Effects of Heat Waves During Post-natal Development on Mitochondrial and Whole Body Physiology: An Experimental Study in Zebra Finches

Human-induced climate change is increasing the frequency, duration, and intensity of heat waves and exposure to these extreme temperatures impacts individual physiology and performance (e.g., metabolism, water balance, and growth). These traits may be susceptible to thermal conditions experienced during embryonic development, but experiments focusing on post-natal development are scant. Documented effects of heat waves on whole-body metabolism may reflect changes in mitochondrial function, but most studies do not measure physiological traits at both the cellular and whole organism levels. Here, we exposed nests of zebra finches to experimentally simulated heat waves for 18 days after hatching and measured body mass, growth rate, whole-body metabolic rate, body temperature, wet thermal conductance, evaporative water loss, and relative water economy of chicks at three ages corresponding to ectothermic (day 5), poikilothermic (day 12), and homoeothermic (day 50) stages. Additionally, we measured mitochondrial bioenergetics of blood cells 80 days post-hatch. While early-life exposure to heat wave conditions did not impact whole body metabolic and hygric physiology, body temperature was lower for birds from heated compared with control nests at both 12 and 50 days of age. There was also an effect of nest heating at the cellular level, with mitochondria from heated birds having higher endogenous and proton-leak related respiration, although oxidative phosphorylation, maximum respiratory capacity, and coupling efficiency were not impacted. Our results suggest that early-life exposure to high ambient temperature induces programming effects on cellular-level and thermal physiology that may not be apparent for whole-animal metabolism

Sociocultural Determinants of Teenage Childbearing Among Latinas in California

Objectives U.S. Latinas have a persistently high rate of teenage childbearing, which is associated with adverse outcomes for both mother and child. This study was designed to investigate the roles of socioeconomic factors and acculturation in teenage childbearing in this population. Methods Logistic regression was used to analyze the association of measures of acculturation (language spoken at home, nativity, and age at immigration) and respondents’ parents’ education with age at first birth in a stratified sample of post-partum women in California. Results The unadjusted odds ratio for teenage birth for Latinas versus non-Latina Whites was 5.2 (95% CI 4.1–6.6). Nativity was not significantly associated with teen birth, but speaking Spanish at home was positively associated and immigrating at a later age was negatively associated with teen birth. Overall, these measures of acculturation accounted for 17% (95% CI 8–28%) of the difference in odds of teen birth between Latinas and non-Latina Whites. Higher levels of education among respondents’ parents had differentially protective effects across the racial/ethnic groups. Controlling for disparities in respondents’ parents’ education without changing its differential effects across racial/ethnic groups reduced the odds ratio for Latinas compared to non-Latina Whites by 30% (95% CI 14–60%). Conclusion These findings call into question common assumptions about the protective effect of acculturation on teen fertility and suggest that improving childhood socioeconomic factors among Latinas may decrease teen childbearing

Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

<p>Abstract</p> <p>Background</p> <p>The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation.</p> <p>Methods</p> <p>First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets).</p> <p>Results</p> <p>Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising".</p> <p>Conclusion</p> <p>The ICF Core Sets for the acute hospital and early post-acute rehabilitation facilities are highly relevant for rehabilitation nursing. Linking nursing interventions with ICF Core Set categories is a feasible way to analyse nursing. Using the ICF Core Sets to describe goals of nursing interventions both facilitates inter-professional communication and respects patient's needs. The ICF may thus be a useful framework to set nursing intervention goals.</p

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Computed tomography-3D-volumetry: a valuable adjunctive diagnostic tool after bariatric surgery

Aim: After bariatric surgery, a variety of complaints may arise. Identification of the causes of such symptoms is often challenging due to the postoperatively modified anatomy. While standard examinations with upper endoscopy and upper gastrointestinal series might miss the three-dimensional anatomic nature of the problem, quantitative three-dimensional computed tomography volumetry (3D-CT) of the upper gastrointestinal tract offers a novel, adjunctive examination, revealing the detailed anatomy. The aim of this study was to analyse the clinical value of 3D-CT in post-bariatric patients.Methods: Prospective data of 279 patients, who underwent 3D-CT due to complications after different bariatric procedures, were retrospectively analysed. Directly before examination, the surgical-modified stomach was distended with an effervescent-powder. CT images were 3D-reconstructed and, further, gastric volume was calculated.Results: In total, 279 patients were examined. Time between surgery and examination was significantly different between Roux-en-Y gastric bypass (n = 168) (54.3 ± 38.6 months) and sleeve gastrectomy (n = 78) (27.8 ± 21.7 months) (P = 0.0001). Others, less numerous, but included procedures were one-anastomosis/mini gastric bypass (n = 11), and dated procedures, such as the vertical banded gastrostomy. The examination allowed calculation of the gastric volume, and the 3D-reconstructions depicted accurately the pivotable anatomic details of the modified upper gastrointestinal tract with 360° view. As a robust result, patients with a higher gastric volume showed more weight regain after sleeve gastrectomy.Conclusion: 3D-CT is easy-to-perform and facilitates identification of the post-surgical three-dimensional gastric anatomy. It represents a valuable additional diagnostic tool in post-bariatric patients with post-procedural complications. 3D-CT might be an important preoperative tool prior to revisional surgery. In addition, this is the only exact and reproducible calculation of the gastric volume

Fast-track rescue weight reduction therapy to achieve rapid technical operability for emergency bariatric surgery in patients with life-threatening inoperable severe obesity - A proof of concept study

Background and aims: Severe obesity (BMI >= 60 kg/m(2)) in multimorbid patients can be acutely life-threatening. While emergency weight-loss surgery is urgently needed to preserve life, most patients are in an inoperable state. Pre-surgical bridging therapy is required to achieve technical operability through weight reduction. Standard bridging using an intragastric balloon (IB) can achieve operability in 6 months but is unsuitable for some patients in a critical condition. A non-invasive fast-track rescue therapy to achieve very rapid operability is urgently needed. We investigated whether a rescue weight reduction therapy (RWR) consisting of liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, a leucine-rich amino acid infusion and a hypocaloric diet, can accelerate readiness for emergency surgery in patients with acutely life-threatening severe obesity. Methods: In this proof-of-concept study, prospective data from patients treated with RWR (intervention group 1, n = 26) were mathematically matched with retrospective biometric data of 26 patients with severe obesity (historic control group 2) who underwent standard 6-month bridging with IB. A rating scale was developed to identify patients needing urgent fast-track bridging. Results: Rapid weight loss was observed in all patients on the RWR therapy. All achieved operability after a mean RWR bridging duration of 20.7 +/- 6.9 days. Baseline weight was 236.3 +/- 35.8 kg in group 1 compared with 230.1 +/- 32.7 kg in group 2. Mean body weight loss during RWR was 27.5 +/- 14.1 kg, compared with 20.9 +/- 10.5 kg in group 2 (P = 0.0629). Conclusions: Pre-operative bridging using liraglutide in combination with a leucine-rich amino acid infusion and hypocaloric diet was effective in all cases of acutely life-threatening severe obesity, achieving technical operability within only ca. 2-4 weeks. This therapy has potential as a life-saving rescue therapy for multimorbid patients with severe obesity who were previously untreatable. (C) 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved

Endoscopic Management of Clinically Severe Obesity: Primary and Secondary Therapeutic Procedures

Purpose of Review In the treatment of epidemic obesity and metabolic disorders, conservative approaches often fail to achieve the treatment goal in patients with very high BMI. To date, bariatric surgery accomplishes the most sustainable results in patients with morbid obesity. This leads to a treatment gap for lower and middle classes of obesity defined by BMI. Primary endoscopic procedures, which are less invasive than surgery, may be able to sufficiently fill this gap. Furthermore, secondary endoscopic procedures have developed into an essential addition regarding complication management of bariatric surgeries. The purpose of this review was to point out the latest developments in the field of bariatric endoscopy, including both primary and secondary procedures. Recent Findings Innovative devices and their possible applications will be discussed. These include various endoscopic suturing techniques as well as newly developed implants for the upper gastrointestinal tract to counteract the obesity epidemic. The growing understanding of the pathophysiology of obesity and the role of the gastrointestinal tract allows for the development of more effective endoscopic procedures regarding obesity treatment

Minimally abnormal Pap testing and cervical histology in HIV-infected women

To assess the underlying histology of HIV-infected women with minimally abnormal Pap tests compared to HIV-uninfected women by evaluating their colposcopic and histologic outcomes. Retrospective analysis was performed to identify HIV-infected women who had at least one cervical Pap test from 2002 through 2008 at Boston Medical Center. We identified women who underwent colposcopy within 6 months of a minimally abnormal Pap test (atypical squamous cells of undetermined significance with positive high-risk human papillomavirus testing [ASCUS/HPV+] or low-grade squamous intraepithelial lesion (LSIL)). Our outcome was the proportion of HIV-infected women with histologic cervical intraepithelial neoplasia 2 or worse (CIN2+). We then compared these outcomes to those of a cohort of HIV-uninfected women from the same institution. There were 655 HIV-infected women who had Pap testing in the study time frame, and 146 (22%) had a minimally abnormal Pap test (ASCUS/HPV+ or LSIL). Of the 90 HIV-infected women who had subsequent colposcopy within 6 months, colposcopy was negative for 20 (22%), CIN1 for 41 (46%), and CIN2+ for the remaining 29 (32%). During the same time period, there were 747 HIV-uninfected women who underwent colposcopy within 6 months of a minimally abnormal Pap test. Colposcopy was negative for 336 (45%), CIN1 for 254 (34%), and CIN2+ for 157 (21%). After adjusting for differences in age and race, the HIV-infected women were more likely to have CIN2+ after a minimally abnormal Pap test (p=0.002) (adjusted odds ratio [OR] 2.17, 95% confidence interval [CI] 1.33-3.62). There were no diagnosed cases of cervical cancer. HIV-infected women have higher rates of underlying CIN2+ for minimally abnormal Pap tests compared with HIV-uninfected women

Changes in Plasma Metabolomic Profile Following Bariatric Surgery, Lifestyle Intervention or Diet Restriction—Insights from Human and Rat Studies

Although bariatric surgery is known to change the metabolome, it is unclear if this is specific for the intervention or a consequence of the induced bodyweight loss. As the weight loss after Roux-en-Y Gastric Bypass (RYGB) can hardly be mimicked with an evenly effective diet in humans, translational research efforts might be helpful. A group of 188 plasma metabolites of 46 patients from the randomized controlled Würzburg Adipositas Study (WAS) and from RYGB-treated rats (n = 6) as well as body-weight-matched controls (n = 7) were measured using liquid chromatography tandem mass spectrometry. WAS participants were randomized into intensive lifestyle modification (LS, n = 24) or RYGB (OP, n = 22). In patients in the WAS cohort, only bariatric surgery achieved a sustained weight loss (BMI −34.3% (OP) vs. −1.2% (LS), p ≤ 0.01). An explicit shift in the metabolomic profile was found in 57 metabolites in the human cohort and in 62 metabolites in the rodent model. Significantly higher levels of sphingolipids and lecithins were detected in both surgical groups but not in the conservatively treated human and animal groups. RYGB leads to a characteristic metabolomic profile, which differs distinctly from that following non-surgical intervention. Analysis of the human and rat data revealed that RYGB induces specific changes in the metabolome independent of weight loss