Considerable Weight Loss Research Articles

GLP-1 Receptor Agonists in Overweight and Obese Individuals With Type 1 Diabetes Using an Automated Insulin Delivery Device: A Real-World Study.

Automated insulin delivery (AID) systems have improved glycemic control in individuals with type 1 diabetes (T1D) but overweight and increased cardiovascular risk remain a challenge. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with improved cardiometabolic profile but are currently not approved for the treatment of T1D. Individuals with T1D at Steno Diabetes Center Copenhagen, Denmark, treated with AID and off-label GLP-1 RA for at least six months between January 2017 and May 2024 were included in a retrospective chart review study. Nineteen individuals with (median [range]) age 42 (24-60) years were included. At GLP-1 RA initiation, hemoglobin A1c (HbA1c) was 7.3% (6.1%-8.7%), HbA1c 56 (43-72) mmol/mol, body weight 91.5 (78.0-115.0) kg, and body mass index 35.4 (27.0-42.0) kg/m2. Time in range was 74% (29%-82%), time above range 25% (18%-71%) while time below range was 1% (0%-5%). After six months of treatment, body weight changed -11% (-22% to -3%; P = .001) and total daily insulin dose changed -15.1 (-32.5 to -8.2) IU (P = .004). There were no significant changes in HbA1c or other glucose measures. One person developed ketoacidosis caused by infusion set failure, but none reported severe hypoglycemia. Glucagon-like peptide-1 receptor agonist as add-on therapy for six months in individuals with obesity and AID-treated T1D led to considerable weight loss and a reduction in insulin dose.

A comparison of efficacy of erector spinae plane block versus serratus anterior plane block plus subcostal transversus abdominus plane block for bariatric laparoscopic sleeve gastrectomy surgery: study protocol for a randomised clinical trial

BackgroundObesity is a rapidly growing global health concern. Limited long-term success of diet, behavioural modification and medical therapy have led to the increased performance of bariatric surgery. Laparoscopic sleeve gastrectomy, which permanently reduces the size of the stomach, has been shown to cause considerable weight loss, as well as improving or even eliminating obesity related medical comorbidities such as diabetes, obstructive sleep apnoea and hypertension. Unfortunately, this surgery can also result in significant postoperative pain which, when combined with the dangers of perioperative opioid administration for bariatric patients, can lead to a significantly reduced quality of recovery. Opioid-sparing analgesia has been widely recommended for perioperative bariatric patients, but research into the optimum regional analgesia approach for this surgery is lacking, with no trials to date comparing different regional analgesic techniques. This study protocol describes a randomised clinical trial aimed at answering this question, comparing the quality of recovery after laparoscopic sleeve gastrectomy for patients who receive erector spinae plane block, versus those who receive serratus anterior plane block plus subcostal TAP block.MethodsWe propose a prospective, randomised, blinded (investigator) clinical trial in a tertiary hospital in Ireland. Seventy patients presenting for laparoscopic sleeve gastrectomy will be randomised to two study groups—group A will receive bilateral erector spinae blockade; group B will receive left sided serratus anterior plane block plus subcostal TAP blocks. Both groups will receive the same dose of the same local anaesthetic and the different regional technique performed will be the only difference in their care. The primary outcome will be QoR-15 scores at 24 h postoperatively, a validated international tool for assessing a patient’s overall postoperative recovery.DiscussionRegional analgesia should be a mainstay of perioperative opioid-sparing analgesia where possible. This is especially important in the bariatric cohort who are particularly susceptible to the complications of perioperative opioid administration. To the best of our knowledge, this trial will be the first to compare efficacy of two different regional analgesia techniques for bariatric patients undergoing laparoscopic sleeve gastrectomy surgery.Trial registrationThis trial was pre-registered on clinicaltrials.gov, registration number NCT05839704, on March 5, 2023. All items from the World Health Organisation Trial Registration Data Set have been included.

Does the length of bypassed bowel during distal gastric bypass affect weight loss?

Weight recurrence (WR) affects > 20% of patients following Roux-en-Y gastric bypass (RYGB). Shortening of the common channel (CC) after RYGB (distal bypass) has been proposed for additional weight loss in patients with WR, but results vary, and concerns for vitamin deficiencies/malnutrition exist. Our aim was to determine whether the percentage of bowel bypassed after distal bypass is associated with the amount of postoperative weight loss. Patients undergoing distal bypass between 2018 and 2022 were reviewed. Small bowel limb lengths before and after distal bypass were measured, and the percentage of bypassed bowel was calculated (= bypassed biliopancreatic limb/total small bowel length). Patients were dichotomized into two groups based on the percentage bypassed bowel (≤ 50% vs. > 50%). Weight loss (measured as excess BMI loss; EBIL%), comorbidities resolution, complications, and nutritional deficiencies were reviewed. Thirty female patients underwent distal bypass during the study period. After distal bypass, the Roux was lengthened to 150cm (75-175cm) from 75cm (20-200cm), and the CC shortened to 150cm (100-310cm) from 510cm (250-1000cm). These changes resulted in an increase in the size of the bypassed biliopancreatic limb from 40cm (15-90cm) to 330cm (180-765cm) and a total alimentary limb (TALL; Roux + CC) shortening from 590cm (400-1075cm) to 300cm (250-400cm). The group with > 50% bowel bypassed had higher EBIL%. Overall EBIL% was 36.9 ± 14.7%, 53.3 ± 25.6%, and 62.1 ± 36.9% at 0.5, 1, and 2years, respectively. There were minimal vitamin deficiencies. Diabetes resolved in 100% (n = 3/3), HTN in 67% (n = 10/15), and GERD in 73% (n = 11/15). Complication rate was 23%. No reintervention for malnutrition or vitamin deficiencies was required. Distal bypass effectively leads to considerable weight loss and comorbidity improvement in patients with WR after RYGB, but the amount of weight loss depends on the percentage of bypassed bowel. An exact threshold of bypassed bowel that optimizes weight loss outcomes and simultaneously minimizes the nutritional complications needs to be determined. Meanwhile, close monitoring for vitamin deficiencies is recommended.

The Efficacy of Roux-en-Y Gastric Bypass in Young-Onset Diabetes Mellitus: A Narrative Review.

Type 2 diabetes mellitus (T2DM) in youth is invading the communities because, if not controlled on time, the long-term complications include cardiovascular diseases, nephropathy, neuropathy, and retinopathy that cause immense mortality and morbidity. Lifestyle changes and antidiabetic drugs are considered the foundation of T2DM therapy. However, these adjustments usually do not effectively produce long-term glycemic regulation, especially in patients with obesity of the third and fourth degrees. Bariatric surgery has also been identified as an efficacious intervention for obesity and obesity-related complications such as T2DM. Roux-en-Y gastric bypass (RYGB) has proven to be one of the most effective procedures in causing considerable weight loss and enhancing glycemic changes. This review provides a comprehensive analysis of RYGB in patients with young-onset T2DM regarding the improvement of glycemic control, weight loss, and diabetes comorbidities. RYGB has been established as a practice in the treatment of T2DM and severe obesity. This narrative review underscores the various effects of RYGB, such as enhanced glycemic control, considerable and long-term weight loss, and reduced cardiovascular disease risks. However, the review also points toward the directions and the adverse effects of RYGB regarding metabolic and skeletal health. There are risks of nutritional deficiencies, increased fracture rates, and even relapse to diabetes, which make patient selection, proper pre and postoperative investigation, and critical monitoring.

Efficacy in diet-induced obese mice of the hepatotropic, peripheral cannabinoid 1 receptor inverse agonist TM38837.

The cannabinoid CB1 receptor has a well-established role in appetite regulation. Drugs antagonizing central CB1 receptors, most notably rimonabant, induced weight loss and improved the metabolic profile in obese individuals but were discontinued due to psychiatric side effects. However, metabolic benefits were only partially attributable to weight loss, implying a role for peripheral receptors, and peripherally restricted CB1 receptor antagonists have since been of interest. Herein, we describe the evaluation of the peripherally restricted potent CB1 receptor inverse agonists TM38837 and TM39875, with acidic functionality, which were administered daily to diet-induced obese (DIO) mice for 5weeks at doses for which CNS-mediated effects were minimal. Compounds were tested in dose-response in acute studies to compare efficacy (gastric transport) and extent of CNS exposure (hypothermia and satiety sequence) to demonstrate peripheral restriction and select doses for the subsequent chronic DIO study. TM38837 but not TM39875 produced considerable (26%) weight loss, linked to a sustained reduction in food intake, together with improvements in plasma markers of inflammation and glucose homeostasis. Pharmacokinetic analysis indicated high plasma and low brain levels for both compounds with high liver levels for TM38837 (but not TM39875) due to hepatic uptake. Weight loss and metabolic benefits of TM38837 are likely not CNS-mediated but could be linked to enhanced liver exposure, which implicates intracellular CB1 receptors in hepatocytes as a possible driver of obesity and co-morbidities.

Study of Extraction, Treatment and Characterization of Pineapple Leaves Fibers as Potential Utility in Textile Industry

Extraction, treatment and characterization of pineapple leaves fibres was achieved. The study revealed that water retting is the best way to extract fibers as it is easily controlable which reduces the chance of reducing the strength of fibres. Also,it was observed that dried pineapple leaves fibres take longer time to ret compare to fresh leaves.The fibers were treated using NaOH for scouring while bleaching was carried out using H2O2. The treatment of fibers was conducted to get rid of fat, wax and other impurities as well as undesired colors bonded to fibers that could not be removed through water retting. The best scouring concentration of NaOH was found to be 1.25 % while the best bleaching concentration of H2O2 was found to be 10 %. More so, FTIR was carried out for both treated and untreated fibers and it was shown that wax, fat and other impurities can be removed by fibres’ scouring and bleaching. This was further confirmed by the use of Soxhlet to extract ethanol-benzene extract from both treated and untreated fibres, where untreated fibres showed a considerable weight loss while the treated fibers did not show any weight loss. Thereafter, mercerization was carried out and it was found out that the best mercerization concentration for pineapple leaves fibres is NaOH is 10%. Furthermore, the quantitative analysis of pineapple leaves fibers revealed that the fibers have, ethanol-benzene extractives of 2.6 %, pectin content of 1.53%, Lignin content of 12%, cellulose content of 79% and ash content of 2.15 %. The fibers showed a water, oil and vapor absorption of 82%,32 % and 29% respectively. Also, the thermal analysis showed that the degradation temperature is 400 0C while the fibers started to display thermal instability at 350 0C. Moreover, SEM and XRD analysis showed that the treatment of fibres participated in removal of wax and oil as well as other gummy materials, which also is in line with FTIR results obtained. Keywords: Extraction, Pineapple Leaves Fibers, Scouring, Bleaching, Mercerization, Characterization, Textile

Extraction, Treatment and Characterization of Banana Pseudo-Stem Fibers as Potential Utility in Textile Industry

Extraction, treatment and characterization of banana pseudo stem fibres was achieved. The study revealed that water retting is the best way to extract fibers, however the gummy materials bending fibres together must be weakened by boiling the fibres rich material prior to retting where the fibres were able to be extracted at 14th day of retting. The fibers were treated using NaOH for scouring while bleaching was carried out using H2O2. The treatment of fibers was conducted to get rid of fat, wax and other impurities as well as undesired colors bonded to fibers that could not be removed through water retting. The best scouring concentration of NaOH was found to be 17.5 % while the best bleaching concentration of H2O2 was found to be 2 %. More so, FTIR was carried out for both treated and untreated fibers and it was shown that wax, fat and other impurities can be removed by fibres’ scouring and bleaching. This was further confirmed by the use of Soxhlet to extract ethanol-benzene extract from both treated and untreated fibres, where untreated fibres showed a considerable weight loss while the treated fibers did not show any weight loss. Thereafter, mercerization was carried out and it was found out that the best mercerization concentration of NaOH is 15%. Furthermore, the quantitative analysis of the banana pseudo-stem fibers revealed that the fibers have, ethanol-benzene extractives of 4.2 %, pectin content of 3.07%, Lignin content of 18%, cellulose content of 68.3% and ash content of 4.2 %. The fibers showed a water, oil and vapor absorption of 71%,59 % and 8% respectively. Also, the thermal analysis showed that the degradation temperature is 370 0C while the fibers started to display thermal instability at 290 0C. Moreover, SEM and XRD analysis showed that the treatment of fibres participated in removal of wax and oil as well as other gummy materials, which also is in line with FTIR results obtained. Keywords: Extraction, Banana Pseudo-stem Fibers, Scouring, Bleaching, Mercerization, Characterization, Textile

Clinical Relevance of Physical Function Outcomes in Cancer Cachexia.

Managing clinical manifestations of cancer/treatment burden on functional status and quality of life remains paramount across the cancer trajectory, particularly for patients with cachexia who display reduced functional capacity. However, clinically relevant criteria for classifying functional impairment at a single point in time or for classifying meaningful functional changes subsequent to disease and/or treatment progression are lacking. This unmet clinical need remains a major obstacle to the development of therapies for cancer cachexia. This review aims to describe current literature-based evidence for clinically meaningful criteria for (1) functional impairment at a single timepoint between cancer patients with or without cachexia and (2) changes in physical function over time across interventional studies conducted in patients with cancer cachexia. The most common functional assessment in cross-sectional and interventional studies was hand grip strength (HGS). We observed suggestive evidence that an HGS deficit between 3 and 6 kg in cancer cachexia may display clinical relevance. In interventional studies, we observed that long-duration multimodal therapies with a focus on skeletal muscle may benefit HGS in patients with considerable weight loss. Future studies should derive cohort-specific clinically relevant criteria to confirm these observations in addition to other functional outcomes and investigate appropriate patient-reported anchors.

Antidiabetic Activity of Isolated Compounds of Crinum solapurense Leaves Extract in Albino Wistar Rats

Background: The leaves extracts of Crinum solapurense are examined for in-vivo antidiabetic pharmacological action. Methods: Plant material including different multi-component mixes has a large number of bioactive chemicals. Therefore, it is crucial to separate and determine these compounds which have active phytoconstituents are responsible for the pharmacological action. The extracts for action in-vivo antidiabetic investigation from the leaves extract of Crinum solapurense are the subject of the current research project. From the leaves, ethanolic extracts of the medicinal plant Crinum solapurense, two alkaloid compounds—gulonic acid & shikimic acid—were identified. The alkaloids found in the phytoconstituents of Crinum solapurense leaves may be the cause of their pharmacological action. Results: In the DNSA inhibition assay method the IC50 value was observed to be 5.31 & 11.17 μg/ml for shikimic acid & gulonic acid correspondingly. In the Iodine-Starch Technique the IC50 value was observed to be 9.91 & 12.70 μg/ml for shikimic acid & gulonic acid correspondingly. In the In-vivo animal study of Gulonic acid in the group that was not given any treatment, diabetic rats displayed considerable weight loss at the end of the trial (p ˂0.001). When dexamethasone was administered, the diabetic group's blood glucose levels significantly increased in comparison to the control group (p is equal to 0.01). Two parameters were improved in a dosage-dependent way when mice were given glibenclamide or gulonic acid at a dose of 50.00 or 100.00 milligrams per kilogram body weight. Diabetes led to a substantial rise in HbA1c (p˂0.05) in the group of diabetics who were not receiving treatment. Conclusion: Based on the in-vivo animal study it was concluded that the leaves extracts of Crinum solapurense show significant effects of antidiabetic pharmacological action in diabetes induced animals.

The Role of Semaglutide in Weight Management: An Analysis of Clinical Studies for Overweight and Obese Adults

Obesity is a mounting global health challenge, and recent advancements in pharmacologic interventions have brought new hope to this complex issue. One such intervention, semaglutide, marketed as Ozempic and Wegovy, has shown promising results in weight management among adults with overweight or obesity. This paper synthesizes findings from key clinical studies to evaluate the efficacy, safety, and long-term impact of semaglutide in weight management. Semaglutide, initially developed for type 2 diabetes management, functions by mimicking the human glucagon-like peptide-1, thereby reducing appetite and food intake. Regulatory bodies in the United States, Europe, the United Kingdom, and Canada have approved its use for weight mana gement at a weekly dose of 2.4 mg, marking a significant step in obesity treatment. Alongside its benefits, the paper also addresses the safety profile and adverse effects associated with semaglutide. While generally well-tolerated, rare but serious adverse effects have been reported, necessitating a careful assessment of risks and benefits in clinical practice. In conclusion, semaglutide presents a significant advancement in the pharmacologic management of obesity. Its ability to induce considerable weight loss, coupled with improvements in cardiovascular and metabolic health, positions it as a promising tool in the arsenal against obesity. Future research should focus on long-term efficacy, safety, and the integration of comprehensive lifestyle interventions to optimize treatment outcomes.

Optimizing and characterizing 4-methyl substituted pyrazol-3-carboxamides leading to the peripheral cannabinoid 1 receptor inverse agonist TM38837

Several series of diverse pyrazole-3-carboxamides functionalized with 4-methylamides, 4-methylcarboxylic acids and 4-methyltetrazoles were prepared from the corresponding 4-cyanomethylpyrazoles and investigated as Cannabinoid receptor 1 (CB1) antagonists and inverse agonists with the aim of making compounds with less CNS (Central Nervous System) mediated side-effects compared to rimonabant. The compounds were evaluated and optimized with respect to lipophilicity, solubility, CB1 potency, metabolism, distribution to brain and liver, effect on weight loss in diet-induced mice models. A few carboxylic acids and tetrazoles were selected as especially promising with the tetrazole TM38837 subsequently demonstrating impressive efficacy in various animal models of obesity, producing considerable weight loss and improvements on plasma markers of inflammation and glucose homeostasis, at doses apparently producing negligible brain exposure. TM38837 became the first peripherally restricted CB1 antagonist or inverse agonist to enter clinical trials supporting its lack of CNS effects and it is now believed that the non-CNS mediated efficacy is linked to high liver exposure. This opens opportunities to be explored in other indications such as nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH). Note that this is a first-time disclosure of the structure of TM38837 and other structures appearing in literature are not connected with this program.

Effect of safranal or candesartan on 3-nitropropionicacid-induced biochemical, behavioral and histological alterations in a rat model of Huntington's disease.

3-nitropropionic acid (3-NP) is a potent mitochondrial inhibitor mycotoxin. Systemic administration of 3-NP can induce Huntington's disease (HD)-like symptoms in experimental animals. Safranal (Safr) that is found in saffron essential oil has antioxidant, anti-inflammatory and anti-apoptotic actions. Candesartan (Cands) is an angiotensin receptor blocker that has the potential to prevent cognitive deficits. The present study aims to investigate the potential neuroprotective efficacy of Safr or Cands in 3-NP-induced rat model of HD. The experiments continued for nine consecutive days. Rats were randomly assigned into seven groups. The first group (Safr-control) was daily intraperitoneally injected with paraffin oil. The second group (Cands- and 3-NP-control) daily received an oral dose of 0.5% carboxymethylcellulose followed by an intraperitoneal injection of 0.9% saline. The third and fourth groups received a single daily dose of 50 mg/kg Safr (intraperitoneal) and 1 mg/kg Cands (oral), respectively. The sixth group was daily treated with 50 mg Safr kg/day (intraperitoneal) and was intraperitoneally injected with 20 mg 3-NP/ kg, from the 3rd till the 9th day. The seventh group was daily treated with 1 mg Cands /kg/day (oral) and was intraperitoneally injected with 20 mg 3-NP/ kg, from the 3rd till the 9th day. The present results revealed that 3-NP injection induced a considerable body weight loss, impaired memory and locomotor activity, reduced striatal monoamine levels. Furthermore, 3-NP administration remarkably increased striatal malondialdehyde and nitric oxide levels, whereas markedly decreased the total antioxidant capacity. Moreover, 3-NP significantly upregulated the activities of inducible nitric oxide synthase and caspase-3 as well as the Fas ligand, in striatum. On the contrary, Safr and Cands remarkably alleviated the above-mentioned 3-NP-induced alterations. In conclusion, Safr and Cands may prevent or delay the progression of HD and its associated impairments through their antioxidant, anti-inflammatory, anti-apoptotic and neuromodulator effects.

Actinomicosis mamaria: presentación de un caso clínico

Breast actinomycosis is a chronic suppurative infection characterized by the presence of external fistulas in the skin of the breasts. It is rare in this location and may be primary in the mammary gland or secondary to a lung condition. We present the clinical case of a 71-year-old female patient who presented a hard tumor that compromised the entire left breast, with intense pain as well as impossibility of mobility of the left upper limb, considerable weight loss; Thoracic tomography report led to suspicion of malignant neoplasm of the breast and the result of the pathology study was a mammary Actinomycosis. For which, we emphasize the importance of a high suspicion, diagnosis and treatment for its satisfactory prognosis.

Benefits in routinely measured liver function tests following bariatric surgery: a retrospective cohort study.

Bariatric surgery is well-established to support long-term metabolic health benefits associated with considerable weight loss. Here, we aim to determine the longer-term impact of bariatric surgery on liver enzymes and associations with other metabolic improvements. One hundred patients who underwent bariatric surgery between 2007 and 2014 were included, and changes in liver enzymes, anthropometric measures and other parameters were observed over a mean 9.8 years. At the time of surgery, the mean age was 45.4 ± 9.6 years, weight 141.2 ± 31.6kg, and body mass index (BMI) 50.2 ± 10.1kg/m2. Most patients underwent sleeve gastrectomy [n = 71] with a mean follow-up duration 9.8 ± 2.3 years. From baseline, alanine transaminase (ALT) reduced by 41.3% within 12 months post-operatively (36.6 ± 29.2 U/L to 21.5 ± 14.9 U/L, p < 0.001), which was sustained at recent follow-up (20.2 ± 10.7 U/L, p < 0.001). There were associated reductions in body weight, BMI, HbA1c, blood pressure and triglycerides. Patients with greater baseline ALT had the greatest reduction in ALT over follow-up. Bariatric surgery is associated with rapid and sustained improvements in routine liver enzymes at 10 years, and sustained improvements in features of the metabolic syndrome. The online version contains supplementary material available at 10.1007/s40200-023-01311-4.

Alternative Eco-friendly Treatment of Hollow Cellulosic Fiber-Based Hybrid Composites for Remarkable Reactive Dyeing

Egyptian Chorisia hollow fibers have been blended with cotton waste, polyester waste, and raw bamboo at various ratios and weft counts using open-end spinning. The blended fabrics of hybrid composites were subjected to atmospheric plasma, pectinase, and lipase enzyme treatments, as well as the substitution of all hazardous chemicals, as sustainable alternatives to traditional alkaline scouring. The impacts of the treatments on the hollow-based fabrics' hydrophilicity, surface morphology, and color performance have been discussed. Pretreatment is associated with considerable weight loss (~ 12%) and a wetting time of less than 5 s which represents adequate absorbency of the composite. The enzymatic treatment contributed to looser arrangement of the fibrils which indicates an effective elimination of lignin and hemicellulose. The crystalline sections were greatly influenced by enzymatic treatment, providing effective decrease of cellulose crystallinity by about 30–40% as revealed by X-ray diffraction (XRD) measurements. Compared to conventional scouring, bio-scouring discharges significantly less effluent. The treated composite using either enzyme or plasma pretreatment method produced about at least 300% higher color yield (K/S) and 100% enhanced dye fixation (% F) than the untreated fabric. The lipase pretreatment without subsequent to atmospheric plasma treatment could be enough to achieve the highest hydrophilicity and color performance level under the experimental conditions.

Anti-tuberculosis treatment-induced hepatotoxicity in a post-operative setting

The most frequent cause of infectious disease-related mortality globally is tuberculosis (TB), a multisystemic disease with a wide range of presentations and symptoms. Around 12% of extrapulmonary TB cases and 1–3% of all TB cases are caused by abdominal TB. The issue of antituberculosis drug-induced liver injury (ATLI), which has long been a challenge in the management of TB infection, is one of increased significance. The major steps to reduce the occurrence of ATLI are to identify the possible risk factors of hepatotoxicity and to provide an appropriate weight-based anti-tuberculosis treatment (ATT). This case report clarifies the significance of appropriate weight-based dosing of ATT, particularly in a post-operative environment as evidenced in this instance where the patient experienced considerable post-operative weight loss.

Thermal Properties of Ultrasound-Extracted Okra Mucilage

Utilizing chemical and physicochemical techniques, the mucilage part of okra was extracted with the use of ultrasound, and the polysaccharide extract’s structural and thermal characteristics were assessed. Analysis of the extraction yield revealed that there was no discernible impact of time and that the yield increased with a decreasing okra to distilled water ratio (mean 8%). Differential scanning calorimetry was employed to determine the phase change enthalpy by examining the glass transition temperature and enthalpy. The glass transition temperatures of the samples were found to be about 50 °C and the melting temperatures were in the range of 166–170 °C for varied solid/solvent ratios (1:10, 1:25, 1:30, and 1:50) and extraction durations of 5 and 30 min. Using thermogravimetry (TG) and differential thermogravimetry (DTG) techniques, it was discovered that the okra polysaccharides were thermally stable with considerable weight loss above 240 °C. For the purpose of illuminating the bonds of the polysaccharides, FTIR analysis was used to characterize the polysaccharides obtained by the varying extraction times and rates of solid/solvent. This analysis provides detailed information about the composition of the extracts. It was found that the molecular structure of the mucilage from okra was unaffected by the varying ratios and times. The study’s findings indicated that the use of ultrasound could be a promising approach for extracting polysaccharides that possess strong thermal stability, making them suitable for use in various industrial applications. The study noted that variations in ultrasound application time and solid/solvent ratios did not appear to impact the thermal stability of the extracted polysaccharides. The important parameters for the extraction conditions such as the time and low amount of sample used are preferred for applications. The findings obtained indicate that ultrasonic extraction application at a 1/50 solid/solvent ratio for 5 min is statistically significant in terms of thermal properties and yield. These findings could have important implications for the energy costs associated with the industrial use of ultrasound extraction.

Ceramics Properties of Indurated-Shale Quarry Wastes from Abakaliki, Southeastern Nigeria: Application as Raw Materials in Roofing-Tile Production

AbstractThe present study describes research carried out to evaluate the mineralogical, geochemical and technological properties of indurated shale-quarry wastes and assess the suitability of these low-cost and locally available quarry wastes generated from crushed indurated shales for possible use as alternatives to fresh raw materials in the manufacture of roofing-tile products. Firstly, the mineralogical and chemical properties of the indurated shales were investigated by X-ray diffraction (XRD) and X-ray fluorescence, while their physical properties were identified by grain-size distribution, Atterberg limits, and clay activity. Samples of indurated shale-quarry wastes (ISQWs) were subjected to heat treatment at elevated firing temperatures to provide the required strength and durability and their ceramics properties (linear shrinkage, weight loss, water absorption, bulk density, and flexural strength) were determined. From the results, the ISQWs were composed predominantly of fine particles with medium plasticity and clay activity with values generally &gt;0.75. The mineralogy revealed a predominance of aluminosilicates (illite-kaolinite-smectite-chlorite) with large quartz contents and variable percentages of carbonate and feldspar. The oxides were dominated by SiO2 and Al2O3, small amounts of ferromagnesian minerals, and considerable amounts of alkalis (K2O and Na2O) which act as fluxes. The CaO concentrations were variable and related to carbonate contents. Characterizations based on compositional ternary (total clay mineral-carbonate-quartz + feldspar) systems, Casagrande clay workability charts, and Winkler and McNally diagrams revealed their suitability for ceramics applications as the majority of ISQW samples fell within the specifications for roofing tiles. The ISQWs fired at a high temperature of 1000°C revealed considerable weight loss, reduction in both linear shrinkage and water absorption with insignificant increase in flexural strength. In order to achieve excellent ceramics properties and further reduce sintering temperature for their suitability as raw materials in the production of roofing tiles, beneficiations of ISQWs are highly recommended.

The combined effect of BMI and age on ART outcomes.

For a woman with infertility and overweight/obesity, can infertility treatment be postponed to first promote weight loss? Advice regarding a delay in IVF treatment to optimize female weight should consider female age, particularly in women over 38 years for whom only substantial weight loss in a short period of time (3 months) seems to provide any benefit. Body weight excess and advanced age are both common findings in infertile patients, creating the dilemma of whether to promote weight loss first or proceed to fertility treatment immediately. Despite their known impact on fertility, studies assessing the combined effect of female age and BMI on cumulative live birth rates (CLBRs) are still scarce and conflicting. We performed a multicentre retrospective cohort study including 14 213 patients undergoing their first IVF/ICSI cycle with autologous oocytes and subsequent embryo transfers, between January 2013 and February 2018 in 18 centres of a multinational private fertility clinic. BMI was subdivided into the following subgroups: underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obesity (≥30.0 kg/m2). The primary outcome was CLBR. The secondary outcome was time to pregnancy. To assess the influence of female age and BMI on CLBR, two multivariable regression models were developed with BMI being added in the models as either an ordinal categorical variable (Model 1) or a continuous variable (Model 2) using the best-fitting fractional polynomials. CLBR was estimated over 1-year periods (Model 1) and shorter timeframes of 3 months (Model 2). We then compared the predicted CLBRs according to BMI and age. When compared to normal weight, CLBRs were lower in women who were overweight (adjusted odds ratio (aOR) 0.86, 95% CI 0.77-0.96) and obese (aOR 0.74, 95% CI 0.62-0.87). A reduction of BMI within 1 year, from obesity to overweight or overweight to normal weight would be potentially beneficial up to 35 years old, while only a substantial reduction (i.e. from obesity to normal BMI) would be potentially beneficial in women aged 36-38 years. Above 38 years of age, even considerable weight loss did not compensate for the effect of age over a 1-year span but may be beneficial in shorter time frames. In a timeframe of 3 months, there is a potential benefit in CLBR if there is a loss of 1 kg/m2 in BMI for women up to 33.25 years and 2 kg/m2 in women aged 33.50-35.50 years. Older women would require more challenging weight loss to achieve clinical benefit, specifically 3 kg/m2 in women aged 35.75-37.25 years old, 4 kg/m2 in women aged 37.50-39.00 years old, and 5 kg/m2 or more in women over 39.25 years old. This study is limited by its retrospective design and lower number of women in the extreme BMI categories. The actual effect of individual weight loss on patient outcomes was also not evaluated, as this was a retrospective interpatient comparison to estimate the combined effect of weight loss and ageing in a fixed period on CLBR. Our findings suggest that there is potential benefit in weight loss strategies within 1 year prior to ART, particularly in women under 35 years with BMI ≥25 kg/m2. For those over 35 years of age, weight loss should be considerable or occur in a shorter timeframe to avoid the negative effect of advancing female age on CLBR. A tailored approach for weight loss, according to age, might be the best course of action. No specific funding was obtained for this study. All authors have no conflicts to declare. N/A.

Randomized controlled trial of prepregnancy lifestyle intervention to reduce recurrence of gestational diabetes mellitus

Preconception lifestyle intervention holds potential for reducing gestational diabetes mellitus, but clinical trial data are lacking. This study aimed to determine the effects of a prepregnancy weight loss intervention on gestational diabetes mellitus recurrence in women with overweight/obesity and previous gestational diabetes mellitus. A 2-site, randomized controlled trial comparing a prepregnancy lifestyle intervention with educational control was conducted between December 2017 and February 2022. A total of 199 English- and Spanish-speaking adults with overweight/obesity and previous gestational diabetes mellitus were randomized to a 16-week prepregnancy lifestyle intervention with ongoing treatment until conception or educational control. The primary outcome was gestational diabetes mellitus recurrence. Analyses excluded 6 participants who conceived but did not have gestational diabetes mellitus ascertained by standard methods. In the 63 (33%) women who conceived and had gestational diabetes mellitus ascertained (Ns=38/102 [37%] intervention vs 25/91 [28.0%] control; P=.17), those in the intervention group had significantly greater weight loss at 16 weeks compared with controls (4.8 [3.4-6.0] vs 0.7 [-0.9 to 2.3] kg; P=.001) and a greater proportion lost ≥5% of body weight (50.0% [17/34] vs 13.6% [3/22]; P=.005). There was no significant difference in the incidence of gestational diabetes mellitus recurrence between the intervention (57.9% [ns=23/38]) and the control group (44.0% [ns=11/25]; odds ratio, 1.8 [0.59-5.8]). Independent of group, greater prepregnancy weight loss predicted 21% lower odds of gestational diabetes mellitus recurrence (odds ratio, 0.79 [0.66-0.94]; P=.008). A ≥5% weight loss before conception reduced the odds of gestational diabetes mellitus recurrence by 82% (odds ratio, 0.18 [0.04-0.88]; P=.03). Lifestyle intervention produced considerable prepregnancy weight loss but did not affect gestational diabetes mellitus rates. Given that the conception rate was 50% lower than expected, this study was underpowered.