Feasibility of Bariatric Surgery as a Strategy for Secondary Prevention in Cardiovascular Disease: A Report from the Swedish Obese Subjects Trial

Aims. Evaluation of bariatric surgery as secondary prevention in obese patients with ischemic heart disease (IHD). Methods. Analysis of data from 4047 subjects in the Swedish Obese Subjects (SOSs) study. Thirty-five patients with IHD are treated with bariatric surgery (n = 21) or conventional treatment (n = 14). Mean follow-up is 10.8 years. Results. Bariatric surgery resulted in sustained weight loss during the study period. After 2 years, the surgery group displayed significant reductions in cardiovascular risk factors, relief from cardiorespiratory symptoms, increments in physical activity, and improved quality of life. After 10 years, recovery from hypertension, diabetes, physical inactivity, and depression was still more common in the surgery group. There were no signs of increased cardiovascular morbidity or mortality in the surgery group. Conclusion. Bariatric surgery appears to be a safe and feasible treatment to achieve long-term weight loss and improvement in cardiovascular risk factors, symptoms, and quality of life in obese subjects with IHD

Svensk Dagfjärilsövervakning, årsrapport för 2017

Detta är den åttonde årsrapporten från Svensk Dagfjärilsövervakning, ett nationellt miljö-övervakningsprogram som koordineras av Lunds universitet på uppdrag av Naturvårdsverket sedan 2010. Svensk Dagfjärilsövervakning är ett samarbete mellan Sveriges Entomologiska Förening, Naturvårdsverket, Lunds universitet, Sveriges lantbruksuniversitet och Länsstyrelserna. Verksamheten möjliggörs av frivilliga landet runt som mellan den 1 april och 30 september räknar fjärilar. Räkningen sker med en gemensam, systematisk metodik och fördelas på 3-7 inventeringstillfällen under säsongen. Det finns två olika sätt att övervaka, dels punktlokaler som är områden med 25 m radie som bevakas i 15 min per besök, dels slingor som är 0,5-3 km långa rutter som man inventerar i lugn promenadtakt. Genom att övervakningen upprepas inom säsongen och över flera år är det möjligt att skatta hur fjärilsfaunan förändras i antal och artsammansättning. Det åttonde årets övervakning har resulterat i rapporter från 192 slingor och 286 punktlokaler. Slingorna och punkterna är spridda över hela landet, från Beddingestrand i söder till Vuollerim i norr. Antalet rapportörer under 2017 har varit 283 och Svensk Dagfjärilsövervakning har räknat in 64 322 fjärilar av 93 arter. I medeltal har det setts 10,7 arter per punktlokal och 16,1 arter per slinga. För varje funnen fjärilsart redovisar rapporten 2017 års observationer som ett totalantal, en utbredningskarta och figur över de veckor då arten påträffats. Talrikaste arterna 2017 var i tur och ordning luktgräsfjäril, citronfjäril och slåttergräsfjäril. Trender i antal mellan 2010 och 2017 har skattats med hjälp av analysverktyget TRIM för 86 dagfjärils- och bastardsvärmararter. Av dessa minskade 19 arter jämfört med 2010, 15 arter ökade, 8 arter var stabila, medan övriga arter varierade så pass mycket att trenderna är osäkra. Sammanvägda index, så kallade miljöindikatorer har räknats fram för 1) de tolv arter som ingår i den europeiska miljöindikatorn för gräsmarksfjärilar, 2) de tjugo vanligaste fjärilsarterna, 3) fjärilar i jordbruksmiljöer, samt 4) fjärilar i skogsmarker. Miljöindikatorerna för gräsmarksfjärilar och skogsfjärilar är stabila under perioden 2010-2017. Trenderna för miljöindikatorerna för de 20 vanligaste dagfjärilarna och fjärilar i jordbruksmiljöer är att dessa grupper minskar måttligt men signifikant under perioden

Zastosowanie leku XENical w zapobieganiu cukrzycy u osób z otyłością — badanie XENDOS. Badanie randomizowane z zastosowaniem orlistatu jako dodatkowego, oprócz zmian stylu życia, czynnika zapobiegania cukrzycy typu 2 u pacjentów z otyłością

INTRODUCTION. It is well established that the risk of developing type 2 diabetes is closely linked to the presence and duration of overweight and obesity. A reduction in the incidence of type 2 diabetes with lifestyle changes has previously been demonstrated. We hypothesized that adding a weight-reducing agent to lifestyle changes may lead to an even greater decrease in body weight, and thus the incidence of type 2 diabetes, in obese patients. MATERIAL AND METHODS. In a 4-year, double-blind, prospective study, we randomized 3,305 patients to lifestyle changes plus either orlistat 120 mg or placebo, three times daily. Participants had a BMI &#8805; 30 kg/m2 and normal (79%) or impaired (21%) glucose tolerance (IGT). Primary endpoints were time to onset of type 2 diabetes and change in body weight. Analyses were by intention to treat. RESULTS. Of orlistat-treated patients, 52% completed treatment compared with 34% of placebo recipients (P < 0.0001). After 4 years&#8217; treatment, the cumulative incidence of diabetes was 9.0% with placebo and 6.2% with orlistat, corresponding to a risk reduction of 37.3% (P = 0.0032). Exploratory analyses indicated that the preventive effect was explained by the difference in subjects with IGT. Mean weight loss after 4 years was significantly greater with orlistat (5.8 vs. 3.0 kg with placebo; P < 0.001) and similar between orlistat recipients with impaired (5.7 kg) or normal glucose tolerance (NGT) (5.8 kg) at baseline. A second analysis in which the baseline weights of subjects who dropped out of the study was carried forward also demonstrated greater weight loss in the orlistat group (3.6 vs. 1.4 kg; P < 0.001). CONCLUSIONS. Compared with lifestyle changes alone, orlistat plus lifestyle changes resulted in a greater reduction in the incidence of type 2 diabetes over 4 years and produced greater weight loss in a clinically representative obese population. Difference in diabetes incidence was detectable only in the IGT subgroup; weight loss was similar in subjects with IGT and or NGT.WSTĘP. Ryzyko rozwoju cukrzycy typu 2 wiąże się ściśle z obecnością i czasem trwania nadwagi oraz otyłości. Wpływ wprowadzenia zmian stylu życia na zmniejszenie częstości cukrzycy typu 2 potwierdzono we wcześniejszych badaniach. Wysunięto hipotezę, według której zastosowanie dodatkowego czynnika powodującego zmniejszenie masy ciała u chorych, którym udało się ten cel częściowo osiągnąć pod wpływem zmiany stylu życia, pozwala uzyskać jeszcze lepsze efekty, a w konsekwencji prowadzi do dalszej redukcji częstości cukrzycy typu 2 u pacjentów z otyłością. MATERIAŁ I METODY. Do trwającego 4 lata, prospektywnego, randomizowanego badania, przeprowadzonego metodą podwójnie ślepej próby zakwalifikowano 3305 pacjentów, których losowo podzielono na dwie grupy. W pierwszej grupie, obok wprowadzenia zmian stylu życia, pacjentom podawano 3 razy na dobę orlistat w dawce 120 mg, a w drugiej &#8212; placebo. Wskaźnik masy ciała (BMI, body mass index) uczestników badania był większy lub równy 30 kg/m2, stężenie glukozy było prawidłowe (79%) lub rozpoznawano upośledzoną tolerancję glukozy (IGT, impaired glucose tolerance) (21%). Jako główne kryterium oceny badania przyjęto czas do wystąpienia cukrzycy typu 2 oraz zmianę masy ciała. Przeprowadzono analizę według pierwotnej intencji leczenia (intention to treat). WYNIKI. Leczenie ukończyło 52% badanych otrzymujących orlistat i 34% przyjmujących placebo (p < 0,0001). Po 4 latach terapii skumulowane ryzyko wystąpienia cukrzycy w grupie otrzymującej placebo wyniosło 9%, natomiast w grupie przyjmującej orlistat &#8212; 6,2%, co oznacza redukcję ryzyka o 37,3% (p = 0,0032). Na podstawie analizy uzyskanych danych stwierdzono, że efekt prewencyjny wynikał z różnic wśród pacjentów z upośledzoną tolerancją glukozy. Średnia redukcja masy ciała po 4 latach obserwacji była znacząco wyższa w grupie leczonej orlistatem (5,8 vs. 3,0 kg w grupie otrzymującej placebo; p < 0,001) oraz podobna u pacjentów otrzymujących orlistat z wyjściową upośledzoną (5,7 kg) lub prawidłową tolerancją glukozy (NGT, normal glucose tolerance) (5,8 kg). W drugiej analizie, w której uwzględniono zmiany masy ciała u osób wyłączonych z badania, również wykazano większą redukcję masy ciała w grupie leczonej orlistatem (3,6 vs. 1,4 kg; p < 0,001). WNIOSKI. W badaniu przeprowadzonym w reprezentatywnej populacji osób z otyłością wykazano, że w porównaniu z postępowaniem opartym wyłącznie na zmianie stylu życia, dodanie orlistatu spowodowało większy spadek częstości cukrzycy typu 2 oraz większą redukcję masy ciała w okresie 4 lat. Różnica w częstości cukrzycy była widoczna tylko w podgrupie z IGT, zmniejszenie masy ciała było podobne zarówno w podgrupie z IGT, jak i z NGT

Large out-of-plane spin-orbit torque in topological Weyl semimetal candidate TaIrTe4

Topological quantum materials, with novel spin textures and broken crystal symmetries are suitable candidates for spintronic memory technologies. Their unique electronic properties, such as protected surface states and exotic quasiparticles, can provide an out-of-plane spin polarized current needed for external field free magnetization switching of magnets with perpendicular magnetic anisotropy. Conventional spin-orbit torque materials, such as heavy metals and topological insulators, provide only an in-plane spin polarized current, and recently explored materials with lower crystal symmetries provide very low out-of-plane spin polarized current components, which is not suitable for energy-efficient spin-orbit torque (SOT) applications. Here, we demonstrate a large out-of-plane damping-like SOT at room temperature using a topological Weyl semimetal candidate TaIrTe4 with a lower crystal symmetry. We performed spin-orbit torque ferromagnetic resonance (STFMR) experiments in a TaIrTe4/Ni80Fe20 heterostructure and observed a large out-of-plane damping-like SOT efficiency. The out-of-plane spin Hall conductivity is estimated to be an order of magnitude higher than the reported values in other materials. These findings of high spin Hall conductivity and large out-of-plane SOT efficiency are suitable for the development of energy efficient and external field-free spintronic devices

Strong in-plane magnetic anisotropy (Co0.15Fe0.85)5GeTe2/graphene van der Waals heterostructure spin-valve at room temperature

Van der Waals (vdW) magnets are promising owing to their tunable magnetic properties with doping or alloy composition, where the strength of magnetic interactions, their symmetry, and magnetic anisotropy can be tuned according to the desired application. However, most of the vdW magnet based spintronic devices are so far limited to cryogenic temperatures with magnetic anisotropies favouring out-of-plane or canted orientation of the magnetization. Here, we report room-temperature lateral spin-valve devices with strong in-plane magnetic anisotropy of the vdW ferromagnet (Co0.15Fe0.85)5GeTe2 (CFGT) in heterostructures with graphene. Magnetization measurements reveal above room-temperature ferromagnetism in CFGT with a strong in-plane magnetic anisotropy. Density functional theory calculations show that the magnitude of the anisotropy depends on the Co concentration and is caused by the substitution of Co in the outermost Fe layer. Heterostructures consisting of CFGT nanolayers and graphene were used to experimentally realize basic building blocks for spin valve devices such as efficient spin injection and detection. The spin transport and Hanle spin precession measurements prove a strong in-plane and negative spin polarization at the interface with graphene, which is supported by the calculated spin-polarized density of states of CFGT. The in-plane magnetization of CFGT at room temperature proves its usefulness in graphene lateral spin-valve devices, thus opening further opportunities for spintronic technologies

Associations between macronutrient intake and serum lipid profile depend on body fat in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

The present study aimed to investigate the relationships between macronutrient intake and serum lipid profile in adolescents from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) cross-sectional study (2006–7), and to assess the role of body fat-related variables in these associations. Weight, height, waist circumference, skinfold thicknesses, total choles- terol, HDL-cholesterol (HDL-C), LDL-cholesterol, TAG, apoB and apoA1 were measured in 454 adolescents (44 % boys) aged 12·5–17·5 years. Macronutrient intake (g/4180 kJ per d (1000 kcal per d)) was assessed using two non-consecutive 24 h dietary recalls. Associations were evaluated by multi-level analysis and adjusted for sex, age, maternal education, centre, sum of four skinfolds, moderate-to-vigorous

The complexity of kidney disease and diagnosing it – cystatin C, selective glomerular hypofiltration syndromes and proteome regulation

Estimation of kidney function is often part of daily clinical practice, mostly done by using the endogenous glomerular filtration rate (GFR)-markers creatinine or cystatin C. A recommendation to use both markers in parallel in 2010 has resulted in new knowledge concerning the pathophysiology of kidney disorders by the identification of a new set of kidney disorders, selective glomerular hypofiltration syndromes. These syndromes, connected to strong increases in mortality and morbidity, are characterized by a selective reduction in the glomerular filtration of 5–30 kDa molecules, such as cystatin C, compared to the filtration of small molecules <1 kDa dominating the glomerular filtrate, for example water, urea and creatinine. At least two types of such disorders, shrunken or elongated pore syndrome, are possible according to the pore model for glomerular filtration. Selective glomerular hypofiltration syndromes are prevalent in investigated populations, and patients with these syndromes often display normal measured GFR or creatinine-based GFR-estimates. The syndromes are characterized by proteomic changes promoting the development of atherosclerosis, indicating antibodies and specific receptor-blocking substances as possible new treatment modalities. Presently, the KDIGO guidelines for diagnosing kidney disorders do not recommend cystatin C as a general marker of kidney function and will therefore not allow the identification of a considerable number of patients with selective glomerular hypofiltration syndromes. Furthermore, as cystatin C is uninfluenced by muscle mass, diet or variations in tubular secretion and cystatin C-based GFR-estimation equations do not require controversial race or sex terms, it is obvious that cystatin C should be a part of future KDIGO guidelines.publishedVersio