Weight history and its association with the weight loss achieved in a publicly funded clinical obesity management program were examined in 9348 patients. Weight history (frequency and magnitude of weight losses) was collected through questionnaires at enrollment, and weight change was assessed with retrospective electronic medical chart review. The majority of patients reported developing overweight prior to the age of 40 years and having lost at least 4.5kg (10lb) of weight at least once in their lifetime. Those who had an earlier onset of overweight had a higher frequency of past weight loss and had more cumulative weight loss over their lifetime. In women, but not men, earlier age of overweight onset and lifetime weight loss were associated with modestly greater weight loss at the clinic. Women with greater weight-loss history also have modestly greater weight loss at the obesity management clinic. Thus, successful long-term obesity management, particularly for women, may include a series of repeated attempts at weight loss that should not be viewed as failures but could be viewed instead as practice.

Acromioclavicular joint pathology such as osteoarthritis has historically been treated with either an open or arthroscopic distal clavicle resection. Over the years the trend has been toward more minimally invasive treatment options with the arthroscope. In this article we highlight the use of the nanoscope to visualize the resection which can be performed through a small percutaneous incision. The advantages of this technique include the use of smaller portals, which should lead to improved earlier outcomes, and less iatrogenic damage to the shoulder.

Managing non-communicable diseases (NCDs) in crisis-affected and fragile humanitarian contexts requires special attention because primary health care systems often collapse or become compromised in such settings. As a result, addressing and managing these diseases become more challenging. Humanitarian organizations that intervene in crisis situations are increasingly including NCD management in the services they support and provide; however, they encounter a range of issues such as ensuring the quality of care, sustainability of programs, and the possibility of unintended harms. This case study explores ethical considerations raised by a mobile NCD program run by an international humanitarian organization in a country affected by a protracted civil war.

AbstractThe tradition of storytelling is perhaps as old as the history of human evolution itself; with or without language, this practice enables the sharing of experiences, generates a range of emotions and responses, and fosters social connectedness. Every culture has its own tradition of not only delivering narrative, but also aiming to utilize that narrative to effectively communicate and persuade its audiences and viewers and make a social impact through storytelling. The Patachitra scroll painting tradition of West Bengal is a unique folk tradition of visual storytelling among rural communities known as patuas who paint and sing their scrolls. Their themes include folklore, epics and mythologies, but also contemporary issues, such as health, nutrition, literacy, child rights and environment and current affairs, to name a few. This paper follows the trajectory of patachitra art from its historical beginnings to the present, addressing artists’ responses to social and cultural shifts, breaking of gender barriers, acting as catalysts of socioeconomic empowerment, and ensuring the sustainability of their trade in the face of global market demands.KeywordsPatachitraFolk artGlobalizationEmpowermentGender equality

Objective To examine the associations between patient struggles, health, and weight management changes during the COVID-19 pandemic. Methods 585 patients attending a publicly funded clinical weight management program responded to an electronic survey. Results Over half of the patients reported worsened overall health, mental health, physical activity, or diet during the pandemic. Approximately 30% of patients lost ≥3% of their body weight and 21% gained ≥3% of their body weight between March and July of the pandemic. Reports of social isolation was associated with increased odds for weight loss in women (OR = 2.0, 1.2–3.3), while low motivation (OR = 1.9, 1.0–3.7), depression (OR = 2.5, 1.0–6.3), and struggles with carbohydrate intake (OR = 2.1, 1.0–4.3) were associated with weight gain. Cooking more at home/eating less take out was associated with increased likelihood of weight loss (OR = 2.1, 1.1–3.9) and lower odds for weight gain (OR = 0.2, 0.1 to 0.97). Working from home was not associated with weight loss or weight gain (P > 0.6). Conclusion The COVID-19 pandemic is associated with certain factors that may facilitate weight loss and other factors that promote weight gain. Thus, depending on the patient experience during the pandemic, prevention of weight gain may be more appropriate than weight loss.

Abstract The consequences of subsea crude pipeline failure drastically affect the continuity of oil supply and the ability of operating companies to meet market demand. Moreover, it reduces clients’ confidence and reliance on operating companies. There are mainly two types of failures that severely affect the integrity and operability of a pipeline. These are the leakage caused by gradual thinning of the pipeline due to corrosion and the leakage caused by a rupture pressure. The first form of failure results in a constant slow leakage that go over time without being noticed. While the second form of failure takes place without warning which makes the restoration effort extremely difficult and time consuming. Both forms of failure result in delayed production, environmental damage, legal claims as well as financial losses that operating companies could incur. Moreover, leaked oil products adversely impact other industries which bring these industries into a halt. Such industries may include fishery, maritime transportation, and tourism industries. This paper presents a method for predicting the financial losses that a company could incur in the event a corroded pipeline undergoes the abovementioned failures. Basically, this method can be used as a standard estimating tool for predicting the financial losses if such events occur.

Polymer coating emboli have been affiliated with persisting brain lesions after endovascular procedures.1–6 Patient symptoms include headaches, fevers, chills (ie, constitutional symptoms), neurological presentations of focal weakness, sensory and visual deficits, and seizures. Follow-up imaging highlights distinct areas of contrast enhancement in slightly different locations, with some lesions increasing in number and size (see figure 1). Polymer particles from various coating compositions have different rates of degradation, absorption, and metabolism or excretion (DAM/E). These varied rates of DAM/E may have impacts on persisting brain lesions, recurrent patient symptoms, and adverse event outcomes. Figure 1 Characteristic MRI of patients with persisting brain lesions. T1 postcontrast images highlighting an increase in the number and size of lesions (white arrows) over a 12 month period. Also note formation of new enhancing lesions. Images used with permission by Williams and Wilkins Co. (license ID: 1100407-1). Degradation is the chemical breakdown of a polymer by hydrolysis, oxidation, or enzymatic processes. A faster degradation rate may result in less obstruction within blood vessels or reduced presence …

Human papillomavirus (HPV) antibody responses to the 9-valent human papillomavirus (9vHPV) vaccine among girls and boys (aged 9-14 years) receiving 2-dose regimens (months 0, 6 or 0, 12) were noninferior to a 3-dose regimen (months 0, 2, 6) in young women (aged 16-26 years) 4 weeks after last vaccination in an international, randomized, open-label trial (NCT01984697). We assessed response durability through month 36. Girls received 2 (months 0 and 6 [0, 6]: n = 301; months 0 and 12 [0, 12]: n = 151) or 3 doses (months 0,2, and 6 [0, 2, 6]: n = 301); boys received 2 doses ([0, 6]: n = 301; [0, 12]: n = 150); and young women received 3 doses ([0, 2, 6]: n = 314) of 9vHPV vaccine. Anti-HPV geometric mean titers (GMTs) were assessed by competitive Luminex immunoassay (cLIA) and immunoglobulin G-Luminex immunoassay (IgG-LIA) through month 36. Anti-HPV GMTs were highest 1 month after the last 9vHPV vaccine regimen dose, decreased sharply during the subsequent 12 months, and then decreased more slowly. GMTs 2 to 2.5 years after the last regimen dose in girls and boys given 2 doses were generally similar to or greater than GMTs in young women given 3 doses. Across HPV types, most boys and girls who received 2 doses (cLIA: 81%-100%; IgG-LIA: 91%-100%) and young women who received 3 doses (cLIA: 78%-98%; IgG-LIA: 91%-100%) remained seropositive 2 to 2.5 years after the last regimen dose. Antibody responses persisted through 2 to 2.5 years after the last dose of a 2-dose 9vHPV vaccine regimen in girls and boys. In girls and boys, antibody responses generated by 2 doses administered 6 to 12 months apart may be sufficient to induce high-level protective efficacy through at least 2 years after the second dose.

Research on women who consume cannabis has predominantly focused on the perinatal period whereby cannabis consumption is problematized, linked to negative perinatal outcomes, and related to substance use and mental health challenges. When this historical literature and research about cannabis consumption is considered through a sociolegal and intersectional lens, questions emerge about how cannabis legalization may benefit and harm women, particularly women who experience marginalization along various axes of identity such as gender, race, and class. Questions also emerge about how women who consume cannabis may be perceived, represented, and treated as part of health and social care practices, particularly while pregnant and parenting. This commentary seeks to untangle what could be at stake for pregnant women and mothers, and what could be emphasized in future research endeavors, in the new era of cannabis legalization in Canada. The authors encourage research initiatives that attend to and reimagine harm reduction philosophies, and that integrate intersectional, feminist, and participatory action research approaches.