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The worldwide obesity epidemic.sup.1 makes it important to understand how lipid turnover (the capacity to store and remove lipids) regulates adipose tissue mass. Cross-sectional studies have shown that excess body fat is associated with decreased adipose lipid removal rates.sup.2,3. Whether lipid turnover is constant over the life span or changes during long-term weight increase or loss is unknown. We determined the turnover of fat cell lipids in adults followed for up to 16 years, by measuring the incorporation of nuclear bomb test-derived .sup.14C in adipose tissue triglycerides. Lipid removal rate decreases during aging, with a failure to reciprocally adjust the rate of lipid uptake resulting in weight gain. Substantial weight loss is not driven by changes in lipid removal but by the rate of lipid uptake in adipose tissue. Furthermore, individuals with a low baseline lipid removal rate are more likely to remain weight-stable after weight loss. Therefore, lipid turnover adaptation might be important for maintaining pronounced weight loss. Together these findings identify adipose lipid turnover as an important factor for the long-term development of overweight/obesity and weight loss maintenance in humans. Long-term changes in body weight are determined by rates of adipose lipid turnover., Author(s): P. Arner [sup.1] , S. Bernard [sup.2] , L. Appelsved [sup.3] , K.-Y. Fu [sup.3] , D. P. Andersson [sup.1] , M. Salehpour [sup.4] , A. Thorell [sup.5] [sup.6] [...]

Niklas Ekerstad,1,2 Synneve Dahlin Ivanoff,3 Sten Landahl,4 Göran Östberg,5 Maria Johansson,5 David Andersson,6 Magnus Husberg,2 Jenny Alwin,2 Björn W Karlson7 1Department of Cardiology, NU (NÄL-Uddevalla) Hospital Group, Trollhättan-Uddevalla-Vänersborg, 2Department of Medical and Health Sciences, Division of Health Care Analysis, Linköping University, 3Center of Aging and Health (AGECAP), Section of Health and Rehabilitation, 4Department of Geriatrics, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, 5Division of Internal and Acute Medicine, NU Hospital Group, Trollhättan-Uddevalla-Vänersborg, 6Department of Management and Engineering, Division of Economics, 7Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Background: A high percentage of individuals treated in specialized acute care wards are frail and elderly. Our aim was to study whether the acute care of such patients in a comprehensive geriatric assessment (CGA) unit is superior to care in a conventional acute medical care unit when it comes to activities of daily living (ADLs), frailty, and use of municipal help services.Patients and methods: A clinical, prospective, controlled trial with two parallel groups was conducted in a large county hospital in West Sweden and included 408 frail elderly patients, age 75 or older (mean age 85.7 years; 56% female). Patients were assigned to the intervention group (n=206) or control group (n=202). Primary outcome was decline in functional activity ADLs assessed by the ADL Staircase 3 months after discharge from hospital. Secondary outcomes were degree of frailty and use of municipal help services.Results: After adjustment by regression analyses, treatment in a CGA unit was independently associated with lower risk of decline in ADLs [odds ratio (OR) 0.093; 95% confidence interval (CI) 0.052–0.164; P

Niklas Ekerstad,1,2 Björn W Karlson,3 Synneve Dahlin Ivanoff,4 Sten Landahl,5 David Andersson,6 Emelie Heintz,7 Magnus Husberg,2 Jenny Alwin2 1Department of Cardiology, NU (NÄL-Uddevalla) Hospital Group, Trollhattan, 2Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, 3Department of Molecular and Clinical Medicine, Institute of Medicine, 4Centre for Ageing and Health, AGECAP, Department of Health and Rehabilitation, 5Department of Geriatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 6Division of Economics, Department of Management and Engineering, Linköping University, Linköping, 7Health Outcomes and Economic Evaluation Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden Objective: The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit. Design: This is a clinical, prospective, randomized, controlled, one-center intervention study. Setting: This study was conducted in a large county hospital in western Sweden. Participants: The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206) or control group (n=202). Mean age of the patients was 85.7 years, and 56% were female. Intervention: This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. Measurements: The primary outcome was the change in health-related quality of life (HRQoL) 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3). Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. Results: After adjustment by regression analysis, patients in the intervention group were less likely to present with decline in HRQoL after 3 months for the following dimensions: vision (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.14–0.79), ambulation (OR =0.19, 95% CI =0.1–0.37), dexterity (OR =0.38, 95% CI =0.19–0.75), emotion (OR =0.43, 95% CI =0.22–0.84), cognition (OR = 0.076, 95% CI =0.033–0.18) and pain (OR =0.28, 95% CI =0.15–0.50). Treatment in a CGA unit was independently associated with lower 3-month mortality adjusted by Cox regression analysis (hazard ratio [HR] =0.55, 95% CI =0.32–0.96), and the two groups did not differ significantly in terms of hospital care costs (P>0.05). Conclusion: Patients in an acute CGA unit were less likely to present with decline in HRQoL after 3 months, and the care in a CGA unit was also independently associated with lower mortality, at no higher cost. Keywords: frailty, elderly, acute care, intervention, comprehensive geriatric assessment

The increase in integrated multitrophic aquaculture (IMTA), where seaweed (particularly Ulva rigidaC.Agardh, 1823) is used as a feedstock and a wastewater scrubber in South African IMTA systems, has necessitated research into seaweed growth rates, which hassubsequently increased production technologies. Seaweed growth can be increased by controlling the culture media. One of the means to control growth rate is through CO2gas addition to culture media via aeration. This has the potential added benefit of usingwaste CO2 production from an alternative source to decrease overall carbon dioxide emissions. The consequence of elevated CO2 concentration on the pH of culture medium and the equivalent functional reactions in the seaweed were examined using U. rigida in flow-through systems. Toxicity investigation of Hydrogen ion concentrations werecarried out on U. rigida to examine their anatomy cum functional differences arising due to CO2 exerted stress. Elevated CO2 levels and the accompanying decrease in culture media pH (4.71 - 6.67) leadto a significant decrease in biomass with varied sporulation activities. In addition, U. rigida in flow-through systems showed a gradual degeneration in specific growth rate, from day 7, atvarying rates until the end of the experiment in the following sequence pH 7.20 > 8.20 > 7.50 > 7.80. The treatment set at pH 7.20 yielded the greatest specific biomassandthe greatest produce. The cultured input stocking rate of 5 g.l-1 of seawater proved to be suitable for cultivation. ThepH toxicity reaction was significant in predicting the suitability of seaweed cultured under CO2 induced concentrations. [ABSTRACT FROM AUTHOR]