reduction of power as weight loss thresholds approached 20% for S. pneumoniae and L. monocytogenes models. Hence, weight loss thresholds need to be adapted to each model of infection used in a laboratory. Overall, weight loss is a valuable predictor of mortality that contributes to the robustness of composite scores. To our knowledge, this is the most extensive study exploring the relationship between weight loss threshold and sepsis outcome. It underscores the importance of the infection-model-specific evaluation of weight loss for use in clinical scores defining humane endpoints to minimize mouse suffering without compromising statistical power and scientific objectives. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases are an increasing threat in sub-Saharan Africa (SSA), and overweight and obesity are affecting people across all socioeconomic groups. Some studies suggest that big body sizes may be perceived as desirable among women in SSA and that high prevalence of obesity and overweight are especially present in low socioeconomic societies. This study explores the role of socioeconomic factors in the perception of the ideal body among Kenyan women and whether perceptions and beliefs about the ideal body should be considered relevant when targeting the prevention of obesity and overweight. Method: In-depth interviews were conducted with 8 Kenyan women with varying educational backgrounds, aged between 21 and 48, using a qualitative study design. The interviews were conducted in December 2022 and January 2023 in Nairobi, audio-recorded, transcribed and analysed through qualitative content analysis and a coding system using deductive and inductive codes. Results: The participants reported that conclusions about a person's health and wealth status are drawn based on different body sizes. Furthermore, traditional views about the ideal body size, societal pressure, as well as the women's own experience with their body size play a role in the perception of an ideal body. Conclusion: Small-sized women desire to gain weight as society may view them as weak and sick. Big-sized women aim to reduce weight primarily due to health complications. Nevertheless, traditionally, a big-sized woman is considered strong and wealthy, creating external pressure on women to fulfil this body image—these findings emphasise traditional aspects in designing culturally sensitive prevention and intervention methods to address overweight and obesity. [ABSTRACT FROM AUTHOR]

Background: Data-driven trajectory modeling approaches have been used to identify participant subgroups with differing responses to digital lifestyle interventions. Identifying contributing factors to different participant subgroups can inform tailored strategies to early "rescue" intervention non-responders. Self-monitoring (SM) is a central mechanism in lifestyle interventions for driving behavior change and can serve as an early indicator for later intervention response. This qualitative study aimed to compare SM experiences between intervention response subgroups and to identify contributing factors to intervention response subgroups in a 6-month digital lifestyle intervention for adults with overweight or obesity. Results: Participants were middle-aged (52.9 ± 10.2 years), mostly female (65%), and of Hispanic ethnicity (55%). Four major themes with emerged from the thematic analysis: Acceptance towards SM Technologies, Perceived SM Benefits, Perceived SM Barriers, and Responses When Facing SM Barriers. Participants across both subgroups perceived SM as positive feedback, aiding in diet and physical activity behavior changes. Both groups cited individual and technical barriers to SM, including forgetfulness, the burdensome SM process, and inaccuracy. The Responder Group displayed positive problem-solving skills that helped them overcome the SM barriers. In contrast, some in the Non-responder Group felt discouraged from SM. Both subgroups found diet SM particularly challenging, especially due to technical issues such as the inaccurate food database, the time-consuming food entry process in the Fitbit app. Conclusions: Our study indicates that qualitative analysis is valuable for translating data-driven findings to actionable intervention improvement strategies. Our findings may inform the development of practical SM improvement strategies in future digital lifestyle interventions for weight loss. Notably, building problem solving skills emerge as a key approach to prevent potential non-responders from intervention disengagement. [ABSTRACT FROM AUTHOR]

Background: This case report explores the long-term dynamics of insulin secretion and glycemic control in two patients with diabetes mellitus type 2 over 20 years. The observations underscore the impact of lifestyle interventions, including weight loss and calorie restriction, on insulin secretion patterns and glucose levels during 75 g oral glucose tolerance tests. Additionally, the role of hemoglobin A1c fluctuations, influenced by various factors such as body weight, exercise, and pharmacological interventions, is investigated. Case presentation: Case 1 involves a Japanese woman now in her late 70s who successfully maintained her hemoglobin A1c below 7% for over two decades through sustained weight loss and lifestyle changes. Despite a gradual decline in the homeostasis model assessment of β cell function, the patient exhibited remarkable preservation of insulin secretion patterns over the 20-year follow-up. In case 2, a Japanese woman, now in her early 70s, experienced an improvement in hemoglobin A1c to 6.3% after a period of calorie limitation due to a wrist fracture in 2018. This incident seemed to trigger a temporary rescue of pancreatic β cell function, emphasizing the dynamic nature of insulin secretion. Both cases highlight the potential for pancreatic β cell rescue and underscore the persistence of insulin secretion over the 20-year follow-up. Additionally, we have briefly discussed three additional cases with follow-ups ranging from 10 to 17 years, demonstrating similar trends in glucose and insulin ratios. Conclusions: Long-term lifestyle interventions, such as weight loss and calorie restriction, can preserve pancreatic β cell function and maintain glycemic control in type 2 diabetes patients over 20 years. Two patients showed stable or improved insulin secretion and favorable hemoglobin A1c levels, challenging the traditional view of irreversible β cell decline. The findings highlight the importance of personalized, nonpharmacological approaches, suggesting that sustained lifestyle changes can significantly impact diabetes management and potentially rescue β cell function. [ABSTRACT FROM AUTHOR]

Background. High numbers of young people are living with obesity in England, with associated negative impacts on their mental and physical health. Social prescribing involves professionals referring individuals to community‐based services to provide additional health and well‐being support. Social prescribing may be a helpful way to provide holistic support to young people living with obesity alongside weight management services. However, there is a need to better understand the availability of community‐based services that could provide this support. Aims. This study aimed to explore the process for mapping community‐based services to be part of a social prescribing offer within children's specialist weight management services in one region of England and to provide an understanding of the availability of community‐based services in this region that are accessible for this population. Method. Community‐based services providing physical activity opportunities to young people in an area local to a specialist weight management service (South Yorkshire) were mapped using a mixed methods approach, including scoping of online resources and meetings with relevant contacts. Services were identified and reviewed against criteria developed through stakeholder engagement to assess suitability for young people living with obesity. Results. A total of 933 community‐based services were identified across South Yorkshire between January and June 2023. Scoping and suitability assessment of these services took 6 months. There was often limited information provided about services, particularly relating to costs. Nineteen services met all suitability criteria. Conclusion. It requires time and capacity to identify relevant community‐based services as part of a social prescribing offering. Although a high number of services were identified, few of these were suitable for young people living with obesity. Consideration should be given to how young people can be supported to access services, as well as how services can be supported to meet the needs of young people living with severe obesity. [ABSTRACT FROM AUTHOR]

Background: Obesity, characterized by excessive fat accumulation, poses a significant public health challenge globally. Recent advancements in medical technology have heralded the emergence of endoscopic bariatric treatments (EBTs) as innovative alternatives to conventional obesity interventions. Despite previous systematic reviews and network meta-analyses, they also highlighted discrepancies in outcomes and efficacy among different EBTs. Here, we will update a systematic review and network meta-analysis of randomized controlled trials (RCTs) focusing on EBTs and presents a protocol for the reproducibility and transparency. Methods: The core protocol of this study was registered at PROSPERO database (CRD42024514249) on Jan 2024. Core databases including MEDLINE through PubMed, Embase, and Cochrane library will be searched relevant studies, and a systematic review with network meta-analysis will be performed. Two evaluators (EJ Gong and CS Bang) will independently screen the titles and abstracts following the eligibility criteria; (1) RCTs investigated the compared the efficacy of EBTs and controls; (2) studies published in English; and (3) studies in full-text format. We will exclude studies meeting the following criteria; (1) studies that did not report the treatment outcomes, such as percent excess weight loss or percent total body weight loss; (2) case reports and review articles; (3) ineligible research objects, for example, animals or children; and (4) insufficient data regarding treatment outcome. The primary outcomes will be the common efficacy metric found after systematic review of relevant studies, such as percent excess weight loss or percent total body weight loss with a follow-up of at least 6 months. Narrative (descriptive) synthesis is planned and quantitative synthesis will be used if the included studies are sufficiently homogenous. The quality of the identified studies will be assessed using the Cochrane Risk of Bias assessment tool version 2.0 (ROB 2.0). All the systematic review and network meta-analysis process will be undertaken keeping the principles of the Preferred Reporting Items for a Systematic Review and Meta-analysis for systematic review protocols (PRISMA-P) and PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions (PRISMA-NMA). Discussion: This updated systematic review and network meta-analysis will provide information about comparative efficacy of various EBTs and this will help physicians in the decision-making process for the selection of treatment modalities in the clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the tissue dissolving capacities of sodium and calcium hypochlorite [NaOCl and Ca(OCl)2] solutions applied without activation or with two irrigant activation methods. Materials and Methods: One hundred and eight dentin cavities were prepared. Preweighed tissue pieces were placed in these dentin cavities, and samples were divided into nine groups of twelve. In groups 1, 2, and 3, NaOCl was used with non-activation (NA), passive ultrasonic (PUA), and laser activation (LA). With the same techniques, Ca(OCl)2 was used in groups 4, 5, and 6, and distilled water was used in groups 7, 8, and 9. The weight loss of tissue samples was calculated and analyzed using Two-way ANOVA and Duncan tests. Results: Distilled water groups showed no tissue dissolution in any conditions. NaOCI and Ca(OCI)2 showed statistically similar dissolving effectiveness when used with the same technique. Activated groups dissolved significantly greater tissue than non-activated ones, the highest in LA. Conclusions: Ca(OCI)2 can be an alternative to NaOCl; for both, the first choice of activation may be the LA. [ABSTRACT FROM AUTHOR]

Introduction: Antimicrobial therapy plays a crucial role in the management of CDI patients. However, the standard agent for treating CDIs is limited to oral fidaxomicin or vancomycin. For patients made nil by mouth, there is a clinically urgent and essential need to develop an intravenous antibiotic. Methods: For C. difficile with the lowest MIC of nemonoxacin and vancomycin, the inhibitory effects were tested using the kinetic time-kill assay and ex vivo coculture model. The effectiveness of nemonoxacin and vancomycin in inhibiting spore germination, the sporicidal activity, and the treatment of mice with CDIs were compared. Results: For clinical isolates and laboratory strains, lower MICs of nemonoxacin against C. difficile than levofloxacin and ciprofloxacin were observed, even in those harboring point mutations in the quinolone-resistance determining region. Although nemonoxacin failed to suppress spore outgrowth and germination in C. difficile, it exhibited an effective inhibitory effect against C. difficile in the kinetic time-kill assay and the ex vivo co-culture model. Mice receiving intraperitoneal nemonoxacin had less weight loss, higher cecum weight, a longer colon length, and lower expression of the tcdB gene, compared with untreated mice. Notably, there were no significant differences observed in weight loss, cecum weight, colon length, or tcdB gene expression between mice treated with vancomycin and those treated with any dose of nemonoxacin. Similarly, no significant differences were found between mice receiving combination therapy of intraperitoneal nemonoxacin plus oral vancomycin and those treated with intraperitoneal nemonoxacin or oral vancomycin alone. Discussion: The potential role of nemonoxacin, which can be administered parenterally, for treating CDIs was evidenced through the in vitro, ex vivo, and mouse models. [ABSTRACT FROM AUTHOR]

Weight loss induced by glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) and dual glucagon‐like peptide‐1 receptor (GLP‐1R)/glucose‐dependent insulinotropic polypeptide receptor agonists is coming closer to the magnitudes achieved with surgery. However, with greater weight loss there is concern about potential side effects on muscle quantity (mass), health and function. There is heterogeneity in the reported effects of GLP‐1‐based therapies on lean mass changes in clinical trials: in some studies, reductions in lean mass range between 40% and 60% as a proportion of total weight lost, while other studies show lean mass reductions of approximately 15% or less of total weight lost. There are several potential reasons underlying this heterogeneity, including population, drug‐specific/molecular, and comorbidity effects. Furthermore, changes in lean mass may not always reflect changes in muscle mass as the former measure includes not only muscle but also organs, bone, fluids, and water in fat tissue. Based on contemporary evidence with the addition of magnetic resonance imaging‐based studies, skeletal muscle changes with GLP‐1RA treatments appear to be adaptive: reductions in muscle volume seem to be commensurate with what is expected given ageing, disease status, and weight loss achieved, and the improvement in insulin sensitivity and muscle fat infiltration likely contributes to an adaptive process with improved muscle quality, lowering the probability for loss in strength and function. Nevertheless, factors such as older age and severity of disease may influence the selection of appropriate candidates for these therapies due to risk of sarcopenia. To further improve muscle health during weight loss, several pharmacological treatments to maintain or improve muscle mass designed in combination with GLP‐1‐based therapies are under development. Future research on GLP‐1‐based and other therapies designed for weight loss should focus on more accurate and meaningful assessments of muscle mass, composition, as well as function, mobility or strength, to better define their impact on muscle health for the substantial number of patients who will likely be taking these medications well into the future. [ABSTRACT FROM AUTHOR]

Obesity is a complex chronic disease with increasing prevalence across the globe. Medical nutrition therapy (MNT) is an important component of obesity treatment, and low‐calorie diets (LCDs) and very‐low‐calorie diets (VLCDs) are part of the MNT toolbox. This narrative review focuses on the latest evidence and clinical guidelines regarding the use and impact of meal replacements (MRs) as part of LCDs/VLCDs for the treatment of obesity and some associated complications. MRs can be used in conjunction with food as partial diet replacement (PDR) or can be used exclusively to serve as the sole source of dietary energy (total diet replacement [TDR]). Use of MR may be associated with better control of cravings and hunger typically observed during reduced calorie intake through effects of ketosis or stimuli narrowing, although the exact mechanisms for these effects remain unclear. Several clinical guidelines have endorsed the use of MRs as a part of MNT for obesity, primarily based on evidence that shows an average weight reduction of ~10 kg or more with TDR over at least 12 months in large, randomized controlled trials. When compared to usual care controls, these effects are 6–8 kg greater, and when compared to food‐based diets, the effects are nearly twice the effect of a food‐based diet. MR‐based diets have been found to be safe and associated with improvements in quality of life. These diets are also effective for improving key cardiometabolic health outcomes, including dysglycaemia, blood pressure, lipids, and metabolic associated fatty liver. The effectiveness, safety, and associated health improvement makes MRs use a valuable strategy for several higher risk clinical scenarios where weight reduction is indicated. [ABSTRACT FROM AUTHOR]

Background: Binge eating (BE) is associated with a range of cognitive control deficits related to impulsivity, including lower response inhibition, preference for immediate gratification, and maladaptive decision-making. The aim was to investigate whether impulsivity and BE may interact with the decision process and underlying brain activity in outpatients with overweight or obesity who are starting a treatment to achieve weight loss. Methods: A sample of 26 treatment-seeking outpatients with overweight or obesity was evaluated for impulsivity, BE, and temporal discounting rates. Impulsivity was measured with the Barratt Impulsiveness Scale (BIS-11), according to which two groups were composed: high BIS and low BIS; BE was assessed with the eating disorders module of the Structured Clinical Interview for DSM5—Research Version, according to which two groups were composed: with (BE group) or without BE (NBE group). Changes in subjective value of rewards were measured with the Temporal Discounting Task (TDt) where participants had to choice between sooner but smaller vs. later but larger monetary rewards. These choices were made in two differently delayed conditions ("Now" and "Not-now"). Brain rhythms were recorded through high-density electroencephalogram (hd-EEG) during the TDt. Results: Patients with BE reported more impulsive tendencies and perceived sooner rewards as more gratifying when both options were delayed (Not-now condition, p = 0.02). The reward choice in the TDt was accompanied by a general EEG alpha band desynchronization in parietal areas observed without differences between experimental conditions and patients groups. No effects were observed within the Now condition or in the other EEG bands. Conclusions: The tendency to favor immediate rewards may constitute an obstacle to adhering to treatment plans and achieving weight loss goals for outpatients with overweight or obesity. Clinicians are therefore encouraged to include psychological factors, such as impulsivity and dysfunctional eating behaviors, when designing weight loss programs. By addressing these psychological aspects, clinicians can better support patients in overcoming barriers to adherence and achieving sustainable weight loss. Trial registration: This study was approved by the Ethics Committee of the Department of Psychological, Health, and Territorial Sciences of the University G. d'Annunzio of Chieti-Pescara (Prot. n. 254 of 03/14/2017). Plain English Summary: Although the health risk of overweight and obesity is widely acknowledged, weight loss treatments are often unsuccessful in the long term due to several factors. Binge eating (BE) might explain some of the reduced benefits from the treatments. In this study, we investigated whether impulsivity and BE may interact decision processes among outpatients with overweight or obesity, and we looked at their underlying brain activity. Patients with BE tended to be more impulsive and to prefer sooner rewards compared to later ones. In all patients, α oscillations in the parietal lobe have been observed to play a dominant role during reward choice processes. A preference for immediate rewards might help to explain the low long-term success of weight loss treatment plans. The study may also provide useful information for clinicians working with patients with overweight or obesity. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of the NSW Health "Get Healthy Information and Coaching Service®"(Get Healthy) to facilitate weight loss on a population scale has been documented, but this was based on self-reported measures. Our study aims to test the effectiveness of the Get Healthy Service on objectively measured weight, BMI, waist circumference, and changes in other health behaviours, including nutrition, physical activity and alcohol intake. Methods: Men and women aged 40–70 years (n = 154) with pre-diabetes (5.7% < HbA1c < 6.5%) were referred from GP Practices to the Get Healthy Service, NSW Health. A subset (n = 98) participated in the "Zinc In Preventing the Progression of pre-Diabetes" (ZIPPeD) trial (ACTRN12618001120268). Results: The self-reported outcomes showed a statistically significant improvement from baseline to 12 months in weight (mean 2.7 kg loss, p < 0.001), BMI (mean 1 unit reduction, p < 0.001), and waist circumference (mean 4.3 cm reduction, p < 0.001). However, in the objectively measured outcomes from ZIPPeD, the differences were more modest, with point estimates of 0.8 kg mean weight loss (p = 0.1), 0.4 unit reduction in BMI (p = 0.03), and 1.8 cm reduction in waist circumference (p = 0.04). Bland-Altman plots indicated that discrepancies were due to a small number of participants who dramatically underestimated their weight or BMI. There were minimal changes in nutrition, physical activity, and alcohol. Conclusions: The potential benefits of Get Healthy should be interpreted with caution as we have shown significant differences between self-reported and objectively measured values. More valid and objective evidence is needed to determine the program's effectiveness and cost-effectiveness. [ABSTRACT FROM AUTHOR]

Background and Objectives Two exploratory 6-month pilots of triadic walking with culturally celebratory social reminiscence in gentrifying neighborhoods tested feasibility and health impact among normal and mildly cognitively impaired (MCI) older Black adults. Research Design and Methods Fourteen triads walked 1-mile 3×/week, using a navigational application with image-based reminiscence prompts. Focus groups evaluated perceived health impact and experience. Primary outcome measures were program evaluations (feasibility), pre–post self-report health, Montreal Cognitive Assessment, blood pressure, and weight. Analysis used mean rank scores for program evaluations, pre–post paired t -tests for health outcomes, and thematic coding for 30 focus groups. Results Feasibility: Retention was 74% and 86% for pilots, and 100% and 92%, respectively, were "extremely likely" to recommend to friends/family. Mean rank scores indicated appropriate pace and dose, effective conversational prompts, and program readiness with minor changes. Health impact: Self-rated health, mood, activity levels, and energy improved, days feeling downhearted decreased, and days feeling calm/peaceful were maintained or improved. Among Cohort 2, cognitive assessment scores were maintained or improved for 67%; for MCI, 76% had mean improvement of 2.4 (p  = .045). Blood pressure and weight decreased for 78% and 44%, respectively. Focus groups: Perceived impact of triadic walking included increased physical and social activity outside the program, increased awareness of cognitive decline risk and personal agency, and deep-seated sense of community connection. Discussion and Implications Triadic walking provides structure, accountability, connection, and purpose, motivating sustained engagement. Walking programs that center socialization, particularly within culturally meaningful contexts, may be more effective among older Black adults. Clinical Trial Registration Number NCT05906654 ; NCT05906667 [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer cachexia is a complex metabolic condition that is often overlooked and recognized in a late irreversible phase. There is a continuing effort to discover and define a biochemical biomarker of the condition. In this study, we have chosen interleukin-13 (IL-13) and transforming growth factor beta (TGF-β), i.e., two cytokines with presumed roles in the development of cancer cachexia, and we measured their concentrations in the serum and saliva of cachectic patients with metastatic solid tumors, non-cachectic patients with metastatic solid tumors, and healthy individuals. We have demonstrated the role of saliva cytokine measurement as a potential sample for cachexia investigations as opposed to the standard approach to biomarker research, which is serum measurement. We have also found that the salivary IL-13 and TGF-ß are independent risk factors and thus could serve as potential biomarkers of the condition, a fact that warrants further research and confirmation. Cancer cachexia is a syndrome characterized by weight and muscle loss and functional impairment, strongly influencing survival in cancer patients. In this study, we aimed to establish the role of saliva cytokine measurement in cancer cachexia investigation and define two potential independent salivary biomarkers of the condition. Methods: serum and saliva specimens were obtained from 78 patients. Forty-six patients were non-cachectic, and 32 patients were cachectic (per SCRINIO group criteria), all with metastatic solid tumors. Commercial ELISA kits were used to determine the salivary and serum concentrations of interleukin 13 (IL-13) and transforming growth factor beta (TGF-β) in two patient groups and healthy controls. Laboratory values were obtained from the hospital information system, and weight and height were measured at the time of sampling. Results: A statistically significant difference was observed between the groups in saliva IL-13 concentrations but no difference in serum concentrations. Statistically significant differences were also observed between the groups in saliva and serum concentrations of TGF-β. Logistic regression analysis has identified salivary IL-13 and TGF-β as independent factors for cancer cachexia. Conclusions: We demonstrated saliva as a valuable specimen for cachexia investigation and established IL-13 and TGF-β as potential cancer cachexia biomarkers. Further research is needed to evaluate these findings. [ABSTRACT FROM AUTHOR]

Very low energy diets (VLEDs) contain <800 kcal/day and typically comprise formulated meal replacement products with adequate protein and micronutrients. Food-based VLEDs are an alternative approach, but it is uncertain whether they can provide adequate nutrition within an 800 kcal/day restriction. This analysis aimed to assess the nutritional adequacy of food-based VLEDs compared with formula VLEDs. A systematized literature review was conducted to identify balanced food-based VLEDs by searching five scientific databases from inception to 23 March 2023 and online sources between 1 and 7 May 2023. Ultimately, nine diets were analyzed for nutritional content and compared with Codex Alimentarius standards for formula foods, and Australian estimated average requirement and adequate intake (AI) for adults 19–50 years. Optifast® was used as a comparator. None of the VLEDs met all nutritional benchmarks. Three food-based diets had nutrient profiles similar to formula VLEDs, with one being adequate for all nutrients except thiamine, magnesium and zinc in men and iron in women. All VLEDs, including Optifast®, did not meet AI for dietary fiber, except one. In general, food-based VLEDs offered more fiber than Optifast®. In conclusion, food-based VLEDs were inadequate in certain micronutrients but offered more dietary fiber than formula VLEDs. These nutritional deficits do not preclude food-based VLEDs from being recommended, provided they are addressed. [ABSTRACT FROM AUTHOR]

Obesity is a critical public health issue, necessitating effective weight loss interventions. While various dietary regimens have been explored, individual responses to interventions often vary. This study involved a 3-month dietary intervention aiming at assessing the role of macronutrient composition and the potential role of genetic predisposition in weight loss among Greek adults. This randomized clinical trial followed the CONSORT principles, recruiting 202 participants overall; 94 received a hypocaloric, high-protein diet and 108 received a high-carbohydrate, hypocaloric diet. Genetic predispositions were assessed through 10 target variants known for their BMI associations. Participants' weight and BMI values were recorded at baseline and post-intervention (n = 202 at baseline, n = 84 post-intervention) and an imputation method was applied to account for the observed missing values. Participants experienced a statistically significant weight loss across all dietary regimens (p < 0.001). Genetic analyses did not display statistically significant effects on weight loss. No significant differences in weight loss were observed between macronutrient groups, aligning with the POUNDS Lost and DIETFITS studies. This study underscores the importance of dietary interventions for weight loss and the potential contributions of genetic makeup. These findings contribute to obesity management within the Greek population and support the need for further research in personalized interventions. [ABSTRACT FROM AUTHOR]

Background/Objectives: Traditional weight-loss methods often result in the loss of both fat and muscle mass. For individuals with sarcopenic obesity (SO), additional muscle loss can exacerbate sarcopenia, leading to further declines in muscle strength and function, ultimately worsening quality of life. To mitigate this risk, weight-loss strategies should emphasize the preservation and building of muscle mass through adequate protein intake and tailored resistance training. This study aimed to evaluate changes in SO status following a 4-week multidisciplinary weight-loss intervention program in hospitalized patients with obesity. Methods: This study included adult patients with obesity (BMI > 30 kg/m2, aged 18–90 years). The SO diagnosis was performed using the handgrip strength (HGS) test and skeletal muscle mass (SMM) by bioelectrical impedance analysis (BIA) according to ESPEN/EASO-2022 guidelines. Results: A total of 2004 patients were enrolled, 64.8% female, with a mean age of 56 (±14) years and a BMI of 40.7 (±6.48) kg/m2. SO was present in 9.38% (188 patients) at baseline. At discharge, 80 patients (42.55%) were no longer classified as sarcopenic and showed significant improvements in HGS. The likelihood of resolving SO was not modified in patients with only phase angle (PhA) improvement (p-value = 0.141). Patients with HGS increment had a 65% probability to be No-SO at discharge and this probability, with the concomitant PhA increment, rose to 93% (p-value < 0.0001), indicating that functional changes and good nutrition status are crucial in improvement of SO. Muscle mass (MM) and SMMI remained unchanged in the studied cohort. Conclusions: Improvements in HGS and the PhA are potential markers for the efficacy of weight-loss programs tailored to patients with SO. These findings suggest that specific interventions focusing on these markers could be beneficial in managing SO patients. [ABSTRACT FROM AUTHOR]

Background: Psychiatric symptoms are highly prevalent in patients with severe obesity, often representing pivotal factors in the development and progression of this condition. This study examines the association between negative emotional dysregulation (NED) and weight loss following bariatric surgery. Methods: Ninety-nine patients were consecutively enrolled at the Obesity Center of the Pisa University Hospital between March 2019 and February 2021, during a routine psychiatric evaluation before bariatric surgery. Psychopathological dimensions were assessed using the Mini-International Neuropsychiatric Interview (MINI), the Reactivity, Intensity, Polarity, and Stability questionnaire in its 40-item version (RIPoSt-40), the Wender–Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) and the Barratt Impulsiveness Scale (BIS-11). Based on a RIPoSt-40 cut-off score of 70, subjects were divided into two groups: with (NED+) and without (NED−) NED. Results: NED+ subjects had a higher rate of psychiatric comorbidities and eating disorders than NED− patients. Of the total sample, 76 underwent bariatric surgery, and 65 of them were re-evaluated one-year after surgery. Among them, 10 of 28 NED+ subjects (37.5%) had inadequate weight loss one year after surgery compared to 5 of 37 NED− subjects (13.5%) (p = 0.035, OR 3.55, 95%, C.I. 1.05–12.03). Conclusions: Our results suggest a significant association between NED and inadequate weight loss at one-year post surgery. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery (BS) is effective for achieving significant weight loss. However, weight regain (WR) is an emerging problem. Objective: To assess the prognostic value of morning serum cortisol, a 1 mg dexamethasone suppression test (DST), 24 h urinary free cortisol (UFC) and late-night salivary cortisol (LNSC) in a cohort of patients with severe obesity (pwSO) undergoing BS in terms of weight loss and WR. Methods: Patients scheduled for BS underwent the following procedures at baseline, 12 months and 24 months after BS: medical history, anthropometric data, blood analysis and cortisol tests. We evaluated total weight loss (TWL) ≥ 30% at 1 year and WR after 2 years as an increase of ≥10% of the maximum weight lost. Results: In total, 142 subjects were included; 101 (71.1%) were females and the mean age was 45.9 ± 9.2 years. Up to 76.8% of subjects achieved ≥30% TWL, without statistically significant differences in DST results or morning serum cortisol, UFC or LNSC levels. However, a higher pre-surgery morning serum cortisol level was a significant predictor of a WR ≥ 10% (cortisol 17.8 [IQR 13.1–18.5] vs. 12.0 [IQR 8.8–15.8] μg/dL; p < 0.01); OR of 1.216 (95% CI 1.069–1.384); AUC [0.761, CI: (0.616–0.906); p < 0.01]. A cut-off value of cortisol > 13.0 μg/dL was predictive of a WR ≥ 10% (sensitivity 0.71; specificity 0.63). Conclusions: No cortisol test was useful in predicting weight loss; however, the pre-surgery morning serum cortisol level was able to predict a WR ≥ 10% in a cohort of pwSO 2 years after BS. A cut-off value of cortisol > 13 μg/dL might be an easy tool to identify patients at higher risk of WR, enabling healthcare providers to implement tailored, long-term strategies to minimize this outcome. [ABSTRACT FROM AUTHOR]

Introduction: Several previous studies have explored whether sex has prognostic significance in patients with small cell lung cancer (SCLC). In this retrospective study, we aimed to show the clinical significance of sex in SCLC patients. Methods: A total of 378 SCLC patients were assessed retrospectively. Results: Sixty-one (16.1%) patients were women; 26 of 131 (19.9%) patients had limited disease (LD-SCLC); and 14.2% of patients (35 of 247 patients) had extended disease (ED-SCLC). In all SCLC patients, regardless of stage, female patients were more likely to be nonsmokers (7.7 vs. 1%, p = 0.04 for LD-SCLC; and 11.4 vs. 1.4%, p = 0.001 for ED-SCLC) and more often to be anemic (26.9 vs. 11.4%, p = 0.04 for LD-SCLC; and 45.7 vs. 28%, p = 0.03 for ED-SCLC). While women with LD-SCLC were diagnosed younger (<60) than men (65.4 vs. 37.1%, p = 0.009), they had larger (>5 cm) tumors (69.2 vs. 42.9%, p = 0.01). Moreover, obesity (77.1 vs. 56.4%, p = 0.02) and less weight loss (88.6 vs. 73.6%, p = 0.04) were more common in women with ED-SCLC than in men. However, there were no associations between sex and significant prognostic factors, such as performance status, metastasis site, serum LDH level, response to chemotherapy, and disease recurrence. Outcomes in LD-SCLC patients were found to be similar between sexes; median overall survivals in women compared to men was 18 versus 15 months, respectively (p = 0.8). On the other hand, female patients with ED-SCLC had better survivals; median survivals for women versus men were 10 versus 7 months, respectively (p = 0.008). This significance for female ED-SCLC patients was also maintained in the multivariate analysis (p = 0.001). Conclusion: While the survival rates of female patients, who constitute a small proportion of SCLC patients, are no different from men in LD-SCLC, they are better in ED-SCLC. [ABSTRACT FROM AUTHOR]

BACKGROUND:-Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. HIV infection is a multisystem disease and is associated often with a wide range of hematological abnormalities, including impaired hematopoiesis, immune mediated cytopenias and coagulopathies, particularly in the later part of the disease. These hematological abnormalities include anemia, leukopenia, thrombocytopenia, and sometimes pancytopenia with variable bone marrow abnormalities. Here we study the hematological abnormalities and clinical profile in HIV positive patients before and after 3 months of ART. Hence all newly diagnosed HIV patients were investigated for hematological abnormalities as it has a significant impact on the clinical outcome and treated accordingly to reduce morbidity and mortality and improve the quality of life. METHODOLOGY:- A comparison study was conducted in a tertiary care center Guru Gobind Singh Medical College & Hospital Faridkot, Punjab for a period of 18 months on 100 HIV positive patients. The patients admitted to the Department of Medicine, attended OPD and ART center with the diagnosis of HIV infection as per standard NACO criteria were included in the study. A detailed history, physical examination, and relevant investigations were conducted. Data were collected using a pre-tested proforma to meet the objectives of the study. RESULT:-In total 100 HIV positive patients the mean age (years) was 37.90 ± 11.66 and males were more common than females .35.0% of the participants had infection of HIV by heterosexual route of transmission, followed by intravenous drug use, by needle injury, by unknown source and only one percent had from mother to child transmission. In clinical profile common symptoms were malaise 38%, followed by fever 27%, weight loss 27%, than females .35.0% of the participants had infection of HIV by heterosexual route of transmission, followed by intravenous drug use, by needle injury, by unknown source and only one percent had from mother to child transmission. In clinical profile common symptoms were malaise 38%, followed by fever 27%, weight loss 27%, rash 14%, oral thrush 13%, cough 11%, seizure 2%, lymphadenopathy 1% and diarrhea 1% before taking ART. In hematological profile anemia (46%) was the most common laboratory finding in the study, followed by thrombocytopenia (24%) and leucopenia (8%).A significant improvement was seen in hematological parameters and clinical profile after 3 months of ART. Non significant changes was observed in liver function test and renal function test in the study. CONCLUSION:- The prevalence of anemia, leucopenia and thrombocytopenia was relatively more common in HIV infected treatment naïve patients as compared to those on ART. [ABSTRACT FROM AUTHOR]

Goal-oriented exercise motives are important predictors of men's physical activity behaviours and experiences, and body-related perceptions. To date, men's exercise goal motives have been studied predominantly in isolation, and person-centred approaches that identify distinct goal motive profiles and their correlates have been limited. To address this gap, 322 men (mean age = 34.15, SD = 11.53) were recruited to participate in an online multi-national cross-sectional survey, and latent profile analysis was used to identify profiles based on an adapted version of the Reasons for Exercising Inventory. Comparisons were made for levels of LTPA, physical activity enjoyment, body surveillance, and body attitudes between the profiles. Five profiles were identified, with three profiles having low, average, and high levels of all forms of goal-oriented motives, respectively. Additionally, one profile was characterised mainly by appearance goals and one profile by weight loss goals. Participants in the low overall goal-oriented motivation profile participated in less LTPA than the other profiles, and the participants in the weight loss and appearance profiles reported significantly less exercise enjoyment than the high overall goal-oriented motivation profile. As expected, participants in the profile motivated by appearance reported greater body surveillance and more negative body attitudes. Leveraging a person-centred approach, these results advance previous literature on men's exercise goal-oriented motives, and the ways in which distinct goal-oriented motive profiles are associated with physical activity experiences and body-related perceptions. Interventions targeting different forms of goal-oriented motivation may have the potential to enhance men's physical activity experiences and body-related perceptions. [ABSTRACT FROM AUTHOR]

Tobacco stalk is a cellulose-rich material and a sustainable alternative to be applied as a plant-based nanofibrillated cellulose (NFC) source. NFC use has garnered attention in the development of oral pharmaceutical forms, despite concerns about its safety due to the adverse effects of nicotine on health. Therefore, we aimed at establishing the safety of NFC derived from tobacco stalk for its potential use as a novel pharmaceutical excipient, exploring its potential functions for tablet production. We conducted acute and subchronic oral toxicity tests in adult female Wistar rats. Initially, individual animals received sequential doses (175–5,000 mg·kg−1) for 24 hours followed by a careful observation of any toxic effects. Subsequently, 20 rats were divided into four groups for a subchronic assay, evaluating toxicity signs, body weight changes, hematological, biochemical, and histopathological parameters. No deaths or other clinical toxicity signs were observed in either the acute or the subchronic assays. We noticed a significant reduction in body weight gain (p < 0.05) after 14 days. We found statistical differences for hematological and biochemical parameters, unrelated to dosage. There were no observed toxic effects, and tobacco stalk ingestion did not adversely affect organ morphology in the histopathological evaluation. The oral administration of NFC at 5,000 mg·kg−1 per day for 28 days was well-tolerated by treated rats, with no reported deaths. In conclusion, NFC derived from tobacco stalk has shown to be a sustainable and safe alternative for use as an excipient at experimental doses, demonstrating compatibility with its proposed applications. [ABSTRACT FROM AUTHOR]

Objective: The aim of this meta-analysis was to investigate the effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on blood glucose and weight in adolescents with overweight/obesity and/or type 2 diabetes mellitus (T2DM) aged <18 years. Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched for all randomized controlled trials (RCTs) up to August 2023 comparing GLP-1RAs with placebo in overweight/obese and/or T2DM adolescents and extracted relevant data for meta-analysis. Results: Fourteen RCTs were included in the meta-analysis with a total of 1,262 participants. Results revealed that the GLP-1RAs group had a more significant reduction in glycosylated hemoglobin A1c (HbA1c; risk difference (RD)=-0.34%, p<0.001) than the control group. However, there was no difference in fasting plasma glucose [fasting plasma glucose (FPG); RD=-2.07 mg/dL, p=0.065] between the two groups. Nonetheless, the experimental group that received exenatide showed no significant reduction in HbA1c (p=0.253) and FPG (p=0.611) between the two groups. The GLP-1RAs group had a more significant decline in body weight (RD=-4.28 kg, p=0.002) and body mass index (BMI) (RD=-1.63 kg/m2, p=0.002) compared to the control group. The experimental group was given liraglutide (RD=-2.31 kg, p=0.038) or exenatide (RD=-2.70 kg, p<0.001). Compared to the control group, the experimental group had a more significant drop in body weight than the control group. However, for the experimental group that received liraglutide, the BMI had a no significant reduction between the two groups (RD=-0.81 kg/m2, p=0.260). For the experimental group using exenatide, BMI declined more significantly in the intervention group than in the control group (RD=-1.14 kg/m2, p<0.001). Conclusion: This study showed that GLP-1RAs reduced HbA1c, FPG, and weight loss in overweight/obese and/or T2DM adolescents. Liraglutide was better than exenatide in terms of glucose reduction. Nevertheless, in terms of weight control, exenatide was more effective than liraglutide. [ABSTRACT FROM AUTHOR]

Tailings dust can negatively affect the surrounding environment and communities because the tailings are vulnerable to wind erosion. In this study, the effects of halides (sodium chloride [NaCl], calcium chloride [CaCl2], and magnesium chloride hexahydrate [MgCl2·6H2O]), and polymer materials (polyacrylamide [PAM], polyvinyl alcohol [PVA], and calcium lignosulfonate [LS]) were investigated for the stabilization of tailings for dust control. Erect milkvetch (Astragalus adsurgens), ryegrass (Lolium perenne L.), and Bermuda grass (Cynodon dactylon) were planted in the tailings and sprayed with chemical dust suppressants. The growth status of the plants and their effects on the mechanical properties of tailings were also studied. The results show that the weight loss of tailings was stabilized by halides and polymers, and decreased with increasing concentration and spraying amount of the solutions. The penetration resistance of tailings stabilized by halides and polymers increased with increasing concentration and spraying amount of the solutions. Among the halides and polymers tested, the use of CaCl2 and PAM resulted in the best control of tailings dust, respectively. CaCl2 solution reduces the adaptability of plants and therefore makes it difficult for grass seeds to germinate normally. PAM solutions are beneficial for the development of herbaceous plants. Among the three herbaceous species, ryegrass exhibited the best degree of development and was more suitable for growth in the tailings. The ryegrass plants planted in the tailings sprayed with PAM grew the best, and the root-soil complex that formed increased the shear strength of the tailings. [ABSTRACT FROM AUTHOR]

Aims/Introduction: We conducted a 5 year post‐trial monitoring study of our previous randomized 24 week, open‐label, active‐controlled trial that showed beneficial effects of ipragliflozin on metabolic dysfunction‐associated steatotic liver disease (MASLD), identical to those of pioglitazone. Materials and Methods: In our previous trial, 66 patients with MASLD and type 2 diabetes were randomly assigned to receive either ipragliflozin (n = 32) or pioglitazone (n = 34). Upon its conclusion, 61 patients were monitored for 5 years for outcome measures of MASLD, glycemic, and metabolic parameters. Differences between the two groups were analyzed at baseline, 24 weeks, and 5 years; changes in outcome measures from baseline were also evaluated. Results: At 5 years, the mean liver‐to‐spleen attenuation ratio increased by 0.20 (from 0.78 ± 0.24 to 0.98 ± 0.20) in the ipragliflozin group and by 0.26 (from 0.76 ± 0.26 to 1.02 ± 0.20) in the pioglitazone group (P = 0.363). Similarly, ipragliflozin and pioglitazone significantly improved serum aminotransferase, HbA1c, and fasting plasma glucose levels over 5 years. In the ipragliflozin group, significant reductions in body weight and visceral fat area observed at 24 weeks were sustained throughout the 5 years (−4.0%, P = 0.0075 and −7.6%, P = 0.045, respectively). Moreover, ipragliflozin significantly reduced the values of fibrosis markers (serum ferritin and FIB‐4 index), was well tolerated, and had a higher continuation rate for 5 years compared with pioglitazone. Conclusions: Ipragliflozin and pioglitazone improved MASLD and glycemic parameters over 5 years. In the ipragliflozin group, significant reductions in body weight and visceral fat mass persisted for 5 years. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To compare the percent weight change and metabolic outcomes among diabetic participants with obesity on intermittent fasting (IF) 16:8, IF 14:10, or normal controlled diets. Materials and Methods: A randomized controlled trial was conducted to randomize participants into three groups. Each group followed IF 16:8, IF 14:10, according to the protocol 3 days/week for 3 months or a control group. Results: A total of 99 participants completed the study. The percentage weight change from baseline was −4.02% (95% CI, −4.40 to −3.64) in IF 16:8, −3.15% (95% CI, −3.41 to −2.89) in IF 14:10, and −0.55% (95% CI, −1.05 to −0.05) in the control group. The percentage weight loss from baseline was significantly more in both IF groups (P < 0.001, both) when compared with the control group. Weight loss was significantly more in the IF 16:8 group than in that of the IF 14:10 group (P < 0.001). Metabolic outcomes (decrease in FBS and HbA1C, and improvement in lipid profiles) were significantly improved from baseline in both IF groups in comparison with the control group. Conclusions: Either IF 16:8 or 14:10 had a benefit in the percentage weight change, glucose and lipid profiles in obese diabetic patients compared with the control group when consumed for 3 days a week for 3 months. [ABSTRACT FROM AUTHOR]

Aim: Bile acids (BAs) are implicated in the pathogenesis of several metabolic syndrome‐related diseases, including insulin resistance (IR) and type 2 diabetes (T2D). It has been reported that IR and T2D are associated with an increased ratio of 12α/non‐12α‐hydroxylated BAs in the circulating BA pool. It is, however, unknown whether the improvement of insulin sensitivity inversely affects BA composition in humans. Therefore, we assessed whether lifestyle‐induced weight loss induces changes in BA metabolism in people with obesity, with or without T2D, and if these changes are associated with metabolic parameters. Materials and Methods: Individual BAs and C4 were quantified by ultra‐high‐performance liquid chromatography‐tandem mass spectrometry in plasma samples collected from two cohorts of people with obesity (OB) and with T2D and obesity (T2D), before and after a lifestyle intervention. Results: Lifestyle‐induced weight loss improved glycaemic control in both cohorts, with plasma BA concentrations not affected by the lifestyle interventions. The ratio of 12α/non‐12α‐hydroxylated BAs remained unchanged in OB (p =.178) and even slightly increased upon intervention in T2D (p =.0147). Plasma C4 levels were unaffected in OB participants (p =.20) but significantly reduced in T2D after intervention (p =.0003). There were no significant correlations between the ratio of 12α/non‐12α‐hydroxylated BAs and glucose, insulin, or homeostatic model assessment‐IR, nor in plasma triglycerides, low‐density lipoprotein cholesterol, lipoprotein (a) in the T2D cohort. Conclusions: Lifestyle‐induced weight loss did improve glycaemic control but did not affect BA concentrations. Improvements in insulin sensitivity were not associated with changes in BA parameters in people with obesity, with or without T2D. [ABSTRACT FROM AUTHOR]

Aim: To compare the incidence of adverse events (AEs) related to antiobesity medications (AOMs; glucagon‐like peptide‐1 receptor agonists [GLP‐1RAs] vs. non‐GLP‐1RAs) after bariatric surgery. Methods: This single‐centre retrospective cohort included patients (aged 16–65 years) who had undergone laparoscopic Roux‐en‐Y gastric bypass or sleeve gastrectomy (cohort entry date) and initiated AOMs. Participants were categorized as users of US Food and Drug Administration (FDA)‐approved, off‐label, or GLP‐1RA AOMs if documented as receiving the medication on or after cohort entry date. Non‐GLP‐1RA AOMs were phentermine, orlistat, topiramate, canagliflozin, dapagliflozin, empagliflozin, naltrexone, bupropion/naltrexone and phentermine/topiramate. GLP‐1RA AOMs included: semaglutide, dulaglutide, exenatide and liraglutide. The primary outcome was AE incidence. Logistic regression was used to determine the association of AOM exposure with AEs. Results: We identified 599 patients meeting our inclusion criteria, 83% of whom were female. Their median (interquartile range [IQR]) age was 47.8 (40.9–55.4) years. The median duration of surgery to AOM exposure was 30 months. GLP‐1RAs use was not associated with higher odds of AEs: adjusted odds ratio (aOR) 1.1 (95% confidence interval [CI] 0.5–2.6) and aOR 1.1 (95% CI 0.6–2.3) for GLP‐1RA versus FDA‐approved and off‐label AOM use, respectively. AOM initiation ≥12 months after surgery was associated with lower risk of AEs compared to <12 months (aOR 0.01 [95% CI 0.0–0.01]; p < 0.001). Conclusion: Our results showed that GLP‐1RA AOMs were not associated with an increased risk of AEs compared to non‐GLP‐1RA AOMs in patients who had previously undergone bariatric surgery. Prospective studies are needed to identify the optimal timeframe for GLP‐1RA initiation. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship between thyroid function and weight regain in patients with obesity after metabolic surgery. Methods: This retrospective study enrolled 162 patients who underwent metabolic surgery. Correlations between decreases in thyroid hormone levels and changes in weight, waist circumference (WC) and the Chinese visceral adiposity index (CVAI) were assessed. Binary logistic regression and receiver operating characteristic (ROC) curves were used to identify predictors and clinically useful cut‐off values, respectively. Results: The levels of thyroid‐stimulating hormone (TSH) and free triiodothyronine (FT3) decreased markedly at 1 year after surgery, as did weight, body mass index (BMI), triglycerides, total cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, WC and CVAI. Decreases in TSH and FT3 after metabolic surgery were associated with changes in weight, BMI and CVAI. Binary logistic regression and ROC curve analyses confirmed that decreases in TSH can predict good weight loss after metabolic surgery to some extent. Finally, binary logistic regression and ROC curve analyses confirmed that changes in TSH can predict weight regain after metabolic surgery. Conclusions: Changes in TSH and FT3 after metabolic surgery were correlated with changes in weight and CVAI. Changes in thyroid hormones can predict weight regain in patients with obesity who underwent metabolic surgery. [ABSTRACT FROM AUTHOR]

Aim: To perform a meta‐analysis to investigate the effects of intermittent fasting (IF), as compared with either a control diet (CON) and/or calorie restriction (CR), on body composition and cardiometabolic health in individuals with prediabetes and type 2 diabetes (T2D). Methods: PubMed, Web of Science, and Scopus were searched from their inception to March 2024 to identify original randomized trials with parallel or crossover designs that studied the effects of IF on body composition and cardiometabolic health. Weighted mean differences (WMDs) or standardized mean differences with 95% confidence intervals (CIs) were calculated using random‐effects models. Results: Overall, 14 studies involving 1101 adults with prediabetes or T2D were included in the meta‐analysis. IF decreased body weight (WMD −4.56 kg [95% CI −6.23 to −2.83]; p = 0.001), body mass index (BMI; WMD −1.99 kg.m2 [95% CI −2.74 to −1.23]; p = 0.001), glycated haemoglobin (HbA1c; WMD −0.81% [95% CI −1.24 to −0.38]; p = 0.001), fasting glucose (WMD −0.36 mmol/L [95% CI −0.63 to −0.09]; p = 0.008), total cholesterol (WMD −0.31 mmol/L [95% CI −0.60 to −0.02]; p = 0.03) and triglycerides (WMD −0.14 mmol/L [95% CI −0.27 to −0.01]; p = 0.02), but did not significantly decrease fat mass, insulin, low‐densitiy lipoprotein, high‐density lipoprotein, or blood pressure as compared with CON. Furthermore, IF decreased body weight (WMD −1.14 kg [95% CI −1.69 to −0.60]; p = 0.001) and BMI (WMD −0.43 kg.m2 [95% CI −0.58 to −0.27]; p = 0.001), but did not significantly affect fat mass, lean body mass, visceral fat, insulin, HbA1c, lipid profiles or blood pressure. Conclusion: Intermittent fasting is effective for weight loss and specific cardiometabolic health markers in individuals with prediabetes or T2D. Additionally, IF is associated with a reduction in body weight and BMI compared to CR, without effects on glycaemic markers, lipid profiles or blood pressure. [ABSTRACT FROM AUTHOR]

A study published in the journal Diabetes, Obesity & Metabolism examined the use of semaglutide, a medication for type 2 diabetes, and its association with the risk of postoperative pneumonia in older patients with type 2 diabetes in Ontario, Canada. The study found that there was no increased risk of pneumonia among patients using semaglutide compared to those who did not use the medication. This information is important for healthcare providers and patients considering the use of semaglutide before surgery. However, further research is needed to fully understand the safety of semaglutide and similar medications in the perioperative period. [Extracted from the article]