Significant Improvements In Weight Research Articles

Long-Term Effectiveness of Off-Label Risperidone Treatment in Children and Adolescents: A Randomized, Placebo-Controlled Discontinuation Study.

Objectives: Risperidone is commonly prescribed off-label in children and adolescents to manage disruptive behavior. This study aimed to investigate continued benefits of risperidone after at least 1 year of treatment and effects of discontinuation on physical health. Methods: Thirty-five youths (aged 6-18 years, intelligence quotient [IQ] >70) who were treated with risperidone for at least 1 year in regular clinical practice receiving outpatient care were randomly assigned to double-blind continuation of risperidone during 16 weeks or continuation for 2 weeks, gradual dose lowering over 6 weeks, and placebo for 8 weeks. Primary outcome was the total Disruptive Behavior (D-total) score of the parent-reported Nisonger Child Behavior Rating Form-Typical IQ (NCBRF-TIQ). Secondary outcome measures were the clinician-rated Clinical Global Impressions-Improvement scale (CGI-I), the parent, child, and teacher-rated Strengths and Difficulties Questionnaire (SDQ), the parent-rated Retrospective Modified Overt Aggression Scale (R-MOAS), and several health parameters (Udvalg for Kliniske Undersøgelser Side Effect Rating Scale [UKU-SERS], dyskinesia, akathisia, parkinsonism, body mass index (BMI), waist circumference, and laboratory outcomes). Mixed models for repeated measures were conducted for continuous outcomes and a chi-square test for the CGI-I. Results: Discontinuation of risperidone, as compared with continuation, was not associated with significant changes in parent-reported disruptive behaviors. However, discontinuation was related to significant deterioration in parent-rated verbal aggression, teacher-rated behavioral functioning, clinician-rated general functioning, and significant improvements in weight, BMI, waist circumference, and glucose, insulin, and prolactin levels. Although 56% of participants in the discontinuation group experienced relapse, causing premature withdrawal from the study, 44% was able to successfully discontinue risperidone. Conclusion: Discontinuation of risperidone was associated with deterioration on some, but not all behavioral measures according to this explorative study. Discontinuation was associated with important health gains. Despite long-term benefits of risperidone, attempts to withdraw risperidone should be undertaken in individual children. This is a crucial step in preventing harm and fostering health.

Effectiveness of a hybrid approach in integrating GLP-1 agonists and lifestyle guidance for obesity and pre-diabetes management: RWE retrospective study

AimEmerging anti-obesity pharmacotherapy provides an option to correct maladaptive physiological and hormonal changes associated with obesity. One of the widely used medications in this context is glucagon-like peptide 1 (GLP-1) agonists. However, the misuse of these medications without any guidance and monitoring of lifestyle modifications can lead to unfavorable outcomes. The study aims to evaluate the effectiveness of a hybrid care model, incorporating GLP-1 and GLP-1/GIP agonist therapies, in managing obese patients with/without pre-diabetes. This study showcases the midway results of a 6-month program, which includes a multidisciplinary care team and digital technology for continuous engagement and monitoring of patients, both in-clinic and remotely. MethodsIn a retrospective observational study, 115 participants were treated with GLP-1s (semaglutide, tirzepatide, and liraglutide). Physicians, dietitians, and coaches worked together to support behavioral changes using a dedicated app provided to patients. At the care team end, an integrated portal enabled continuous data flow allowing for the care team to provide personalized care via chat at regular intervals. Data collected included food logs, continuous glucose monitoring (CGM), and digital biomarkers such as sleep and activity. ResultsAt the midpoint of the program, participants exhibited statistically significant improvements in various metabolic parameters. Mean weight reduction was 8 %, with significant reductions in BMI, fat mass, and cholesterol levels. 24 (20.9 %) of patients lost ≥5 % of body weight, 55 (47.8 %) patients lost ≥10 % weight, and 36 (31.3 %) patients lost ≥15 % weight. Sub-analysis of pre-diabetic patients (n=36) demonstrated substantial improvements, including control of pre-diabetes in 80.6 % of cases and reduced HbA1c levels back to normoglycemia (5.39 ± 0.27). ConclusionThe Zone.Health's program, which combines pharmacotherapy with continuous engagement and monitoring to enable sustainable lifestyle modifications, demonstrated significant improvements in weight, body composition, and metabolic markers. Pre-diabetes was also effectively addressed. It is necessary to conduct further research to assess the long-term sustainability and optimal adoption of such care models into clinical practice.

Empowering Medical Students: Unveiling the Benefits of Nutrition Seminars and Plant-Based Diets in Medical School Education

Background: Whole-food, plant-based (WFPB) dietary patterns can be used as a lifestyle modification to lower blood pressure and lose weight. This study aimed to observe the effects of WFPB dietary patterns and improve nutrition education in medical school. Methods: Forty-six medical students participated in the four-week Plant Plunge challenge, which consisted of a pre- and post-challenge health screening, weekly nutrition seminars, and the personal challenge to eat more WFPB. Afterward, an anonymous survey was sent to participants to analyze nutrition education quality in medical school. Results: The Wilcoxon Signed Rank test indicated statistically significant improvement in weight and blood pressure (BP) (N = 33). The median (interquartile range) difference in weight from pre- to post- was −.9 (−2.2, .0, P < .0461) pounds, whereas the differences in systolic and diastolic BP were −5.0 (−9.0, −.5, P < .049) and −7.0 (−11.0, −2.0, P < .0037) mmHg, respectively. Participants were significantly more likely to advocate for the integration of nutrition information into the medical school curriculum ( P = .0162). Conclusions: Short-term lifestyle modifications with WFPB dietary patterns help reduce weight and BP. Incorporating nutrition seminars in medical education may improve long-term patient outcomes.

Dedalo Vola project: The effect of choral singing on physiological and psychosocial measures. An Italian pilot study

Several studies have been conducted that show the crucial role of active participation in music in health promotion (e.g. Dingle et al., 2021; Sheppard & Broughton, 2020); however, little research has focused on the biopsychosocial effects of choral singing. The present study aims to evaluate the effectiveness, in terms of improving physiological and psychosocial factors, of a choral program for middle-aged and older individuals. We integrated our study with qualitative observations of the atmosphere and flow state experienced by the choristers. The data were collected before and after 12 weeks of training, with 23 participants took part in the study. They experienced significant improvements in weight, oxygen saturation, heart rate, and satisfaction of psychological needs. A beneficial trend, although not statistically significant, were observed for blood pressure, cholesterol, triglycerides, stress, psychological needs, and mental health. The observations progressively revealed a more cohesive and focused group. Our findings support the potential for cross-disciplinary collaboration between healthcare and arts policy to promote and enhance health and well-being throughout the lifespan.

Undernutrition in young children with congenital heart disease undergoing cardiac surgery in a low-income environment

BackgroundMalnutrition (undernutrition) in children with congenital disease (CHD) is a notable concern, with preoperative and persistent growth failure post-cardiac surgery contributing to poorer outcomes. Poor growth in children with CHD in low-income environments is exacerbated by feeding difficulties, poverty, delayed diagnosis, and late corrective surgery. This study describes and compares the growth of young children with CHD undergoing cardiac surgery in central South Africa from before to 6-months after cardiac surgery.MethodsChildren 30 months and younger, with their mothers, were included in this prospective observational descriptive study. Weight- height-, and head circumference-for-age z-scores were used to identify children who were underweight, stunted and microcephalic. Z-scores for growth indices were compared from baseline to 3-months and 6-months post-cardiac surgery. Changes in growth over time were calculated using a 95% confidence interval on the difference between means. Linear regression was used to determine the association between growth and development, health-related quality of life and parenting stress respectively.ResultsForty mother-child pairs were included at baseline. Most children (n = 30) had moderate disease severity, with eight children having cyanotic defects. A quarter of the children had Down syndrome (DS). Twenty-eight children underwent corrective cardiac surgery at a median age of 7.4 months. Most children (n = 27) were underweight before cardiac surgery [mean z-score − 2.5 (±1.5)], and many (n = 18) were stunted [mean z-score − 2.2 (±2.5)]. A quarter (n = 10) of the children had feeding difficulties. By 6-months post-cardiac surgery there were significant improvements in weight (p = 0.04) and head circumference (p = 0.02), but complete catch-up growth had not yet occurred. Malnutrition (undernutrition) was strongly associated (p = 0.04) with poorer motor development [Mean Bayley-III motor score 79.5 (±17.5)] before cardiac surgery. Growth in children with cyanotic and acyanotic defects, and those with and without DS were comparable.ConclusionMalnutrition (undernutrition) is common in children with CHD in central South Africa, a low-income environment, both before and after cardiac surgery, and is associated with poor motor development before cardiac surgery. A diagnosis of CHD warrants regular growth monitoring and assessment of feeding ability. Early referral for nutritional support and speech therapy will improve growth outcomes.

Alterations in muscle strength among patients with GI cancers receiving oral nutritional support as soon as malnutrition was detected: ONMUS study.

741 Background: The main goal of our multicenter study, focusing on patients with gastrointestinal (GI) cancers receiving nutritional support, was to monitor the alterations in muscle strength among individuals who began oral nutritional support (ONS) as soon as malnutrition was detected. Additionally, our study had secondary objectives, which included assessing the adherence to ONS, examining the impact of ONS on anthropometric measurements, analyzing chemotherapy compliance, and evaluating the overall quality of life. Methods: The ONMUS study was conducted at 8 centers in Turkey. The study aimed to involve patients with GI cancer who had used ONS for a minimum of 1 week and had an ECOG performance score of 0-1. Patients underwent evaluations by both a dietitian and an oncologist during the baseline visit, as well as at the 2nd and 3rd month visits. Various parameters, including age, gender, performance status, disease stage, treatment adherence, food consumption records, anthropometric measurements, muscle function measured with a handgrip device, and quality of life scales, were assessed. Results: The study comprised 426 patients. The median age was 62 years, with a range spanning from 19 to 90 years. Colorectal cancer was the primary diagnosis in 51% of the patients, while hepatobiliary, gastric, esophageal, and small bowel cancers accounted for 20.9%, 20.7%, 6.5%, and 1% of cases, respectively. A significant majority, 78.2% (n=319), of the patients were diagnosed at stage 4, and nearly all, 99.3% (n=411), were undergoing chemotherapy. Patients who adhered to ONS at or above 75% of the recommended usage were categorized as compliant. Among this group, there was a significant increase in body mass index ( P=0.005). Handgrip measurements for assessing muscle strength demonstrated a statistically significant increase, with handgrip weight rising from 24.9 ± 8.9 kg at the first visit to 26.1 ± 8.9 kg at the third visit ( P=0.009). ONS-compliant patients also showed statistically significant improvements in weight, total body water, basal metabolic rate, and calf circumference measurements. The proportion of ONS-compliant patients decreased from 80.5% (n=343) at the first visit to 62.4% (n=93) at the third visit. Additionally, a statistically significant improvement was observed in food consumption records ( P=0.004). In assessments using the EORTC QLQ-C30, there were significant improvements noted in general health status, fatigue, pain, and insomnia scales, as well as in physical, emotional, and social functioning. Furthermore, a significant difference was identified between visits 1 and 2 in PG-SGA scoring ( P<0.001). Conclusions: ONS compliance is evident in the significant improvement observed in muscle strength, anthropometric measurements, and quality of life data. The importance of addressing malnutrition in patients with GI cancer cannot be overstated. Therefore, it is imperative to maintain regular monitoring of their nutritional status and adherence to ONS.

Postural Control and Weight Bearing Symmetry Patterns in Patients Post Lumbar Spinal Decompression Surgery

Background Prolapsed intervertebral disc is one of the most common reasons for low back pain often causing altered postural control and weight bearing symmetry of foot. Although these components are known to be affected there is limited literature available explaining the postural control and weight bearing symmetry post spinal decompression surgical procedures.Objective The study was formulated with the objective to understand postural control and symmetry of weight bearing patterns among patients post lumbar spinal decompression surgery.Methods The study was conducted involving 65 patients who were assessed pre-and post-lumbar decompression surgery. Nintendo Wii balance board was used to assess the patients at all intervals.Results The post-surgical values at discharge showed a clinical improvement in postural control bilaterally left P0.068 and right P0.031 but showed deterioration at one month with right P0.076 and significant on left side P0.009. Contrary to this the follow up values at one month showed a significant improvement in weight bearing symmetry P0.001. Pain values both on activity and at rest taken at both follow-up intervals F1 and F2 showed a statistically significant reduction P0.001.Conclusion Postural control assessed with single limb stance shows worsening at one month post decompression procedure. Weight bearing symmetry parameters may demonstrate a decline immediately post lumbar decompression surgery but may show a significant improvement along with reduction in pain post surgically as early as one month.

Determinants of nutritional outcome among beneficiaries of Nutrition Rehabilitation Centre

Background: Under Mission Balam Sukham, children of 6 months to 5 years having severe acute malnutrition (SAM) along with complications are managed at Nutrition Rehabilitation Centre (NRC). They are admitted for 14 days with the provision of a nutritional diet and medicines. Objectives: To explore determinants of nutritional outcome of SAM children admitted at NRC Methods: A prospective cohort study was conducted comprising 63 children aged 6 months to 5 years having SAM along with complications admitted at NRC of New Civil Hospital, Surat (NCHS) for 10 months. Results: The majority of participants were boys (54%), 12-23 months of age (50.8%), and Grade III socioeconomic class (39.6%). The duration of stay ranged from 2-36 days. The average duration of stay was 12.78 + 6.49 days; 14.26 ± 5.99 days for boys and 11.10 + 6.73 for girls. 18.8% stayed at NRC for 14 days. The average weight gain was 5.46 g/kg/day. A significant improvement in weight was seen in boys (t=2.20, p<0.05), working mothers (t=2.44, p<0.01), exclusively breastfed children (t=3.62, p<0.01) of 6-11 months, full-term children of 12-23 months (t=4.0, p<0.05). The children of 12-23 months (t=2.90, p<0.01) and boys (t=2.15, p<0.05) showed significant improvement in underweight (WAZ). Wasting improved significantly in age below 36 months (p<0.05). 20.6% could achieve the target weight. Conclusion: NRC is an effective life-saving modality for malnutrition but its outcome is associated with factors like boys, exclusive breastfeeding, and full-term.

Effect of Different Levels of FYM and Recommended Dose of Fertilizer and their Methods of Application on Groundnut in Western Uttar Pradesh

A two-year field experiment was conducted at the Research farm of Kisan Post Graduate College (Chaudhary Charan Singh University, Meerut), Simbhaoli, Hapur, Uttar Pradesh, from July-October of 2016 and 2017, respectively, to investigate the response of organic manures (farmyard manure) and chemical fertilizers and their method of application (broadcasting and root zone application) on Groundnut crop under assured irrigation. The soil of the field experiment was clay loam with chemical reaction 7.80, electrical conductivity (0.31 mm uS cm-1), low in organic carbon content (0.37%), low in available nitrogen and medium in phosphorus, and high in potassium. Results of the field experiment revealed that pod yield of groundnut improved by root zone placement of farmyard manure (FYM) and inorganic fertilizers mainly through a significant improvement in weight of 100 kernels. FYM and different NPK levels of fertilizers were applied as broadcasting and root zone placement in different treatments. Application of 14.0 tonnes of FYM ha-1 recorded significantly higher pod yield over the control plot. Root zone application of 75% of the recommended dose of 20 kg N, 80 kg P2O5, and 20 kg K2O ha-1 resulted in higher dry matter accumulation which leads to higher pod yield. Amid the interaction effect, a combination of 14.0 tonnes of FYM ha-1+75% RDF, 14.0 tonnes of FYM ha-1+root zone application and 100% RDF of NPK+root zone application obtained the highest pods yield as compared to other treatment combinations.

Feasibility and preliminary effectiveness of a cognitive-behavioral, family-centered partial hospitalization program for adolescents with anorexia nervosa and atypical anorexia nervosa at six- and twelve-month follow-up.

This study examined the feasibility and preliminary effectiveness of a cognitive-behavioral, family-centered partial hospitalization program (PHP) for adolescents with anorexia nervosa (AN) and atypical AN (AAN), and described the outpatient services received following discharge. Participants (N=31) completed anthropometric and self-report assessments at admission, discharge, and six and twelve months after discharge from the PHP. Descriptive statistics explored markers of feasibility. Paired samples t-tests evaluated changes in weight and eating disorder (ED) symptomatology from admission to discharge, admission to six-month follow-up, and admission to twelve-month follow-up. Descriptive statistics and effect sizes compared symptoms at each timepoint between participants with AN and AAN. Results indicated that we were successful at recruiting greater than 50% of adolescents approached for this study. We collected follow-up data from more than 70% of participants at discharge, but did not meet this retention benchmark at six-month and twelve-month follow-ups. The entire sample demonstrated significant improvements in weight and ED symptomatology from admission to discharge, and generally maintained these improvements at six- and twelve-month follow-up. While descriptive statistics suggested that participants with AN and AAN received similar outpatient services following discharge from the PHP, those with AN experienced greater improvement in self-reported ED symptomatology than those with AAN at six- and twelve-month follow-up. These findings provide preliminary support for the efficacy of PHPs in treating adolescents with AN and AAN. Further research with larger sample sizes should investigate whether adolescents with AAN experience poorer outcomes than those with AN following discharge from a PHP.

The Effectiveness of Patient Education on Laparoscopic Surgery Postoperative Outcomes to Determine Whether Direct Coaching Is the Best Approach: Systematic Review of Randomized Controlled Trials.

As of 2022, patient adherence to postoperative guidelines can reduce the risk of complications by up to 52.4% following laparoscopic abdominal surgery. With the availability of various preoperative education interventions (POEIs), understanding which POEI results in improvement in patient outcomes across the procedures is imperative. This study aims to determine which POEI could be the most effective on patient outcomes by systematically reviewing all the POEIs reported in the literature. In total, 4753 articles investigating various POEIs (eg, videos, presentations, mobile apps, and one-on-one education or coaching) were collected from the PubMed, Embase, and Scopus databases. Inclusion criteria were adult patients undergoing abdominal laparoscopic surgery, randomized controlled trials, and studies that provided postoperative outcomes. Exclusion criteria included studies not published in English and with no outcomes reported. Title and abstract and full-text articles with POEI randomized controlled studies were screened based on the above criteria through a blinded, dual review using Covidence (Veritas Health Innovation). Study quality was assessed through the Cochrane Risk of Bias tool. The included articles were analyzed for educational content, intervention timing, intervention type, and postoperative outcomes appropriate for a particular surgery. Only 17 studies matched our criteria, with 1831 patients undergoing laparoscopic cholecystectomy, bariatric surgery (gastric bypass and gastric sleeve), and colectomy. In total, 15 studies reported a statistically significant improvement in at least 1 patient postoperative outcome. None of these studies were found to have an overall high risk of bias according to Cochrane standards. In total, 41% (7/17) of the included studies using direct individual education improved outcomes in almost all surgery types, while educational videos had the greatest statistically significant impact for anxiety, nausea, and pain postoperatively (P<.01). Direct group education demonstrated significant improvement in weight, BMI, exercise, and depressive symptoms in 33% (2/6) of the laparoscopic gastric bypass studies. Direct education (individual or group based) positively impacts postoperative laparoscopic surgery outcomes. PROSPERO CRD42023438698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=438698.

1801-PUB: Efficacy and Safety of Once-Weekly Semaglutide in People with Type 1 Diabetes in Real-World Practice

Introduction: Semaglutide has shown significant improvements in weight and HbA1c in T2D, but the data about the efficacy and safety in people with T1D (PWT1D) are scarce. Aims &amp; Methods: We conducted a retrospective study including adults with T1D and obesity who had initiated once weekly (OW) semaglutide adjunct to insulin, to evaluate its efficacy and safety. Results: Twenty-one subjects were included (52.4% female, mean age 44.2 ± 12.9 years, diabetes duration 19.1 ± 10.8 years, HbA1c 7.7 ± 0.8%, BMI 38.3 ± 5.9 kg/m2). Of them, 47.6% had hypertension, 52.4% dyslipidaemia, 23.8% cardiovascular disease, and 19% renal disease. Mean treatment duration was 30.4 weeks. Mean OW semaglutide dose was 0.8 ± 0.2 mg. Significant reductions in HbA1c (-0,6 ± 0.7%), weight (-8.1 ± 6.1 kg; -7.5 ± 5.8%) and daily insulin dose (-20.7 ± 18.9 U/day) were achieved. An HbA1c reduction of ≥ 0.4% was seen in 61.9% of subjects. Weight loss ≥ 5% and ≥ 10% were achieved in 57.1% and 33.3% of cases, respectively. Significant improvements in time in range (+8.8 ± 13.4%) and time in hyperglycemia &amp;gt;250 mg/dL (-5.3 ± 5.1%) were attained. Four subjects experienced gastrointestinal adverse events, and two of them discontinued treatment. Conclusions: Adjunct treatment with OW semaglutide in PWT1D in a real-life setting resulted in promising results in glycemic control, weight, and insulin requirements, in a safe and well-tolerated manner. Disclosure V.Bellido: None. N.Gros herguido: None. S.Amuedo: None. L.Baena ariza: None. S.M.Alfonso: None.

Change in cardiometabolic risk factors in a pilot safety-net plant-based lifestyle medicine program.

Interventions emphasizing healthful lifestyle behaviors are proliferating in traditional health care settings, yet there is a paucity of published clinical outcomes, outside of pay-out-of-pocket or employee health programs. We assessed weight, hemoglobin A1c (HbA1c), blood pressure, and cholesterol for 173 patients of the Plant-Based Lifestyle Medicine Program piloted in a New York City safety-net hospital. We used Wilcoxon signed-rank tests to assess changes in means, from baseline to six-months, for the full sample and within baseline diagnoses (i.e., overweight or obesity, type 2 diabetes, prediabetes, hypertension, hyperlipidemia). We calculated the percentage of patients with clinically meaningful changes in outcomes for the full sample and within diagnoses. The full sample had statistically significant improvements in weight, HbA1c, and diastolic blood pressure. Patients with prediabetes or overweight or obesity experienced significant improvements in weight and those with type 2 diabetes had significant improvements in weight and HbA1c. Patients with hypertension had significant reductions in diastolic blood pressure and weight. Data did not show differences in non-high-density lipoprotein cholesterol (non-HDL-C), but differences in low-density lipoprotein cholesterol (LDL-C) were approaching significance for the full sample and those with hyperlipidemia. The majority of patients achieved clinically meaningful improvements on all outcomes besides systolic blood pressure. Our study demonstrates that a lifestyle medicine intervention within a traditional, safety-net clinical setting improved biomarkers of cardiometabolic disease. Our findings are limited by small sample sizes. Additional large-scale, rigorous studies are needed to further establish the effectiveness of lifestyle medicine interventions in similar settings.

Enhancing Obesity Management Through a Nurse Practitioner-Guided Behavioral Counseling Program

Although the prevalence of obesity in the United States is increasing, its treatment in primary care remains subpar. Implementing obesity reduction programs can result in significant benefits to patients. This study demonstrates that the use of a nurse practitioner-led program can result in weight loss. Thirty-six participants who were overweight or had obesity received biweekly behavioral counseling sessions over a 10-week period. Significant improvement in weight, waist circumference, blood pressure, quality of life, and self-efficacy for exercise was noted. Implementing similar programs can help patients attain weight loss and have an overall improvement in quality of life.

Nutritional impact of CFTR modulators in children with cystic fibrosis.

Nutritional status is a major prognostic factor for breathing and the survival of patients with cystic fibrosis (CF). Since 2012, the development of CFTR modulators has considerably transformed the outcome of this disease. Indeed, both lung function and body mass index are improved by CFTR modulators, such as Lumacaftor/Ivacaftor. However, few data exist regarding the outcome of nutritional intakes under Lumacaftor/Ivacaftor. We conducted a prospective single-center study in children with CF treated with Lumacaftor/Ivacaftor to evaluate their nutritional intake before and after treatment. Thirty-four children were included in this study, with a median age of 12.4 years [11.9; 14.7]. There was no significant improvement in weight, height or BMI. Patients' total energy intake was not significantly changed with Lumacaftor/Ivacaftor, while carbohydrate intakes decreased significantly. We found that blood levels of vitamin E and Selenium were significantly increased under Lumacaftor/Ivacaftor, without a significant increase in supplementation. In patients with a BMI Z-score < 0 at treatment initiation, there was a significant improvement in weight and BMI Z-score, while TEI and carbohydrate intakes were significantly lower. We showed that treatment with Lumacaftor/Ivacaftor improved the nutritional status of patients without necessarily being associated with an increase in nutritional intake. Although these data need to be confirmed in larger cohorts, they support the hypothesis that weight gain under modulators is multifactorial, and may be related to a decrease in energy expenditure or an improvement in absorption.

Association between Body Composition Parameters and Heart Rate in a Sample of Adolescents with Anorexia Nervosa.

Eating disorders affect the physical and mental health of millions of Americans. Body composition trends in relation to heart rate in adolescents with eating disorders remain understudied. The aim of the present study was to determine whether body composition parameters (percent body fat, percent skeletal muscle mass) are correlated with heart rate in a sample of adolescents with anorexia nervosa. This study included patients 11 to 19 years old who presented to an outpatient eating disorder clinic (N = 49). Patients underwent bioelectrical impedance analysis to estimate body composition parameters. Descriptive statistics, linear regression, and paired t tests were used to evaluate the data. Heart rate was inversely associated with percent skeletal muscle mass (P < 0.001) and positively associated with percent body fat (P = 0.001). Patients demonstrated significant improvements in weight, body mass index percentile, skeletal muscle mass, percent body fat, and heart rate when comparing results at the first and last visits (P < 0.01). Overall, there was an inverse relation between percent skeletal muscle mass and heart rate and a positive association between body fat and heart rate. Our study demonstrates the importance of assessing percent body fat and skeletal muscle mass rather than weight or body mass index alone in adolescents with eating disorders.

Pilot Study of the Feasibility of a Worksite Plant-Based Diabetes Prevention Program

This study aimed to explore the feasibility and acceptability of implementing a worksite diabetes prevention program-Beat Diabetes-on the basis of a plant-based diet and encouragement of physical activity. This was a mixed-methods pilot study using a 1-group pretest‒post-test design. The participants were university employees. A 13-week group-based intervention adapted from the Diabetes Prevention Program to emphasize a plant-based diet and on the basis of the Health Action Process Approach. Program implementation and participant acceptability were assessed through surveys, weekly documentation of the process, and individual interviews. Consumption of healthy and less healthy plant-based foods and animal-based foods, physical activity, and Health Action Process Approach‒based psychosocial determinants were measured through questionnaires before and after the program, as was blood glucose. Weights were measured weekly. A total of 14 participants were enrolled, with 93% retention. Program implementation was feasible and highly acceptable to participants and also resulted in significant improvements in weight, healthy relative to less healthy plant-based and animal-based foods, vigorous physical activity, blood glucose, and psychosocial determinants of behavior change. On the basis of our pilot study, conducting a worksite plant-based diabetes prevention program was feasible and acceptable and elicited positive changes in physiologic, behavioral, and psychosocial variables related to the risk of diabetes.

Real-world Data of Glycemic Control in a Suburban Population in Northern India during the COVID-19 Pandemic

Abstract Background: This study compared the 2-year glycemic outcomes with oral antidiabetic drugs (OADs) versus combination of OADs with insulin among the real-world patients at a single suburban center in India during the COVID-19 pandemic. Methods: Patients aged &gt;18 years on the treatment for type 2 diabetes mellitus were included and followed up for 2 years. The patients were divided into four groups according to their antidiabetic medication as follows: (1) sodium-glucose cotransporter-2 inhibitors (SGLT2i) + insulin + OADs; (2) SGLT2i + OADs; (3) insulin + OADs (excluding SGLT2i); and (4) OADs excluding SGLT2i. Patients who were reluctant to initiate insulin as add-on therapy or those already taking insulin but wanting to switch to OADs were prescribed SGLT2i as add-on therapy. The parameters measured at every follow-up were blood pressure, weight, fasting blood sugar (FBS), postprandial blood sugar, and HbA1c. Results: In all, 1204 patients were included in the study. The mean age of patients was 59.07 ± 13.08 years, and 729 (60.54%) were males. Out of 1204 patients, the HbA1c data were available for only 472 patients. All glycemic parameters were maintained in the SGLT2i + Insulin + OADs group over the period of 3 years with no significant change in their values. The number of patients in the SGLT2i + OADs group more than doubled over the 2 years of follow-up. There was a significant improvement in weight and FBS at year 2 in this group. A significant improvement in HbA1c and FBS was seen in patients with baseline HbA1c ≥10 at baseline. No statistically significant change was observed in any of the clinical parameters in patients in the Insulin + OADs (excluding SGLT2i) group. Only about 50% of those who were on insulin at baseline, continued insulin at the first and second follow-up. In the OADs (excluding SGLT2i) group, weight and post lunch blood sugar showed a significant decrease at the second follow-up. Among patients who remained on OADs throughout the study, there was a significant improvement in HbA1c from baseline at year 2, although other parameters did not show any significant improvement. Conclusion: Patients on various OAD regimens showed better glycemic control compared to those on combined insulin and OADs in this study in a suburban population in India.

Follow up and outcome of transcatheter device closure in pediatric patients in a tertiary cardiac centre of Nepal

BackgroundCongenital heart diseases have significant effect on the growth and development of a child. Timely intervention helps a child to grow and develop to full potential. Cardiac interventionists have not long ago developed methods to cure conditions via transcatheter methods like device closures for shunt lesions. These interventions have been hugely accepted and applied all over the world. ObjectivesThe aim of this study was to determine the outcome of Transcatheter device closure in Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD) and Patent Ductus Arteriosus (PDA) in terms of improvement in echocardiographic parameters and nutritional well-being. It also outlined the immediate and long term complications of Transcatheter device closure of the shunt lesions. MethodologyA prospective study was carried out among 129 pediatric patients who underwent Transcatheter device closure of shunt lesions at Shahid Gangalal National Heart Centre from March 2019 to March 2021. Simple convenient, consecutive non-probability sampling method was used for the study.Independent sample t-test was applied to see the correlation and significance of continuous variables and Linear regression was used to find out relation between weight gain and device closure. ResultsAmong 129 pediatric patients having either ASD, PDA or VSD without other comorbidities who underwent transcatheter device closure at Shahid Gangalal National Heart Centre, there was 1 mortality (0.7 %), 3 device embolization (2.3 %), 11 (8.5 %) tiny residual leaks, 6 (4.6 %) femoral artery thrombosis, 19 (14.7 %) Left ventricular systolic dysfunction, 4 (3.1 %) new onset arrhythmia, 13(10.0 %) new onset trivial AR and 2 (1.5 %) mild obstruction to surrounding structures. There were no long term complications observed during the study period. Pulmonary artery pressures improved in most along with normalization of chamber dilatation. There was significant improvement in weight of children at the end of one year follow up (P < 0.001), however among individual shunt lesion, only patients undergoing PDA device closure demonstrated significant weight gain. ConclusionTranscatheter device closure is a promising, safe and effective means of treatment for ASD, PDA and VSD. It has significant bearing in weight gain as well as general well-being of children. Judicious selection of cases, proficient expertise and availability of suitable infrastructures are paramount for successful outcome.

Retrofitting hollow fibre carbon capture systems to decarbonise surface transport

On-board carbon capture and storage (CCS) is being recognised as an essential transitional solution for transport decarbonisation. However, due to inherent space constraints, retrofitting current CCS technology to vehicles is challenging. Herein, the feasibility of a novel hollow fibre carbon capture system impregnated with a carbon xerogel for on-board CCS was assessed. The working capacity of four carbon xerogels with varying surface area/surface groups, over ten temperature swing adsorption (TSA) cycles, was studied in a packed bed adsorption unit (PBAU). The highest-performing carbon xerogel (i.e. CX) was deposited inside a hollow fibre support to form the hollow fibre adsorption unit (HFAU). Under typical vehicle exhaust gas compositions (i.e. 14 vol% CO2 + 3 vol% H2O balanced in air) and at mild operating conditions (i.e. adsorption at 25 °C, 1 atm; desorption at 125 °C, 1 atm), the HFAU exhibited a 1.3 times greater working capacity than the equivalent PBAU (i.e. 4.7 mmol g−1 and 3.5 mmol g−1, respectively), due to minimized mass transfer limitations. In addition, the results obtained were used in a study that compared hollow fibre carbon capture systems and packed bed carbon capture systems designed to be retrofitted to three transport scenarios: (1) a light-duty vehicle (car/van); (2) a large regional delivery truck; and, (3) a ferry. For scenarios 2 and 3, the findings of the study showcased the potential of retrofitting a hollow fibre carbon capture system to these large surface transport modes. However, for scenario 1, despite obtaining a hollow fibre carbon capture system that was 3.5 times smaller, 5.7 times lighter and 6.6 times cheaper than the packed bed carbon capture system, it cannot be feasibly retrofitted without significant improvements in weight. Furthermore, a short-hand simplified heat exchange approach was presented to obtain the TSA operation temperatures of the carbon capture systems.