CONTEXT Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, ...long-term outcomes are uncertain. OBJECTIVE To examine the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks 6 years after surgery. DESIGN, SETTING, AND PARTICIPANTS A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index BMI ≥ 35) participants aged 18 to 72 years (82% women; mean BMI, 45.9; 95% CI, 31.2-60.6) who sought and received RYGB surgery (n = 418), sought but did not have surgery (n = 417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n = 321; control group 2). MAIN OUTCOME MEASURES Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment. RESULTS Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%-28.9%) of their initial body weight compared with 0.2% (95% CI, −1.1% to 1.4%) gain in control group 1 and 0% (95% CI, −1.2% to 1.2%) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%-96%) and 76% (95% CI, 72%-81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%-75%) in the RYGB surgery group, 8% (95% CI, 0%-16%) in control group 1, and 6% (95% CI, 0%-13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7-57.6; P < .001) vs control group 1 and 21.5 (95% CI, 5.4-85.6; P < .001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%-4%; vs 17%; 95% CI, 10%-24%; OR, 0.11; 95% CI, 0.04-0.34 compared with control group 1 and 15%; 95% CI, 9%-21%; OR, 0.21; 95% CI, 0.06-0.67 compared with control group 2; both P < .001). The numbers of participants with bariatric surgery–related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for the RYGB surgery group and 2 control groups, respectively. CONCLUSION Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years.
While telomere repeat-containing non-coding RNA has been identified in a variety of eukaryotes, its biological role is not yet clear. We have identified telomeric transcripts in fission yeast, a ...model system that combines precise genetic manipulability with telomeres remarkably similar to those of human. Like human and budding yeast, fission yeast harbours a population of telomeric RNA molecules containing G-rich telomeric repeats transcribed from the subtelomere to the telomere. In addition, we detect substantial levels of C-rich telomeric RNA whose appearance is independent of the RNA-dependent RNA polymerase, suggesting that the telomere repeats themselves serve as promoter sites; multiple distinct subtelomeric RNAs are also present. The regulation of these transcripts depends on the telomere-associated proteins Taz1 and Rap1, as deletion of taz1(+) or rap1(+) leads to increased levels of both telomere repeat-containing and subtelomeric transcripts. In contrast, loss of the heterochromatin proteins Swi6 or Clr4 or the telomerase regulator Rif1 results in elevated subtelomeric RNA levels while telomere-repeat containing transcript levels remain repressed. Coupled with the large body of knowledge surrounding the functions of telomeric and heterochromatin factors in fission yeast, these in vivo analyses suggest testable models for the roles of TERRA in telomere function.
Only 25% of US adults achieve adequate physical activity (PA). Obtaining a PA history is an appropriate first step when evaluating this behavior. The Physical Activity Vital Sign (PAVS) is a clinical ...tool designed to screen for PA in adults.
To determine how responses to the PAVS questions associate with BMI, overweight, and obesity, we performed a cross-sectional study utilizing the PAVS, and measured height and weight. Data were collected from adults at 2 clinics within the Utah Health Research Network.
Adjusting for demographic factors, BMI decreased 0.91 units for every reported day of PA during a typical week (P < .001), and the odds of obesity was significantly decreased by 0.73 for every day of PA reported in a typical week, (P = .001).
Response to the PAVS question of typical behavior is highly correlated with BMI. Although response to the PAVS question of behavior last week is not correlated, this question may prompt accurate recall to the typical week question and help guide patient counseling. Our results support the construct validity for the use of the PAVS as a clinical screening tool and suggest the need for additional research to characterize the properties of the PAVS.
Cellular growth control is important for all living organisms, but experimental investigation into this problem is difficult because of the complex range of growth regulatory mechanisms. Here, we ...have used the fission yeast
to identify potential master regulators of growth. At the restrictive temperature, the
strain enters the meiotic developmental program, but arrests in meiotic G2 phase as
is essential for meiotic progression. These cells do not grow, even in an abundance of nutrients. To identify regulators of growth that can reverse this growth arrest, we introduced an ORFeome plasmid library into the
strain. Overexpression of eight genes promoted cell growth; two of these were core RNA polymerase subunits, and one was
, an S6 kinase thought to contribute to TORC1 signalling. Sck2 had the greatest effect on cell growth, and we also show that it significantly increases the cellular transcription rate. These findings indicate, for the first time, that global transcriptional control mediated through S6 kinase signalling is central to cellular growth control.
In human cells and yeast, an intact “hydrophobic patch” substrate docking site is needed for mitotic cyclin centrosomal localization. A hydrophobic patch mutant (HPM) of the fission yeast mitotic ...cyclin Cdc13 cannot enter mitosis, but whether this is due to defective centrosomal localization or defective cyclin-substrate docking more widely is unknown. Here, we show that artificially restoring Cdc13-HPM centrosomal localization promotes mitotic entry and increases CDK (cyclin-dependent kinase) substrate phosphorylation at the centrosome and in the cytoplasm. We also show that the S-phase B-cyclin hydrophobic patch is required for centrosomal localization but not for S phase. We propose that the hydrophobic patch is essential for mitosis due to its requirement for the local concentration of cyclin-CDK with CDK substrates and regulators at the centrosome. Our findings emphasize the central importance of the centrosome as a hub coordinating cell-cycle control and explain why the cyclin hydrophobic patch is essential for mitosis.
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•Cyclin B centrosomal localization is needed for mitotic entry in fission yeast•Centrosomal cyclin-CDK promotes substrate phosphorylation at the centrosome and cytoplasm•The same substrate docking region targets both S- and M-phase B-cyclin to the centrosome•S-phase cyclin localization to the centrosome is not necessary for DNA replication
Roberts et al. find that yeast cyclin B-CDK centrosomal localization is essential for mitotic entry and promotes phosphorylation of centrosomal and cytoplasmic CDK substrates. The same hydrophobic patch substrate docking region mediates the localization of both S- and M-phase B-cyclin to the centrosome and is not required for S phase.
Objective A multidisciplinary collaboration between the neurosurgical team and the pharmacy was established to conduct a pilot study in which discharged neurosurgical patients from a community ...hospital would receive medication reconciliation services and counseling by a pharmacy specialist to determine the impact on patient safety, readmission rates, and medication compliance. Methods Pharmacists reviewed discharge medication reconciliations of neurosurgical patients to address any discrepancies with the nurse practitioners or physicians prior to discharge and provided discharge medication counseling to the patient/families at the bedside. The service was provided on weekdays during the eight-hour pharmacist shift in addition to other daily responsibilities. Data were analyzed by type and the total number of pharmacy interventions encountered during the discharge medication reconciliation process, time to complete services, and readmission rates. Lastly, the discharged neurosurgical patients that were not seen by pharmacists during the one-month pilot study were reviewed retrospectively to determine potential interventions. Results A total of 48 neurosurgical patients were discharged during the one-month pilot study; 27 patients received discharge medication reconciliation services and counseling from the pharmacy specialists. Sixty-three pharmacy interventions were accepted with prevention of medication errors/adverse drug reactions (21%, n=21) and addition of missing medication (21%, n=21) being the most common intervention types. The mean time to complete the services was 27 minutes and there was one non-medication-related readmission of the 27 patients seen. Twenty-one neurosurgical patients who were discharged without receiving services were reviewed retrospectively. It was determined that there was a potential for another 64 pharmacy interventions in which clarification of indication (33%, n=21) was the most common intervention type, followed by prevention of medication errors/adverse drug reactions (25%, n=16) and addition of missing medication (22%, n=14). There was a total of one medication-related readmission of the 21 patients not seen by the pharmacist during the pilot study. Conclusion The collaboration of pharmacists in the discharge process benefits neurosurgical patients by reducing the number of discrepancies when transitioning home and provides an additional layer of safety to reduce medication errors and/or prevent adverse events.
Stages of Weight Change Among an Occupational Cohort Ott, Ulrike; Stanford, Joseph B.; Greenwood, Jessica L.J. ...
Journal of occupational and environmental medicine,
03/2015, Letnik:
57, Številka:
3
Journal Article
Recenzirano
OBJECTIVE:To assess the readiness to change dietary intake and body weight among production workers. We also ascertained differences between self-perceived and measured body mass index.
METHODS:This ...cross-sectional study queried physical activity, psychosocial factors, fruit and vegetable intake, and readiness to change based on the transtheoretical model.
RESULTS:Sixty-three (28%) workers were overweight, and 114 (50%) were obese. Obese workers were in the following stages of weight changeprecontemplation (4%), contemplation (45%), preparation (13%), action (21%), and (17%) maintenance. Ten percent of overweight workers erroneously reported their body mass index to be normal.
CONCLUSIONS:About half of overweight/obese workers were in the precontemplation or contemplation stages for healthy dietary changes or weight loss. Recognizing the stages of change with regard to weight and the self-perception of weight status may help tailor workplace health promotion programs.
Abstract
Despite the prime importance of telomeres in chromosome stability, significant mysteries surround the architecture of telomeric chromatin. Through micrococcal nuclease mapping, we show that ...fission yeast chromosome ends are assembled into distinct protected structures ('telosomes') encompassing the telomeric DNA repeats and over half a kilobase of subtelomeric DNA. Telosome formation depends on the conserved telomeric proteins Taz1 and Rap1, and surprisingly, RNA. Although yeast telomeres have long been thought to be free of histones, we show that this is not the case; telomere repeats contain histones. While telomeric histone H3 bears the heterochromatic lys9-methyl mark, we show that this mark is dispensable for telosome formation. Therefore, telomeric chromatin is organized at an architectural level, in which telomere-binding proteins and RNAs impose a unique nucleosome arrangement, and a second level, in which histone modifications are superimposed upon the higher order architecture.
•Opicapone is a 3rd generation catechol-O-methyl transferase (COMT) inhibitor approved in April 2020 by the FDA.•Opicapone is used once daily as adjunctive to levodopa/carbidopa to reduce “off” ...periods in patients with Parkinson’s disease.•In clinical trials BIPARK I and II, 50 mg of opicapone once daily was shown to be noninferior to entacapone and reduced the mean off time by about 50 min when compared to placebo.•Most common treatment-emergent adverse events for opicapone were dyskinesia, falls, insomnia, and elevated blood creatine phosphokinase levels; it has not been associated with severe hepatic impairment.
Objective: To provide a drug review of the newly FDA approved catechol-O-methyl transferase (COMT) inhibitor, opicapone, for the use of end-of-motor motor fluctuation in adults with Parkinson’s disease. Data sources: A literature search of Pubmed was performed till May 2020 using the following key terms: opicapone, Ongentys, and BIA 9-1067. Review articles, clinical trials, and drug monographs were reviewed. Study selection and data extraction: Relevant English-language monographs and studies conducted in humans were considered. Data synthesis: Opicapone was FDA approved for the treatment of end-of-motor motor fluctuation in adults with Parkinson’s disease in April 2020 based on two published randomized clinical trials that were 14 to 15 weeks in duration called BIPARK I and BIPARK II. Based on the clinical trials, 50 mg of opicapone once daily was shown to be noninferior to entacapone and reduced the mean off time by about 50 min when compared to placebo. Most common treatment-emergent adverse events were dyskinesia, falls, insomnia, and elevated blood creatine phosphokinase levels. Relevance to patient care and clinical practice: Opicapone overcomes the limitations associated with other COMT inhibitors since it is dosed once daily, well tolerated, and has not been associated with the risk of hepatic failure. When switching from entacapone to opicapone a reduction in “off” time of −39.3 min was also seen. Conclusions: Opicapone is a once daily 3rd generation COMT inhibitor that has the potential to benefit patients with Parkinson’s disease who are experiencing end-of-motor fluctuations.
Two Industrial Cohorts Ott, Ulrike; Stanford, Joseph B.; Thiese, Matthew S. ...
Journal of occupational and environmental medicine
57, Številka:
5
Journal Article
Recenzirano
OBJECTIVE:To describe demographic and health characteristics, and factors associated with obesity among production workers.
METHODS:This cross-sectional study analyzed baseline data from two ...occupational cohorts. Regression modeling was used to assess associations between worker characteristics and obesity.
RESULTS:A total of 1974 subjects were included in these analyses. The mean body mass index was 29.5 kg/m (SD = 6.5). Having smoked in the past and currently smoking decreased the odds of being obese in the WISTAH Distal Upper Extremity cohort, whereas those feeling depressed had increased odds of being obese. Being a Pacific Islander/Native Hawaiian and married increased the odds of obesity in the BackWorks Low Back Pain cohort.
CONCLUSIONS:Factors associated with obesity differed substantially between the two cohorts. Recognizing factors associated with obesity in specific work settings may provide opportunities for optimizing preventive workplace interventions.
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