Anti-Obesity Medical Devices

Obesity is a major health problem worldwide responsible for increased morbidity/mortality and high cost for the society. Management of obesity requires multidisciplinary approaches including diet, food supplement, exercise, behavior change, drug, medical device, gut microbiome manipulation, and surgery. Anti-obesity medical devices are an option for subjects who have not responded to more conservative medical treatments but want an alternative to surgery. Compared to bariatric surgery, they have the advantage of being less invasive, easier to perform, and reversible. In the United States of America (USA), based on the expected weight loss, the Center for Devices and Radiological Health (CDRH) of the Food and Drug Administration (FDA) categorizes anti-obesity medical devices as weight-loss devices or weight-management devices. The weight-loss devices include gastric band devices, gastric space-occupying devices, and gastric emptying devices. The weight-management devices include oral removable palatal space-occupying devices and ingested transient gastric space-occupying devices. The effectiveness, safety, and cost of anti-obesity medical devices vary considerably by the type of medical device. Their use should always be combined with lifestyle changes. Considering the large market size of obesity treatment, anti-obesity medical devices can play a major role in the management of obesity

Gut Microbiome in Obesity Management

Obesity is a worldwide pandemic causing increased morbidity/mortality and high cost for the society. Management of obesity requires multidisciplinary approaches including diet, food supplement, exercise, behavior change, drug, medical device, gut microbiome manipulation, and surgery. Over the past two decades, there has been a growing awareness of the importance of gut microbiome in human health and disease. Profound changes affecting the diversity and the abundance of gut microbiome are associated with several disorders including obesity. A decrease in microbiome diversity and an increase in the ratio of Firmicutes-to-Bacteroidetes phyla have been reported in obese subjects. The gut microbiome can be manipulated to change the host metabolism and manage obesity. Potential interventions include diet (e.g., low calories, low fat, and high fiber), prebiotics (e.g., inulin, lactulose, and resistant starch), probiotics (e.g., yogurt, cheese, and milk), synbiotics (combination of prebiotics and probiotics), bariatric surgery (e.g., Roux-en-Y gastric bypass), and fecal microbiota transplantation (through colonoscopy, esophagogastroduodenoscopy, orogastric tube, or oral capsule). A better understanding of the interactions between different diets and gut microbiome should help the development of new guidelines for the prevention and management of obesity

Detecting three-qubit bound MUB diagonal entangled states via Nonlinear optimal entanglement witnesses

One of the important approaches to detect quantum entanglement is using linear entanglement witnesses EWs. In this paper, by determining the envelope of the boundary hyper-planes defined by a family of linear EWs, a set of powerful nonlinear optimal EWs is manipulated. These EWs enable us to detect some three qubits bound MUB (mutually unbiased bases) diagonal entangled states, i.e., the PPT (positive partial transpose) entangled states. Also, in some particular cases, the introduced nonlinear optimal EWs are powerful enough to separate the bound entangled regions from the separable ones. Finally, we present numerical examples to demonstrate the practical accessibility of this approach. Keywords :nonlinear optimal entanglement witnesses, mutually unbiased bases, MUB diagonal statesComment: 34 pages 11 figure

Early life characteristics, social mobility during childhood and risk of stroke in later life: findings from a Swedish cohort.

AIMS: To investigate if early life characteristics and social mobility during childhood are associated with incident thrombotic stroke (TS), haemorrhagic stroke (HS) and other stroke (OS). METHODS: Our study population consists of all live births at Uppsala University Hospital in 1915-1929 (Uppsala Birth Cohort; n = 14,192), of whom 5532 males and 5061 females were singleton births and lived in Sweden in 1964. We followed them from 1 January 1964 until first diagnosis of stroke (in the National Patient Register or Causes of Death Register), emigration, death, or until 31 December 2008. Data were analysed using Cox regression, stratifying by gender. RESULTS: Gestational age was negatively associated with TS and OS in women only. Women had increased risk of TS if they were born early preterm (<35 weeks) (HR 1.54 (95% CI 1.02-2.31)) or preterm (35-36 weeks) (HR 1.37 (95% CI 1.03-1.83)) compared to women born at term. By contrast, only women who were early preterm (HR 1.98 (95% CI 1.27-3.10) had an increased risk of OS. Men who were born post-term (⩾42 weeks) had increased risk of HS (HR 1.45 (95% CI 1.04-2.01)) compared with men born at term, with no association for women. TS was associated with social mobility during childhood in women: women whose families were upwardly or downwardly mobile had increased risk of TS compared to women who were always advantaged during childhood. CONCLUSIONS: Gestational age and social mobility during childhood were associated with increased risk of stroke later in life, particularly among women, but there was some heterogeneity between stroke subtypes

Treatment of Nonalcoholic Fatty Liver Disease through Changes in Gut Microbiome and Intestinal Epithelial Barrier

Nonalcoholic fatty liver disease (NAFLD) is a leading liver disease worldwide with a prevalence of approximately 25% among adult population. The highest prevalence is observed in Middle East and the lowest prevalence in Africa. NAFLD is a spectrum of liver disorders ranging from simple steatosis to nonalcoholic steatohepatitis (NASH). Pro-inflammatory diet, overweight/obesity, inflammation, insulin resistance, prediabetes, type 2 diabetes, dyslipidemia, disrupted gut microbiome, and impaired intestinal barrier function are important risk factors associated with and/or contributing to NAFLD. Gut microbiome is a complex and diverse microbial ecosystem essential for the maintenance of human health. It is influenced by several factors including diet and medications. Gut microbiome can be disrupted in NAFLD. Intestinal epithelial barrier is the largest and most important barrier against the external environment and plays an important role in health and disease. Several factors including diet and gut microbiome impact intestinal barrier function. NAFLD can be associated with impaired intestinal barrier function (increased intestinal permeability). There are no specific drugs that directly treat NAFLD. The first-line therapy of NAFLD is currently lifestyle intervention. Weight loss is an important component in the treatment of NAFLD subjects who have excess body weight. Gut microbiome and intestinal epithelial barrier are becoming promising targets for the treatment of several diseases including NAFLD. In the absence of approved pharmacotherapy for the treatment of NAFLD/NASH, in addition to lifestyle intervention and weight loss (in case of excess body weight), focus should also be on correcting gut microbiome and intestinal permeability (directly and/or through gut microbiome modulation) using diet (e.g., low-fat diet, high-fiber diet, and Mediterranean diet), prebiotics (nondigestible food ingredients), probiotics (nonpathogenic living microorganisms), synbiotics (combination of prebiotics and probiotics), and fecal microbiota transplantation (transfer of healthy stool)

Consequences of COVID-19 Pandemic Including Endocrine and Metabolic Impacts

A pandemic is an epidemic that spreads globally. Coronavirus disease 2019 (COVID-19) caused a major pandemic that affected human health and activities around the world since the beginning of 2020 and became a major international emergency. Through multiple paths, COVID-19 pandemic influenced life at individual, familial, societal, and environmental levels and led to a global economic recession. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the disease. It invades the target cells by binding to angiotensin-converting enzyme 2 (ACE2). Endocrine and metabolic systems can be implicated in COVID-19 infection. Subjects with several comorbidities (e.g., hypertension, diabetes, and obesity) are more likely to be infected and are at a higher risk for complications and death from COVID-19. Wearing mask, social distancing, home confinement, and isolation have been recommended and implemented in several countries to curb the spread of the outbreak. Vaccination remains the best protective measure. Different vaccines are now available and have been used. The worldwide impact of COVID-19 pandemic may last several years

Impact of Climate Change on Life

Climate is changing in an accelerating pace. Climate change occurs as a result of an imbalance between incoming and outgoing radiation in the atmosphere. The global mean temperatures may increase up to 5.4°C by 2100. Climate change is mainly caused by humans, especially through increased greenhouse gas emissions. Climate change is recognized as a serious threat to ecosystem, biodiversity, and health. It is associated with alterations in the physical environment of the planet Earth. Climate change affects life around the globe. It impacts plants and animals, with consequences for the survival of the species. In humans, climate change has multiple deleterious consequences. Climate change creates water and food insecurity, increased morbidity/mortality, and population movement. Vulnerable populations (e.g., children, elderly, indigenous, and poor) are disproportionately affected. Personalized adaptation to the consequences of climate change and preventive measures are key challenges for the society. Policymakers must implement the appropriate strategies, especially in the vulnerable populations

The Centenarians: An Emerging Population

Long life is a topic of great interest in medicine and among the general public. The “successful aging” which is a high priority for individuals and societies, is aging without any disabilities and severe diseases. In several countries, the increase in life expectancy has led the very old to become the fastest growing segment of the population. Centenarians are subjects living 100 years or older. The majority of centenarians are females (female to male ratio around 3.6/1). A very small fraction of centenarians (up to 0.5%) will live 110 years or older (supercentenarians). Most centenarians have managed to avoid, postpone, or overcome the important age-related and life-threatening diseases and disabilities (e.g., ischemic heart disease, stroke, chronic obstructive pulmonary disease, cancer, respiratory infection, type 2 diabetes, osteoporosis, and dementia). Some forecasts suggest that most babies born in developed countries since 2000 will become centenarians. In 2020, the number of centenarians in the world was approximately 573,000, mainly from the United States of America (USA). This number could reach approximately 3,676,000 by 2050. In the absence of the genetic predisposition to become centenarian, there are several ways to extend longevity (e.g., lifestyle, reduction of several life-threatening diseases and disabilities, hormonal replacement or blockade, antioxidants, maintenance of a proper autophagic activity, stem cell therapy, and gene therapy). The continuous increase of the number of centenarians has worldwide practical implications including profound impact on intergenerational interactions and significant financial challenges for any society, especially in relation to medical expenses