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Introduction Gastrointestinal anastomoses with classical sutures and/or metal staples have resulted in significant bleeding and leak rates. This multi-site study evaluated the feasibility, safety, and preliminary effectiveness of a novel linear magnetic compression anastomosis device, the Magnet System (MS), to form a side-to-side duodeno-ileostomy (DI) diversion for weight loss and type 2 diabetes (T2D) resolution. Methods In patients with class II and III obesity (body mass index [BMI, kg/m2] ≥ 35.0– ≤ 50.0 with/without T2D [HbA1C > 6.5%]), two linear MS magnets were delivered endoscopically to the duodenum and ileum with laparoscopic assistance and aligned, initiating DI; sleeve gastrectomy (SG) was added. There were no bowel incisions or retained sutures/staples. Fused magnets were expelled naturally. Adverse events (AEs) were graded by Clavien-Dindo Classification (CDC). Results Between November 22, 2021 and July 18, 2022, 24 patients (83.3% female, mean ± SEM weight 121.9 ± 3.3 kg, BMI 44.4 ± 0.8) in three centers underwent magnetic DI. Magnets were expelled at a median 48.5 days. Respective mean BMI, total weight loss, and excess weight loss at 6 months (n = 24): 32.0 ± 0.8, 28.1 ± 1.0%, and 66.2 ± 3.4%; at 12 months (n = 5), 29.3 ± 1.5, 34.0 ± 1.4%, and 80.2 ± 6.6%. Group mean respective mean HbA1C and glucose levels dropped to 1.1 ± 0.4% and 24.8 ± 6.6 mg/dL (6 months); 2.0 ± 1.1% and 53.8 ± 6.3 mg/dL (12 months). There were 0 device-related AEs, 3 procedure-related serious AEs. No anastomotic bleeding, leakage, stricture, or mortality. Conclusion In a multi-center study, side-to-side Magnet System duodeno-ileostomy with SG in adults with class III obesity appeared feasible, safe, and effective for weight loss and T2D resolution in the short term.

In spite of our habits, it is not immediate for us to give a meaning to the speed c of light, expressed by a number in meters per second. This supposes, on the one hand, that meter and second (space and time), are defined in a preliminary and independent way (but how to do it without supporting them on the phenomena?); and, on the other hand, that we consider light alone, without comparing it to any other phenomenon (with Poincaré, let us recognize however that only relations between quantities associated to the phenomena are accessible to us, according to a relational approach).The history of science supports these reservations: the speed of light is never estimated by the ratio of an interval of space to an interval of time, but always by the dimensionless ratio of two movements put in correspondence; we write it v/c, where v refers to another phenomenon than light. We can speak of a speed ratio, but this already supposes that time and space are defined, and, in all rigor, this is not appropriate. Symmetrically, the evaluation of a velocity v alone, for a phenomenon other than light, is not possible without involving light: one falls into a circle of endless regressions, where one only compares ratios of type v/c between them. This circle is stopped by deciding by decree (cf. the definition of the meter, 1983) the value of c = c0, which amounts to fixing the ratio between two "speeds", that of "one meter per second" and c. It is then to choose a standard, useful to compare between them all the phenomena of propagation (and to define in the process a space-time frame). In our terrestrial situation, this allows us to focus on the comparative quantification of the different velocities v (this is what interests us), referring to a fixed c0. However, it should be remembered that, in this understanding, all the motions that we measure on earth or in cosmology only refer at the beginning to ratios of the type v/c whose denominator is not more known than the numerator. Depending on the situation, we could fix one or the other, or consider that one or the other varies with respect to "values" that it has in other conditions. It seems to us in this context that we have the "right" to compare the "speed" of light to itself elsewhere or at another time, as for example that of its "local" apprehension c0 in the solar system compared to that in its cosmological paths, covering intergalactic distances. It happens that a certain number of important problems of cosmology show up by anomalous velocities v (higher than those expected) measured from the earth (dark matter, dark energy...), while each time, it is still only a ratio of the type v/c that is evaluated. One way to solve these difficulties is to assign to the speed of light in the denominator of the v/c ratio a value lower than the c0 value (the assignment of a macroscopic speed lower than the local one in the traversing of a refractive medium is a comparable approach). This is balanced by decreasing v from its initial value in our local units, and thus understanding the problematic excess that was observed. This approach seems to us to be promising and worth testing for various questions (including those concerning the shape of the rotation curves of stars in galaxies, cosmic inflation, Hubble tension, etc.). It does not prevent us from relying on the Lorentz transformation which expresses the relativity of the time and space scales associated with the motion chosen locally as a reference, and provides a fundamental structural framework for physical quantities (cf. Magueijo's analyses on the variable speed of light; our approach is not identified with his). It leads to a lengthening of the history of the universe, without compromising the scales of distances nor the sequence of stages defined by physicists. It also opens the debate on the coupled variation of the constants of physics (G, c...) already evoked in the literature.

Lors d’une exposition récente sur l’Antarctique, notre attention a été attirée par des structures spectaculaires, visibles dans certains icebergs (on trouve sur le réseau Internet des vues de telles structures dans des icebergs d’origines diverses). Celles-ci sont constituées d’ensembles de prismes verticaux de glace, ou de plans parallèles (eux aussi verticaux), formant des colonnades. Ces dernières sont séparées par des surfaces horizontales du reste de l’iceberg au-dessus (les basculements de ceux-ci modifient ces directions) ; les diamètres des prismes et les épaisseurs des plans apparaissent décimétriques à pluri-décimétriques. Les structures sont inscrites dans la masse de la glace, l’érosion marine et la fonte les soulignant et les mettant en valeur (sous des surplombs de l’iceberg massif). A notre connaissance, il ne semble pas y avoir de description raisonnée, ni de proposition d’explication. Nous nous contentons ici de brosser un cadre interprétatif potentiel. Nous ne donnons pas en détail les raisons qui nous guident ; elles sont inspirées par notre connaissance de la solidification des magmas géologiques donnant des structures comparables : orgues et plans (voir les références ci-dessous). Nous imaginons ainsi que lors de son entrée dans la mer, un morceau de glacier, qui constitue une « réserve de froid » importante, peut, dans certaines conditions, faire geler la mer à son contact dans ses parties immergées (il y a donc formation de glace nouvelle). La mer étant riche en NaCl, le point de solidification de l’eau est fonction de la teneur en sel au voisinage du contact glace / mer. Suivant les gradients de température en jeu, le phénomène de surfusion de constitution peut jouer, et l’interface glace / eau montrer une instabilité ; celle-ci est responsable de la formation de digitations, c’est-à-dire que des doigts, ou des plans parallèles de glace, s’avancent dans l’eau lors de la congélation. Les spécialistes de sciences des matériaux discutent les gradients de température en trois dimensions permettant une bifurcation entre le régime colonnaire et le régime planaire. Du fait de leur croissance, les doigts / plans vont se souder ; ils vont laisser entre eux des joints correspondant à des zones plus fragiles, mises en relief par les processus d’érosion / fonte postérieurs, lors du soulèvement de l’iceberg. Si la glace d’eau ne peut contenir de sel, elle ne peut non plus contenir toute une série d’éléments chimiques, y compris des gaz, qui vont se trouver « expulsés » à l’extérieur. Est-ce là une explication des dégagements gazeux observés le long des joints par les plongeurs (Raphaël Sané, com. pers., 2022) et parfois envisagés comme responsables des structures (alors qu’ils en seraient une conséquence) ? Nous verrons dans l’avenir si ce cadre est à garder tel quel, à amender, ou à abandonner. Il nous invite à faire des observations nouvelles, des mesures de types variés (chimiques, de pétrofabrique), à lire sur des sujets connexes, à débattre avec les personnes compétentes. Des estimations préliminaires faisant intervenir les paramètres principaux du problème (températures, enthalpie de fusion, capacités calorifiques, diffusivités thermiques et moléculaires, gradients thermiques, pente du liquidus dans le diagramme de phase, intervention de la convection solutale) sont encourageantes. Nous remercions nos collègues glaciologues de Toulouse et de Grenoble pour de premiers échanges (parmi eux Frédérique Rémy, Christian Vincent), ainsi que, de façon spéciale, Raphaël Sané (guide naturaliste) pour ses photographies et ses remarques utiles (sans vouloir compromettre aucun dans les hypothèses présentées). Nous saluons les médiateurs de la Rotonde (CCSTI de la Loire et Ecole des Mines) pour l’exposition (automne 2021) à l’origine de cette réflexion.Guy B. & Lecoze J., C.R. Acad. Sc. Paris, 1990; Guy B., J. Volc. Geoth. Res., 2010; Guy B., Thiéry V., Garcia D., Bascou J. & Broekmans M., Miner. Petrol., 2020.

The basic proposal is presented: movement precedes both space and time that are derived from it. As a line of justification, one must guard against two temptations: a) that of believing that reality imposes on us in a univocal way the words to describe it, each one referring to their own qualities of the corresponding objects; b) that of believing that the concepts can reach a state of purity that abstracts them completely from human knowledge, which is rooted in the functioning of the body. In response, two dimensions of thought are particularly adapted: 1) a relational dimension: one can only compare phenomena to other phenomena (movements to other movements) and conventions are necessary. Space and time are the names of these comparisons; 2) an embodiment dimension: the concepts of space and time have a meaning first in the experience of the body inside the world (lived in terms of movements), before the words. The presentation of the proposal is followed by some elements of history of the concepts of space and time, a discussion on the way to express the objectivity of embodied knowledge, and some consequences that may already be foreseen, in social and human sciences, as well as in physics.

Purpose The COVID-19 pandemic caused a lockdown in many countries, which induced negative dietary habits and sedentary behavior. Studies suggest that weight loss of patients undergoing bariatric surgery was equally affected. The aim was to evaluate the impact of COVID-19 on weight loss, obesity-related comorbidities, and nutritional status at 1-year follow-up after gastric bypass (GB). Methods Retrospective observational case–control study of patients undergoing primary GB in a tertiary referral Belgian center. COVID-19 period group was composed by those whose 1-year postoperative period was affected by the COVID-19 pandemic and lockdown: from October 1, 2019, to March 31, 2020. The control group was composed of patients operated from October 1, 2018, to March 31, 2019. Electronic clinical records were reviewed searching: baseline characteristics, weight and comorbidities evolution, and biochemical values. Results A total of 47 patients in the COVID-19 period group and 66 in the non-COVID-19 period group were analyzed. There were no significant differences in baseline characteristics. A reduced weight loss was observed at 1-year follow-up, in terms of percentage of excess weight loss (%EWL) (82.4% [SD: 21.6] vs. 82.4% [SD: 21.6]; p: 0.043) and body mass index (BMI) (27.8 kg/m2 [IQR: 25.8–30.0] vs. 26.2 kg/m2 [IQR: 24.6–28.6]; p: 0.029) for COVID-19 period group vs. non-COVID-19 period group, respectively. There was a similar reduction of obesity-related comorbidities, without clinically significant differences in the nutritional follow-up. Conclusion The COVID-19 pandemic and lockdown had an impact on weight loss at 1-year follow-up after gastric bypass. Graphical abstract