A citrus pericarp-inspired ternary bio-mimetic film with slow-release functional units and its application in preserving grape.

Bariatric metabolic surgery (Roux-en-Y gastric bypass [RYGB] and sleeve gastrectomy [SG]) effectively treats obesity and type 2 diabetes; however, weight loss varies, necessitating predictive factors. We analysed 12- and 24-month weight loss data from 811 patients (RYGB or SG). Factor Analysis of Mixed Data and neural network (NN) modelling identified distinct patient phenotypes and predicted weight-loss patterns. A comparative analysis evaluated weight loss and recurrence between the two procedures. RYGB showed significantly greater weight loss than SG at both 12 (30.3% vs. 25.4%; p<0.001) and 24months (26.3% vs. 21.4%; p<0.001). SG revealed greater variability with bimodal weight loss distributions. Unsupervised clustering of SG patients highligheted three phenotypes: the highest responders were women with favourable metabolic profiles; the lowest responders were mostly men with insulin resistance and diabetes. A NN achieved an overall accuracy of 72.5% in predicting 12-month weight loss from baseline characteristics. In RYGB, clustering was less distinct, though baseline metabolic health influenced weight trajectories. A NN predicted weight recurrence versus sustained loss with 74% accuracy. Poor outcomes were associated with higher baseline glucose, insulin resistance, and dyslipidemia; younger age and absence of diabetes predicted better responses. RYGB was superior to SG, even for metabolic high-risk individuals. Baseline metabolic health predicts weight-loss outcomes and recurrence risk. RYGB offered greater and more consistent mid-term weight loss, especially benefiting metabolically high-risk patients. Procedure choice must be individualized accounting for specific risk profile and potential complications. These results advocate for a precision-medicine approach in bariatric procedure selection.

Information on therapeutic inertia (TI) in weight loss in people with type 2 diabetes (T2D) is limited. To describe the prevalence of TI in the management of overweight/obesity in people with T2D undergoing primary care program (PCP) follow-up and weight changes according to the prescribed treatment. A retrospective longitudinal study was conducted in patients with T2D with body mass index (BMI) ≥25kg/m2 followed by PCP. The following data were obtained from medical records at the first assessment, 6 and 12months: anthropometric data, HbA1c, medications added according to their effect on weight, and specialist referrals (nutrition and metabolic and bariatric surgery). A total of 128 patients were included (age 65.5±11.7years, HbA1c 7.8±1.7%, BMI 33.1±5.7kg/m2). The mean HbA1c at the end of follow-up was 7.4%±1.4%. Twenty-five percent achieved ≥5% weight loss after 12months. The proportion of patients without weight-loss interventions increased from 59% in the first assessment to 86% and 89% after 6 and 12months of follow-up. Patients who lost ≥5% of their weight were more likely to be referred to dietary counseling at program entry (37.5% vs. 23.4%) and at 6months (18.8% vs. 6.4%) compared to patients who gained weight. In addition, the prescription of SGLT2 inhibitors/GLP1-receptor agonist was higher in this group at 6months (49.3% vs. 10.7%). Although there was a reduction in HbA1c, the TI for prescribing weight-loss interventions was high. This suggests the importance of including weight loss as a therapeutic goal alongside lowering HbA1c in primary care.

To evaluate the effectiveness of semaglutide compared with lifestyle counselling alone for weight loss in diabetic and non-diabetic patients with obesity. This multi-site, retrospective, observational study uses data from electronic health records which are part of the Greater Plains Collaborative (GPC) in a time-to-event analysis for comparative effectiveness. Participants were adults with obesity receiving semaglutide for a minimum of 16 weeks or lifestyle counselling with at least three sessions within the first 16 weeks. The primary outcome is incidence of 10% or greater reduction in weight from baseline. Of 3927 eligible participants, 615 were prescribed semaglutide and 3312 received lifestyle counselling. Following propensity score matching, each group (diabetic and non-diabetic) consisted of 120 and 495 participants, respectively. Hazard ratios for 10% weight loss were significantly higher from semaglutide for non-diabetic (1.63 [95% CI: 1.32, 2.01; p < 0.001]) and diabetic (2.45 [95% CI: 1.47, 4.09; p < 0.001]) populations. These data from our study suggest that semaglutide therapy compared with lifestyle counselling alone is more effective in achieving at least 10% weight loss. This information may be used to inform clinical practice guidelines and stimulate future research on the long-term effectiveness of various weight loss options for individuals with obesity.

Change in self-esteem after weight-loss treatment. Alexithymia as a psychological mechanism.

Comparative midterm ramifications of one anastomosis gastric bypass, Roux-en-Y gastric bypass, and sleeve gastrectomy: A retrospective cohort study of 6,234 patients.

Swallowing-related outcomes and organ-at-risk dosimetry after proton versus photon radiotherapy in nasopharyngeal carcinoma.

Microbial-induced corrosion costs billions of dollars, including replacing plastics degraded by fungi. Fungal growth is moisture dependent, but we need to better understand how equilibrium relative humidity (ERH) affects plastic degradation. The goal of this project was to measure how ERH impacts degradation of polyester polyurethane foam by Aureobasidium pullulans and identify potential genetic pathways. We incubated three environmental strains of A. pullulans on foam at 50%, 85%, and 100% ERH and evaluated degradation through foam weight loss, Scanning Electron Microscopy (SEM), external nutrient availability, RNA sequencing, and proxy Impranil clearing. Higher ERH after 1 week of incubation corresponded to greater weight loss in foam (p = 0.002), with percent weight loss ranging from 0.11% to 5.1%. SEM foam imaging shows signs of fungal growth and degradation at high ERH while nutrient data suggests that, beyond the foam, additional carbon is not required. We identified 10 cutinases among the three strains. In one strain, two cutinases were 2.5 to 100-fold upregulated at 85% and 100% ERH compared to 50% (p < 0.05) and the cutinase with the highest upregulation demonstrated clearing of Impranil. Our results demonstrate that increased relative humidity can increase fungal degradation of polyurethane foams as relevant for biodegradation prevention or promotion.

Proteomic effects of short-term liraglutide vs. placebo in a blinded crossover RCT: Implications for efficacy, safety, and comparison with semaglutide.

Obesity and T2DM substantially increase postoperative risk, with higher surgical site infections in obesity and up to a 65% increase in overall complications in T2DM. This study assesses the impact of weight loss interventions-metabolic bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonists (GLP-1RA)-on BMI reduction and how that translates to postoperative outcomes in general surgery patients. Patients undergoing general surgery (2016-2024) were identified in the Epic Cosmos database. GLP-1RA or MBS exposure occurred 1-3 years preoperatively (GLP-1RA coverage ≥ 80%). Entropy balancing produced weighted cohorts with similar baseline profiles, followed by multivariable regression models assessing the association between weight loss intervention and BMI change, and the impact of BMI on postoperative outcomes. Overall 9470 individuals underwent a general surgery procedure. Median patient age was 64, with mostly females (60.6%). More patients received GLP-1RA (n = 7823, 82.3%) than MBS (n = 1647, 17.4%). MBS patients had higher initial BMIs (≥ 40: 60.8% vs. 24.5%, p < 0.001). MBS led to greater BMI reduction than GLP-1RA (Mean difference: -9.89, 95% CI: -9.64, -10.34). Higher BMI at time of a general surgical procedure correlated with increased postoperative complications (OR: 1.01, 95% CI: 1.00-1.01) and extended LOS (OR: 1.01, 95% CI: 1.00-1.01). MBS was associated with lower complication odds (OR: 0.87, 95% CI: 0.78-0.98). MBS improved surgical outcomes in patients with obesity and T2DM through greater BMI reduction compared with GLP-1RAs. These findings support the role of preoperative weight loss to mitigate surgical risk; however, evaluating outcomes relative to no intervention remains an important future direction.

Alarm symptoms at coeliac disease (CeD) diagnosis predict a more severe disease presentation, but the long-term implications remain unclear. We studied the prevalence of alarm symptoms at diagnosis and their association with outcomes. A mixed-method cohort study combined retrospective medical record review with data collection through patient interviews and blood sampling from 814 adult patients with CeD after a median of 9.7 years on a gluten-free diet (GFD). Validated questionnaires assessed symptoms and quality of life. Alarm symptoms included anaemia, weight loss, dysphagia, vomiting, melaena, and rectal bleeding. Patients were grouped by the presence or absence of alarm symptoms. 45% of the patients presented with alarm symptoms, primarily (95%) anaemia and weight loss. These patients were significantly more often female (83 vs. 71%; P < 0.001), had more severe clinical presentation ( P < 0.001; reported severe symptoms 41 vs. 2%) and more advanced mucosal damage ( P < 0.001; subtotal or total villous atrophy 72 vs. 57%) than those without these symptoms. On GFD, these patients experienced fewer persistent symptoms (asymptomatic 71 vs. 79%; P = 0.035) but more often had osteopenia/osteoporosis (15 vs. 9%; P = 0.008). The groups did not differ in the strictness of GFD, positivity of CeD autoantibodies, quality of life, fractures, or other comorbidities. Alarm symptoms were common at CeD diagnosis. After 9.7 years on a GFD, patients with alarm symptoms had a higher incidence of osteopenia/osteoporosis, but generally did not demonstrate poorer long-term outcomes compared to those without alarm symptoms.

Tuberculosis (TB) is a bacterial infection caused by the bacilli, Mycobacterium Tuberculosis (MTB). While it primarily affects the lungs, various other organs like the lymph nodes, pleura, and peritoneum can be involved in Extrapulmonary Tuberculosis (EPTB). Involvement of the tonsils, however, is extremely rare, even in a TB-endemic country like India. Tonsillar TB may occur secondary to pulmonary infection through lymphatic or haematogenous dissemination, and its presentation often mimics malignancy (fever, loss of weight). This case report contains a case of a 56-year-old male patient who presented with progressive dysphagia, significant weight loss, low-grade fever, and cervical lymphadenopathy. Clinical examination revealed a unilateral tonsillar enlargement with firm neck nodes, initially raising a strong suspicion of malignancy. Routine blood investigations were normal, and a diagnostic tonsillectomy was performed, whose histopathological examination revealed granulomatous inflammation with caseous necrosis. The diagnosis was then confirmed by microbiological evidence of MTB. The novelty of this case report lies in the isolated tonsillar involvement without active pulmonary disease, its close clinical resemblance to malignancy, and the diagnostic challenge involved. Early recognition and accurate diagnosis are crucial for initiating appropriate therapy and preventing transmission.

The effect of frailty on early postoperative outcomes of lobectomy for lung cancer in older adults - A United States National Retrospective Cohort Study.

Retrospective chart review on psychiatric manifestations of GLP-1 agonist usage.

Functional ability index predicts cardiovascular disease and comorbid health outcomes in older Chinese adults: A national longitudinal cohort study.

Development of a nucleotide prodrug of 4'-fluorouridine to improve tolerability.

While antineutrophil cytoplasmic antibody (ANCA)-associated small-vessel vasculitis (AAV) is increasingly recognized, cases presenting with initial gastrointestinal symptoms remain underexplored. This study aimed to analyze the clinical characteristics of AAV patients with gastrointestinal onset. Seven AAV patients meeting ACR/EULAR criteria, who presented with gastrointestinal symptoms between January 2017 and 2024, were retrospectively identified. A literature review was conducted across multiple databases, including PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, and Wanfang. In total, 23 patients were included in the study. Among the 23 AAV patients with gastrointestinal symptoms, 15 (65.2%) were male, with a median age of 54 years (range: 18-79). Common clinical manifestations included hematochezia (56.5%), weight loss (43.5%), and purpura (34.8%). Eight (34.8%) had superficial gastritis, and seven (30.4%) had colonic ulcers, as identified by gastrointestinal endoscopy. Laboratory findings revealed elevated D-dimer levels and anemia in most patients, with impaired renal function and a median hemoglobin level of 105 g/L. Anti-PR3 immunoglobulin G (IgG) and antimyeloperoxidase IgG antibodies were positive in 83.3 and 80% of cases, respectively. Abdominal computed tomography (CT) revealed wall thickening in 39.1% of patients, and chest CT identified interstitial lung disease in 73.9% of patients. Nine patients (39.1%) were initially misdiagnosed, with five (55.6% of those nine) misdiagnosed as having inflammatory bowel disease. Most patients responded well to glucocorticoid and immunosuppressive therapy, with 39.1% receiving a combination of glucocorticoids and cyclophosphamide. Gastrointestinal symptoms in AAV are rare, and misdiagnosis remains a concern. Early detection requires assessing gastrointestinal, pulmonary, and renal involvement.

Ganoderma lucidum polysaccharide ameliorates cancer cachexia with enhanced efficacy in aged group by reprogramming arginine metabolism to modulate Treg formation.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are among the most effective treatments for type 2 diabetes mellitus (T2DM). GLP-1 RAs stimulate pancreatic receptors, improving glycemia by boosting insulin secretion while decreasing glucagon secretion. GLP-1 receptors are present in pancreatic tissue. They are also found in extra-pancreatic tissue and have been shown to reduce body weight while also protecting the heart and endothelial cells. The most prevalent types of GLP-1 RAs can be injected twice daily (exenatide), once daily (lixisenatide and liraglutide), or once weekly (albiglutide, dulaglutide, exenatide once, semaglutide, tirzepatide). GLP-1 receptor agonists also reduce gastric emptying, preventing substantial post-meal glycaemic increases. Many publications have been written regarding GLP-1 RAs, covering various features of this family. However, the purpose of this study is to investigate the pharmacological design models and pharmacokinetic characteristics of the most regularly used members of this class, as well as to highlight contemporary developments in GLP-1 RAs. It also describes the physicochemical features, techniques of manufacture, the effects of molecular structure, and structural modifications on pharmacological activity. The literature review was completed using a structured approach to identify and integrate relevant literature. It involved a broad search of reputable medical databases using inclusion and exclusion criteria. They are classified as short-acting or long-acting based on the length of their action. Short-acting GLP-1 RAs and long-acting GLP-1 RAs have differing efficacy profiles. Furthermore, the methods of administration, mode of action, and side effects of these medications are relevant to their pharmacological design and pharmacokinetic properties. The treatment of type 2 diabetes and obesity has evolved with the advent of GLP-1 RAs. These drugs have a multifaceted approach, emphasizing glycemic regulation, weight loss, and reduction of cardiovascular risk. Their unique mode of action, strong safety profile, and ability to be individualized according to each patient's needs make them a valuable therapeutic option in the management of metabolic disorders. Their pharmacological activities are also influenced by their different structural and pharmacokinetic properties. GLP-1 RAs have a complex strategy due to their pharmacological nature. The variations in their design have led to various members with varying pharmacodynamic and pharmacokinetic features.

Mitigating loss of lean muscle in GLP-1 and dual GLP-1/GIP agonists: Pipeline opportunities and limitations.