Adolescent Bariatric Surgery Programs: Progress in Pennsylvania

Objective: In 2019 the American Academy of Pediatrics (AAP) called for increased access to Metabolic and Bariatric Surgery (MBS). To understand adolescent weight loss programs offering MBS in Pennsylvania, a survey was completed. Methods: Adolescent weight loss centers in Pennsylvania offering MBS were identified using the American Society for Metabolic and Bariatric Surgery (ASMBS) on-line directory and Google search. Phone interviews were conducted with the director of each program. Results: Eight programs were identified. Operations were performed in seven adult hospitals. Six had Comprehensive Adolescent Accreditation through the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). A total of 92 adolescents were operated on in the year from June 2021 to July 2022 which is an 84% increase from the preceding year. Ninety patients received a sleeve gastrectomy. Adult bariatric surgeons were involved in all operations. Six of the programs were led by diplomates of the American Board of Obesity Medicine. Each clinic had a psychologist. No program had all eight of the health care professionals recommended by the authors, but two programs had seven of the eight. In addition, three included a social worker, two an exercise physiologist and two had pediatric subspecialists incorporated into the clinic. Two programs had the operating surgeon caring for patients in the multidisciplinary clinic. Conclusion: This survey of programs across Pennsylvania shows an increase in the number of bariatric operations. More progress is necessary to improve access to this service and improve the quality of programs in Pennsylvania. Keywords: Metabolic, Obesity, Weight Los

Calcium mobilization via intracellular ion channels, store organization and mitochondria in smooth muscle

In smooth muscle, Ca2+ release from the internal store into the cytoplasm occurs via inositol trisphosphate (IP3R) and ryanodine receptors (RyR). The internal Ca2+ stores containing IP3R and RyR may be arranged as multiple separate compartments with various IP3R and RyR arrangements, or there may be a single structure containing both receptors. The existence of multiple stores is proposed to explain several physiological responses which include the progression of Ca2+ waves, graded Ca2+ release from the store and various local responses and sensitivities. We suggest that, rather than multiple stores, a single luminally-continuous store exists in which Ca2+ is in free diffusional equilibrium throughout. Regulation of Ca2+ release via IP3R and RyR by the local Ca2+ concentration within the stores explains the apparent existence of multiple stores and physiological processes such as graded Ca2+ release and Ca2+ waves. Close positioning of IP3R on the store with mitochondria or with receptors on the plasma membrane creates ‘IP3 junctions’ to generate local responses on the luminally-continuous store

Influence of the irradiation temperature on the surface structure and physical/chemical properties of Ar ion-irradiated bulk metallic glasses

Surface treatments using multiple Ar ion irradiation processes with a maximum energy and fluence of 200 keV and 1 × 1016 ions/cm 2, respectively, have been performed on two different metallic glasses: Zr55Cu28Al10Ni7 and Ti 40Zr10Cu38Pd12. Analogous irradiation procedures have been carried out at room temperature (RT) and at T = 620 K (0.9 Tg, where Tg denotes the glass transition). The structure, mechanical behavior, wettability and corrosion resistance of the irradiated alloys have been compared with the properties of the as-cast and annealed (T = 620 K) non-irradiated specimens. While ion irradiation at RT does not significantly alter the amorphous structure of the alloys, ion irradiation close to Tg promotes decomposition/nanocrystallization. Consequently, the hardness (H) and reduced Young's modulus (Er) decrease after irradiation at RT but they both increase after irradiation at 620 K. While annealing close to Tg increases the hydrophobicity of the samples, irradiation induces virtually no changes in the contact angle when comparing with the as-cast state. Concerning the corrosion resistance, although not much effect is found after irradiation at RT, an improvement is observed after irradiation at 620 K, particularly for the Ti-based alloy. These results are of practical interest in order to engineer appropriate surface treatments based on ion irradiation, aimed at specific functional applications of bulk metallic glasses. © 2014 Elsevier B.V. All rights reserved.status: publishe