The deep learning model is overfitted and the accuracy of the test set is reduced when the deep learning model is trained in the network intrusion detection parameters, due to the traditional loss function convergence...The deep learning model is overfitted and the accuracy of the test set is reduced when the deep learning model is trained in the network intrusion detection parameters, due to the traditional loss function convergence problem. Firstly, we utilize a network model architecture combining Gelu activation function and deep neural network;Secondly, the cross-entropy loss function is improved to a weighted cross entropy loss function, and at last it is applied to intrusion detection to improve the accuracy of intrusion detection. In order to compare the effect of the experiment, the KDDcup99 data set, which is commonly used in intrusion detection, is selected as the experimental data and use accuracy, precision, recall and F1-score as evaluation parameters. The experimental results show that the model using the weighted cross-entropy loss function combined with the Gelu activation function under the deep neural network architecture improves the evaluation parameters by about 2% compared with the ordinary cross-entropy loss function model. Experiments prove that the weighted cross-entropy loss function can enhance the model’s ability to discriminate samples.展开更多
The current existing problem of deep learning framework for the detection and segmentation of electrical equipment is dominantly related to low precision.Because of the reliable,safe and easy-to-operate technology pro...The current existing problem of deep learning framework for the detection and segmentation of electrical equipment is dominantly related to low precision.Because of the reliable,safe and easy-to-operate technology provided by deep learning-based video surveillance for unmanned inspection of electrical equipment,this paper uses the bottleneck attention module(BAM)attention mechanism to improve the Solov2 model and proposes a new electrical equipment segmentation mode.Firstly,the BAM attention mechanism is integrated into the feature extraction network to adaptively learn the correlation between feature channels,thereby improving the expression ability of the feature map;secondly,the weighted sum of CrossEntropy Loss and Dice loss is designed as the mask loss to improve the segmentation accuracy and robustness of the model;finally,the non-maximal suppression(NMS)algorithm to better handle the overlap problem in instance segmentation.Experimental results show that the proposed method achieves an average segmentation accuracy of mAP of 80.4% on three types of electrical equipment datasets,including transformers,insulators and voltage transformers,which improve the detection accuracy by more than 5.7% compared with the original Solov2 model.The segmentation model proposed can provide a focusing technical means for the intelligent management of power systems.展开更多
BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AI...BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.展开更多
BACKGROUND Over one-third of Americans carry the diagnosis of obesity,many also with obesity-related comorbidities.This can place patients at increased risk of operative and postoperative complications.The intragastri...BACKGROUND Over one-third of Americans carry the diagnosis of obesity,many also with obesity-related comorbidities.This can place patients at increased risk of operative and postoperative complications.The intragastric balloon has been shown to aid in minor weight loss,however its weight recidivism in patients requiring short interval weight loss has not been well studied.AIM To evaluate weight loss,ability to undergo successful elective surgery after intragastric balloon placement,and weight management after balloon removal.METHODS This study is a retrospective review of patients in a single academic institution undergoing intragastric balloon placement from 2019-2023 to aid in weight loss prior to undergoing elective surgery.Clinical outcomes including weight loss,duration of balloon placement,successful elective surgery,weight regain postballoon and post-procedure complications were assessed.Exclusion criteria included those with balloon in place at time of study.RESULTS Thirty-three patients completed intragastric balloon therapy from 2019-2023 as a bridge to elective surgery.All patients were required to participate in a 12-month weight management program to be eligible for balloon therapy.Elective surgeries included incisional hernia repair,umbilical hernia repair,inguinal hernia repair,and knee and hip replacements.The average age at placement was 53 years±11 years,majority(91%)were male.The average duration of intragastric balloon therapy was 186 days±41 days.The average weight loss was 14.0 kg±7.4 kg and with an average percent excess body weight loss of 30.0%(7.9%-73.6%).Over half of the patients(52.0%)achieved the goal of 30-50 lbs(14-22 kg)weight loss.Twenty-one patients(64%)underwent their intended elective surgery,2 patients(6%)deferred surgery due to symptom relief with weight loss alone.Twenty-one of the patients(64%)have documented weights in 3 months after balloon removal,in these patients the majority(76%)gained weight after balloon removed.In patients with weight regain at 3 months,they averaged 5.8 kg after balloon removal in the first 3 months,this averaged 58.4%weight regain of the initial weight lost.CONCLUSION Intragastric balloon placement is an option for short-term weight management,as a bridge to elective surgery in patients with body mass index(BMI)>35.Patients lost an average of 14 kg with the balloon,allowing two-thirds of patients to undergo elective surgery at a healthy BMI.However,most patients regained an average of 58%of the original weight lost after balloon removal.The intragastric balloon successfully serves as a tool for rapid weight loss,though patients must be educated on the risks including weight regain.展开更多
Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World H...Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World Health Organization (WHO) has estimated that, at the end of 2022, 1 out of every 8 individuals were obese, and that the global adult obesity rates have over doubled since 1990, even as the adolescent obesity rates have quadrupled. Thus, as of 2022, nearly 2.5 billion adults, aged 18 years and above, were overweight, with 890 million being obese. Obesity and overweight incidence rate has been gradually increasing over the years, presenting significant challenges to the healthcare systems throughout the globe. In this regard, the objective of this systematic review was to evaluate the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. Methodology: To attain the above stated study objective, a systematic evaluation of previous studies was carried out, particularly studies that assessed the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. The authors have used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the selection of eligible studies for inclusion in the study. Results: The findings indicate that lifestyle interventions resulted in 5% - 10% weight reduction and significant improvements in metabolic indicators, while pharmacotherapy (GLP-1 receptor agonists) achieved up to 15% weight reduction and considerable metabolic health benefits. Further, comparative studies show lifestyle modifications provide overall health benefits, while medication is necessary for non-responders. Conclusion: Individualized treatment strategies are crucial, and further research is needed on long-term consequences and combination therapies.展开更多
Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases o...Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases of patients with schizophrenia who experienced substantial weight loss while on long-term clozapine therapy. The first case involves a 35-year-old male who lost 21.3% of his initial body weight, and the second case describes a 54-year-old female who lost 30.2% of her initial weight, despite having comorbid hypothyroidism. Both patients showed improvement in psychiatric symptoms concurrent with the weight loss. Comprehensive investigations did not reveal other clear etiologies for the weight reduction. These cases challenge the conventional understanding of clozapine’s metabolic effects and highlight the potential for atypical responses in some individuals. The report discusses possible mechanisms for this unusual phenomenon, including genetic factors and altered pharmacokinetics. It also emphasizes the need for individualized monitoring and management strategies in clozapine therapy. These findings contribute to the growing body of evidence suggesting that metabolic responses to clozapine may be more complex and varied than previously thought, underscoring the importance of personalized approaches in schizophrenia treatment.展开更多
There is rapidly increasing uptake of GLP-1 (glucagon-like peptide-1) agonistssuch as semaglutide worldwide for weight loss and management of non-alcoholicsteatohepatitis (NASH). remains a paucity of safety data in th...There is rapidly increasing uptake of GLP-1 (glucagon-like peptide-1) agonistssuch as semaglutide worldwide for weight loss and management of non-alcoholicsteatohepatitis (NASH). remains a paucity of safety data in the vulnerable NASHcirrhotic population. We report herein the first documented case of liver decompensationand need for liver transplant waitlisting in a patient with NASHcirrhosistreated with semaglutide. Rapid weight loss led to the development ofascites and hepatic encephalopathy and an increase in the patients Model forEndstage Liver Disease-Na (MELD-Na) score from 11 to 22. Aggressive nutritionalsupplementation was commenced and the semaglutide was stopped. Overthe following months she regained her weight and her liver recompensated andher MELD-Na decreased to 13, allowing her to be delisted from the transplantwaitlist. This case serves as a cautionary tale to clinicians using semaglutide in thecirrhotic population and highlights the need for more safety data in this patientgroup.展开更多
Background: The prevalence of individuals who are obese or overweight is an increasing global epidemic that is associated with a multitude of adverse health conditions. Multiple strategies are available to promote wei...Background: The prevalence of individuals who are obese or overweight is an increasing global epidemic that is associated with a multitude of adverse health conditions. Multiple strategies are available to promote weight loss in these populations, including the use of caloric restriction and/or liquid diets. We determined the impact of a low-calorie, nutrient-dense, primarily liquid diet on body weight and associated measures of metabolic health in overweight and obese men and women. Methods: Twenty-six men and women (age: 42.6 ± 10.8) completed a seven-day intervention using the USANA Active Nutrition Jumpstart program, which consisted of consuming three meal replacement shakes and three to four servings of fruits and vegetables, along with a probiotic, three metabolism supplements, and two vitamin packs each day. Pre-post measurements included body composition—determined (via DXA), fasting levels of lipids and glucose in heparinized whole blood, weight, waist circumference, hip circumference, heart rate, and blood pressure. Subjective mood and hunger were also assessed. Results: The dietary program was well-tolerated, and the intervention resulted in a mean weight loss of approximately 4.5 pounds. Clinically relevant reductions were noted in systolic and diastolic blood pressure, cholesterol (total and LDL), and glucose. In addition, there were favorable changes in self-esteem, energy, motivation, and physical appearance. Conclusion: A one-week period of adherence to the Active Nutrition Jumpstart program positively impacted subjective feelings, while resulting in significant weight loss and other health benefits that may have clinical relevance. Longer-term interventions are needed to sustain these initial results.展开更多
Introduction: Obesity is a preventable health condition, yet it remains a complex relapsing global health conundrum, triggering an array of comorbidities, including diabetes, dyslipidemia, hypertension, and mental hea...Introduction: Obesity is a preventable health condition, yet it remains a complex relapsing global health conundrum, triggering an array of comorbidities, including diabetes, dyslipidemia, hypertension, and mental health decline. This review intends to highlight the success of semaglutide for its therapeutic intervention for weight loss management in diabetics and non-diabetics and HbA1c reduction in type 2 diabetics. Methods: We searched and systematically reviewed the literature from within the past ten years on semaglutide utilization for weight loss and HbA1c reduction. Databases investigated included PMC, JAMA, Nature Medicine, and The Lancet, resulting in four original research articles that were systematically reviewed. Web consultations with WHO, CDC, and Healthy People 2030 were conducted to ascertain epidemiological obesity and diabetes data. AAFP and USPSTF references were included for obesity management and preventive care guidelines. Results: Based on results from systematically reviewing four original research studies, semaglutide can effectively reduce elevated weight and HbA1c, using the once-weekly subcutaneous injection formulation. A composite average percent weight loss of 8.27% (16 - 20 pounds) and an average HbA1c percent reduction rate of 1.07% (3 - 4 points) were attained. There were no major adverse events reported from any of the four original research studies related to the drug. Discussion: With evidence from several studies after its FDA approval, semaglutide delivers a promise for weight loss management and HbA1c reduction for appropriate patient populations. Clinician and patient education on its proper use should be continuously revisited.展开更多
Aim: Excessive increase of weight followed by massive weight loss distorts the shape of the umbilicus as part of the affected skin of the abdomen. There is usually discrepancy between the elongated umbilicus at the ti...Aim: Excessive increase of weight followed by massive weight loss distorts the shape of the umbilicus as part of the affected skin of the abdomen. There is usually discrepancy between the elongated umbilicus at the time the patient was gaining excessive weight and the thinned abdominal wall after the massive weight loss. This study discusses a procedure that aims at restoring the shape of the umbilicus to its original shape as much as possible. Patients and Methods: In 4 years retrospective study from the 1st of March 2016 till the end of February 2020, the files of the patients who underwent abdominoplasty after massive weight loss with umbilicoplasty performed, as part of the procedure, were reviewed. In these patients the caudal part of the umbilicus at 6 o’clock site was excised in an oblique direction with slanting cut going to both 3 and 9 o’clock directions to shorten the elongated umbilicus keeping the cephalic part at 12 o’clock intact. This residual elongated cephalic part was utilized to make the shape of the hood of the umbilicus. A bolster suture was used at 12 o’clock to add a small depression above the hood. This technique gave the umbilicus the vertical “T” triangular shape with hooding. A questionnaire to assess patients’ satisfaction regarding the shape, depth, location, size, scarring and overall result of the umbilicoplasty procedure was conducted. The questionnaire used a five-point Likert-type scale as follows: 1 (poor), 2 (fair), 3 (good), 4 (very good), and 5 (excellent). Results were collected and evaluated. Results: 197 patients underwent full abdominoplasty surgery during this 4 years study. Those who underwent umbilicoplasty during the abdominoplasty procedure were 34 patients. The results of the questionnaire could be obtained from 23 patients of them. Each patient gave a number from 1 - 5 for each aspect of the questionnaire of the umbilicus shape, depth, location, size, scarring and overall result. This resulted in total number of points of 115 for each aspect (23 patients × 5 points). The patients’ satisfaction with the shape of the umbilicus was 78.3% (90 out of the 115 points), 80.9% satisfaction rate with the depth (93 out of 115), 98.3% with the location (113 out of 115), 89.6% with the size (103 out of 115), 82.6% with the scar (95 out of 115) and 86.1% as an overall result (99 out of 115). Conclusion: Shortening of the elongated umbilicus at its caudal part with slanting incision directing to its cephalic part gives it the preferred vertical triangular “T” shape. Utilizing the length of the cephalic part in making the hood of the umbilicus and using a bolster suture to make a depression above the hood adds a shape near to the original natural one. The patients’ satisfaction ranged from “very good” to “excellent” according to the five-point Likert-type scale.展开更多
Background:Cachexia is a metabolic state with weight and muscle mass loss as its basic characteristics.This study aims to reveal the influ-ence of weight loss on the progression of cancer cachexia,and to determine its...Background:Cachexia is a metabolic state with weight and muscle mass loss as its basic characteristics.This study aims to reveal the influ-ence of weight loss on the progression of cancer cachexia,and to determine its impact on the patient prognosis.Methods:A total of 2990 cancer patients were enrolled in this retrospective study.Demographic information,clinical materials,and follow-up data were collected for all patients.A receiver operating characteristic curve was used to determine threshold values for weight loss within the past six months(WL).Kaplan-Meier curves and Cox proportional hazard regression models were adopted for survival analyses.Results:After excluding ineligible patients,2480 patients were included in the analysis,705(28.4%)of whom were considered to be ca-chexic.A WL of 10%was determined to be the optimal threshold for diagnosing malnutrition according to the Patient-Generated Subjective Global Assessment.Notably,WL>10%was a predictor of survival outcomes only in the general population(HR=1.218,95%Cl=1.002-1.481,P=0.048),but not in the cachexic population,based on the multivariable Cox regression model.A larger proportion of cachexic pa-tients with WL>10%had a nutritional risk screening 2002 score≥3(25.7%vs 13.7%,P<0.001)and a modified Glasgow Prognosis Score=2(12.8%vs 7.8%,P=0.032).No significant difference was observed in the degree of decreased muscle strength or quality of life(P>0.05).Conclusions:Weight loss is a predictor of impaired survival in the general population,but not in the cachexic population.The present study shows that cachexic patients with severe weight loss had a higher risk of malnutrition,a worse systemic inflammation status,and more severe malnutrition,but that the weight loss itself was not associated with the prognosis of these patients or the progression of their cachexia.展开更多
BACKGROUND The high incidence and mortality of gastric cancer(GC)pose a significant threat to human life and health,and it has become an important public health challenge in China.Body weight loss is a common complica...BACKGROUND The high incidence and mortality of gastric cancer(GC)pose a significant threat to human life and health,and it has become an important public health challenge in China.Body weight loss is a common complication after surgical treatment in patients with GC and is associated with poor prognosis and GC recurrence.However,current attention to postoperative weight change in GC patients remains insufficient,and the descriptions of postoperative weight change and its influencing factors are also different.AIM To investigate body weight changes in patients with GC within 6 mo after gastrectomy and identify factors that influence dynamic body weight changes.METHODS We conducted a prospective longitudinal study of 121 patients with GC and collected data before(T0)and 1(T1),3(T2),and 6(T3)mo after gastrectomy using a general data questionnaire,psychological distress thermometer,and body weight measurements.The general estimation equation(GEE)was used to analyze the dynamic trends of body weight changes and factors that influence body weight changes in patients with GC within 6 mo of gastrectomy.RESULTS The median weight loss at T1,T2,and T3 was 7.29%(2.84%,9.40%),11.11%(7.64%,14.91%),and 14.75%(8.80%,19.84%),respectively.The GEE results showed that preoperative body mass index(BMI),significant psychological distress,religious beliefs,and sex were risk factors for weight loss in patients with GC within 6 mo after gastrectomy(P<0.05).Compared with preoperative low-weight patients,preoperative obese patients were more likely to have weight loss(β=14.685,P<0.001).Furthermore,patients with significant psychological distress were more likely to lose weight than those without(β=2.490,P<0.001),and religious patients were less likely to lose weight 6 mo after gastrectomy than those without religious beliefs(β=-6.844,P=0.001).Compared to female patients,male patients were more likely to experience weight loss 6 mo after gastrectomy(β=4.262,P=0.038).CONCLUSION Male patients with GC with high preoperative BMI,significant psychological distress,and no religious beliefs are more likely to lose weight after gastrectomy.展开更多
The multiple patterns of internal solitary wave interactions(ISWI)are a complex oceanic phenomenon.Satellite remote sensing techniques indirectly detect these ISWI,but do not provide information on their detailed stru...The multiple patterns of internal solitary wave interactions(ISWI)are a complex oceanic phenomenon.Satellite remote sensing techniques indirectly detect these ISWI,but do not provide information on their detailed structure and dynamics.Recently,the authors considered a three-layer fluid with shear flow and developed a(2+1)Kadomtsev-Petviashvili(KP)model that is capable of describing five types of oceanic ISWI,including O-type,P-type,TO-type,TP-type,and Y-shaped.Deep learning models,particularly physics-informed neural networks(PINN),are widely used in the field of fluids and internal solitary waves.However,the authors find that the amplitude of internal solitary waves is much smaller than the wavelength and the ISWI occur at relatively large spatial scales,and these characteristics lead to an imbalance in the loss function of the PINN model.To solve this problem,the authors introduce two weighted loss function methods,the fixed weighing and the adaptive weighting methods,to improve the PINN model.This successfully simulated the detailed structure and dynamics of ISWI,with simulation results corresponding to the satellite images.In particular,the adaptive weighting method can automatically update the weights of different terms in the loss function and outperforms the fixed weighting method in terms of generalization ability.展开更多
AIM: To explore the effects and mechanism of action of antidepressant mirtazapine in functional dyspepsia(FD) patients with weight loss.METHODS: Sixty depressive FD patients with weight loss were randomly divided into...AIM: To explore the effects and mechanism of action of antidepressant mirtazapine in functional dyspepsia(FD) patients with weight loss.METHODS: Sixty depressive FD patients with weight loss were randomly divided into a mirtazapine group(MG), a paroxetine group(PG) or a conventional therapy group(CG) for an 8-wk clinical trial. Adverse effects and treatment response were recorded. The Nepean Dyspepsia Index-symptom(NDSI) checklist and the 17-item Hamilton Rating Scale of Depression(HAMD-17) were used to evaluate dyspepsia and depressive symptoms, respectively. The body composition analyzer was used to measure body weight and fat. Serum hormone levels were measured by ELISA.RESULTS:(1) After 2 wk of treatment, NDSI scores were significantly lower for the MG than for the PG and CG;(2) After 4 or 8 wk of treatment, HAMD-17 scores were significantly lower for the MG and PG than for the CG;(3) After 8 wk of treatment, patients in the MG experienced a weight gain of 3.58 ± 1.57 kg, which was significantly higher than that observed for patients in the PG and CG. Body fat increased by 2.77 ± 0.14kg, the body fat ratio rose by 4%, and the visceral fat area increased by 7.56 ± 2.25 cm2; and(4) For the MG, serum hormone levels of ghrelin, neuropeptide Y(NPY), motilin(MTL) and gastrin(GAS) were significantly upregulated; in contrast, those of leptin, 5-hydroxytryptamine(5-HT) and cholecystokinin(CCK) were significantly downregulated. CONCLUSION: Mirtazapine not only alleviates symptoms associated with dyspepsia and depression linked to FD in patients with weight loss but also significantly increases body weight(mainly the visceral fat in body fat). The likely mechanism of mirtazapine action is regulation of brain-gut or gastrointestinal hormone levels.展开更多
Dietary supplements represent an increasingly common source of drug-induced liver injury. Hydroxycut is a popular weight loss supplement which has previously been linked to hepatotoxicity, although the individual chem...Dietary supplements represent an increasingly common source of drug-induced liver injury. Hydroxycut is a popular weight loss supplement which has previously been linked to hepatotoxicity, although the individual chemical components underlying liver injury remain poorly understood. We report two cases of acute hepatitis in the setting of Hydroxycut exposure and describe possible mechanisms of liver injury. We also comprehensively review and summarize the existing literature on commonly used weight loss supplements, and their individual components which have demon-strated potential for liver toxicity. An increased effort to screen for and educate patients and physicians about supplement-associated hepatotoxicity is warranted.展开更多
A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and wei...A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, spaceoccupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo Over Stitch, Trans Oral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoB arrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons(Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and Sati Sphere. The Aspire Assist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo Over Stitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery.展开更多
The purpose of the study was to test the therapeutic effects of novel vaccines for reducing weight gain and increasing weight loss in diet induced obesity (DIO) model. Male C57BL/6 J mice, fed a 60% Kcal fat diet fo...The purpose of the study was to test the therapeutic effects of novel vaccines for reducing weight gain and increasing weight loss in diet induced obesity (DIO) model. Male C57BL/6 J mice, fed a 60% Kcal fat diet for 8 weeks prior to the start of the study, were vaccinated via the intraperitoneal route with two formulations (JH17 & JH]8) of chimeric-somatostatin vaccines at 1 and 22 days of the study. Control mice were injected with PBS. All mice continued to be feed the 60% Kcal fat diet for the week and food intake was measured weekly. At week 6 6 week study. Body weights were measured two times a mice were euthanized and a terminal bleed was made and antibody levels to somatostatin and levels of insulin-like growth factor 1 (IGF-1) were determined. Vaccination with both vaccine formulations induced a statistically significant body weight change over the study period, as compared with PBS controls. Percentage of baseline body weight was also significantly affected by vaccination during the study period. Vaccinates finished the study at 104% and 107% of baseline weight, JHI7 & JH18 respectively, while untreated controls reached 115% of baseline weight. Food intake per mouse was similar in all mouse groups during the entire study. Control mice did not demonstrate any antibody titers to somatostatin, while all vaccinated mice had measurable antibody responses (〉 1:500,000 titer). IGF-1 levels were not statistically significant among the groups, but were elevated in the JH18 vaccinates (mean 440.4 ng/mL) when compared with PBS controls (mean 365.6 ng/mL). Vaccination with either JH17 or JH18 chimeric -somatostatin vaccines produced a statistically significant weight loss as compared with PBS controls (P 〈 0.0001), even though the DIO mice with continually fed a 60% Kcal fat diet. The weight loss/lower weight gain observations were even more significant, as all mice consumed similar amounts of food for the entire study. The presence of high levels of anti-somatostatin antibodies at 6 weeks was correlative with the weight observations and confirmed the success of vaccination.展开更多
Objective The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss(DBCWL).Methods A total of 680 primary and middle ...Objective The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss(DBCWL).Methods A total of 680 primary and middle school students were included in this study. Their body height, weight, and waistline were effectively measured, and they were also evaluated to assess their body dissatisfaction, perception of dietary behaviors, and DBCWL. The correlation among these factors was analyzed using mediating effect models.Results The prevalence of overweight/obesity and abdominal obesity was significantly higher in males than in females(P < 0.05). Overweight/obesity, abdominal obesity, and body dissatisfaction significantly increased the risk for DBCWL(OR = 2.57, 2.77, and 1.95, respectively). Overweight/obesity and abdominal obesity significantly increased the risk for body dissatisfaction(OR = 6.00 and 4.70,respectively). Significant mediating effects of body dissatisfaction were observed in correlation between overweight/obesity and DBCWL and between abdominal obesity and DBCWL(OR = 2.20 and 1.92,respectively;P < 0.05), and the proportions of mediating effects among the total effects were 48.89% and 46.60%, respectively.Conclusion Body dissatisfaction might play an important mediating effect in association between DBCWL and obesity, which indicates that guiding children to correctly recognize their body might be more conducive than promoting obese children toward weight loss through dietary behavior changes.展开更多
The fertility of sows mainly depends on the embryo losses during gestation and the survival rate of the postfarrowing piglets.The selection of highly-prolific sows has been mainly focused on the selection of genotypes...The fertility of sows mainly depends on the embryo losses during gestation and the survival rate of the postfarrowing piglets.The selection of highly-prolific sows has been mainly focused on the selection of genotypes with high ovulatory quota.However,in the early-and post-implantation stages,the rate of embryo losses was increased with the increase of zygotes.Among the various factors,placental growth and development is the vital determinant for fetal survival,growth,and development.Despite the potential survival of fetuses with deficient placental development,their life-conditions and growth can be damaged by a process termed intrauterine growth retardation(IUGR).The newborn piglets affected by IUGR are prone to increased morbidity and mortality rates;meanwhile,the growth,health and welfare of the surviving piglets will remain hampered by these conditions,with a tendency to exacerbate with age.Functional amino acids such as glycine,proline,and arginine continue to increase with the development of placenta,which are not only essential to placental growth(including vascular growth)and development,but can also be used as substrates for the production of glutathione,polyamines and nitric oxide to benefit placental function in many ways.However,the exact regulation mechanism of these amino acids in placental function has not yet been clarified.In this review,we provide evidence from literature and our own work for the role and mechanism of dietary functional amino acids during pregnancy in regulating the placental functional response to fetal loss and birth weight of piglets.This review will provide novel insights into the response of nutritionally nonessential amino acids(glycine and proline)to placental development as well as feasible strategies to enhance the fertility of sows.展开更多
The worldwide epidemic of obesity and its medical complications are being dealt with a combination of life style changes(e.g.,healthier diet and exercise),medications and a variety of surgical interventions.The Roux-e...The worldwide epidemic of obesity and its medical complications are being dealt with a combination of life style changes(e.g.,healthier diet and exercise),medications and a variety of surgical interventions.The Roux-en Y gastric bypass(RYGB) and laparoscopic adjustable gastric banding(LAGB) are two of the most common weight loss surgeries for morbid obesityassociated metabolic syndrome and insulin resistance.A vast majority of patients that undergo RYGB and LAGB are known to experience marked weight loss and attenuation of diabetes.A number of recent studies have indicated that the rates of remission in glycemic control and insulin sensitivity are significantly greater in patients that have undergone RYGB.A plausible hypothesis to explain this observation is that the gastric bypass surgery as opposed to the gastric banding procedure impinges on glucose homeostasis by a weight loss-independent mechanism.In a recent paper,Bradley et al have experimentally explored this hypothesis.The authors compared several clinical and laboratory parameters of insulin sensitivity and β-cell function in cohorts of RYGB and LAGB patients before and after they lost approximately 20% of their body mass.Afterweight loss,both groups of patients underwent similar changes in their intra-abdominal and total adipose tissue volume,hepatic triglyceride and circulating leptin levels.The RYGB patients who lost 20% body mass,manifested higher postprandial output of glucose,insulin and glucagon-like peptide-1;these laboratory parameters remained unchanged in LABG patients.Irrespective of the observed differences in transient responses of RYGB and LAGB patients to mixed meal,the overall glycemic control as judged by glucose tolerance,multi-organ insulin sensitivity and β-cell function were nearly identical in the two groups.Both RYGB and LAGB patient cohorts also experienced similar changes in the expression of a number of pro-and anti-inflammatory markers.Based on these analyses,Bradley et al concluded that similar restoration of insulin sensitivity and b-cell function in non-diabetic obese patients that have undergone RYGB and LAGB were directly due to marked weight loss.These data have important implications for the risk/benefit analysis of weight loss therapy by bariatric procedures.展开更多
文摘The deep learning model is overfitted and the accuracy of the test set is reduced when the deep learning model is trained in the network intrusion detection parameters, due to the traditional loss function convergence problem. Firstly, we utilize a network model architecture combining Gelu activation function and deep neural network;Secondly, the cross-entropy loss function is improved to a weighted cross entropy loss function, and at last it is applied to intrusion detection to improve the accuracy of intrusion detection. In order to compare the effect of the experiment, the KDDcup99 data set, which is commonly used in intrusion detection, is selected as the experimental data and use accuracy, precision, recall and F1-score as evaluation parameters. The experimental results show that the model using the weighted cross-entropy loss function combined with the Gelu activation function under the deep neural network architecture improves the evaluation parameters by about 2% compared with the ordinary cross-entropy loss function model. Experiments prove that the weighted cross-entropy loss function can enhance the model’s ability to discriminate samples.
基金Jilin Science and Technology Development Plan Project(No.20200403075SF)Doctoral Research Start-Up Fund of Northeast Electric Power University(No.BSJXM-2018202).
文摘The current existing problem of deep learning framework for the detection and segmentation of electrical equipment is dominantly related to low precision.Because of the reliable,safe and easy-to-operate technology provided by deep learning-based video surveillance for unmanned inspection of electrical equipment,this paper uses the bottleneck attention module(BAM)attention mechanism to improve the Solov2 model and proposes a new electrical equipment segmentation mode.Firstly,the BAM attention mechanism is integrated into the feature extraction network to adaptively learn the correlation between feature channels,thereby improving the expression ability of the feature map;secondly,the weighted sum of CrossEntropy Loss and Dice loss is designed as the mask loss to improve the segmentation accuracy and robustness of the model;finally,the non-maximal suppression(NMS)algorithm to better handle the overlap problem in instance segmentation.Experimental results show that the proposed method achieves an average segmentation accuracy of mAP of 80.4% on three types of electrical equipment datasets,including transformers,insulators and voltage transformers,which improve the detection accuracy by more than 5.7% compared with the original Solov2 model.The segmentation model proposed can provide a focusing technical means for the intelligent management of power systems.
文摘BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.
文摘BACKGROUND Over one-third of Americans carry the diagnosis of obesity,many also with obesity-related comorbidities.This can place patients at increased risk of operative and postoperative complications.The intragastric balloon has been shown to aid in minor weight loss,however its weight recidivism in patients requiring short interval weight loss has not been well studied.AIM To evaluate weight loss,ability to undergo successful elective surgery after intragastric balloon placement,and weight management after balloon removal.METHODS This study is a retrospective review of patients in a single academic institution undergoing intragastric balloon placement from 2019-2023 to aid in weight loss prior to undergoing elective surgery.Clinical outcomes including weight loss,duration of balloon placement,successful elective surgery,weight regain postballoon and post-procedure complications were assessed.Exclusion criteria included those with balloon in place at time of study.RESULTS Thirty-three patients completed intragastric balloon therapy from 2019-2023 as a bridge to elective surgery.All patients were required to participate in a 12-month weight management program to be eligible for balloon therapy.Elective surgeries included incisional hernia repair,umbilical hernia repair,inguinal hernia repair,and knee and hip replacements.The average age at placement was 53 years±11 years,majority(91%)were male.The average duration of intragastric balloon therapy was 186 days±41 days.The average weight loss was 14.0 kg±7.4 kg and with an average percent excess body weight loss of 30.0%(7.9%-73.6%).Over half of the patients(52.0%)achieved the goal of 30-50 lbs(14-22 kg)weight loss.Twenty-one patients(64%)underwent their intended elective surgery,2 patients(6%)deferred surgery due to symptom relief with weight loss alone.Twenty-one of the patients(64%)have documented weights in 3 months after balloon removal,in these patients the majority(76%)gained weight after balloon removed.In patients with weight regain at 3 months,they averaged 5.8 kg after balloon removal in the first 3 months,this averaged 58.4%weight regain of the initial weight lost.CONCLUSION Intragastric balloon placement is an option for short-term weight management,as a bridge to elective surgery in patients with body mass index(BMI)>35.Patients lost an average of 14 kg with the balloon,allowing two-thirds of patients to undergo elective surgery at a healthy BMI.However,most patients regained an average of 58%of the original weight lost after balloon removal.The intragastric balloon successfully serves as a tool for rapid weight loss,though patients must be educated on the risks including weight regain.
文摘Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World Health Organization (WHO) has estimated that, at the end of 2022, 1 out of every 8 individuals were obese, and that the global adult obesity rates have over doubled since 1990, even as the adolescent obesity rates have quadrupled. Thus, as of 2022, nearly 2.5 billion adults, aged 18 years and above, were overweight, with 890 million being obese. Obesity and overweight incidence rate has been gradually increasing over the years, presenting significant challenges to the healthcare systems throughout the globe. In this regard, the objective of this systematic review was to evaluate the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. Methodology: To attain the above stated study objective, a systematic evaluation of previous studies was carried out, particularly studies that assessed the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. The authors have used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the selection of eligible studies for inclusion in the study. Results: The findings indicate that lifestyle interventions resulted in 5% - 10% weight reduction and significant improvements in metabolic indicators, while pharmacotherapy (GLP-1 receptor agonists) achieved up to 15% weight reduction and considerable metabolic health benefits. Further, comparative studies show lifestyle modifications provide overall health benefits, while medication is necessary for non-responders. Conclusion: Individualized treatment strategies are crucial, and further research is needed on long-term consequences and combination therapies.
文摘Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases of patients with schizophrenia who experienced substantial weight loss while on long-term clozapine therapy. The first case involves a 35-year-old male who lost 21.3% of his initial body weight, and the second case describes a 54-year-old female who lost 30.2% of her initial weight, despite having comorbid hypothyroidism. Both patients showed improvement in psychiatric symptoms concurrent with the weight loss. Comprehensive investigations did not reveal other clear etiologies for the weight reduction. These cases challenge the conventional understanding of clozapine’s metabolic effects and highlight the potential for atypical responses in some individuals. The report discusses possible mechanisms for this unusual phenomenon, including genetic factors and altered pharmacokinetics. It also emphasizes the need for individualized monitoring and management strategies in clozapine therapy. These findings contribute to the growing body of evidence suggesting that metabolic responses to clozapine may be more complex and varied than previously thought, underscoring the importance of personalized approaches in schizophrenia treatment.
文摘There is rapidly increasing uptake of GLP-1 (glucagon-like peptide-1) agonistssuch as semaglutide worldwide for weight loss and management of non-alcoholicsteatohepatitis (NASH). remains a paucity of safety data in the vulnerable NASHcirrhotic population. We report herein the first documented case of liver decompensationand need for liver transplant waitlisting in a patient with NASHcirrhosistreated with semaglutide. Rapid weight loss led to the development ofascites and hepatic encephalopathy and an increase in the patients Model forEndstage Liver Disease-Na (MELD-Na) score from 11 to 22. Aggressive nutritionalsupplementation was commenced and the semaglutide was stopped. Overthe following months she regained her weight and her liver recompensated andher MELD-Na decreased to 13, allowing her to be delisted from the transplantwaitlist. This case serves as a cautionary tale to clinicians using semaglutide in thecirrhotic population and highlights the need for more safety data in this patientgroup.
文摘Background: The prevalence of individuals who are obese or overweight is an increasing global epidemic that is associated with a multitude of adverse health conditions. Multiple strategies are available to promote weight loss in these populations, including the use of caloric restriction and/or liquid diets. We determined the impact of a low-calorie, nutrient-dense, primarily liquid diet on body weight and associated measures of metabolic health in overweight and obese men and women. Methods: Twenty-six men and women (age: 42.6 ± 10.8) completed a seven-day intervention using the USANA Active Nutrition Jumpstart program, which consisted of consuming three meal replacement shakes and three to four servings of fruits and vegetables, along with a probiotic, three metabolism supplements, and two vitamin packs each day. Pre-post measurements included body composition—determined (via DXA), fasting levels of lipids and glucose in heparinized whole blood, weight, waist circumference, hip circumference, heart rate, and blood pressure. Subjective mood and hunger were also assessed. Results: The dietary program was well-tolerated, and the intervention resulted in a mean weight loss of approximately 4.5 pounds. Clinically relevant reductions were noted in systolic and diastolic blood pressure, cholesterol (total and LDL), and glucose. In addition, there were favorable changes in self-esteem, energy, motivation, and physical appearance. Conclusion: A one-week period of adherence to the Active Nutrition Jumpstart program positively impacted subjective feelings, while resulting in significant weight loss and other health benefits that may have clinical relevance. Longer-term interventions are needed to sustain these initial results.
文摘Introduction: Obesity is a preventable health condition, yet it remains a complex relapsing global health conundrum, triggering an array of comorbidities, including diabetes, dyslipidemia, hypertension, and mental health decline. This review intends to highlight the success of semaglutide for its therapeutic intervention for weight loss management in diabetics and non-diabetics and HbA1c reduction in type 2 diabetics. Methods: We searched and systematically reviewed the literature from within the past ten years on semaglutide utilization for weight loss and HbA1c reduction. Databases investigated included PMC, JAMA, Nature Medicine, and The Lancet, resulting in four original research articles that were systematically reviewed. Web consultations with WHO, CDC, and Healthy People 2030 were conducted to ascertain epidemiological obesity and diabetes data. AAFP and USPSTF references were included for obesity management and preventive care guidelines. Results: Based on results from systematically reviewing four original research studies, semaglutide can effectively reduce elevated weight and HbA1c, using the once-weekly subcutaneous injection formulation. A composite average percent weight loss of 8.27% (16 - 20 pounds) and an average HbA1c percent reduction rate of 1.07% (3 - 4 points) were attained. There were no major adverse events reported from any of the four original research studies related to the drug. Discussion: With evidence from several studies after its FDA approval, semaglutide delivers a promise for weight loss management and HbA1c reduction for appropriate patient populations. Clinician and patient education on its proper use should be continuously revisited.
文摘Aim: Excessive increase of weight followed by massive weight loss distorts the shape of the umbilicus as part of the affected skin of the abdomen. There is usually discrepancy between the elongated umbilicus at the time the patient was gaining excessive weight and the thinned abdominal wall after the massive weight loss. This study discusses a procedure that aims at restoring the shape of the umbilicus to its original shape as much as possible. Patients and Methods: In 4 years retrospective study from the 1st of March 2016 till the end of February 2020, the files of the patients who underwent abdominoplasty after massive weight loss with umbilicoplasty performed, as part of the procedure, were reviewed. In these patients the caudal part of the umbilicus at 6 o’clock site was excised in an oblique direction with slanting cut going to both 3 and 9 o’clock directions to shorten the elongated umbilicus keeping the cephalic part at 12 o’clock intact. This residual elongated cephalic part was utilized to make the shape of the hood of the umbilicus. A bolster suture was used at 12 o’clock to add a small depression above the hood. This technique gave the umbilicus the vertical “T” triangular shape with hooding. A questionnaire to assess patients’ satisfaction regarding the shape, depth, location, size, scarring and overall result of the umbilicoplasty procedure was conducted. The questionnaire used a five-point Likert-type scale as follows: 1 (poor), 2 (fair), 3 (good), 4 (very good), and 5 (excellent). Results were collected and evaluated. Results: 197 patients underwent full abdominoplasty surgery during this 4 years study. Those who underwent umbilicoplasty during the abdominoplasty procedure were 34 patients. The results of the questionnaire could be obtained from 23 patients of them. Each patient gave a number from 1 - 5 for each aspect of the questionnaire of the umbilicus shape, depth, location, size, scarring and overall result. This resulted in total number of points of 115 for each aspect (23 patients × 5 points). The patients’ satisfaction with the shape of the umbilicus was 78.3% (90 out of the 115 points), 80.9% satisfaction rate with the depth (93 out of 115), 98.3% with the location (113 out of 115), 89.6% with the size (103 out of 115), 82.6% with the scar (95 out of 115) and 86.1% as an overall result (99 out of 115). Conclusion: Shortening of the elongated umbilicus at its caudal part with slanting incision directing to its cephalic part gives it the preferred vertical triangular “T” shape. Utilizing the length of the cephalic part in making the hood of the umbilicus and using a bolster suture to make a depression above the hood adds a shape near to the original natural one. The patients’ satisfaction ranged from “very good” to “excellent” according to the five-point Likert-type scale.
基金provided by the Doctor of Excellence Program from The First Hospital of Jilin University(No.JDYY-DEP-2022024)
文摘Background:Cachexia is a metabolic state with weight and muscle mass loss as its basic characteristics.This study aims to reveal the influ-ence of weight loss on the progression of cancer cachexia,and to determine its impact on the patient prognosis.Methods:A total of 2990 cancer patients were enrolled in this retrospective study.Demographic information,clinical materials,and follow-up data were collected for all patients.A receiver operating characteristic curve was used to determine threshold values for weight loss within the past six months(WL).Kaplan-Meier curves and Cox proportional hazard regression models were adopted for survival analyses.Results:After excluding ineligible patients,2480 patients were included in the analysis,705(28.4%)of whom were considered to be ca-chexic.A WL of 10%was determined to be the optimal threshold for diagnosing malnutrition according to the Patient-Generated Subjective Global Assessment.Notably,WL>10%was a predictor of survival outcomes only in the general population(HR=1.218,95%Cl=1.002-1.481,P=0.048),but not in the cachexic population,based on the multivariable Cox regression model.A larger proportion of cachexic pa-tients with WL>10%had a nutritional risk screening 2002 score≥3(25.7%vs 13.7%,P<0.001)and a modified Glasgow Prognosis Score=2(12.8%vs 7.8%,P=0.032).No significant difference was observed in the degree of decreased muscle strength or quality of life(P>0.05).Conclusions:Weight loss is a predictor of impaired survival in the general population,but not in the cachexic population.The present study shows that cachexic patients with severe weight loss had a higher risk of malnutrition,a worse systemic inflammation status,and more severe malnutrition,but that the weight loss itself was not associated with the prognosis of these patients or the progression of their cachexia.
文摘BACKGROUND The high incidence and mortality of gastric cancer(GC)pose a significant threat to human life and health,and it has become an important public health challenge in China.Body weight loss is a common complication after surgical treatment in patients with GC and is associated with poor prognosis and GC recurrence.However,current attention to postoperative weight change in GC patients remains insufficient,and the descriptions of postoperative weight change and its influencing factors are also different.AIM To investigate body weight changes in patients with GC within 6 mo after gastrectomy and identify factors that influence dynamic body weight changes.METHODS We conducted a prospective longitudinal study of 121 patients with GC and collected data before(T0)and 1(T1),3(T2),and 6(T3)mo after gastrectomy using a general data questionnaire,psychological distress thermometer,and body weight measurements.The general estimation equation(GEE)was used to analyze the dynamic trends of body weight changes and factors that influence body weight changes in patients with GC within 6 mo of gastrectomy.RESULTS The median weight loss at T1,T2,and T3 was 7.29%(2.84%,9.40%),11.11%(7.64%,14.91%),and 14.75%(8.80%,19.84%),respectively.The GEE results showed that preoperative body mass index(BMI),significant psychological distress,religious beliefs,and sex were risk factors for weight loss in patients with GC within 6 mo after gastrectomy(P<0.05).Compared with preoperative low-weight patients,preoperative obese patients were more likely to have weight loss(β=14.685,P<0.001).Furthermore,patients with significant psychological distress were more likely to lose weight than those without(β=2.490,P<0.001),and religious patients were less likely to lose weight 6 mo after gastrectomy than those without religious beliefs(β=-6.844,P=0.001).Compared to female patients,male patients were more likely to experience weight loss 6 mo after gastrectomy(β=4.262,P=0.038).CONCLUSION Male patients with GC with high preoperative BMI,significant psychological distress,and no religious beliefs are more likely to lose weight after gastrectomy.
基金supported by the National Natural Science Foundation of China under Grant Nos.12275085,12235007,and 12175069Science and Technology Commission of Shanghai Municipality under Grant Nos.21JC1402500 and 22DZ2229014.
文摘The multiple patterns of internal solitary wave interactions(ISWI)are a complex oceanic phenomenon.Satellite remote sensing techniques indirectly detect these ISWI,but do not provide information on their detailed structure and dynamics.Recently,the authors considered a three-layer fluid with shear flow and developed a(2+1)Kadomtsev-Petviashvili(KP)model that is capable of describing five types of oceanic ISWI,including O-type,P-type,TO-type,TP-type,and Y-shaped.Deep learning models,particularly physics-informed neural networks(PINN),are widely used in the field of fluids and internal solitary waves.However,the authors find that the amplitude of internal solitary waves is much smaller than the wavelength and the ISWI occur at relatively large spatial scales,and these characteristics lead to an imbalance in the loss function of the PINN model.To solve this problem,the authors introduce two weighted loss function methods,the fixed weighing and the adaptive weighting methods,to improve the PINN model.This successfully simulated the detailed structure and dynamics of ISWI,with simulation results corresponding to the satellite images.In particular,the adaptive weighting method can automatically update the weights of different terms in the loss function and outperforms the fixed weighting method in terms of generalization ability.
文摘AIM: To explore the effects and mechanism of action of antidepressant mirtazapine in functional dyspepsia(FD) patients with weight loss.METHODS: Sixty depressive FD patients with weight loss were randomly divided into a mirtazapine group(MG), a paroxetine group(PG) or a conventional therapy group(CG) for an 8-wk clinical trial. Adverse effects and treatment response were recorded. The Nepean Dyspepsia Index-symptom(NDSI) checklist and the 17-item Hamilton Rating Scale of Depression(HAMD-17) were used to evaluate dyspepsia and depressive symptoms, respectively. The body composition analyzer was used to measure body weight and fat. Serum hormone levels were measured by ELISA.RESULTS:(1) After 2 wk of treatment, NDSI scores were significantly lower for the MG than for the PG and CG;(2) After 4 or 8 wk of treatment, HAMD-17 scores were significantly lower for the MG and PG than for the CG;(3) After 8 wk of treatment, patients in the MG experienced a weight gain of 3.58 ± 1.57 kg, which was significantly higher than that observed for patients in the PG and CG. Body fat increased by 2.77 ± 0.14kg, the body fat ratio rose by 4%, and the visceral fat area increased by 7.56 ± 2.25 cm2; and(4) For the MG, serum hormone levels of ghrelin, neuropeptide Y(NPY), motilin(MTL) and gastrin(GAS) were significantly upregulated; in contrast, those of leptin, 5-hydroxytryptamine(5-HT) and cholecystokinin(CCK) were significantly downregulated. CONCLUSION: Mirtazapine not only alleviates symptoms associated with dyspepsia and depression linked to FD in patients with weight loss but also significantly increases body weight(mainly the visceral fat in body fat). The likely mechanism of mirtazapine action is regulation of brain-gut or gastrointestinal hormone levels.
文摘Dietary supplements represent an increasingly common source of drug-induced liver injury. Hydroxycut is a popular weight loss supplement which has previously been linked to hepatotoxicity, although the individual chemical components underlying liver injury remain poorly understood. We report two cases of acute hepatitis in the setting of Hydroxycut exposure and describe possible mechanisms of liver injury. We also comprehensively review and summarize the existing literature on commonly used weight loss supplements, and their individual components which have demon-strated potential for liver toxicity. An increased effort to screen for and educate patients and physicians about supplement-associated hepatotoxicity is warranted.
文摘A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, spaceoccupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo Over Stitch, Trans Oral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoB arrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons(Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and Sati Sphere. The Aspire Assist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo Over Stitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery.
文摘The purpose of the study was to test the therapeutic effects of novel vaccines for reducing weight gain and increasing weight loss in diet induced obesity (DIO) model. Male C57BL/6 J mice, fed a 60% Kcal fat diet for 8 weeks prior to the start of the study, were vaccinated via the intraperitoneal route with two formulations (JH17 & JH]8) of chimeric-somatostatin vaccines at 1 and 22 days of the study. Control mice were injected with PBS. All mice continued to be feed the 60% Kcal fat diet for the week and food intake was measured weekly. At week 6 6 week study. Body weights were measured two times a mice were euthanized and a terminal bleed was made and antibody levels to somatostatin and levels of insulin-like growth factor 1 (IGF-1) were determined. Vaccination with both vaccine formulations induced a statistically significant body weight change over the study period, as compared with PBS controls. Percentage of baseline body weight was also significantly affected by vaccination during the study period. Vaccinates finished the study at 104% and 107% of baseline weight, JHI7 & JH18 respectively, while untreated controls reached 115% of baseline weight. Food intake per mouse was similar in all mouse groups during the entire study. Control mice did not demonstrate any antibody titers to somatostatin, while all vaccinated mice had measurable antibody responses (〉 1:500,000 titer). IGF-1 levels were not statistically significant among the groups, but were elevated in the JH18 vaccinates (mean 440.4 ng/mL) when compared with PBS controls (mean 365.6 ng/mL). Vaccination with either JH17 or JH18 chimeric -somatostatin vaccines produced a statistically significant weight loss as compared with PBS controls (P 〈 0.0001), even though the DIO mice with continually fed a 60% Kcal fat diet. The weight loss/lower weight gain observations were even more significant, as all mice consumed similar amounts of food for the entire study. The presence of high levels of anti-somatostatin antibodies at 6 weeks was correlative with the weight observations and confirmed the success of vaccination.
基金supported by the National Natural Science Foundation of China [81502823]Outstanding Young Talent Key program of College and University in Anhui province [gxyq ZD2017063]University Natural Science Foundation of Anhui province [KJ2019A0298]
文摘Objective The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss(DBCWL).Methods A total of 680 primary and middle school students were included in this study. Their body height, weight, and waistline were effectively measured, and they were also evaluated to assess their body dissatisfaction, perception of dietary behaviors, and DBCWL. The correlation among these factors was analyzed using mediating effect models.Results The prevalence of overweight/obesity and abdominal obesity was significantly higher in males than in females(P < 0.05). Overweight/obesity, abdominal obesity, and body dissatisfaction significantly increased the risk for DBCWL(OR = 2.57, 2.77, and 1.95, respectively). Overweight/obesity and abdominal obesity significantly increased the risk for body dissatisfaction(OR = 6.00 and 4.70,respectively). Significant mediating effects of body dissatisfaction were observed in correlation between overweight/obesity and DBCWL and between abdominal obesity and DBCWL(OR = 2.20 and 1.92,respectively;P < 0.05), and the proportions of mediating effects among the total effects were 48.89% and 46.60%, respectively.Conclusion Body dissatisfaction might play an important mediating effect in association between DBCWL and obesity, which indicates that guiding children to correctly recognize their body might be more conducive than promoting obese children toward weight loss through dietary behavior changes.
基金jointly supported by the National Key R&D Program of China (2021YFD1300401)National Natural Science Foundation of China(31902165)Natural Science Foundation of Guangdong Province(2021A1515012116)
文摘The fertility of sows mainly depends on the embryo losses during gestation and the survival rate of the postfarrowing piglets.The selection of highly-prolific sows has been mainly focused on the selection of genotypes with high ovulatory quota.However,in the early-and post-implantation stages,the rate of embryo losses was increased with the increase of zygotes.Among the various factors,placental growth and development is the vital determinant for fetal survival,growth,and development.Despite the potential survival of fetuses with deficient placental development,their life-conditions and growth can be damaged by a process termed intrauterine growth retardation(IUGR).The newborn piglets affected by IUGR are prone to increased morbidity and mortality rates;meanwhile,the growth,health and welfare of the surviving piglets will remain hampered by these conditions,with a tendency to exacerbate with age.Functional amino acids such as glycine,proline,and arginine continue to increase with the development of placenta,which are not only essential to placental growth(including vascular growth)and development,but can also be used as substrates for the production of glutathione,polyamines and nitric oxide to benefit placental function in many ways.However,the exact regulation mechanism of these amino acids in placental function has not yet been clarified.In this review,we provide evidence from literature and our own work for the role and mechanism of dietary functional amino acids during pregnancy in regulating the placental functional response to fetal loss and birth weight of piglets.This review will provide novel insights into the response of nutritionally nonessential amino acids(glycine and proline)to placental development as well as feasible strategies to enhance the fertility of sows.
文摘The worldwide epidemic of obesity and its medical complications are being dealt with a combination of life style changes(e.g.,healthier diet and exercise),medications and a variety of surgical interventions.The Roux-en Y gastric bypass(RYGB) and laparoscopic adjustable gastric banding(LAGB) are two of the most common weight loss surgeries for morbid obesityassociated metabolic syndrome and insulin resistance.A vast majority of patients that undergo RYGB and LAGB are known to experience marked weight loss and attenuation of diabetes.A number of recent studies have indicated that the rates of remission in glycemic control and insulin sensitivity are significantly greater in patients that have undergone RYGB.A plausible hypothesis to explain this observation is that the gastric bypass surgery as opposed to the gastric banding procedure impinges on glucose homeostasis by a weight loss-independent mechanism.In a recent paper,Bradley et al have experimentally explored this hypothesis.The authors compared several clinical and laboratory parameters of insulin sensitivity and β-cell function in cohorts of RYGB and LAGB patients before and after they lost approximately 20% of their body mass.Afterweight loss,both groups of patients underwent similar changes in their intra-abdominal and total adipose tissue volume,hepatic triglyceride and circulating leptin levels.The RYGB patients who lost 20% body mass,manifested higher postprandial output of glucose,insulin and glucagon-like peptide-1;these laboratory parameters remained unchanged in LABG patients.Irrespective of the observed differences in transient responses of RYGB and LAGB patients to mixed meal,the overall glycemic control as judged by glucose tolerance,multi-organ insulin sensitivity and β-cell function were nearly identical in the two groups.Both RYGB and LAGB patient cohorts also experienced similar changes in the expression of a number of pro-and anti-inflammatory markers.Based on these analyses,Bradley et al concluded that similar restoration of insulin sensitivity and b-cell function in non-diabetic obese patients that have undergone RYGB and LAGB were directly due to marked weight loss.These data have important implications for the risk/benefit analysis of weight loss therapy by bariatric procedures.