Substantial Weight Research Articles

DR10627, a Novel Dual Glucagon‑like Peptide‑1 and Gastric Inhibitory Polypeptide Receptor Agonist for the Treatment of Obesity and Type 2 Diabetes Mellitus.

Diabetes and obesity are momentous risk factors threatening people's lives and health. Currently available incretin analogue glucagon-like peptide 1 (GLP-1) possesses huge hypoglycemic effect with the unsatisfactory effect of weight loss. Co-agonists targeting GLP-1R plus glucagon receptor (GCGR) or gastric inhibitory polypeptide receptor (GIPR) show synergistic benefits in glycaemic control and weight loss. Here, we describe a novel dual GIP and GLP-1 receptor agonist, DR10627, and performed a preclinical assessment of it. The agonistic ability of DR10627 was indirectly assessed by inducing cAMP accumulation in Chinese hamster ovary (CHO) cells transfected with GLP-1R or GIPR in vitro. The plasma pharmacokinetics of DR10627 were analysed in cynomolgus monkeys. The OGTTs were performed in Sprague‑Dawley (SD) rats. The glucose lowering effects were evaluated by repeated administration of DR10627 in diabetic (db/db) mice for 4 weeks. The effects of anti-obesity and improving metabolism of DR10627 were evaluated by repeated administration of DR10627 in diet-induced obesity (DIO) mice for 57 days. DR10627 had the capacity to activate both GLP-1R and GIPR in vitro. The terminal half-life of DR10627 was found to be approximately 4.19-5.8 h in cynomolgus monkeys. DR10627 had a great improvement in oral glucose tolerance in SD rats. Moreover, DR10627 had a potent glucose-lowering effect in db/db mice, and the hypoglycemic effect of 18 nmol/kg DR10627 was better than that of 50 nmol/kg liraglutide. In addition, 10 and 30 nmol/kg DR10627 possessed the ability of potentiating the weight-loss, lipid-lowing efficacy and improving metabolism to a greater extent than 80 nmol/kg liraglutide. Preclinical assessment demonstrated that administration of DR10627 resulted in glucose lowering in SD rats and db/db mice, and substantial body weight reduction and metabolism improvement in DIO mice. DR10627 is a promising agent deserving further investigation for the treatment of type 2 diabetes and obesity.

Substantial Weight Loss May Not Improve Early Outcomes of Total Knee Arthroplasty in the Morbidly Obese

BackgroundBody mass index (BMI) cutoffs for morbidly obese patients otherwise indicated for total knee arthroplasty (TKA) have been widely proposed and implemented, though they remain controversial. Previous studies suggested that a 5% reduction in BMI may be associated with fewer postoperative complications. Thus, the purpose of this study was to determine whether a substantial reduction in preoperative BMI in morbidly obese patients improved 90-day outcomes after TKA. MethodsThere were 1,270 patients who underwent primary TKA at a single institution and had a BMI > 40 recorded during the year prior to surgery. Patients were stratified into three cohorts based on whether their BMI within 3 months to 1 year preoperatively had decreased by ≥ 5% (228 patients [18%]); increased by ≥ 5% (310 [24%]); or remained unchanged (within 5%) (732 [58%]) on the day of surgery. There were several baseline differences between the cohorts with respect to medical comorbidities. The rate of 90-day complications and six-week patient-reported outcome measures were compared via univariate and multivariable analyses. ResultsOn univariate analysis, individual and total complication rates were similar between the cohorts (P > .05). On multivariable logistic regression, the risk of complications was similar in patients who had decreased versus unchanged BMI (OR [odds ratio] 1.0; P = .898). However, there was a higher risk of complications in the increased BMI cohort compared to those patients who had an unchanged BMI (OR 1.5; P = .039). The six-week patient-reported outcome measures were similar between the cohorts. ConclusionsPatients who have a BMI > 40 who achieved a meaningful reduction in BMI prior to TKA did not have a lower rate of 90-day complications than those whose BMI remained unchanged. Furthermore, considering that nearly one in four patients experienced a significant increase in BMI while awaiting surgery, postponing TKA may actually be detrimental.

PRINCIPLES OF MATHEMATICAL SIMULATION OF MINING VEHICLES USING APPLIED MATHEMATICAL SOFTWARE

The transportation of rock mass and coal in mining operations relies heavily on the efficiency and reliability of mining transport systems. This study delves into the intricate dynamics of chassis functions during transportation, emphasizing the critical role of transmitting dynamic stresses and mass to the road or rail structures. With a focus on increasing productivity, modern mining locomotives and heavy dump trucks now carry substantial adhesion adhesive weights, allowing for the hauling of heavier loads even on steep slopes. The integration of scientific simulations and research-based design methods aids in identifying and managing dynamic loading effects within mining vehicle chassis. This approach minimizes the transfer of dynamic loads onto the bolster structure, enhancing system reliability and operational efficiency. Computer-aided software plays a vital role in stream-lining the development process, reducing the need for costly physical prototypes and extensive testing in challenging mining environments. The study outlines simplified calculation schemes for mining transport utilities, balancing the need for accuracy with computational efficiency. By utilizing mathematical models and simulation techniques, the dynamics of mine locomotives and dump trucks can be accurately evaluated, guiding design decisions and operational strategies. The application of Lagrange equations and software tools like “Wolfram Mathematica” facilitates the generation of differential equations for dynamic analysis, providing insights into vehicle dynamics and road interactions. Overall, this research underscores the importance of advanced modeling and simulation techniques in optimizing mining transport systems, enhancing safety, productivity, and reliability in demanding mining environments. Purpose. To highlight the application of mathematical software as an instrument for mechanical system dynamics study, that allows scientifically substantiate the usage of new technical solutions during their development. Method. Development a system of differential equations using Lagrange equations of the 2nd order, which are solved in Wolfram Mathematica. Preparation of initial conditions and mass-inertia data can be done by any known software. The generalized mathematical model can be used for any vehicle suspending unnecessary coordinates. Results. Implementation of new technical solutions without scientific ground could be resulted in difficulties while exploitation. For its removal necessary to receive dynamical characteristics. Existing engineering calculation methods are not suitable, especially because of tight time and limited financing. The customized mathematical models can be developed and solved on demand using available software. A scientific novelty. Enhancement of theoretical and experimental research become possible owing to the usage of mod- ern approaches of dynamic systems simulation using applied mathematical software Wolfram Mathematica. Obtained model can be modified in few operation from one mass task into multibody system with maximum 69 free displacements (coordinates). Practical value. The possibility to receive customized simulation model fast, verified with increased quality for scientific purposes.

HiFly-Dragon: A Dragonfly Inspired Flapping Flying Robot with Modified, Resonant, Direct-Driven Flapping Mechanisms

This paper describes a dragonfly-inspired Flapping Wing Micro Air Vehicle (FW-MAV), named HiFly-Dragon. Dragonflies exhibit exceptional flight performance in nature, surpassing most of the other insects, and benefit from their abilities to independently move each of their four wings, including adjusting the flapping amplitude and the flapping amplitude offset. However, designing and fabricating a flapping robot with multi-degree-of-freedom (multi-DOF) flapping driving mechanisms under stringent size, weight, and power (SWaP) constraints poses a significant challenge. In this work, we propose a compact microrobot dragonfly with four tandem independently controllable wings, which is directly driven by four modified resonant flapping mechanisms integrated on the Printed Circuit Boards (PCBs) of the avionics. The proposed resonant flapping mechanism was tested to be able to enduringly generate 10 gf lift at a frequency of 28 Hz and an amplitude of 180° for a single wing with an external DC power supply, demonstrating the effectiveness of the resonance and durability improvement. All of the mechanical parts were integrated on two PCBs, and the robot demonstrates a substantial weight reduction. The latest prototype has a wingspan of 180 mm, a total mass of 32.97 g, and a total lift of 34 gf. The prototype achieved lifting off on a balance beam, demonstrating that the directly driven robot dragonfly is capable of overcoming self-gravity with onboard batteries.

DARLOS: a lightweight dual-arm robotic live-line operation system for autonomous high-voltage distribution grid maintenance

Purpose This paper aims to present a novel lightweight distribution grid operating robot system with focus on lightweight and multi-functionality, aiming for autonomous and live-line maintenance operations. Design/methodology/approach A ground-up redesign of the dual-arm robotic system with 12-DoF is applied for substantial weight reduction; a dual-mode operating control framework is proposed, with vision-guided autonomous operation embedded with real-time manual teleoperation controlling both manipulators simultaneously; a quick-swap tooling system is developed to conduct multi-functional operation tasks. A prototype robotic system is constructed and validated in a series of operational experiments in an emulated environment both indoors and outdoors. Findings The overall weight of the system is successfully brought down to under 150 kg, making it suitable for the majority of vehicle-mounted aerial work platforms, and it can be flexibly and quickly deployed in population dense areas with narrow streets. The system equips with two dexterous robotic manipulators and up to six interchangeable tools, and a vision system for AI-based autonomous operations. A quick-change tooling system ensures the robot to change tools on-the-go without human intervention. Originality/value The resulting dual-arm robotic live-line operation system robotic system could be compact and lightweight enough to be deployed on a wide range of available aerial working platforms with high mobility and efficiency. The robot could both conduct routine operation tasks fully autonomously without human direct operation and be manually operated when required. The quick-swap tooling system enables lightweight and durable interchangeability of multiple end-effector tools, enabling future expansion of operating capabilities across different tasks and operating scenarios.

The Bidirectional Relationship between Weight Gain and Cognitive Function in First-Episode Schizophrenia: A Longitudinal Study in China.

Patients with schizophrenia often encounter notable weight gain during their illness, heightening the risk of metabolic diseases. While previous studies have noted a correlation between obesity and cognitive impairment in schizophrenia, many were cross-sectional, posing challenges in establishing a causal relationship between weight gain and cognitive function. The aim of this longitudinal study is to examine the relationship between weight gain and cognitive function in patients with first-episode schizophrenia (FES) during the initial 6-month antipsychotic treatments. Employing linear and logistic regression analyses, the study involved 337 participants. Significantly, baseline scores in processing speed (OR = 0.834, p = 0.007), working memory and attention (OR = 0.889, p = 0.043), and executive function (OR = 0.862, p = 0.006) were associated with clinically relevant weight gain (CRW, defined as an increase in body weight > 7%) at the 6-month endpoint. On the other hand, CRW correlated with improvements in the Brief Visuospatial Memory Test (p = 0.037). These findings suggest that patients with lower baseline cognitive performance undergo more substantial weight gain. Conversely, weight gain was correlated with cognitive improvements, particularly in the domain of visual learning and memory. This suggested a potential bidirectional relationship between weight gain and cognitive function in first-episode schizophrenia patients.

GLP-1 Receptor Agonists Promote Weight Loss Among People with HIV.

Weight gain and associated metabolic complications are increasingly prevalent among people with HIV (PWH). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are incretin-based therapies for diabetes and weight management that have been shown to result in substantial weight loss; however, studies of their effects in PWH are limited. A retrospective single-center cohort study was conducted among PWH who were taking GLP-1RAs at UC San Diego Owen Clinic between 2/1/2021 to 2/1/2023. Baseline clinical data were collected and changes in weight, body mass index (BMI), and hemoglobin A1C (A1C) before starting GLP-1RAs compared to the most recent clinic visit were calculated (with a minimum of 3 months follow-up time required). Logistic regression was performed to identify variables associated with >5% of total body weight loss. A total of 225 patients received on average 13 months of GLP-1RA therapy, with 85 (37.8%) achieving the maximum GLP-1RA dose. GLP-1RA therapy resulted, on average, in a loss of 5.4 kg, decrease in BMI by 1.8 kg/m2, and decrease in A1C by 0.6%. In the multivariable analysis, higher baseline BMI [OR 1.10 (1.03-1.16)], treatment duration of GLP-1RA therapy greater than 6 months [OR 3.12 (1.49-6.49], and use of tirzepatide [OR 5.46 (1.44-20.76)] were significantly more likely to be associated with >5% weight loss. Use of GLP-1RAs led to declines in weight, BMI, and hemoglobin A1C among PWH and offers an additional strategy to address weight gain and diabetes.

Optimizing callus induction and indirect organogenesis in non-dormant corm explants of Gloriosa superba (L.) via media priming

IntroductionGloriosa superba L. is an endangered ornamental plant of significant medicinal, commercial, and cultural value. This study establishes an efficient protocol for rapid in vitro propagation of this plant species through callus-mediated organogenesis using non-dormant corm explants.MethodsPlant tissue culture techniques were employed to facilitate the in vitro regeneration process of Gloriosa superba L. This encompassed various stages, including the acquisition of plant material, surface sterilization, formulation of growth media, and the execution of callogenesis, shooting, rooting, and acclimatization experiments.Results and DiscussionInvestigation into the impact of plant growth regulators on callogenesis unveiled diverse callus morphologies, dependent on regulator type and concentration, with the NAA and KN combination emerging as the most effective for callus induction. Specifically, the callus induction medium supplemented with 1.5 mg L−1 NAA, 0.5 mg L−1 KN, and 10 mg L−1 casein hydrolysate (CH) achieved remarkable results, boasting an 81.25% callus induction rate and a substantial callus biomass fresh weight of 333 mg. Furthermore, the combination of BAP and NAA facilitated optimal shoot primordia induction and shooting in callus derived from non-dormant corm explants. The shoot induction medium, enriched with 2.0 mg L−1 BAP, 0.5 mg L−1 NAA, 5 mg L−1 CH, and 20% (v/v) coconut water (CW), resulted in an impressive 83.33% shoot primordia formation rate and an average of 6.86 shoot primordia per callus. For root induction, the medium supplemented with 1.0 mg L−1 IBA displayed a high root induction rate of 81.25% and robust rooting (+++). Successful acclimatization of in vitro plantlets in controlled environments and shade net houses culminated in thriving growth, and upon transplantation into a garden soil blend (garden soil : sand : vermiculite, 2:1:1, v/v), with direct sunlight exposure, the plantlets demonstrated commendable development and form, boasting a 69% survival rate at the seven-week mark. These findings offer a robust foundation for scalable and sustainable propagation strategies, ensuring the conservation and utilization of this valuable species.

Addressing the Orbital Debris Threat Directionality for Enhanced Protection of Low-Earth-Orbit Robotic Spacecraft

This study conducts a detailed investigation into addressing the directionality of micrometeoroid and orbital debris (MMOD) threats, emphasizing the strategic placement of protective resources on a spacecraft. The research considers the conversion of the structural sandwich panel and the multilayer thermal blanket into multifunctional elements that provide MMOD protection without causing substantial weight gain or affecting operational parameters. The effectiveness of the reconfigured components, such as the foam core sandwich panel and multilayer insulation blanket toughened by Nextel fabrics, is evaluated using developed and validated numerical models and experimental methods. Their performance is demonstrated by meeting the protection needs of the Canadian robotic Radarsat Constellation Mission spacecraft.

E-Cigarettes, Smoking Cessation, and Weight Change: Retrospective Secondary Analysis of the Evaluating the Efficacy of e-Cigarette Use for Smoking Cessation Trial.

While smoking cessation has been linked to substantial weight gain, the potential influence of e-cigarettes on weight changes among individuals who use these devices to quit smoking is not fully understood. This study aims to reanalyze data from the Evaluating the Efficacy of e-Cigarette Use for Smoking Cessation (E3) trial to assess the causal effects of e-cigarette use on change in body weight. This is a secondary analysis of the E3 trial in which participants were randomized into 3 groups: nicotine e-cigarettes plus counseling, nonnicotine e-cigarettes plus counseling, and counseling alone. With adjustment for baseline variables and the follow-up smoking abstinence status, weight changes were compared between the groups from baseline to 12 weeks' follow-up. Intention-to-treat and as-treated analyses were conducted using doubly robust estimation. Further causal analysis used 2 different propensity scoring methods to estimate causal regression curves for 4 smoking-related continuous variables. We evaluated 5 different subsets of data for each method. Selection bias was addressed, and missing data were imputed by the machine learning method extreme gradient boosting (XGBoost). A total of 257 individuals with measured weight at week 12 (mean age: 52, SD 12 y; women: n=122, 47.5%) were included. Across the 3 treatment groups, of the 257 participants, 204 (79.4%) who continued to smoke had, on average, largely unchanged weight at 12 weeks, with comparable mean weight gain ranging from -0.24 kg to 0.33 kg, while 53 (20.6%) smoking-abstinent participants gained weight, with a mean weight gain ranging from 2.05 kg to 2.70 kg. After adjustment, our analyses showed that the 2 e-cigarette arms exhibited a mean gain of 0.56 kg versus the counseling alone arm. The causal regression curves analysis also showed no strong evidence supporting a causal relationship between weight gain and the 3 e-cigarette-related variables. e-Cigarettes have small and variable causal effects on weight gain associated with smoking cessation. In the E3 trial, e-cigarettes seemed to have minimal effects on mitigating the weight gain observed in individuals who smoke and subsequently quit at 3 months. However, given the modest sample size and the potential underuse of e-cigarettes among those randomized to the e-cigarette treatment arms, these results need to be replicated in large, adequately powered trials. ClinicalTrials.gov NCT02417467; https://www.clinicaltrials.gov/study/NCT02417467.

Worth Their Weight? An Update on New and Emerging Pharmacologic Agents for Obesity and Their Potential Role for Persons with Cardiac Conditions.

Obesity is associated with cardiovascular (CV) conditions, including but not limited to atherosclerotic disease, heart failure, and atrial fibrillation. Despite this, the impact of intentional weight loss on CV outcomes for persons with obesity and established CV conditions remains poorly studied. New and emerging pharmacologic therapies for weight loss primarily targeting the incretin/nutrient sensing axes induce substantial and sustained weight loss. The glucagon-like-peptide 1 receptor agonists (GLP-1 RA) liraglutide and semaglutide have US FDA approval for the treatment of obesity, and the application for an obesity indication for the dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonist tirzepatide is presently under FDA review. Extensive phase II and IIIa randomized controlled trials are underway evaluating permutations of combined GLP-1 RA, GIP receptor agonist, GIP receptor antagonist, and glucagon receptor agonists. Clinical outcome trials of these therapies in persons with obesity at high risk of established CV conditions should make it possible to estimate the role of intentional weight loss in managing CV risk via these medications. High-dose once weekly injectable semaglutide (2.4mg/week) use among persons with obesity and heart failure with preserved ejection fraction was effective at both reducing weight and improving health status; exercise capacity was also improved. Ongoing CV outcome trials of oral semaglutide and once weekly injectable tirzepatide will help to establish the role of these therapies among persons with other CV conditions. In addition to these two therapies targeting a CV claim or indication, many other new therapeutics for weight loss, as reviewed, are currently in development. The impact of pharmacologic-induced weight loss on CV conditions for persons with obesity and established CV conditions is currently under investigation for multiple agents. These therapies may offer new avenues to manage CV risk in persons with obesity and with established or at high risk for CV disease.

Qualitative study of perceptions of factors contributing to success or failure among participants in a US weight loss trial of financial incentives and environmental change strategies

BackgroundThe use of financial incentives and environmental change strategies to encourage health behaviour change is increasingly prevalent. However, the experiences of participants in incentive interventions are not well characterised. Examination...

Physiological Appetite Regulation and Bariatric Surgery.

Obesity remains a common metabolic disorder and a threat to health as it is associated with numerous complications. Lifestyle modifications and caloric restriction can achieve limited weight loss. Bariatric surgery is an effective way of achieving substantial weight loss as well as glycemic control secondary to weight-related type 2 diabetes mellitus. It has been suggested that an anorexigenic gut hormone response following bariatric surgery contributes to weight loss. Understanding the changes in gut hormones and their contribution to weight loss physiology can lead to new therapeutic treatments for weight loss. Two distinct types of neurons in the arcuate hypothalamic nuclei control food intake: proopiomelanocortin neurons activated by the anorexigenic (satiety) hormones and neurons activated by the orexigenic peptides that release neuropeptide Y and agouti-related peptide (hunger centre). The arcuate nucleus of the hypothalamus integrates hormonal inputs from the gut and adipose tissue (the anorexigenic hormones cholecystokinin, polypeptide YY, glucagon-like peptide-1, oxyntomodulin, leptin, and others) and orexigeneic peptides (ghrelin). Replicating the endocrine response to bariatric surgery through pharmacological mimicry holds promise for medical treatment. Obesity has genetic and environmental factors. New advances in genetic testing have identified both monogenic and polygenic obesity-related genes. Understanding the function of genes contributing to obesity will increase insights into the biology of obesity. This review includes the physiology of appetite control, the influence of genetics on obesity, and the changes that occur following bariatric surgery. This has the potential to lead to the development of more subtle, individualised, treatments for obesity.

Trajectories and Predictors for the Development of Clinically Significant Weight Gain in Children and Adolescents Prescribed Second-Generation Antipsychotics.

Background: As many as 60% of pediatric patients taking second-generation antipsychotics (SGA) experience weight gain (antipsychotic-induced weight gain). However, the subgroup that experienced substantial weight increase was poorly understood. This study aimed to identify the development and predictors of clinically significant weight gain (CSWG) among pediatric SGA recipients. Methods: A retrospective analysis of the 2016 to 2021 IQVIA Ambulatory EMR-US database was conducted. The study cohort comprised SGA-naive patients ages 5 to 19, continuously prescribed SGA for ≥90 days. CSWG was defined as a weight gain in BMI z-score >0.5. The development of CSWG was described using the group-based trajectory model approach, and multinomial logistic regression analysis was conducted to examine the risk factors associated with the CSWG trajectories. Results: Of the 16,262 SGA recipients who met the inclusion criteria, 4 distinctive CSWG trajectories were identified: (1) Rapid (14.6%), (2) Gradual (12.6%), (3) Transit (7%), and (4) no CSWG (65.8%). Factors associated with a higher likelihood of having rapid or gradual CSWG versus nonsignificant weight gain were being younger (OR [95% CI] = 12-17 vs. 5-11, Rapid, 0.727 [0.655-0.806]; Gradual, 0.776 [0.668-0.903]), male (Rapid, 1.131 [1.021-1.253]), non-Hispanic White (Black vs. White: Rapid, 0.833 [0.709-0.98]), with lower baseline BMI z-score (Rapid, 0.376 [0.361-0.392]; Gradual, 0.449 [0.424-0.476]), and receiving olanzapine as the initial SGA (Rapid, 1.38 [1.093-1.74]). The Area under the Receiver operating characteristic (ROC) Curve for the comparison of rapid and gradual CSWG with no CSWG trajectory were 0.83 and 0.80, respectively. Conclusions: SGA recipients experienced four distinctive CSWG trajectories (Rapid, Gradual, Transient, and No CSWG). The risk of CSWG could be predicted using patient characteristics at the SGA initiation. This insight highlights the importance of personalized monitoring and timely intervention strategies for at-risk individuals who experienced persistent CSWG in real practice.

Convincing 10-Year Follow-up Results of the Banded Roux-en-Y Gastric Bypass

IntroductionSeveral studies have shown the positive effect on weight loss of the banded Roux-en-Y gastric bypass (BRYGB). Thus far, studies describing the 10-year post-operative results are scarce. Therefore, the aim of this study was to describe the weight loss results, effect on associated medical problems, and complication rates during 10 years of follow-up after BRYGB.MethodData were collected from patients who underwent laparoscopic BRYGB with a non-adjustable silicone gastric ring between January 2011 and March 2013. All patients were included when found to be eligible according to the IFSO criteria.ResultsOne hundred forty-nine patients were included, 110 received a primary BRYGB and 39 received a conversional BRYGB. The primary BRYGB group consisted of 68% female patients with a mean BMI of 44.5 kg/m2 and a mean age of 46 years old. The conversional group consisted of 77% females and had a mean BMI of 34.8 kg/m2 and a mean age of 48 years. At 10-year follow-up, 67.1% of the data was available. Ten-year post-operative 30% total weight loss was seen in the primary group, and 7% in the conversional group. In 10 years, 23% of the patients had complications of which half were ring-related.ConclusionThe addition of a silicon ring to the Roux-en-Y gastric bypass may result in substantial and stable weight loss maintenance 10 years post-operative. Furthermore, the number of patients with long-term complications was low and the number of associated medical problems was significantly reduced.Graphical

Radiation shielding assessment for interventional radiology personnel: Geant4 dosimetry of lead-free compositions

The inherent biological hazards associated with ionizing radiation necessitate the implementation of effective shielding measures, particularly in medical applications. Interventional radiology, in particular, poses a unique challenge as it often exposes medical personnel to prolonged periods of high x-ray doses. Historically, lead and lead-based compounds have been the primary materials employed for shielding against photons. However, the drawbacks of lead, including its substantial weight causing personnel’s inflexibility and its toxicity, have raised concerns regarding its long-term impact on both human health and the environment. Barium tantalate has emerged as a promising alternative, due to its unique attenuation properties against low-energy x-rays, specifically targeting the weak absorption area of lead. In the present study, we employ the Geant4 Monte Carlo simulation tool to investigate various formulations of barium tantalate doped with rare earth elements. The aim is to identify the optimal composition for shielding x-rays in the context of interventional radiology. To achieve this, we employ a reference x-ray spectrum typical of interventional radiology procedures, with energies extending up to 90 keV, within a carefully designed simulation setup. Our primary performance indicator is the reduction in air kerma transmission. Furthermore, we assess the absorbed doses to critical organs at risk within a standard human body phantom protected by the shield. Our results demonstrate that specific concentrations of the examined rare earth impurities can enhance the shielding performance of barium tantalate. To mitigate x-ray exposure in interventional radiology, our analysis reveals that the most effective shielding performance is achieved when using barium tantalate compositions containing 15% Erbium or 10% Samarium by weight. These findings suggest the possibility of developing lead-free shielding solutions or apron for interventional radiology personnel, offering a remarkable reduction in weight (exceeding 30%) while maintaining shielding performance at levels comparable to traditional lead-based materials.

Research on Gangue Detection Algorithm Based on Cross-Scale Feature Fusion and Dynamic Pruning

The intelligent identification of coal gangue on industrial conveyor belts is a crucial technology for the precise sorting of coal gangue. To address the issues in coal gangue detection algorithms, such as high false negative rates, complex network structures, and substantial model weights, an optimized coal gangue detection algorithm based on YOLOv5s is proposed. In the backbone network, a feature refinement module is employed for feature extraction, enhancing the capability to extract features for coal and gangue. The improved BIFPN structure is employed as the feature pyramid, augmenting the model’s capability for cross-scale feature fusion. In the prediction layer, the ESIOU is utilized as the bounding box regression loss function to rectify the misalignment issue between predicted and actual box angles. This approach expedites the convergence speed of the network while concurrently enhancing the accuracy of coal gangue detection. Channel pruning is implemented on the network to diminish model computational complexity and weight, consequently augmenting detection speed. The experimental results demonstrate that the refined YOLOv5s coal gangue detection algorithm outperforms the original YOLOv5s algorithm, achieving a notable accuracy enhancement of 2.2% to reach 93.8%. Concurrently, a substantial reduction in model weight by 38.8% is observed, resulting in a notable 56.2% increase in inference speed. These advancements meet the detection requirements for scenarios involving mixed coal gangue.

A second chance for a new heart? The role of metabolic and bariatric surgery in patients with end-stage heart failure

Obesity is an independent risk factor for heart failure (HF). Substantial weight loss has been shown to reverse obesity-related cardiomyopathy. This study aimed to report our institution's experience with laparoscopic sleeve gastrectomy (LSG) in patients with morbid obesity and end-stage HF. Between 2018 and 2022, 26 patients with end-stage HF were referred for LSG. Of 26 patients, 16 underwent an operation, and 10 did not. After institutional review board approval, a retrospective electronic medical record review was performed to evaluate (i) age, (ii) preoperative weight, (iii) decrease in body mass index (BMI) score, (iv) whether the patient underwent heart transplantation, and (v) mortality. Data analysis was performed using Stata/SE (version 17.0; StataCorp). The Wilcoxon rank-sum test was used to compare continuous variables between the cohorts, and the Pearson chi-square test was used for binary variables with Bonferroni correction applied. The LSG and non-LSG cohorts had comparable ages (P=.088) and starting BMI score (P=.918), and a proportion of patients had a ventricular assist device (P=.191). Patients who underwent LSG lost significantly more weight than the patients who did not, with an average decrease in BMI score of 8.9kg/m2 (SD, ±6.13) and 1.1kg/m2 (SD, ±4.10), respectively (P=.040). Of note, 6 patients (37.5%) who underwent LSG eventually underwent transplantation, compared with 2 patients (20.0%) from the matched cohort (P=.884). Of the 26 patients, there were 6 deaths: 2 (12.5%) in the LSG cohort and 4 (40.0%) in the non-LSG cohort (P=.525). LSG may be safe and effective for weight loss in patients with HF. This operation may provide patients affected by obesity with end-stage HF the lifesaving opportunity to achieve transplant candidacy.

Course and Outcome of Anorexia Nervosa in Adolescents from a Tertiary-level Mental Health Setting in India: A Retrospective Chart Review.

Anorexia nervosa is one of the least studied mental health conditions in the Indian setting. The objective of this study was to assess the course and outcome of anorexia nervosa in adolescents who had presented to a tertiary care child and adolescent psychiatry center over a period of 10 years. The present study is a retrospective chart review of adolescents (up to the age of 18 years) with a diagnosis of anorexia nervosa, coded as F50.0 or F50.1 according to ICD 10, from 1st April 2009 to 31st March 2019. Data were extracted from the case records using standardized abstraction forms and evaluated using descriptive and nonparametric statistics. The average age at presentation and the average age at onset were 14.1 years and 13.1 years, respectively. The male-to-female ratio of the sample who got admitted was 1:9. The average duration of hospital stay was about 30 days. The duration of in-patient care and weight gain were positively correlated, with severe to extremely ill adolescents improving even in less than one month of in-patient care. Seventy per cent of the admitted adolescents followed up. The functional outcome as measured by a 'return to school' improved in 57.1% of the sample. The present study highlights the collaborative multidisciplinary and individualized treatment approach employed for adolescents diagnosed with anorexia nervosa within an inpatient mental health facility in India. Adolescents who presented with more severe illness at the initial assessment, such as an early onset of symptoms and a low BMI, experienced substantial weight gain that exhibited a positive correlation with the length of their stay in the inpatient facility.

New mechanistic insights of anti-obesity by sleeve gastrectomy-altered gut microbiota and lipid metabolism.

The obesity epidemic has been on the rise due to changes in living standards and lifestyles. To combat this issue, sleeve gastrectomy (SG) has emerged as a prominent bariatric surgery technique, offering substantial weight reduction. Nevertheless, the mechanisms that underlie SG-related bodyweight loss are not fully understood. In this study, we conducted a collection of preoperative and 3-month postoperative serum and fecal samples from patients who underwent laparoscopic SG at the First Affiliated Hospital of Shandong First Medical University (Jinan, China). Here, we took an unbiased approach of multi-omics to investigate the role of SG-altered gut microbiota in anti-obesity of these patients. Non-target metabolome sequencing was performed using the fecal and serum samples. Our data show that SG markedly increased microbiota diversity and Rikenellaceae, Alistipes, Parabacteroides, Bactreoidales, and Enterobacteraies robustly increased. These compositional changes were positively correlated with lipid metabolites, including sphingolipids, glycerophospholipids, and unsaturated fatty acids. Increases of Rikenellaceae, Alistipes, and Parabacteroide were reversely correlated with body mass index (BMI). In conclusion, our findings provide evidence that SG induces significant alterations in the abundances of Rikenellaceae, Alistipes, Parabacteroides, and Bacteroidales, as well as changes in lipid metabolism-related metabolites. Importantly, these changes were found to be closely linked to the alleviation of obesity. On the basis of these findings, we have identified a number of microbiotas that could be potential targets for treatment of obesity.