Total Weight Research Articles

Total Gestational Weight Gain Is Explained by Leptin and Body Fat, Regardless of Pre-Pregnancy Body Mass Index and Other Adipokines, in Mexican Adolescents.

Pre-pregnancy body mass index (pBMI) is a predictor of gestational weight gain (GWG). However, other factors, such as adipokines and inflammation markers, may also be associated with GWG. The aim of the study was to determine the association of leptin, adiponectin, irisin, and C-reactive protein, with GWG in adolescents. A longitudinal study was conducted from 2018 to 2023 in adolescents with a clinically healthy pregnancy. The assessments included sociodemographic and clinical data, pBMI, percent of body fat, serum concentrations of leptin, adiponectin, irisin, and high-sensitivity C-reactive protein (hsCRP), and total GWG adequacy. Cox regression models were performed, the outcome variables were inadequate and excessive GWG. In 198 participants, being overweight/obesity was marginally associated with a protective effect against inadequate GWG (HR = 0.44, 95%CI = 0.18-1.06), regardless of maternal characteristics and adipokines. Leptin (HR = 1.014, 95%CI = 1.008-1.021), and body fat percent (HR = 1.11, 95%CI = 1.05-1.17) were associated with a higher risk of excessive GWG, independent of other maternal variables such as pBMI, while adiponectin was associated with a lower risk. These findings suggest that, in Mexican adolescents, adipose tissue and its adipokines during pregnancy may play a more significant role in the final GWG than body weight.

Fundus-to-Antrum Ratio Measured with Fluoroscopy within One Week after Endoscopic Sleeve Gastroplasty Predicts Total Body Weight Loss over Time.

Background and Aims: Endoscopic sleeve gastroplasty (ESG) is a minimally invasive bariatric procedure to induce weight loss through restrictive physiology. This study was designed to evaluate the fluoroscopic measurement of gastric dimensions after ESG as a predictor of Total Body Weight Loss (TBWL) over time. Methods: Post-ESG patients were enrolled prospectively between August 2013 and August 2019. An upper gastrointestinal (GI) fluoroscopy was obtained within 7 days after the procedure. Two blinded, independent radiologists reviewed fluoroscopic images and measured the gastric lumen transverse diameter in three separate areas of the fundus, body, and antrum. The primary outcome was achieving a TBWL of ten percent or more after ESG. Results: In total, 162 patients were included in the analysis (65% female) and had a mean body mass index (BMI) of 39 ± 6 at baseline. Patients had a mean maximum TBWL of 16.5 ± 8.3%. Respectively, 92%, 75%, and 50% of patients achieved a TBWL of 5%, 10%, or 15% or more. The mean post-procedural UGI gastric fundus/antrum transverse measurement ratio was 1.2 ± 0.6. A higher fundus-to-antrum ratio was significantly associated with a TBWL of 10% or more during follow-up in the multivariable model (OR 2.49, 95% CI 1.31-4.71; p-value 0.005). The prediction score based on the fundus-to-antrum ratio hd an area under the ROC curve of 0.79 (95% CI 0.75-0.83) for predicting a TBWL of 10% or more during follow-up. Conclusions: Measuring gastric the fundus/antrum ratio within one week of endoscopic sleeve gastroplasty (ESG) is a consistent and independent predictive measure of sustained TBWL during long-term follow-up.

Brown seaweed as a food ingredient contributing to an adequate but not excessive amount of iodine in the European diet. A case study with bread.

The large amounts of iodine in brown seaweeds may contribute towards an adequate iodine intake, but also pose a food safety risk. In the current work we estimate the maximum amount of the cultivated brown seaweeds Saccharina latissima and Alaria esculenta (blanched and non-blanched) that can be added to white loaf-type wheat-bread so European consumers are protected against excessive chronic intakes. We use data for high-level consumers of bread with special ingredients added from the EFSA comprehensive European food consumption database to construct a conservative risk management model. We bake prototype seaweed bread and use the output from the model to assess exposure to iodine and trace metals. We also assess some bread quality parameters such as sensory characteristics, crumb firmness and specific volume. The maximum level of iodine in bread that would mitigate the European consumer from excess intakes was 857 μg I kg-1 bread. Assuming a typical 60% wheat flour per kilogram of bread, a maximum amount of 11.3 g of dried blanched A. esculenta (115 mg I kg-1 dry weight) could be incorporated per kilogram of wheat flour into the bread recipe whilst for non-blanched S. latissima, which contained 3500 mg I kg-1 dry weight, only a minuscule 350 mg of seaweed was the limit. For prototype breads, seaweed addition had no significant impact on the specific volume and crumb firmness. Levels of cadmium and arsenic in the bread were also of low toxicological concern. A maximum 1-2% brown seaweed of total flour weight could be added to bread to contribute towards European consumers' adequate iodine intake without overexposure. © 2024 The Author(s). Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Biometric Characteristic Study of Green Lipped Mussel, Perna viridis (Linnaeus, 1758) From Malad Creek, Mumbai, India

Biometric Studies are essential to understand the growth rate of the species which helps understand the growth patterns, reproduction rate and population distribution of the species. Growth patterns of molluscs help in evaluating their production potential and energy flows through populations and their distribution. Perna viridis (Linnaeus, 1758) commonly known as the green-lipped mussel or the Asian green mussel belongs to the family Mytilidae. It is distributed along the Indo-Pacific region. They are attached to the rocky substratum along the coast, in the intertidal region. The Biometric Analysis and Length-Weight Relationship study was carried out on Perna viridis (Linnaeus, 1758) to understand their growth rate and population distribution through the Coast of Mumbai. A total of 100 samples were used in this study. The correlation between the Total Weight of the Shell with the organism (WSO) to the Shell Length (SL), Shell Width (SW) and Shell Height (SH) and the correlation between the Soft Tissue Weight of the Organism (WO) to the Shell Length (SL), Shell Width (SW) and Shell Height (SH) gave an idea about the growth factors. The Relative Condition Factor was determined by equation W = aLb. The b values of each correlation showed negative allometric growth with p value to be p<.001 with same significance in Pearson Correlation test. The Relative Condition Factor of WSO-SW and WSO-SL was observed to be above 1 indicating good growth conditions. Thus, biometric studies are a useful tool in study of Perna viridis (Linnaeus 1758) biology, physiology, ecology, growth potential, stock assessment, genetics and breeding of Perna viridis (Linnaeus, 1758).

Organ weights and length anthropometry measures at autopsy for sudden infant death syndrome cases and other infant deaths in the Chicago infant mortality study.

Organ weights are a possible diagnostic or pathophysiological clue to distinguishing sudden infant death syndrome (SIDS) cases from other infant deaths but suffer from major confounding. Using autopsy data from the Chicago Infant Mortality Study, a majority African-American case-control study of deceased infants under 1 year conducted 1993-96, we assessed differences in the weights of brain, thymus, kidneys, lungs, liver, spleen, total body, and four length anthropometry measures in SIDS-diagnosed infants compared to controls. Using exact and coarsened matching, we ran Bayesian linear models with these anthropometry outcomes and repeated the analyses substituting the corresponding fitted allometrically-scaled organ weight indices to account for body size. After detailed analysis and adjustment for potential confounders, we found that matched SIDS infants were generally bigger than controls, with higher mean brain, liver, spleen, thymus, lung, and total body weights, and higher mean head and chest circumference, crown-heel, crown-rump lengths. SIDS infants also had higher mean thymus, liver, spleen, lung and total body weight indices. The association with thymus weight was proportionately greater in magnitude than any other outcome measure and independent of body size. The results of these more detailed analyses are consistent with recent findings from other studies with differing racial compositions, and substantially confirm the primary organ sites for more detailed mechanistic research into the biological dysregulation contributing to underlying pathophysiology of SIDS.

Evaluation of perioperative risk factors for bladder neck contracture after bipolar transurethral resection of the prostate.

Bladder neck contracture after transurethral resection of the prostate is a common complication but without clear predisposing factors. In this prospective study, we evaluated the perioperative risk factors associated with bladder neck contracture after bipolar transurethral resection of the prostate. The study included 391 patients who were admitted for bipolar transurethral resection of the prostate between October 2020 to October 2023 by three experienced surgeons. Forty three patients had bladder neck contracture and their perioperative parameters were compared with randomly chosen 172 patients without bladder neck contracture. There were no significant differences between the studied groups regarding the general and present history characteristics. Re-catheterization after transurethral resection of the prostate, post-operative recurrent urinary tract infection, resection speed, and associated urethral stricture were significantly higher among the bladder neck-contraction group (P < 0.05), while total PSA, total prostate weight, post void residual urine volume, resected gland weight, resection time and catheter duration were significantly lower among the bladder neck-contraction group (P < 0.05). Bladder neck contracture after bipolar transurethral resection of the prostate is more common among patients with small fibrotic prostate, low total PSA, small post- void residual urine volume, those with a higher incidence of post-operative recurrent urinary-tract infection and patients with a higher incidence of re-catheterization after transurethral resection of the prostate.

Determination of Total Phenols, Total Flavonoids and Antioxidant Activity of Watermelon Peel and Rind from Several Cultivation Areas in Indonesia

Background: Watermelon (Citrullus lanatus) consists of peel and rind (30-40% of total fruit weight), commonly discarded as waste. Nonetheless, several studies have shown the potential benefit of these watermelon parts. This study aimed to determine the correlation between the watermelon cultivation areas and their chemical composition, especially phenols and flavonoids. Watermelon peel and rind were obtained from Jember (WJ), Sragen (WS), Langkat (WL), Hulu Sungai Tengah (WHST) and Lombok Tengah (WLT). Methods: The total phenols and flavonoids were determined by using the colorimetric method. Furthermore, the antioxidant activity was determined by using DPPH and ABTS methods. Result: The highest total flavonoids, i.e. 41.86±1,65 mgQE/100 g watermelon, was observed in the WHST rind. While WL peel showed the highest total phenols, i.e. 3.97±0.02 mgGAE/g. The correlation analysis for all samples showed no significant relationship between the antioxidant activity and total flavonoids. However, a significant relationship was found between the DPPH-IC50 and total phenols with a correlation value of 0.47 (p less than 0.01) for both watermelon parts peel and rind. In addition, watermelon peel contains higher total flavonoids compared to rind. But, there was no significant difference in the total phenols between the watermelon peel and rind. To conclude, both watermelon peel and rind obtained from five cultivation areas showed antioxidant activities contributed by the phenolic compounds.

960 Quality of Life Outcomes of Metabolic and Bariatric Surgery Tourism: A Single-Centre Survey-Based Study

Abstract Global obesity affects one in three adults, prompting increased demand for metabolic and bariatric surgery (MBS). Despite its effectiveness, limited access to MBS has led to more people seeking it through medical tourism for lower costs and shorter wait times. However, ethical concerns arise due to limited follow-up care and potential complications. This study compares the quality of life (QOL) of native MBS patients (n = 69) to those engaged in MBS tourism (n = 36) from 11 different countries, utilizing the Bariatric Quality of Life Index (BQLI). Conducted in Lahore, Pakistan, with 105 participants who had MBS in the last 3 years, the survey-based study aims to assess the impact of MBS tourism on QOL and the efficacy of bariatric surgery for weight loss. The study revealed no significant difference in the quality of life between MBS tourism participants and native patients (p &amp;gt; 0.05). Both cohorts experienced considerable weight reduction post-MBS (p = 0.00001). A higher total weight loss percentage (TWL%) correlated positively with increased BQLI scores (p = 0.01). Younger patients experienced significantly improved quality of life after MBS compared to their older counterparts (r = -0.3, p = 0.005). The TWL% exhibited a progressive increase as the months advanced post-MBS (r =0.3, p = 0.004). The type of bariatric surgery (SG, RYGB, OAGB, SADI) didn't significantly affect post-MBS quality of life (p &amp;gt; 0.05).

Analysis of Intraocular Lens Packaging Weight and Waste.

To analyze waste from intraocular lens (IOL) packaging across a variety of brands. Private clinical practice. Prospective weight and composition analysis of all elements of unopened packages of IOLs sold in the US-both preloaded and non-preloaded. Samples were collected from multiple IOL companies in 2023. The primary endpoint for comparison was the total weight of each IOL package, because this generally correlates with the carbon footprint. The percentage of total weight contributed by paper, plastic, Tyvek®, foil, sterile saline solution (fluid), metal, or glossy paper material was also calculated. The non-preloaded IOL package weights ranged from 29 g (Zeiss Lucia) to 80 g (RxSIGHT LAL). Most of the weight was attributable to paper, including the box and instructions for use (IFU) pamphlet. The latter was generally the largest component within the box. The weights of preloaded IOL packages were generally higher than those of their non-preloaded counterparts and ranged from 67 g (Hoya iSert) to 116 g (Rayner RayOne Spheric). Meaningful differences in the IOL packaging weight and waste were noted across different models and manufacturers. Electronic IFU linked to QR codes could replace the need for an IFU pamphlet within every box, significantly reducing the box's size, weight, and carbon footprint. Pairing preloaded IOL cartridges with autoclavable injectors could reduce associated waste. Because of the enormous global volume of IOL implantation, these waste-reducing strategies should be prioritized by IOL manufacturers.

Characterizing Enoxaparin's Population Pharmacokinetics to Guide Dose Individualization in the Pediatric Population.

Pediatric dosing of enoxaparin was derived based on extrapolation of the adult therapeutic range to children. However, a large fraction of children do not achieve therapeutic anticoagulation with initial dosing. We aim to use real-world anti-Xa data obtained from children receiving enoxaparin per standard of care to characterize the population pharmacokinetics (PopPK).Author names: Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Also, kindly confirm the details in the metadata are correct.The author names are accurately presented and the metadata are correct. METHODS: A PopPK analysis was performed using NONMEM, and a stepwise covariate modeling approach was applied for the covariate selection. The final PopPK model, developed with data from 1293 patients ranging in age from 1 day to 18 years, was used to simulate enoxaparin subcutaneous dosing for prophylaxis and treatment based on total body weight (0-18 years, TBW) or fat-free mass (2-18 years, FFM). Simulated exposures in children with obesity (body mass index percentile ≥95th percentile) were compared with those without obesity. A linear, one-compartment PopPK model that included allometric scaling using TBW (<2 years) or FFM (≥2 years) characterized the enoxaparin pharmacokinetic data. In addition, serum creatinine was identified as a significant covariate influencing clearance. Simulations indicated that in patients aged <2 years, the recommended 1.5 mg/kg TBW-based dosing achieves therapeutic simulated concentrations. In pediatric patients aged ≥2 years, the recommended 1.0 mg/kg dose resulted in exposures more comparable in children with and without obesity when FFM weight-based dosing was applied. Using real-world data and PopPK modeling, enoxaparin's pharmacokinetics were characterized in pediatric patients. Using FFM and twice-daily dosing might reduce the risk of overdosing, especially in children with obesity.

Okra cultivation under irrigation with saline water and foliar application of hydrogen peroxide

Foliar application of hydrogen peroxide can induce plant defense mechanisms against salt stress, favoring plant acclimation in regions with qualitative and quantitative scarcity of water resources, such as the Brazilian semi-arid region. From this perspective, this study aimed to evaluate the effects of foliar hydrogen peroxide application on chlorophyll a fluorescence, growth, and production of okra under irrigation with saline water. The experiment was conducted under field conditions in Pombal, PB, using a randomized block design with a 5 × 3 factorial arrangement corresponding to five electrical conductivity levels of water – ECw (0.3, 1.3, 2.3, 3.3, and 4.3 dS m-1) and three hydrogen peroxide concentrations – H2O2 (0, 25, and 50 μM), with five replications. Irrigation water salinity levels up to 2.2 dS m-1 increase the maximum fluorescence of okra plants 75 days after transplanting. Foliar application of 50 µM hydrogen peroxide proved to be beneficial for plant height, stem diameter, stem dry matter, root dry matter, and total dry matter of okra when plants were grown in low-salinity water. The hydrogen peroxide concentrations of 25 and 50 µM increased the number of leaves. However, these concentrations reduced the average weight of the okra dry fruits. Foliar application with 50 µM hydrogen peroxide had a significant effect on the dry leaf phytomass of the okra cv. Clemson American 80 regardless of the electrical conductivity of irrigation water. Foliar hydrogen peroxide application at concentrations up to 50 µM intensifies the deleterious effects of salt stress on the total weight of dried okra fruits. Keywords: Abelmoschus esculentus L., acclimation, salt stress.

Calcium deposition in chicken eggshells: role of host genetics and gut microbiota

Eggshell is predominantly composed of calcium carbonate, making up about 95% of its composition. Eggshell quality is closely related to the amount of calcium deposition in the shell, which requires chickens to maintain a robust state of calcium metabolism. In this study, we introduced a novel parameter, Total Eggshell Weight (TESW), which measures the total weight of eggshells produced by chickens over a period of 10 consecutive d, providing valuable information on the intensity of calcium metabolism in chickens. Genome-wide association study (GWAS) was conducted to explore the genetic determinants of eggshell calcification in a population of 570 Rhode Island Red laying hens at 90 wk of age. This study revealed a significant association between a specific SNP (rs14249431) and TESW. Additionally, using random forest modeling and 2-tailed testing, we identified 3 genera, Lactobacillus in the jejunum, Lactobacillus, and Fournierella in the cecum, that exhibited a significant association with TESW. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis of claudin-1 and occludin genes in individuals with low TESW and high abundance of jejunal Lactobacillus confirmed that the inhibitory effect of jejunal Lactobacillus on calcium uptake was achieved through the up-regulation of tight junctions in intestinal epithelial cells. Notably, both host and microbial factors influence TESW, displaying a mutually influential relationship between them. The microbiome-wide Genome-Wide Association Study (mb-GWAS) identified significant associations between these 3 genera and specific genomic variants, such as rs316115020 and rs316420452 on chromosome 5, rs313198529 on chromosome 11, linked to Lactobacillus in the cecum. Moreover, rs312552529 on chromosome 1 exhibited potential association with Fournierella in the cecum. This study highlights the influence of host genetics and gut microbiota on calcium deposition in eggshells during the late laying phase, providing a foundational reference for studying calcium metabolism in hens.

Mechanical Property Analysis of a Boom-Membrane Structure Used for Aerospace Technologies.

Traditional deployable truss space structures previously had upper limits on their key indicators, such as the deployed area, folded ratio and total weight, and hence, the application of new extendable mechanisms with novel deployment types is desired. Foldable extendable tape spring booms made from FRP (fiber-reinforced polymer) laminate composites and their corresponding boom-membrane structures were invented in recent years to satisfy the needs of the large-scale requirements of spacecraft, especially for antennas, solar sails and solar arrays. This paper aimed to analyze the properties of the deployed states of extendable tape spring booms and their boom-membrane structures. By establishing an analytical model of the boom and the structure, the bending stiffness, critical buckling load of the boom and the fundamental frequency of the membrane structure were acquired. To provide more guidance on the boom-membrane structure design, a geometric and material parametric study was carried out. Meanwhile, an experimental study to investigate the deployed properties of the booms and membrane structures was introduced to afford some practical verification.

Functionality of the V-type ATPase during asexual growth and development of Plasmodium falciparum

V-type ATPases are highly conserved hetero-multi-subunit proton pumping machineries found in all eukaryotes. They utilize ATP hydrolysis to pump protons, acidifying intracellular or extracellular compartments, and are thus crucial for various biological processes. Despite their evolutionary conservation in malaria parasites, this proton pump remains understudied. To understand the localization and biological functions of Plasmodium falciparum V-type ATPase, we employed CRISPR/Cas9 to endogenously tag the subunit A of the V1 domain. V1A (PF3D7_1311900) was tagged with a triple hemagglutinin epitope and the TetR-DOZI-aptamer system for conditional expression under the regulation of anhydrotetracycline. Via immunofluorescence assays, we identified that V-type ATPase is expressed throughout the intraerythrocytic developmental cycle and is mainly localized on the digestive vacuole and parasite plasma membrane. Immuno-electron microscopy further revealed that V-type ATPase is also localized on secretory organelles in merozoites. Knockdown of V1A led to cytosolic pH imbalance and blockage of hemoglobin digestion in the digestive vacuole, resulting in an arrest of parasite development in the trophozoite stage and, ultimately, parasite demise. Using Bafilomycin A1, a specific inhibitor of V-type ATPases, we found that the P. falciparum V-type ATPase is likely involved in parasite invasion but is not critical for ring stage development. Further, we detected a large molecular weight complex in BN-PAGE (∼ 1.0 MDa), corresponding to the total molecular weights of V1 and Vo domains. Together, we show that V-type ATPase is localized on multiple subcellular compartments in P. falciparum, and its functionality throughout the asexual cycle varies depending on the parasite developmental stages.

Effect of glycerol plasticizer on the structure and characteristics of bacterial cellulose-based biocomposite films

Abstract Biocomposite film was successfully produced by combining bacterial cellulose (BC) and sodium alginate (ratio of 80:20) with the addition of glycerol as conventional plasticizer at varied concentration (2, 4, 6% w/w, based on total sample weight) through solution casting method. The influence of glycerol content on structure (by FTIR), mechanical properties, optical properties (by colorimeter and spectrophotometer) and water vapor permeability (WVP, gravimetric method) of BC biocomposite film was investigated. The addition of glycerol disrupts the inter- and intramolecular hydrogen bonds in the cellulose chains, replaced by weaker BC-alginate-glycerol bonds. This resulted a decrease in film density, causing lower tensile strength, lightness, opacity and WVP of BC biocomposite film. An increase in glycerol concentration led to an increase in elongation percentage due to the effect of glycerol plasticization. Film with 4% glycerol exhibited the lowest WVP (5.08x10-13 g/m.s.Pa), highest lightness (L = 73.49), lowest opacity (3.24 Abs/mm) with tensile strength of 19.57 MPa and elongation 8.38%. The addition of glycerol significantly affects the BC biocomposite film properties. The resulting biofilm shows performance equivalent to commercial bioplastic TeloRoll.

Clinical Outcomes of Metabolic Surgery on Diuretic Use in Patients With Heart Failure

The beneficial impacts of metabolic surgery (MS) on patients with heart failure (HF) are incompletely characterized. We aimed to describe the cardiac and metabolic effects of MS in patients with HF and hypothesized that patients with HF would experience both improved metabolic and HF profiles using glycemic control and diuretic dependency as surrogate markers. In this single-center, university-affiliated academic study in the United States, a review of 2,342 hospital records of patients who underwent MS (2017 to 2023) identified 63 patients with a medical history of HF. Preoperative characteristics, 30-day outcomes, and up to 2-year biometric and metabolic outcomes, medication usage, and emergency department utilization were collected. At 24 months, mean body mass index change was -16 kg/m2 (p <0.001) that corresponded to a mean percentage total body weight loss of 29% (p <0.001). Weight loss was accompanied by significant reductions in hemoglobin A1c (p <0.001) and a 65% decrease in diuretic use at 24 months after surgery (p <0.001). Similarly, emergency visits for cardiac conditions (p = 0.06) and intravenous diuresis (p = 0.07) trended favorably at 1 year after surgery compared with 1 year before surgery but were not statistically significant. In conclusion, in patients with HF who were carefully selected, MS appears to provide significant reduction in oral diuretic dependency, and metabolic improvements with trends toward lower rates of emergency department utilization.

The effect of Internet-based nutrition education according to Pender’s health promotion model on gestational weight gain: Study protocol for a randomized controlled clinical trial

BACKGROUND: Gestational weight gain (GWG) should be managed appropriately because both inadequate and excessive weight gain have negative health consequences for mother and child. Therefore, we report the study design for investigating the effect of nutrition education based on Pender’s health promotion model (HPM) through the smartphone app on GWG. MATERIALS AND METHODS: This randomized controlled trial (RCT) will be performed on the Internet for intervention by uploading text messages, audio, images, and portable document format (PDF) files via a group in one of the virtual messenger networks with the title “Nutrition education research plan.” After random allocation, both control and intervention groups will receive the routine prenatal care including dietary recommendations. The data will be collected using a multipart researcher-made questionnaire containing 33 questions including demographic information and Pender’s construct parts. The evaluation is performed with pretest, posttest, and measurement of the obtained weight. Paired and independent samples t-tests and analysis of variance (ANOVA) with repeated measurements will be applied to compare mean scores of constructs of Pender’s HPM and gained weights. RESULTS: The results of this study will clarify whether the present intervention will be effective on the total gestational weight gain and the weight gained in different weeks of pregnancy compared to the control group. CONCLUSION: The obtained findings of this study might be useful for managing GWG and consequently maternal and neonatal outcomes.

Economic evaluation of weight loss and transplantation strategies for kidney transplant candidates with obesity

Novel antiobesity medications, particularly glucagon-like peptide-1 receptor agonists (GLP-1RAs), have expanded weight loss (WL) options for kidney transplantation (KT) candidates with obesity beyond lifestyle modifications and bariatric surgery. However, varying effectiveness, risk profiles, and costs make strategy choices challenging. To aid decision-making, we used a Markov model to examine the cost-effectiveness of different WL strategies over a 10-year horizon. A target WL of 15% of total body weight was used for the base case scenario, and we compared these strategies to a “liberal” KT strategy of transplanting candidates with obesity. Outcomes included costs (2023 US dollars), quality-adjusted life years, and incremental cost-effectiveness ratios. In analysis, a liberal KT strategy was favored over lifestyle modifications and GLP-1RAs. Among WL strategies, bariatric surgery was the most effective and cost the least, whereas lifestyle modification had the highest cumulative costs and was the least effective. Compared to liberal KT, bariatric surgery costs $45 859 per quality-adjusted life year gained. GLP-1RAs were favored over bariatric surgery only when drug costs were below $5000 per year (base cost $12 077). In conclusion, for KT candidates with obesity, a liberal KT strategy and bariatric surgery are preferred over lifestyle modifications alone and GLP-1RAs based on outcomes and cost-effectiveness.

The Use of Semaglutide in Patients With Renal Failure-A Retrospective Cohort Study

ObjectiveSemaglutide, a glucagon-like peptide-1 receptor agonist is approved for weight loss and diabetes treatment, but limited literature exists regarding semaglutide use in patients with advanced chronic kidney disease (CKD). Therefore, this project assessed the safety and efficacy of semaglutide among patients with estimated glomerular filtration rate (eGFR) 15-29 mL/min/1.73 m2 (CKD stage 4), eGFR<15 mL/min/1.73 m2 (CKD stage 5) or on dialysis. MethodsThis is a retrospective electronic medical record based analysis of consecutive patients with advanced CKD (defined as CKD 4 or greater) who were started on semaglutide (injectable or oral). Data was collected between January 2018 and January 2023. Investigators verified CKD diagnosis and manually extracted data. Data were analyzed using Fisher’s exact test, paired t test, linear mixed effects models and Wilcoxon signed rank test. ResultsSeventy-six patients with CKD 4 or greater who initiated semaglutide were included. Most patients had a history of type 2 diabetes mellitus (96.0%), and most were males (53.9%). The mean age was 66.8 y (SD 11.5) with the mean body mass index was 36.2 (SD 7.5). The initial doses were 3 mg orally and 0.25 mg by injection. Maximum prescribed dose was 1 mg (injectable) in 28 (45.2%) patients and 14 mg (orally) in 2 (14.2%) patients. Patients received semaglutide for a median duration of 17.4 (IQR 0.43, 48.8) months. Forty-eight (63.1%) patients reported no adverse effects associated with the therapy. Mean weight decreased from 106.2(SD 24.2) to 101.3 (SD 27.3) kg (P < .001). Eight patients (16%) with type 2 diabetes mellitus T2DM discontinued insulin after starting semaglutide. Mean hemoglobin A1c (HbA1c) decreased from 8.0% (SD 1.7) to 7.1% (SD 1.3) (P < .001). Adverse effects were the primary reason for semaglutide discontinuation (37.0%), with nausea, vomiting, and abdominal pain being the most common complaints. ConclusionsBased on this retrospective study semaglutide appears to be tolerated by most individuals with CKD 4 or greater despite associated gastrointestinal side effects similar to those observed in patients with better kidney function and leads to an improvement of glycemic control and insulin discontinuation in patients with T2DM. Modest weight loss (approximately 4.6% of the total body weight) was observed on the prescribed doses. Larger prospective randomized studies are needed to comprehensively assess the risks and benefits of semaglutide in patients with CKD 4 or greater and obesity.

Impact of harvest time on cold storage performance in Kiwifruit

In the present study the fruits of the cultivar 'Hayward' kiwifruit were harvested at a total soluble solid content of 5–6 % (Harvest I, H1), 6.1–7.0 % (Harvest II, H2), 7.1–8.0 % (Harvest III, H3) and 8.1–9.0 % (Harvest IV, H4) and stored at 0±1°C temperature and 85–90 % relative humidity (RH) conditions for 6 months. Changes in fruit flesh color, flesh firmness, soluble solids content (%), titratable acidity (TA), individual sugars (sucrose, glucose, fructose), ascorbic acid content, antioxidant activity (DPPH, FRAP), total phenolic content, weight loss and marketable fruit were observed at one month intervals. In kiwifruits, an increase was observed in health benefit compounds such as ascorbic acid and total phenolic content, antioxidant capacity by progressing of harvest times. However, early (H1) and late (H4) harvest times led to faster loss in fruit firmness, significant loss in titratable acidity and soluble solid content, higher weight loss rates in fruit. The results show that the second and third harvest times, when the soluble solids content of the fruit is 6.1–7.0 % (H2) and 7.1–8.0 %(H3), seem to be optimum in terms of quality preservation for 'Hayward' kiwis grown in the Black Sea Coast and provides health benefits with a higher marketable fruit rate after 180 days of cold storage. Finally, there was a positive correlation between SCC and sucrose, glucose, fructose. There was a negative relationship between fruit SSC and flesh firmness, TA, L*, C*, h° after 6 months of storage. And also there was a negative correlation between weight loss and marketable product quantity, fruit flesh firmness.