Beta Cell Function as a Baseline Predictor of Weight Loss After Bariatric Surgery

Background: Obesity is a multifactorial disease, which is strongly associated to other metabolic disorders. Bariatric surgery is the most effective treatment of morbid obesity. The role of beta cell function in weight loss after bariatric surgery is uncertain. Aim: To evaluate the association between beta cell function and percentage of total body weight loss (TBWL%) 1, 2, 3, and 4 years after bariatric surgery in patients with morbid obesity. Methods: Retrospective longitudinal study in patients with morbid obesity followed in our center between January 2010 and July 2018. Patients were excluded if they had diabetes at baseline or missing data on the needed parameters. We evaluated baseline Homeostatic Model Assessment of IR, Homeostatic Model Assessment of ß-cell function (HOMA-beta), Quantitative Insulin Sensitivity Check Index, and Matsuda and DeFronzo index, and TBWL% at years 1 to 4. Linear regression models were used to evaluate the association of indexes of insulin resistance with TBWL% (unadjusted and adjusted for age, sex, BMI, and type of surgery). Results: There were 1,561 patients included in this analysis. HOMA-beta was negatively associated with TBWL% at second, third, and fourth years post-surgery (ß = -1.04 [-1.82 to -0.26], p<0.01; ß = -1.16 [-2.13 to -0.19], p=0.02; ß = -1.29 [-2.64 to 0.06], p=0.061, respectively). This was not observed in the first year post-surgery nor for the other indexes. Glycemia at baseline was positively associated to EWL% at second and third years post-surgery. Conclusion: ß-cell function at baseline seems to be associated to long-term weight loss, explicitly after the first year post bariatric surgery. This might be a helpful predictor of weight loss in clinical practice.The authors would like to thank all the CRIO group members for following these patients: John Rodrigues Preto; Eduardo Jorge Lima da Costa; Hugo Miguel Santos Sousa; André Manuel Costa Pinho; Carla Cristina Oliveira Rodrigues Teixeira Galego; Maria Flora Ferreira Sampaio Carvalho Correia; Cidália Fátima Castro Carção Gil; Diva Bizarro Figueiredo Melim; Eduardo Gil Ferreira Rodrigues Pinto; Marco António Costa Silva; Cristina Sarmento Pontes Martins; Luis Miguel Gonçalves Pereira; Inês Vasconcelos Sousa Magalhães; Isabel Maria Boavista Vieira Marques Brandão; Sertório Manuel Freitas Andrade, and Patrícia Maria Lopes Nunes. The authors would also like to thank the patients and the hospital for their support. The authors would like to thank to Associação dos Amigos do Serviço de Endocrinologia do Hospital de S. João

Soil vs. glass: an integrated approach towards the characterization of soil as a burial environment for the glassware of Cucagna Castle (Friuli, Italy)

This research is performed on a selection of archaeological glass finds with corresponding soil samples, excavated on the site of the High Medieval castle Cucagna in Friuli/Northern Italy. In the frame of understanding medieval glass technology and the chemical-physical conditions that influenced the state of preservation of the glass finds, this study uses a multi-analytical line-up of methods to characterize the composition of the glass and basic parameters of the soil including texture, mineralogical composition, pH, redox potential (Eh) and electric conductivity (EC). The results show that glass corrosion in soil not only depends on acidity, alkalinity or glass composition but also on the texture of the soil, measurable as grain-size distribution, and the mineralogical composition. The compositional groups of the glassware from Cucagna indicate the use of various raw material sources, pointing to Northern and Central Italian glass workshops with primary or secondary glass production.[GRAPHICS].FdA – Publicaties zonder aanstelling Universiteit Leide

Isotopic investigations of Chinese ceramics

This chapter provides insights into Chinese ceramic technologies of both bodies and glazes as well as provenance by using isotopes applied to a number of case studies. The use of Sr isotopes to investigate Chinese high-fired Celadon wares and blue-and-white Jingdezhen porcelain (Jiangxi province) has revealed a clear distinction associated with the fluxes used in the glazes: plant ash in celadons and limestone in Jingdezhen glazes, something that is not clear from major element analysis. Furthermore, the technique is able to suggest by implication the nature of the silica source used in the glazes—normally weathered granitic rocks or metamorphic rocks (porcelain stone) which also contains Sr. This leads to an isotopic mixing line of the 2 Sr-rich components and is proof that 2 Sr-rich components were mixed in the manufacture of limestone glaze. This is not the case for plant ash glazes. Eventually, the technique may be used in provenance studies. Like Sr isotope analysis, lead isotope analysis relies on there being a lack of or a minimal change in the isotope ratios when the raw materials are heated. Lead isotope analysis links the use of lead in glazes to the original metal ore and if a kiln uses a distinctive lead source in its glazes, it can provide a provenance for the pottery. This has been very successful in distinguishing Chinese Tang sancai wares made in the Huangye, Huangbao, Liquanfang and Qionglai kilns

Pathogenesis of Sudden Unexpected Death in a Clinical Trial of Patients With Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both

Background-The frequency of sudden unexpected death is highest in the early post-myocardial infarction (MI) period; nevertheless, 2 recent trials showed no improvement in mortality with early placement of an implantable cardioverter-defibrillator after MI. Methods and Results-To better understand the pathophysiological events that lead to sudden death after MI, we assessed autopsy records in a series of cases classified as sudden death events in patients from the VALsartan In Acute myocardial infarctioN Trial (VALIANT). Autopsy records were available in 398 cases (14% of deaths). We determined that 105 patients had clinical circumstances consistent with sudden death. On the basis of the autopsy findings, we assessed the probable cause of sudden death and evaluated how these causes varied with time after MI. Of 105 deaths considered sudden on clinical grounds, autopsy suggested the following causes: 3 index MIs in the first 7 days (2.9%); 28 recurrent MIs (26.6%); 13 cardiac ruptures (12.4%); 4 pump failures (3.8%); 2 other cardiovascular causes (stroke or pulmonary embolism; 1.9%); and 1 noncardiovascular cause (1%). Fifty-four cases (51.4%) had no acute specific autopsy evidence other than the index MI and were thus presumed arrhythmic. The percentage of sudden death due to recurrent MI or rupture was highest in the first month after the index MI. By contrast, after 3 months, the percentage of presumed arrhythmic death was higher than recurrent MI or rupture (chi(2)=23.3, P&lt;0.0001). Conclusions-Recurrent MI or cardiac rupture accounts for a high proportion of sudden death in the early period after acute MI, whereas arrhythmic death may be more likely subsequently. These findings may help explain the lack of benefit of early implantable cardioverter-defibrillator therap