ABSTRACT Introduction High-intensity interval exercise (HIIE) is considered a time-efficient intervention to improve physical health in individuals with obesity. However, data on psychological outcomes are sparse. This study aimed to analyze and compare the acute effects of HIIE on executive function and mental health in young men with and without obesity. Methods Ten men with obesity (OB) (age, 23.10 ± 3.31 yr; body mass index (BMI), 34.6 ± 4.4 kg·m−2) and 10 with normal weight (NW) (age, 23.50 ± 1.64 yr; BMI, 23.1 ± 3.9 kg·m−2) underwent a single HIIE session. Outcomes were assessed at baseline, immediately after (AHS), 2 h after (AHS + 2), and 24 h after (AHS + 24) the HIIE session. Results Interaction effects showed that executive function was impaired in the OB group, with an average increase in reaction time of 407.80 ms (95% confidence interval (CI), 76.62–738.98 ms; P = 0.01) at AHS compared to baseline. Time effects were found for anxiety and depression scores at AHS + 2 for both groups compared to baseline (−2.75; 95% CI, −5.42 to −0.08; P = 0.04), and for anxiety scores at AHS (−2.55; 95% CI, −4.42 to −0.68; P = 0.004). Interaction effects were found for vigor scores at AHS + 2, with a decrease in vigor in the OB group and an increase in the NW group (P = 0.02). Conclusion Although anxiety and depression symptoms are improved 2 h after a HIIE session regardless of BMI category, individuals with obesity may present distinct results in executive function and vigor after a single HIIE bout.

248 Background: Measures of patient experience (PEX) and patient-reported outcomes (PRO) are used by health systems across the US to improve care delivery and quality of life, respectively. Despite their widespread use, little is known regarding the relationship between these two types of patient-generated data. From 2018 to 2023, we conducted a pragmatic type-II hybrid effectiveness/implementation study of an electronic health record (EHR)-embedded symptom management program (eSyM) across six diverse cancer centers. This project focused on patients who started chemotherapy (CHEMO) or had surgery (SURG) for a suspected or confirmed gastrointestinal, gynecologic, or thoracic malignancy. Methods: We conducted a cross-sectional study of adults who were eligible for either the control or intervention arm of the eSyM study to determine if patients who reported having an inferior care-team experience were more likely to report having worse symptoms. Participants completed a one-time survey via REDCap that included elements from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and the Patient-Reported Outcomes Measurement Information System (PROMIS). Analyses determined the extent to which PEX measures were associated with PRO measures by evaluating differences in mean PROMIS scores for those who rated their PEX highly vs. not highly. Results: In total, 1419 respondents reported having cancer for which they received care at a participating center: median age 66, 63% female, 5% black, 13% disabled, 66% married/partnered, 23% high school or less education, 22% somewhat-extreme difficulty paying bills. For both CHEMO and SURG patients, 82% rated their overall cancer care-team experience highly (top box score of 9-10). Compared to patients who did not rate their care-team experience highly, those who did reported better scores for depression, fatigue, anxiety, pain interference, physical function, and self-efficacy (Table). PROMIS values differed for other CAHPS measures too. Conclusions: Among patients receiving routine cancer care, there was a significant association between PEX and multiple PROs. Further investigation of the nature and strength of the association between PEX and PRO measures is warranted. If confirmed, this association could lead to the development of interventions that impact both patient satisfaction and quality of life. Clinical trial information: NCT03850912 . Mean difference in PROMIS scores for patients who rated their care-team experience highly versus not highly (P from two-sample T-test). CHEMO (N=889) SURG (N=530) Mean Diff 95%CI P value Mean Diff 95%CI P value Depression -2.7 -4.3, -1.1 0.001 -3.3 -5.3, -1.4 <0.001 Anxiety -3.7 -5.4, -1.9 <0.001 -3.6 -5.7, -1.5 <0.001 Fatigue -2.3 -4.0, -0.5 0.011 -4.5 -6.8, -2.2 <0.001 Pain interference -3.6 -5.3, -1.9 <0.001 -4.7 -6.7, -2.7 <0.001 Physical function 1.6 0.1, 3.1 0.042 3.5 1.4, 5.6 0.001 Self-efficacy 3.9 2.6, 5.2 <0.001 6.4 4.6, 8.1 <0.001

BackgroundThe increasing incidence and prevalence of childhood overweight (OW) and obesity (OB) are major global health challenges. This study aimed to evaluate the effectiveness of a 2-year healthy lifestyle intervention program in reducing the incidence of OW and OB among schoolchildren aged 11–12 years in Vietnam.MethodsStudy design: Randomized controlled trial.Participants and interventions: In total, 733 students participated in this study. Participants were included from four schools in Hanoi based on a random cluster sampling method. Students’ health outcomes were assessed at baseline and after 2 years.Main outcomes: The primary outcomes were the incidence of OW and OB, and the secondary outcomes were the prevalence and remission of OW and OB. Generalized estimating equations (GEEs) were used to determine the outcomes and risk factors.ResultsAfter the intervention, the prevalence of OW decreased by 9.24% in the intervention group and 3.01% in the control group.After adjustment for age and sex, the odds of overweight were 36.7% lower in the intervention group than in the control group (OR = 0.633; 95% CI: 0.434–0.925; P = 0.018). The incidence of OW was 1.31% in the intervention group compared with 5.33% in the control group. After adjustment for age and sex, the odds of incident overweight in the intervention group were 77.4% lower than in the control group (OR = 0.226; 95% CI: 0.063–0.813; P = 0.023). The proportion of patients who achieved OW remission was 41.22% in the intervention group and 28.68% in the control group. After adjustment for age and sex, the odds of OW remission of overweight were 2.219 times greater in the intervention group than in the control group (OR = 2.219; 95% CI: 1.220–4.036; P = 0.009). For most OB-related factors, there were no significant differences between the intervention and control groups.ConclusionA multicomponent healthy lifestyle intervention was effective in reducing the incidence of OW; however, it had no significant effect on OB among children aged 11–12 years in Hanoi, Vietnam.Trial registrationRetrospectively registered number: UMIN000014992, 20/08/2023.

BackgroundWeight misperceptions are common in children and adolescents, which is related to the engagement of weight loss behaviors. The aim of this study was to investigate the association between body weight perception and weight loss behaviors of lower-calorie diets and increased levels of physical activity (PA).MethodsThe Ningbo Youth Risk Behavior Survey was conducted from 2007 to 2022. A multistage, stratified cluster sampling procedure was utilized to draw target adolescents aged 12 to 18 years participating in each survey wave (2007, 2012, 2017, 2022). Data of anthropometry, weight perception, and weight loss behaviors were collected through self-administered questionnaires. A binary generalized linear model was used to examine associations between body weight perception and weight loss behaviors of lower calorie diets and increased levels of PA.ResultsThe sample sizes for each survey wave were 777, 885, 1588 and 2638. The prevalence of overweight (OW)/obesity (OB), self-perception of OW/OB and overestimated perception increased from 7.6%, 27.0% and 29.1% in 2007 to 16.3%, 39.9% and 41.4% in 2022, respectively. Adolescents that perceived themselves as OW/OB had higher odds of lower-calorie diets (OR: 4.2, 3.3–5.4) and increased level of PA (OR: 3.8, 2.9-5.0), whereas adolescents that perceived themselves as underweight had lower odds of lower-calorie diets (OR: 0.371, 0.253–0.542) and increased levels of PA (OR: 0.381, 0.295–0.559).ConclusionOW, self-perception of OW/OB and overestimated perception were prevalent in Chinese adolescents. Self-perception of OW/OB was positively associated with lower-calorie diets and increased levels of PA. The results can support public health specialists to promote health education of body perception and improve self-esteem in Chinese children and adolescents.

This study investigates the effect of the body mass index (BMI) on the early (2 years) to midterm (5 years) results of medial opening wedge high tibial osteotomy (MOWHTO). A prospectively maintained single-centre database of 1138 knee osteotomies, between 2002 and2022, was retrospectively reviewed. Adult patients who underwent MOWHTO for symptomatic unicompartmental medial knee osteoarthritis (OA), with varus knee malalignment, having failed conservative management, were included. Patients were categorized into threegroups according to their BMI as per the classification from the National Institute for Health and Care Excellence (NICE): the healthy weight (HW) group (BMI of 18.5-24.9 kg/m2), the overweight (OW) (BMI of 25-29.9 kg/m2), and the obesity (OB) group (BMI ≥ 30 kg/m2). Multiple patient-reported outcome measures (n = 6) were recorded preoperatively and at 2 and 5 years postoperatively. Deformity analysis was undertaken preoperatively and postoperatively. The relative risk (RR) of the complications between the HW, OWand OB groups was calculated. The rate of conversion to arthroplasty, and 5and 10 years survivorship were recorded, as well as the hazard ratio (HR) of BMI on survivorship. A total of 574 cases were included in the study: the HW group (n = 96), the OW group (n = 233)and the OB group (n = 245), with a mean BMI of 23 ± 1.5 kg/m2, 27.4 ± 1.4 kg/m2 and 34.4 ± 3.8 kg/m2, respectively. The mean follow-up was 13.3 years (4.8-20.3). The mean mechanical tibiofemoral angle corrections were in the HW group: 7.1 ± 3°, OW group: 6.6 ± 3.5°and OB group: 7.1 ± 3.8°, with no intergroup significant difference (p = n.s.). Clinically, despite lower preoperative scores in the OW and OB groups, no difference was observed postoperatively amongst the three groups. The overall complication rate was 12.5% in the HW group, 6.8% in the OW group, and 9.8% in the OB group. There was no significant difference in the RR of complications between the HW and OW groups (RR = 0.6, 95% confidence interval [CI] = 0.3-1.3)(p = 0.2), and the HW and OB groups (RR = 0.8; 95% CI = 0.3-2.2)(p = 0.7). There was no overall significant difference in survival outcomes based on the BMI between the threegroups (p = 0.4). The HR of conversion to arthroplasty between the HW and OW groups was 1.4 [95% CI = 0.6-3.5](p = 0.5)and between the HW and OB groups was 1.8 [95% CI = 0.8-4.4] (p = 0.2). BMI has no significant effect on either the radiological corrections, clinical outcomes, complicationsor survivorship of MOWHTO at short- to medium-term follow-up. No specific cutoff point for BMI can be recommended as a contraindication to MOWHTO. Level IV, Retrospective cohort study.

BackgroundWomen with overweight (OW) and those with obesity (OB) tend to gain excessive weight during pregnancy, often resulting in adverse outcomes. The long-term effects of mobile health (mHealth) interventions on maternal and infant outcomes remain unclear. AimsTo examine the effects of an mHealth intervention on OW and OB from the course of their pregnancy to six months postpartum. MethodsA randomized controlled trial was conducted in northern Taiwan. Ninety-two pregnant women with a body mass index (BMI)of ≥25 kg/m2 were recruited from prenatal clinics at <17 weeks of gestation. Prepregnancy weight was baseline maternal weight, with data collected subsequently at the last assessment before childbirth and six months postpartum. The intervention group (IG) received the mHealth intervention, while the control group (CG) received standard antenatal care. The trial was registered on ClinicalTrials.gov (identifier: NCT04553731) with the initial registration date of September 16, 2020. FindingsThe IG tended to have a lower mean body weight than the CG at the last assessment before childbirth (82.23 kg vs 84.35 kg) and at six months postpartum (72.55 Kg vs 72.58 Kg). IG's newborn birth weight was significantly lower than CG's (3074.8 vs. 3313.6 g; p = 0.009). Regression analysis revealed that OB in IG had a significant reduction in weight before childbirth (β = -7.51, p = 0.005) compared to OB in CG. Compared to OW in CG, both OW in IG (β = -243.59, p = 0.027) and OB in IG (β = -324.59, p = 0.049) were associated with decreased newborn birth weight. ConclusionsmHealth helped women with obesity to successfully manage their GWG and body weight before childbirth and newborns’ birth weight, despite this effect not persisting to reduce weight retention at six months postpartum.

Transsphenoidal surgery (TSS) is a popular method for resecting pituitary tumors, but it has been associated with severe consequences such as perioperative medical issues, endocrine problems, and surgical complications. The pituitary gland, a bilobed endocrine organ, contains eight hormones and is surrounded by the sella turcica, tuberculum sellae, dorsum sellae, and cavernous sinus dura. The gland's structure is complex, with the optic chiasm and sphenoid sinus being significant structures. The sphenoid sinus, which grows with age and has variable septal and cavitary architecture, can make the transsphenoidal approach more difficult to perform in cases of bleeding, vision loss, or cranial nerve palsy. Understanding the anatomy of the sphenoid sinus is crucial for a safe sellar approach and tumor removal. The operative microscope introduced in the 1960s has further improved surgical outcomes with low morbidity and mortality rates. Pituitary adenomas are extra-arachnoidal tumors that develop outside the boundaries of the cerebrospinal fluid (CSF). They can cause iatrogenic leaks if the arachnoid membrane is ruptured and a cerebrospinal fluid fistula is introduced. Delayed postoperative epistaxis can result from the sphenopalatine artery and the intracavernous internal carotid artery (ICA). Loss of vision can result from physical injuries to the optic nerves or chiasm, which can occur at multiple stages of the operation. Other causes include cerebral vasospasm, traction injury, empty sella syndrome with chiasm prolapse, ophthalmoplegia, and internal injuries to the carotid artery. Injuries to the sphenoid sinus, including proximity to essential tissues, thin or absent bone, and loss of bone, increase the risk of iatrogenic injury. Packing is the initial therapy, and postoperative angiography should be performed afterward. Embolization is considered in situations where packing is inadequate or when there is development to pseudo-aneurysms or carotid cavernous fistulae. Chronic Insipidus Diabetes (DI) is a common disturbance in patients following transsphenoidal surgery (TSS), causing water and electrolyte problems. DI can manifest in various clinical patterns, including transitory, permanent, and triphasic phenotypes. Postoperative syndrome of antidiuretic hormone secretion (SIADH) is also a risk factor, with hyponatremia often delayed and symptomatic. Improved or newly developed hypopituitarism is a risk, with the hypothalamic-pituitary-adrenal (HPA) axis being the most susceptible. Transcranial procedures with HPA or other axis deficits may cause damage to normal residual glands, especially in large tumors. Transsphenoidal techniques can mitigate the risk of dissecting an attenuated gland, but understanding pituitary physiology and sellar anatomy is crucial for improving the procedure and encouraging innovation. Transcranial procedures have a low death rate and risk of significant impairment, but understanding the underlying medical, endocrine, and surgical consequences is essential for successful PA excision.

This study focused on type 2 diabetes mellitus (T2DM) in a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. Mixe comprised an estimated 9.4% (n ≅ 90 000) of the Indigenous population in Oaxaca. Mexico. This study focused on a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. To compare the prevalence of T2DM, overweight (OW), obesity (OB), and hypertension (HTN) between 2007 and 2017 for a small, isolated Mixe community in the Valley of Oaxaca, Mexico. We test whether or not environmental changes have affected T2DM prevalence. Demographic and medical record data were collected in the community in 2007 and 2017 from the medical clinic and the mayor's office. T2DM was medically diagnosed among adults (>34 years old), in 2007 (n = 730) and in 2017 (n = 829). T2DM crude prevalence increased from 6.7% to 12.1% (p < .001) from 2007 to 2017. The mean age of the sample analyzed was 60.6 (SD = 9.7). Age-adjusted T2DM prevalence increased from 6.7% to 10.8% (p < .002). T2DM was 5.7%-5.5% among males (p < .53) and 7.1%-13.6% among females (p < .001). Sex-specific OW and OB simulation studies indicate females had 7% less OW in 2007, and males were unchanged compared with 2017. OB among males and females was significantly higher in 2017 compared with 2007 (increased by 15.2% and 8.3%, males and females, respectively). Sexes combined OW + OB increased 12.7% among males but was unchanged in females (-0.5%). In the sexes combined analysis, OW prevalence increased 12.7% to 27.1% (p < .001) and OB prevalence increased 10.7%-27.9% (p < .001) from 2007 to 2017. HTN did not change significantly from 2007 to 2017 (15.4% and 14.6%, respectively) (p = .63) in adults. Among T2DM individuals, the frequency of HTN was not significantly different in 2007 and 2017 (57.1% and 37%, respectively) (p = .65). Transition to a Western diet consisting of high-carbohydrate foods occurred at the same time as increased T2DM from 2007 to 2017, with a higher prevalence of T2DM noted among females in 2017. An increased prevalence of T2DM, OW, and OB but not HTN was observed in the Mixe community from 2007 to 2017 and was associated with the adoption of a high-carbohydrate Western diet.

Excess Food Energy Intake (EFEI), namely Metabolic Food Waste (MFW) corresponds to excess calorie intake related to overconsumption of food and is responsible for overweight (OW) and obesity (OB) conditions. Identifying its causes and impacts could be important, so that it can be prevented and reduced, generating health, environmental and societal benefits. Therefore, this research quantifies MFW among OW and OB adult populations (18–75 years) in Italy and its environmental and social implications. Life cycle assessment (LCA) through the Simapro 9.5 software was used and then, the results were monetized according to the Environmental Price Handbook to understand the real environmental cost. Finally, Social LCA (S-LCA) was considered following the Product Social Impact Assessment (PSILCA) guidelines to understand the potential social risks behind the food that ends up on our plates. The results highlight the amount of MFW in Italy is 2696 billion kcal/year corresponding to 1.59 Mtons over-consumed food/year, while the impacts are mainly related to global warming (8.78 Mtons CO2 eq/year, or 2.29 % of the total Italian CO2 emissions), terrestrial ecotoxicity (843,451 tons 1.4-DCB/year), freshwater ecotoxicity (222,483 tons 1.4 DCB eq/year), and land consumption (8 million m2a eq/year), mostly due to the meat, fats and oils and sweets overconsumption. Impacts monetization also shows that MFW could induce an environmental price of € 1340/per capita/year, and finally, the S-LCA reveals how overconsumption of food has the potential to affect gender discrimination, water depletion, trade union, and social discrimination due to the high proportion of labor migrants in the agricultural sector.

Childhood obesity has become a worldwide public health concern over the past decade, counting Bosnia and Herzegovina (BiH). The Childhood Obesity Surveillance Initiative (COSI) was established by the World Health Organization (WHO) to address the lack of standardized surveillance data on childhood obesity. However, BiH and its entity, Republic of Srpska (RS), are failing inclusion in such initiative, which hinders efforts to monitor and address the issue. Henceforth, the objective of this nationally funded study was to gather and analyse data on the prevalence of overweight and obesity among primary-school children in RS by implementing the COSI methodology. Weight, height, and BMI of first, second, and third grade children (aged 6-8), from 11 schools (N = 2,030) in the RS region was analysed according to the standardized COSI protocol. The prevalence rates of overall overweight (OW) and obesity (OB) observed were 14.37% (OW 9.09%, OB 5.21%). No gender-related differences were noted (boys 14.36%, girls 14.88%). These findings highlight a concerning trend of increasing overweight and obesity prevalence with age among primary-school children in the RS.