The Beneficial Effect of 12-Hour Fasting, 45 Minutes Exercise Thrice Weekly and Their Combination on Weight Loss, Anthropometric Measures and Metabolic Syndrome

Background: Obesity is the leading preventable cause of death worldwide. It is associated with significant increases in morbidity and mortality. Few studies have addressed, prospectively, the impact of life-style modification in weight-reduction in 1) morbidly obese patients with BMI > 35 kg/m2 and 2) on its associated co-morbid risk factors for metabolic syndrome viz. high blood pressure, diabetes, hyperlipidemia and steatohepatitis as well as psychiatric disorders. Patients and Methods: We prospectively evaluated the role of 1) two meals daily with in between 12-hour fasting, 2) thrice weekly 45-minute active-walk, and 3) their combination, in management of ambulant obese patients, at BMI of 35 to 39.9 kg/m2 who had such multiple acquired metabolic disorders. The study was conducted over 3 years with 45 patients in 3 matched groups with regards to gender, age, BMI, waist circumference, lipid profile (LDL and TG), fibroscan steatosis grade, psychiatric assessment, antidiabetic drugs and antihypertensive ones. Results: At 6 and 12 months, the 3 regimens were well tolerated and were effective in weight loss, improvement in anthropometric measures and management of metabolic syndrome yet the combined one was significantly better in all endpoints. Conclusion: Our protocols of exercise and dieting were effective measures in managing obesity and its associated co-morbidities and their combination is synergetic.

When the Stars Align: Hypertriglyceridemic Pancreatitis Is Inevitable

Background: Acute pancreatitis (AP) is an inflammatory process affecting the pancreas. Hypertriglyceridemic AP (HTAP) is its third leading cause after gallstones followed by alcohol use. It develops when stars align viz. triggers (acquired surges) in patients with genetic hypertriglyceridemia. Case: severe and acute pancreatitis had developed in a 57-year-old man with type IIb familial hyperlipidemia after heavy fatty meals. The acute phase was controlled by holding oral intake with weekly Evolocumab therapy and long-term prevention by weight reduction and Fenofibrate alone. His pancreatic endocrine and exocrine functions remained normal after 2 years of follow-up. Conclusion: Those four measures were safe, practical and effective for short- and long-term management of HTAP.

Nutrition and physical activity in NAFLD:An overview of the epidemiological evidence

Nonalcoholic fatty liver disease(NAFLD)has been recognized as a major health burden.The high prevalence of NAFLD is probably due to the contemporary epidemics of obesity,unhealthy dietary pattern,and sedentary lifestyle.The efficacy and safety profile of pharmacotherapy in the treatment of NAFLD remains uncertain and obesity is strongly associated with hepatic steatosis;therefore,the first line of treatment is lifestyle modification.The usual management of NAFLD includes gradual weight reduction and increased physical activity(PA)leading to an improvement in serum liver enzymes,reduced hepatic fatty infiltration,and,in some cases,a reduced degree of hepatic inflammation and fibrosis.Nutrition has been demonstrated to be associated with NAFLD and Non-alcoholic steatohepatitis(NASH)in both animals and humans,and thus serves as a major route of prevention and treatment.However,most human studies are observational and retrospective,allowing limited inference about causal associations.Large prospective studies and clinical trials are now needed to establish a causal relationship.Based on available data,patients should optimally achieve a 5%-10%weight reduction.Setting realistic goals is essential for long-term successful lifestyle modification and more effort must be devoted to informing NAFLD patients of the health benefits of even a modest weight reduction.Furthermore,all NAFLD patients,whether obese or of normal weight,should be informed that a healthy diet has benefits beyond weight reduction.They should be advised to reduce saturated/trans fat and increase polyunsaturated fat,with special emphasize on omega-3 fatty acids.They should reduce added sugar to its minimum,try to avoid soft drinks containing sugar,including fruit juices that contain a lot of fructose,and increase their fiber intake.For the heavy meat eaters,especially those of red and processed meats,less meat and increased fish intake should be recommended.Minimizing fast food intake will also help maintain a healthy diet.PA should be integrated into behavioral therapy in NAFLD,as even small gains in PA and fitness may have significant health benefits.Potentially therapeutic dietary supplements are vitamin E and vitamin D,but both warrant further research.Unbalanced nutrition is not only strongly associated with NAFLD,but is also a risk factor that a large portion of the population is exposed to.Therefore,it is important to identify dietary patterns that will serve as modifiable risk factors for the prevention of NAFLD and its complications.

Nutritional recommendations for patients with non-alcoholic fatty liver diseases

Fatty liver is the most common liver disease worldwide.Patients with fatty liver disease die primarily from cardiovascular disease and not from chronic liver diseases.Hyperglycemia and hyperinsulinemia induce lipogenesis,thereby increasing the hepatic pool of fatty acids.This pool is also increased by increased delivery of fatty acids through the diet or lipolysis in adipose tissue.Nutritional consultations and lifestyle modification are important in the treatment of non-alcoholic fatty liver disease(NAFLD).Among the dietary constituents,combination of vitamin D,vitamin E,and omega-3 fatty acids shows promise for the treatment of NAFLD.

Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis

BACKGROUND Non-alcoholic steatohepatitis(NASH) has become one of the leading causes of liver disease in the western world. In obese patients weight reduction is recommended. Up to now there are no specific guidelines for weight loss in order to reduce hepatic fat content.AIM To investigate the effects of a 24-wk guided lifestyle intervention program compared to a meal replacement regimen based on soy protein.METHODS Twenty-six subjects with NASH participated in a randomized single-center study. They were randomly assigned to either meal replacement group(MR-G)with soy-yogurt-honey preparation or to guided lifestyle change group(LC-G)with endurance activity and nutrition counselling. Serum alanine transaminase(ALT), aspartate transaminase(AST), lipid parameters, and adipokines were measured. Liver fat content and lipid composition were determined by magnetic resonance imaging and magnetic resonance spectroscopy. Body fat mass and lean body mass were assessed using Bod Pod? device. Pre-and post-intervention monitoring of parameters was performed. Statistical analyses were conducted with SPSS software, results were expressed as median(interquartile range).RESULTS Twenty-two subjects(MR-G, n = 11 and LC-G, n = 11) completed the study(9 women, 13 men; age 52.1(15.0) years, body mass index(BMI) 32.3(3.3) kg/m^2).In both groups a significant weight loss was achieved(MR-G:-6.4(3.6) kg, P <0.01; LC-G:-9.1(10.4) kg, P < 0.01). BMI dropped in both groups(MR-G:-2.3(1.5)kg/m^2, P = 0.003; LC-G:-3.0(3.4) kg/m^2, P = 0.006). Internal fat and hepatic lipid content were markedly reduced in both groups in comparable amount. There was a strong correlation between reduction in liver fat and decrease in ALT.Likewise, both groups showed an improvement in glycemic control and lipid profile. Changes in adipokines, particularly in adiponectin and leptin were closely related to intrahepatic lipid changes.CONCLUSION Comprehensive lifestyle intervention and meal replacement regimen have comparable effects on body and liver fat, as well as decrease in markers of hepatic inflammation among NASH patients.

Characteristics of thickness distribution of tailor-welded tube hydroforming

Both experimental and mechanical analyses were carded out to investigate the characteristics of thickness distribution for tailor-welded tube （TWT） hydroforming with dissimilar thickness. Then, the effects of weld-seam position and thickness difference were also revealed. A multiple-diameter tube was formed to reveal the characteristics and the regularity of thickness distribution during TWT hydroforming. It is indicated that there are obvious fluctuations in thickness distribution though the TWTs have the same expansion ratio. The thinning ratio of thinner tube is bigger than that of thicker tube especially in the zone closed to the weld-seam. The difference in thinning ratio between two tube segments can reach 9%. Consequently, sudden and large fluctuation of thickness appears in the zone nearby the weld-seam. The difference in thinning ratio between thinner and thicker tubes enlarges as the thickness difference increases, but improves as length ratio increases. Different strain states are the main reason to induce nonuniform thickness distribution. The difference in thickness is the main reason to induce different strain states on thinner and thicker tubes.

Osmotic Dehydration of Cherry-Part I. Using General Factorial Design

Cherry is extremely perishable fruit and it needs to be dried in order to preserve the fruit for later uses. In this work, the influences of different osmotic solution concentrations on water loss （WL）, solid gain （SG） and weight reduction （WR） during osmotic dehydration of cherry halves were investigated. These were studied using general factorial design with different sucrose concentrations （40, 55, 70%, w/v） and immersion time （5 hours）. Quadratic regression equations describing the effects of processes on WL, SG and WR were developed. The results revealed that the soaking time and sucrose concentration significantly （P 〈 0.05） influenced most of the quality indices of osmotically-dehydrated cherry halves. It is suggested that the regression equation obtained in this study can be used to find optimum conditions for osmotic dehydration.

Design of Korean Standard Modular Buoy Body Using Polyethylene Polymer Material for Ship Safety

Buoy is the structure which is floated on sea surface in order to indicate the presenting obstacle such as reef and shallow sea and to show the direction of sea route to ship during sailing. Generally, the conventional material of buoy is steel and it has some problems. Firstly this steel light buoy has safety risk in case of collision between ship and steel buoy. Secondly steel buoy revealed high corrosion environment of salted water and oxide and corrosion of steel can lead to marine pollution. Thirdly it needs too much maintain cost because of its heavy weight. In this study, in order to overcome these problems we changed the buoy material from conventional steel body to polyethylene body. Polymer buoy body was designed with module type part and it can reduce total weight up to 43.12%. To evaluate the strength of that part, the structure analysis simulation was carried out with respect to stress, displacement, and strain. Maximum stress was 1.667 × 107 N/m2 and it was 25% of yielding stress of base material. Maximum displacement and strain were 3.164 mm and 0.00433353 and they are too small value and in safe range with comparing to total length of body. The stability of polymer buoy body was compared with conventional buoy with respect to center of gravity, center of buoyancy, metacenter, oscillation period, and tilt angle by wind, tidal current, and wave. Every value was improved comparing conventional one and we can get more stable buoy. Therefore the new polymer buoy body could prove its safety and stability.

Implementation of N-Bit Binary Multiplication Using N - 1 Bit Multiplication Based on Nikhilam Sutra and Karatsuba Principles Using Complement Method

This paper is designed to introduce new hybrid Vedic algorithm to increase the speed of the multiplier. This work combines the principles of Nikhilam sutra and Karatsuba algorithm. Vedic Mathematics is the mathematical system to solve the complex computations in an easier manner. There are specific sutras to perform multiplication. Nikhilam sutra is one of the sutra. But this has some limitations. To overcome the limitations, this sutra is combined with Karatsuba algorithm. High speed devices are required for high speed applications with compact size. Normally multipliers require more power for its computation. In this paper, new multiplication algorithm for the multiplication of binary numbers is proposed based on Vedic Mathematics. The novel portion in the algorithm is found to be in the calculation of remainder using complement method. The size of the remainder is always set as N - 1 bit for any combination of input. The multiplier structure is designed based on Karatsuba algorithm. Therefore, N × N bit multiplication is done by (N - 1) bit multiplication. Numerical strength reduction is done through Karatsuba algorithm. The results show that the reduction in hardware leads to reduction in the delay.

Efficacy of acupuncture on treating obesity and adipose-incurred illnesses

Being overweight and obese impacts health due to adiposity itself and illnesses it incurs,which produces individual and societal financial burdens.This urges effective interventions,including adjunct therapies.Acupuncture,a traditional Chinese medical practice,indicates positive signs for tackling these problems.Investigating 101 empirical human-based projects,this narrative review analyses their outcomes and then provides an overview of the effects of acupuncture in body weight reduction and obesity-induced diseases,either performed alone or with other approaches.It involves 15941 participants from 9-80 years old in China's Mainland,Taiwan,Turkey,Brazil,Egypt,Iran,Greece,Korea,Sudan,Thailand,and the USA.It also reveals practical implications and future research directions,benefiting the development of acupuncture in the modern medical arena for both patients and practitioners.

Application of Composite Materials in the Fire Explosion Suppression System

In order to lighten the weight of the special vehicles and improve their mobility and flexibility, the weight of all subsystems of the whole vehicle must be reduced in the general planning. A fire explosion suppression system is an important subsystem for the self-protection of vehicle, protection of crews and safety of a vehicle. The performances of the special vehicles determine their survival ability and combat capability. The composite bottle is made of aluminum alloy with externally wrapped carbon fiber ; it has been proven by a large number of tests that the new type explosion suppression fire distinguisher made of such composite materials applied in the special vehicle has reliable performance, each of its technical indexes is higher or equal to that of a steel distinguisher, and the composites can also optimize the assembly structure of the bottle, and improve the reliability and corrosion resistance. Most important is that the composite materials can effectively lighten the weight of the fire explosion suppression system to reach the target of weight reduction of the subsystem in general planning.

Research on the Lightweight Design of Body-Side Structure Based on Crashworthiness Requirements

Crash worthiness is the most significant variable during lightweight design of vehicle struc tures.However,crashworthiness studies using the single substructure-based method are limited due to the negligence of interactions among substructures.Thus,a whole structure-based study was conducted for the lightweight design of a body-side structure.In this study,a full finite element model was firstly created and then modified into a simplified model for structural improvements,where the major load-carrying subassemblies were improved from the perspectives of crashworthiness and manufacturing costs.Finally,sensitivity analyses were conducted to further optimize the strength distribution,based on which an adaptive response surface method was employed for thickness optimization of the structure.It is found that through the structural improvements and optimizations,the weight of the structure was significantly reduced even when its crashworthiness was improved.This indicates that the whole structure-based method is effective for lightweight design of vehicle structures.

Current Evidence Concerning Effects of Ketogenic Diet and Intermittent Fasting in Patients with Nonalcoholic Fatty Liver

Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exercise plays a critical role in NAFLD management. In terms of dietary modification, Mediterranean diet is the most studied dietary pattern and is recommended in many guidelines, however, it may not be feasible and affordable for many patients. Recently, a ketogenic diet and intermittent fasting have gained public attention and have been studied in the role of weight management. This article reviews specifically whether these trendy dietary patterns have an effect on NAFLD outcomes regarding intrahepatic fat content, fibrosis, and liver enzymes, the scientific rationales behind these particular dietary patterns, as well as the safety concerns in some certain patient groups.

Application of Conservative Surrogate to Reliability Based Vehicle Design for Crashworthiness

Surrogate models are commonly used for approximation of large computationally expensive vehicle crash simulation to facilitate rapid design space exploration and optimization. Unfortunately, the optimum design based on surrogates may turn out to be infeasible after running finite element crash simulation due to the surrogate errors. To meet this challenge, conservative strategy of surrogate modeling through compensating fitting errors was used for reliability based design optimization of vehicle structures for crashworthiness and weight reduction. The critical crash responses were constructed by unbiased kriging models, and conservative surrogates were obtained via adding safety margin to estimate the crash responses conservatively. The benefits of using conservative surrogates for reliability based design optimization were investigated in the context of constraint feasibility of the optimum designs through a mathematical example and a case study on vehicle crashworthiness design. The results demonstrate that optimization based on conservative surrogate helps to achieve the feasible optimum design, showing more attractive for reliability based design optimization in engineering applications.

Novel bake hardening mechanism for bainite-strengthened complex phase steel

In the automobile industry,stamping and paint baking processes are used to strengthen components,and this not only saves costs,but also further reduces the bodyweight of automobiles.In this work,the bake hardening mechanism of the complex phase(CP)steel CP980 was explored by comparing it with that of DP1180,which has a clear bake hardening mechanism and a carbon content similar to that of CP980.By analyzing the bake hardening response and the microstructural changes of the two steels,we found that the bake hardening process of CP980 was divided into three stages.In the first two stages,the carbon atoms diffused into dislocations to form Cottrell atmosphere pinning dislocations,and excess car-bon atoms formed carbon clusters or low-temperature carbide pinning dislocations that were similar to DP1180.In the third stage,the dislocation acted as rapid channels for carbon diffusion,and fine cementite gradually formed when the carbon clusters gathered at the dislocations as precursors,resulting in pre-cipitation hardening.This novel bake-hardening(BH)mechanism is crucial for obtaining a comprehensive understanding of the strain-baking behavior of advanced high-strength steals(AHSS).

因果、加权系统与还原论——因果与反事实的本体论地位之争

始于20世纪70年代,在可能世界的框架内讨论反事实及其相关问题依然是学术研究的主流,但对于可能世界语义和逻辑的批评从未停止。在还原主义的框架中讨论反事实的语义问题,说明使用可能世界语义分析会得出与直觉不符的结论,从而质疑可能世界语义本身的合法性是可行的径路之一。具体而言,可能世界语义至少面临五个反例,谢弗引入因果独立的概念力图消解它们,虽然谢弗径路有悖于还原主义的热望且依然有其不可解释的反例,但其合理性却被社会科学的因果推断实践所证成。