Excessive Appetite Research Articles

A study on the effects of metacinnabar (β-HgS) on weight and appetite recovery in stressed mice

Ethnopharmacological relevanceDepression is a prevalent stress disorder, yet the underlying physiological mechanisms linking stress to appetite and weight loss remain elusive. While most antidepressants are associated with excessive weight and appetite gain, sertraline (SER) exhibits a lower risk of these side effects. Metacinnabar (β-HgS), the primary component of Tibetan medicine Zuotai, has been shown to enhance mice's resilience against external stress without causing excessive increases in weight or appetite. However, the precise physiological pathway through which β-HgS restores appetite and weight in stressed mice remains unclear. Aim of the studyThe objective of this study is to assess the efficacy of β-HgS in ameliorating weight loss and appetite suppression induced by pressure stimulation in mice, as well as elucidate its potential mechanisms of action. MethodsThe present study employed chronic restraint stress (CRS) and chronic unpredictable mild stress (CUMS) as experimental models to simulate environmental stress encountered in daily life. Subsequently, a series of experiments were conducted, including behavior tests, HE staining of rectal and hippocampal pathological sections, detection of depression-related biological indicators, analysis of intestinal flora diversity, as well as metabolomics analysis of hippocampal and intestinal contents. ResultDysregulation of glycerophospholipid metabolism may represent the principal pathway underlying reduced appetite, body weight, neurotransmitter and appetite hormone levels, heightened inflammatory response, hippocampal and rectal tissue damage, as well as altered composition of intestinal microbiota in stressed mice. Following intervention with SER and β-HgS in stressed mice, the deleterious effects induced by stress can be ameliorated, in which the medium-dose β-HgS exhibited superior performance. ConclusionThe aforementioned research findings suggest that the stress-induced decrease in appetite and body weight in mice may be associated with dysregulation in glycerophospholipid metabolism connecting the gut-brain axis. β-HgS exhibits potential in ameliorating depressive-like symptoms in mice subjected to stress, while concurrently restoring their body weight and appetite without inducing excessive augmentation. Its therapeutic effect may also be attributed to its ability to modulate glycerophospholipid metabolism status and exert influence on the gut-brain axis.

Chemoreactomic study of fonturacetam effects: molecular mechanisms of influence on adipose tissue metabolism

Objective: to conduct chemoreactomic, pharmacoinformatic and chemoneurocytological analyzes of the properties of racetams (piracetam, aniracetam, pramiracetam, levetiracetam, fonturacetam).Material and methods. Chemoreactomic, pharmacoinformatic and chemoneurocytological methods of molecule properties analyzis are based on chemoreactomic methodology – the latest direction in the application of machine learning systems in the field of postgenomic pharmacology. Analysis of pharmacological capabilities of molecules within the framework of chemoreactomic methodology is carried out by comparing the chemical structure of racetam molecules with the structures of molecules for which pharmacological properties were studied using training artificial intelligence algorithms based on big data information presented in PubChem, HMDB, STRING, PharmGKB databases. Based on the entire complex of differences between molecules in interactions with receptor proteins, an “anti-obesity” score was calculated for each one as a serial number of this molecule in descending order by corresponding IC50, EC50 chemoreactomic constants values.Results. The lipolytic effect is predicted specifically for fonturacetam as a result of activation by this molecule of β3-adrenoceptors, adenosine receptors, glucagon-like peptide, sphingosine phosphate and peroxisome proliferators, as well as specific inhibition of cannabinoid, opioid, histamine, glutamate, nociceptin, orexin and neuropeptide Y receptors. Due to these mechanisms fonturacetam will contribute to normalizing appetite and improving adipose tissue metabolism. The total lipolytic effect score was calculated for all established interactions with receptors and amounted to 4.3±0.9 for fonturacetam, 3.0±1.4 for pramiracetam, and 2.5±1.5 for all other molecules.Conclusion. The results of the analysis suggest that the lipolytic effects of fonturacetam (Actitropil – Pharmstandard, Russia) will be much stronger than for other racetams (piracetam, aniracetam, pramiracetam, levetiracetam). Chemoreactomic analysis of fonturacetam indicated new mechanisms of pharmacological action of the molecule, providing a decrease in excess appetite and body weight normalization. Fonturacetam is the only nootropic drug indicated for the treatment of obesity.

Relationship of thyroid function with genetic subtypes and treatment with growth hormone in Prader-Willi syndrome.

Prader-Willi syndrome (PWS) is the most common genetic syndrome with obesity and results from loss of expression of paternally inherited genes on chromosome 15q11-q13 by a variety of mechanisms which include large deletions (70%-75%), maternal uniparental disomy (UPD) (20%-30%), and imprinting defects (2%-5%) or balanced translocations. Individuals often have a characteristic behavior disorder with mild intellectual disability, infantile hypotonia associated with poor sucking, short stature, and obesity. PWS is characterized by hypothalamic-pituitary axis dysfunction with growth hormone (GH) deficiency, hypogonadism, and several other hormonal deficiencies resulting in short stature, centrally driven excessive appetite (hyperphagia), central obesity, cryptorchidism, and decreased lean body mass. In this study, we determined and sought differences in the incidence of thyroid abnormalities among the common genetic subtypes in a cohort of 52 subjects with PWS because there was limited literature available. We also sought the effects of growth hormone (GH) treatment on the thyroid profile. Fifty-two subjects with a genetically confirmed diagnosis of PWS were included in this study at the University of California, Irvine. Blood samples for baseline thyroxine stimulating hormone (TSH) and free thyroxine (fT4) levels were obtained in the morning after an overnight fast for 8-12 h. Statistical analyses were performed with SPSS (SPSS Inc., 21.0). Mean values were analyzed by one-way ANOVA, and student's t-test and statistical significance were set at p < 0.05. The subjects included 26 males and 26 females with an age range of 3-38 years. There were 29 subjects with chromosome 15q11-q13 deletions and 23 with UPD; 28 were GH treated currently or in the past, and 24 never received GH. There was no significant difference in age or body mass index (BMI) (kg/m2) between GH-treated versus non-GH-treated groups. BMI was higher in the deletion group compared to the UPD group (p = 0.05). We identified two individuals who were clinically diagnosed and treated for hypothyroidism, one of whom was on GH supplements. We identified two additional individuals with subclinical hypothyroidism who were not on GH treatment, giving a frequency of 7.6% (4/52) in this cohort of patients. We did not find significant differences in thyroid function (TSH) in the deletion versus UPD groups. We found significant differences in thyroid function, however, between GH-treated and non-GH-treated groups. The mean TSH was lower (2.25 ± 1.17 uIU/M, range 0.03-4.92 uIU/M versus 2.80 ± 1.44 uIU/M, range 0.55-5.33 uIU/M respectively, p = 0.046), and the free T4 levels were significantly higher (1.13 ± 0.70 and 1.03 ± 0.11 ng/dL, respectively, p = 0.05) in the GH-treated individuals compared to non-GH-treated individuals. In this cohort of subjects with PWS, we identified two previously diagnosed individuals with hypothyroidism and two individuals with subclinical hypothyroidism (4/52, 7.6%), three of whom were not receiving GH treatment. We did not find any significant differences in thyroid function between molecular subtypes; however, we found that euthyroid status (lower TSH levels and higher free T4 levels) was significantly higher in individuals who were treated with GH compared to the untreated group. We recommend that individuals with PWS should be screened regularly for thyroid deficiency and start treatment early with GH in view of the potentially lower incidence of thyroid deficiency.

A63: Exercise Improves Appetite and Heart Function in High Fat Drosophila

Purpose: High-fat diets cause obesity and disease leading to excess appetite and cardiovascular disease. At present, there is literature showing the improvement effect of exercise on obesity and related diseases. To explore more deeply the mechanism of action of exercise on appetite improvement and heart function in high-fat diets, we used fruit fly motility models to reveal this aspect of function. Methods: A total of 300 wild-type W1118 virgin flies that matured within 12 hours were collected. They were randomly divided into 100 animals in the normal diet control group (NFD), 100 in the high-fat diet group (HFD), and 100 in the high-fat diet exercise group (HFD+E). Exercise intervention for 7-day-old fruit flies for 5 consecutive days. An EM-CCD high-speed camera was used to record the heartbeat of fruit flies (video at 130 fps, the 30 s), and HC Image software was used to record the cardiogram data. Semi-Automated Optical Heartbeat Analysis (SOHA) quantifies Heart Rate (HR), Heart Period (HP), Diastolic Intervals (DI), Systolic Intervals (SI), Arrhythmia Index (AI), Diastolic Diameter (DD), Systolic Diameter (SD), Fractional Shortening (FS), and Fibrillations (FL). Fruit fly uptake was measured using the FlyPAD high-throughput Drosophila quantitative feeding system. All fruit flies needed to be fed on normal medium for 5 days first and then transferred to fresh normal medium or the high-fat medium on the 6th day for another 2 days. NFD flies are placed in a constant temperature and humidity incubator (25 °C, 50% humidity, 12 h day and night cycle), HFD flies are housed in incubators at 22-24 °C and 50% relative humidity to make high-fat medium by mixing 30% coconut oil and 70% standard medium. Results: The HFD group had an increase in AI, HR and HP, constant SD, decreased DD, and decreased FS. After exercise, HFD+E group had a decrease in HR, an increase in HP, an improvement in AI, an improvement in DD, and no change in SD. The food intake and sipping frequency of fruit flies in the HFD group were significantly higher than those in the NFD group, and during the same time period, the food intake and number of sipping times in the HFD+E group and the HFD group decreased significantly after exercise. Conclusion: Exercise improved excess appetite and cardiac dysfunction in high-fat diets.

THU110 Wrong Tissue At Wrong Place—Rare Case Of Hypopituitarism Secondary To Metastatic Renal Cell Carcinoma

Abstract Disclosure: S. Avula: None. A. Ahmed: None. M. Salim: None. H. Alameddine: None. Introduction: Metastasis to pituitary is very rare occurrence, accounting for 1-4%. Most common primary cancer that metastasis to pituitary are Breast cancer in females and Lung cancer in males. Most of the pituitary metastasis are asymptomatic with symptomatic patient account for around 7 %. Most common symptoms reported are anterior pituitary dysfunction, visual field defects, headache, diabetes insipidus. Metastasis from Renal cell carcinoma (RCC) is very rare with only 25 cases reported so far. Metastases to the pituitary from RCC cause more severe hypopituitarism and visual dysfunction in comparison to those from other primaries. We present a rare case of hypopituitarism due to metastatic RCC presenting after Clinical Case: A 59-year-old male who initially presented in 2010 with complains of abdominal pain, underwent abdominal imaging and was found to have 7 cm solid mass in the right kidney. He underwent right nephrectomy in France and pathology confirmed RCC with no lymph node involvement. Patient didn’t have any adjuvant therapy. He had 5 years of follow up surveillance scans in Palestine which didn’t show any recurrence. In 2021 patient started to notice vision changes with loss of peripheral vision loss on right side but he didn’t seek any medical attention. In 9/2022 he noticed to have excessive fatigue, low libido, low appetite, excessive thirst and worsening of his vision. He had hormonal evaluation done in Palestine which showed low testosterone, cortisol, thyroid levels and was diagnosed with panhypopituitarism and was started on Hydrocortisone, Levothyroxine, Testosterone and Desmopressin. In 9/2022 had MRI brain in Palestine and showed 2cms suprasellar enhancing mass arising in the suprasellar cistern and appears inseparable from the pituitary stalk infundibulum. In 11/2022 he came to USA for further evaluation and management. In November 2022 patient complained of hallucinations, memory loss, personality changes and bitemporal vision loss. MRI brain showed sellar and suprasellar mass, 2.1 x 2.3 x 3.8 cm, extending to the suprasellar cistern and elevates the optic chiasm with possible third ventricle involvement and had increased in size compared to previous scan. On 11/29/22 patient underwent Endoscopic Endonasal Transplanum, Transtuberculum approach for tumor removal, biopsy of sellar and suprasellar tumor which returned as metastatic RCC. Patient was discussed in tumor board and is scheduled for gamma knife. Conclusion: Metastatic RCC to pituitary is very rare and most of them are asymptomatic leading to delay in diagnosis. Treatment of pituitary metastases is not standardized and should be tailored to patients’ clinical conditions, histology, and presence of extra-pituitary metastases. We need more prospective studies to formulate guidelines for management of pituitary metastases. Presentation: Thursday, June 15, 2023

Adrenal insufficiency in patients with Prader-Willi syndrome.

The generalized dysfunction of the hypothalamic-pituitary axis in patients with Prader-Willi syndrome (PWS) is the most likely cause of hypogonadism, inadequate growth hormone secretion, excessive appetite and associated obesity, impaired body temperature regulation, and hypothyroidism. The syndrome is also related to an increased risk of central adrenal insufficiency, although its prevalence remains unknown. The results of the studies in which different methods of pharmacological stimulation were used do not provide conclusive outcomes. As a result, there are no clear guidelines with regard to diagnosis, prevention, or long-term care when adrenal insufficiency is suspected in patients with PWS. Currently, most patients with PWS are treated with recombinant human growth hormone (rhGH). It has been confirmed that rhGH therapy has a positive effect on growth, body composition, body mass index (BMI), and potentially on psychomotor development in children with PWS. Additionally, rhGH may reduce the conversion of cortisone to cortisol through inhibition of 11β-hydroxysteroid dehydrogenase type 1. However, its influence on basal adrenal function and adrenal stress response remains unexplained in children with PWS. This paper reviews the literature related to the hypothalamic-pituitary-adrenal axis dysfunction in the PWS patient population with a focus on children.

Cognitive Behavior Therapy (CBT) Effectiveness in Overcoming Binge Eating Disorder (BED) in Adolescents

This study aims to see the effectiveness of Cognitive Behavior Therapy (CBT) in reducing binge eating disorder (BED) in adolescents. The research method used is an experimental study, namely a single experimental design in a home setting, where the subject is treated with CBT (Cognitive Behavior Therapy) techniques to overcome Binge Eating Disorder (BED). Data collection in this study used the methods of observation, interviews and psychological tests (DAP, BAUM, HTP, and SSCT). Data analysis in this study used an evaluation which was also continuously monitored using a monitoring table during the implementation of the intervention. Thus, the success of the CBT intervention was seen based on the achievement of the targets previously agreed upon by the subjects, especially in the Binge Eating Disorder (BED) eating disorder. The results showed that the intervention process in the form of cognitive behavior therapy (CBT) which was carried out for 10 days got satisfactory results. This is also consistent with the good prognosis of the subjects. Subjects were able to control their excessive appetite, and even changed their snacks to healthier foods, so as not to interfere with their health.

D-Allulose Inhibits Ghrelin-Responsive, Glucose-Sensitive and Neuropeptide Y Neurons in the Arcuate Nucleus and Central Injection Suppresses Appetite-Associated Food Intake in Mice.

d-allulose, a rare sugar, has sweetness with few calories. d-allulose regulates feeding and glycemia, and ameliorates hyperphagia, obesity and diabetes. All these functions involve the central nervous system. However, central mechanisms underlying these effects of d-allulose remain unknown. We recently reported that d-allulose activates the anorexigenic neurons in the hypothalamic arcuate nucleus (ARC), the neurons that respond to glucagon-like peptide-1 and that express proopiomelanocortin. However, its action on the orexigenic neurons remains unknown. This study investigated the effects of d-allulose on the ARC neurons implicated in hunger, by measuring cytosolic Ca2+ concentration ([Ca2+]i) in single neurons. d-allulose depressed the increases in [Ca2+]i induced by ghrelin and by low glucose in ARC neurons and inhibited spontaneous oscillatory [Ca2+]i increases in neuropeptide Y (NPY) neurons. d-allulose inhibited 10 of 35 (28%) ghrelin-responsive, 18 of 60 (30%) glucose-sensitive and 3 of 8 (37.5%) NPY neurons in ARC. Intracerebroventricular injection of d-allulose inhibited food intake at 20:00 and 22:00, the early dark phase when hunger is promoted. These results indicate that d-allulose suppresses hunger-associated feeding and inhibits hunger-promoting neurons in ARC. These central actions of d-allulose represent the potential of d-allulose to inhibit the hyperphagia with excessive appetite, thereby counteracting obesity and diabetes.

Depending on the Dark Triad: exploring relationships between malign personality traits, substance and process addictions

ABSTRACT Background and objective The present study aimed to contribute to the understanding of addiction formation and maintenance by exploring the relationships between Dark Triad (DT) personality trait levels and addiction tendencies to “substances” and “processes.” Incorporating an adapted “Addiction as Excessive Appetites” model within a biopsychosocial framework, relationships between DT trait levels, alcohol, and exercise addictions were examined. Methods Two hundred and eighty-nine adults living in the UK (192 women, 97 men) completed an online questionnaire measuring DT trait levels and indicative addiction scores to alcohol (substance) and exercise (process). These were interrogated using correlation analysis, group mean comparisons and multivariate analysis of variance (MANOVA). Results Significant positive correlations were found between psychopathic, grandiose narcissistic and Machiavellian trait levels with addiction scores to alcohol and exercise. MANOVA demonstrated significant main effects of alcohol and exercise with respect to DT trait levels. In most cases, those in the higher addiction risk groups showed higher psychopathic and Machiavellian trait scores. Conclusions Given the positive associations between DT trait levels and addiction and elevated DT levels in highest risk groups, the data was consistent with the proposed model. Machiavellianism trait levels were more strongly associated with process and substance addictions than found in previous studies.

The evolving epidemiology and differential etiopathogenesis of eating disorders: implications for prevention and treatment.

The evolving epidemiology and differential etiopathogenesis of eating disorders: implications for prevention and treatment.

Socio-psychological factors of personnel management in the context of tourist enterprises development

In modern conditions, which have had a devastating effect on the activities of tourism enterprises, the main tasks remain their preservation and development. Tourism as an industry has a great contribution to the national economy, as it not only provides paid services to the population, but also increases the number of jobs in such industries as transport, construction, hotel and restaurant industry, crafts, museums and more. Personnel management at tourism enterprises should be carried out taking into account the changing environmental conditions, changes in legislation, the ability to carry out tourism activities through hostilities in general. Characteristics of personnel management in crisis conditions of tourist enterprises functioning are considered and social and psychological factors as indicators of activity efficiency are allocated. The article considers the main trends in the functioning of tourist enterprises in the pre-war period, as the war caused almost complete destruction of the tourism sector. Taking into account the current circumstances, the possibilities of forming a motivational mechanism in tourism enterprises, which should be based not on material motivation and wages, but more on labor and status motivation and provide various forms of career advancement, corporate training, development of flexible work schedules and work seats optimization. Psychological factors of personnel management are proposed to be considered in terms of increasing the stress resistance of workers in changing conditions. Among the proposed measures are low-cost opinion polls on the characteristics of stress (loss of appetite or excessive appetite, sleep disturbances, chronic fatigue, rapid speech, loss of humor, irritability, frequent mistakes, unexplained headaches, stomach upset, alcoholism and smoking etc.) at enterprises that allow to identify the level of stress and stress resistance of employees, as well as measures to overcome stress, which are part of corporate culture and promote the tourism enterprises development.

THE KLEINE-LEVIN SYNDROME: A RARE DISEASE WITH OFTEN DELAYED DIAGNOSIS—A REPORT OF TWO CASES IN THE DEPARTMENT OF NEUROLOGY OF THE UNIVERSITY HOSPITAL OF COCODY (CÔTE D'IVOIRE)

TheKleine-Levin syndrome (KLS)is classied among rare diseases[1, 2]. It belongs to the central hypersomnias said to be recurrent and dened according to the International Classication of Sleepiness Disorders, 3rd version (ICSD-3), revised in 2014. For the ICSD-3, the Kleine-Levin syndrome is a disorder characterized by recurrent episodes of hypersomnia andhyperphagia (rapidconsumptionof a large amountoffood),usually with onset in early adolescence inmales but occasionally in laterlife and in women.Amonosymptomatic form of the disorder with hypersomnia only can occur with- out binge eating or hypersexuality [1]. Usually affecting adolescent males, episodes normally last up to a few weeks and terminate with total and spontaneous recovery. Possibly rst reported by Brierre de Bosmont in 1862, the condition however received its name from Willi Kleinewho,in1925,reporteda seriesof casesofperiodichypersomnia and also Max Levin who described a case of periodic hypersomnia and excessive appetite in1930[2].The exactprevalence remainsunknown.But it seems very rare: around one to two cases per million. All cases are not published. A review of the inter- national literature of language between 1962and2004,byArnulf et al.[2], estimatedthenumberofpublishedcases at186.Accordingtotheseauthors,theannualincidencewas2.7in1970,3.5 in 1980, and 5.8 in the 1990s. For these authors, this growth would rather correspond to the extension ofthe globalscientic communication than an actual increase in the prevalence of the syndrome. Patients were described aroundtheworld,includingAsiaandAfrica,withcuriouslyone-sixthofthe world's cases described in Israel [1, 2]. Its etiology remains unknown. The genetic trail was discussed in the presence of familial cases [1, 2]. The diseasemainlyaffectsyoungmales[1,2].Itsdiagnosisisclinical[1,3,4].

Eating disorders in pregnancy

The most frequent eating disorders are anorexia nervosa, binge eating and bulimia nervosa. They are frequently aggravated during pregnancy or postpartum and because they impair the general health and psychosocial functioning of the patients, it is fundamental to be carefully managing these pathologies in a multidisciplinary team. The common association with menstrual irregularities, even with secondary amenorrhea, lead to unplanned pregnancy following the patients’ belief that they are infertile, and this represents a risk factor for both mother and fetus. Carefully attention should be paid in the patients’ assessment due to the concealment behaviors adopted in order to hide the maladaptive patterns or the eventual use of certain potential drugs that are thought to prevent weight gain or an excessive appetite and, moreover, in the postpartum period patient should be carefully investigated for an eventual anxiety or depression syndrome that may arise as a result of the postpartum body shape or weight gain from the pregnancy period.

무절제한 욕망과 감염에 취약한 몸: 질병 담론을 통해 살펴본 착오 희극

The Comedy of Errors has been regarded as inherently disjunctive with its disparate sources, Pauline and Plautine, and its generic mixture of romance and farce. This paper examines how the play appropriates the contemporary disease discourses to represent the domestic and global trade in nascent capitalist England. The diverse approaches to diseases in the early modern period, including conventional humoralism and newly introduced contagion theory, provided a useful frame of reference to formulate characters’ diverse confusion. The Comedy of Errors stresses that “some love that drew him oft from home” can be gluttonous and syphilitic because it exposes the bodies both to the interior disorder from excessive appetite and the contagion as exterior invasion, making them chaotic and strumpeted. Employing amphibolous puns, pointing to the corporeal and the commercial at the same time, The Comedy of Errors articulated the mystery of trade in advance of the vocabulary’s development.

Risky Corporate Bonds in 2021: A Bubble, or Rational Underwriting in a Low-Rate Environment?

In response to the pandemic, the Federal Reserve and US Treasury aggressively supported the corporate debt markets in 2020, both through easy monetary policy and direct participation. As the economy recovered, the Fed maintained an easy monetary policy in pursuit of more robust employment, gross domestic product growth, and inflation targets. Many observers have asserted that these policy actions and other factors have driven a bubble in risk assets, such as equities, special purpose acquisition companies, real estate, commodities, cryptocurrencies, nonfungible tokens, and risky bonds. Others believe that the valuations for at least some of these assets reflect investors’ rational incorporation of the current interest rate environment and economic outlook into their underwriting assumptions. Here, the authors analyze this question with regard to one of the riskiest classes of debt securities—the CCC-rated portion of the corporate high-yield debt market—to draw broader conclusions about the leveraged credit markets in the United States. Using historical market metrics, this portion of the market at its recent peak offered almost no excess return to compensate investors for the risk taken relative to low-risk alternatives. From this, the authors conclude that investors are underwriting significantly more optimistic outcomes than those reflected in historical averages. Although the authors believe that this segment of the market falls short of a true bubble, as they define it, they warn that current conditions pose key risks to investors and to the broader economy. <b>Key Findings</b> ▪ The US high-yield bond market, like other asset classes in the wake of the current easy monetary environment, has reached peak levels. ▪ Consistent with past bubbles, investors have moved up the risk curve, disproportionately bidding up the riskiest portion of this market. ▪ Although this reflects excessive risk appetite on the part of investors, it falls short of a true bubble as we define it. ▪ That said, these conditions pose key risks to investors and to the broader economy.

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Multidimensional Evaluation of Awareness in Prader-Willi Syndrome.

There are no studies about insight or awareness of illness in patients with Prader-Willi Syndrome (PWS). The objective of this study was to explore the level of awareness of the disorder, of the need for medication, and of the social consequences of the disease, as well as of its main symptoms in PWS. We also aimed to explore relationships between awareness and sociodemographic and clinical characteristics, and to compare all data with a matched sample of patients with psychosis. Insight was assessed by an Adapted version of the Scale of Unawareness of Mental Disorder in a cross-sectional pilot study at a University Hospital. Thirty-six individuals with PWS (58.3% women) were included. Results showed that PWS patients had a good awareness of the illness and of the effects of medication, in contrast to a lack of awareness of illness’ social consequences. Awareness of obesity/overweight was excellent, as was the awareness of excessive appetite. Awareness of excessive food intake was only mild. Insight correlated with age and functionality, but not with BMI. PWS patients showed a better insight into the illness but a similar awareness of the effects of the medication and of the social consequences of the disease as compared to schizophrenia-spectrum patients. This profile of insight may have relevant clinical implications.

State of Democracy in Poland versus Environmental Protection

Abstract The paper starts with a review of literature focusing on links between democracy and environmental protection, pointing out a fair weight of scientific evidence that democratic societies on average enjoy a higher level of environmental quality than autocracies. It subsequently provides a quick insight into the recent trends in the state of democracy and the rule of law in Poland as well as a few examples of measures taken concerning environmental policy that have been undertaken after 2015. The paper concludes by expressing concern about certain negative patterns in the Polish environmental policy in the past few years, which seem to be connected to the deficiencies in the rule of law and democracy as observed in Poland. The shrinking space for civil society to participate in democratic governance concerning environmental issues and the excessive appetite of the current government for large infrastructural investments seem to be in contradiction with the European and global strive for sustainable development and tackling climate change. It remains to be seen if the recent negative trends in the Polish environmental policy will have a structural impact on the state of environment in Poland.

Maternal High Fat Diet Programs Male Mice Offspring Hyperphagia and Obesity: Mechanism of Increased Appetite Neurons via Altered Neurogenic Factors and Nutrient Sensor AMPK.

Maternal high-fat (HF) is associated with offspring hyperphagia and obesity. We hypothesized that maternal HF alters fetal neuroprogenitor cell (NPC) and hypothalamic arcuate nucleus (ARC) development with preferential differentiation of neurons towards orexigenic (NPY/AgRP) versus anorexigenic (POMC) neurons, leading to offspring hyperphagia and obesity. Furthermore, these changes may involve hypothalamic bHLH neuroregulatory factors (Hes1, Mash1, Ngn3) and energy sensor AMPK. Female mice were fed either a control or a high fat (HF) diet prior to mating, and during pregnancy and lactation. HF male newborns were heavier at birth and exhibited decreased protein expression of hypothalamic bHLH factors, pAMPK/AMPK and POMC with increased AgRP. As adults, these changes persisted though with increased ARC pAMPK/AMPK. Importantly, the total NPY neurons were increased, which was consistent with the increased food intake and adult fat mass. Further, NPCs from HF newborn hypothalamic tissue showed similar changes with preferential NPC neuronal differentiation towards NPY. Lastly, the role of AMPK was further confirmed with in vitro treatment of Control NPCs with pharmacologic AMPK modulators. Thus, the altered ARC development of HF offspring results in excess appetite and reduced satiety leading to obesity. The underlying mechanism may involve AMPK/bHLH pathways.

Variability and change over time of weight and BMI among adolescents and adults with Prader-Willi syndrome: a 6-month text-based observational study

BackgroundPrader-Willi syndrome (PWS) is a rare neurodevelopmental disorder in which hyperphagia (excessive appetite) is a hallmark feature. Understanding how weight changes over time in this population is important for capturing the contemporary natural history of the disorder as well as assessing the impact of new treatments for hyperphagia. Therefore, we aimed to determine the feasibility of a remote assessment of weight change over time in PWS.MethodsWe developed a text message-based, prospective cohort study of adolescents and adults with PWS to assess changes in weight and body mass index (BMI) over a six-month period. Weight was collected weekly, while changes in height, living situation, access to food, activity level, and medication were collected at three-month intervals.ResultsOne hundred and sixty-five participants enrolled in the study, with a mean age of 19.7 years (range 12–48). There was considerable variability in weight across participants (range: 76.8–207.7 kg). Thirty-three percent of the participants were normal weight, while 15% were overweight and 52% were obese. Overall, the weight of the study participants increased over the study period (mean weight change + 2.35%), while BMI was relatively stable, albeit high (mean BMI of 31.4 at baseline, mean BMI percent change + 1.42%). Changes in living situation, activity, food access, and medication had limited impact on weight and BMI changes. Multivariable analysis found that time, sex, age, and percentage of life on growth hormone (GH) therapy were statistically significant fixed effects. Participants submitted more than 95% of possible weight data points across the 26 weeks of the study.ConclusionsThis remote, observational study of weight change in PWS showed small increases in weight and BMI over a six-month period. Participants were highly compliant with this text message-based study, suggesting that mobile technology-based data collection was manageable for the participants. We anticipate that the results of this study will inform clinical trials for hyperphagia/obesity related therapies in PWS and provide a basis for understanding the efficacy of new therapies for hyperphagia in the real-world setting.