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Αλέξανδρος Γ. Σφακιανάκης

Thursday, November 12, 2020

The Influence of Weight-Related Self-Esteem and Symptoms of Depression on Shape and Weight Concerns and Weight-Loss 12 Months After Bariatric Surgery

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Abstract

Introduction

While body image can improve following bariatric surgery, a portion of patients continue to experience concerns about weight and shape regardless of weight lost. Research is needed to identify risk factors for post-surgical weight and shape concerns given that body dissatisfaction may contribute to poor outcomes.

Aims

To evaluate whether (1) change in weight-related self-esteem and symptoms of depression from pre- to 12-month post-surgery were associated with change in weight and shape concerns independent of weight-loss; (2) improvement in weight and shape concerns, symptoms of depression, and/or weight-related self-esteem predict greater weight-loss 12 months after bariatric surgery; and (3) improvements in weight-related self-esteem, symptoms of depression, weight concerns, or shape concerns predict weight loss.

Methods

Fifty adults approved to receive bariatric surgery self-reported body mass index and completed validated measures of weight-related self-esteem, symptoms of depression, and weight and shape concerns pre- and 12-month post-surgery.

Results

Improvements were observed for weight-related self-esteem, concerns over shape and weight, symptoms of depression, and body mass index from pre- to 12-month post-surgery. Improvement in weight-related self-esteem was associated with concomitant improvements in concerns over shape and weight, independent of weight loss. Improvement in symptoms of depression was associated with improvement in concerns over weight, but not shape. Finally, exploratory analyses indicated that improvements in weight-related self-esteem, and concerns over shape and weight, but not symptoms of depression were associated with improvement in weight-loss.

Conclusions

Weight-related self-esteem may represent an overlooked and important target throughout the bariatric surgery process that could enhance surgical outcomes.

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A human secretome library screen reveals a role for Peptidoglycan Recognition Protein 1 in Lyme borreliosis

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by Akash Gupta, Gunjan Arora, Connor E. Rosen, Zachary Kloos, Yongguo Cao, Jiri Cerny, Andaleeb Sajid, Dieuwertje Hoornstra, Maryna Golovchenko, Natalie Rudenko, Ulrike Munderloh, Joppe W. Hovius, Carmen J. Booth, Christine Jacobs-Wagner, Noah W. Palm, Aaron M. Ring, Erol Fikrig

Lyme disease, the most common vector-borne illness in North America, is caused by the spirochete Borrelia burgdorferi. Infection begins in the skin following a tick bite and can spread to the hearts, joints, nervous system, and other organs. Diverse host responses influence the level of B. burgdorferi infection in mice and humans. Using a systems biology approach, we examined potential molecular interactions between human extracellular and secreted proteins and B. burgdorferi. A yeast display library expressing 1031 human extracellular proteins was probed against 36 isolates of B. burgdorferi sensu lato. We found that human Peptidoglycan Recognition Protein 1 (PGLYRP1) interacted with the vast majority of B. burgdorferi isolates. In subsequent experiments, we demonstrated that recombinant PGLYRP1 interacts with purified B. burgdorferi peptidoglycan and exhibits borreliacidal activity, suggesting that vertebr ate hosts may use PGLYRP1 to identify B. burgdorferi. We examined B. burgdorferi infection in mice lacking PGLYRP1 and observed an increased spirochete burden in the heart and joints, along with splenomegaly. Mice lacking PGLYRP1 also showed signs of immune dysregulation, including lower serum IgG levels and higher levels of IFNγ, CXCL9, and CXCL10.Taken together, our findings suggest that PGLYRP1 plays a role in the host's response to B. burgdorferi and further demonstrate the utility of expansive yeast display screening in capturing biologically relevant interactions between spirochetes and their hosts.
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Combinatorial therapeutic trial plans for COVID-19 treatment armed up with antiviral, antiparasitic, cell-entry inhibitor, and immune-boosters

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Abstract

SARS-CoV-2, or novel coronavirus, is causing the fatal and contagious coronavirus disease-2019 (COVID-19) affecting thousands of people every single day. Researchers are continuously searching for any possible cure and/or vaccine, but no conclusive report is available till date. Like many others, we realize that a rapid, immediate, and elaborate strategy must be adopted to protect mankind. To avoid the time-loss due to clinical trials, we have performed in silico analyses on some FDA-approved drugs to combat COVID-19. We accessed information from public databases and publications, and studied the mechanism of infection of SARS-CoV-2 and the interactions of various drugs with SARS-CoV-2 proteins in silico. We found a few antivirals and antiparasitic drugs to show significant interactions with important SARS-CoV-2 proteins. Particularly Galidesivir, Remdesivir, and Pirodavir have been chosen as suggested antiviral drugs; and Proguanil, Mefloquine, and Artesunate ha ve been chosen as suggested antiparasitic drugs based on such predicted interactions. In addition, inhibitors to prevent host-cell entry and a few supportive immune-boosters can be used in different combinations. Our study proposes a four-way attack to this fatal virus for the possible management of COVID-19 armed up with an antiviral, an antiparasitic drug, a cell-entry inhibitor, and a few supportive immune-boosters, which can be used in different combinations in different groups of people.

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Elastomeric Respirator Mask Senses Fit and Filter Saturation

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Via Medgadget

Researchers at Brigham and Women's Hospital and Massachusetts Institute of Technology have designed a new respirator, conceived as an improvement on standard N95 masks. The transparent respirator contains sensors that allow users to know if the mask is fitting snugly and alerts them when the filters need to be replaced. The mask, called the transparent, elastomeric, adaptable, long-lasting (TEAL) respirator, can be sterilized repeatedly, helping to reduce waste and avoid respirator shortages.

"During the COVID-19 pandemic, the need for respirators and masks has been urgent. Our team has worked to develop a respirator platform that not only fits comfortably and snugly but can also be sterilized and re-sterilized," said Giovanni Traverso, a researcher involved in the study. "In this study, we looked at up to 100 re-sterilization cycles and found that the TEAL respirator we've designed can withstand that."

So far, the researchers have tested a variety of sterilization procedures with the respirator, including bleaching, UV sterilization, autoclaving, microwaving, and exposure to isopropyl alcohol. The mask maintained its elasticity and effectiveness with each sterilization procedure, suggesting that it is suitable for use in a wide variety of healthcare settings.


The device incorporates sensors to help users wear it correctly and ensure that it is functioning as intended. These include a thermochromic coating that changes color when it contacts the skin, helping users to ensure that it is providing a snug fit against the face. Other sensors can detect when the filters are saturated, and a variety of other parameters including exhalation/inhalation pressures, respiratory rate, and exhalation temperature can be measured.

The transparent mask may also help with communication, which can be difficult with conventional masks. "One of the big benefits of the TEAL respirator is that it enables visualization of the lips," said James Byrne, another researcher involved in the study. "This can be immensely helpful in communication and expression, especially during this time when communication through N95 respirators and surgical masks makes it challenging to understand one another."

In a trial of the respirator with a group of volunteers, the majority preferred the respirator compared with conventional respirators, and were able to wear the respirator correctly and easily change the filters. "We were excited to receive the feedback from the trial participants that they would love to continue using and testing the respirator, given its comfort, transparency and ease of use," said Byrne.

Study in ACS Pharmacology and Translational Science: Prospective Evaluation of the Transparent, Elastomeric, Adaptable, Long-Lasting (TEAL) Respirator

Via: Brigham and Women's Hospital

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Health news sharing is reflected in distributed reward-related brain activity

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Abstract
Neuroimaging has identified individ ual brain regions, but not yet whole-brain patterns, that correlate with the population impact of health messaging. We used neuroimaging to measure whole-brain responses to health news articles across two studies. Beyond activity in core reward value-related regions (ventral striatum, ventromedial prefrontal cortex), our approach leveraged whole-brain responses to each article, quantifying expression of a distributed pattern meta-analytically associated with reward valuation. The results indicated that expression of this whole-brain pattern was associated with population-level sharing of these articles beyond previously identified brain regions and self-report variables. Further, the efficacy of the meta-analytic pattern was not reducible to patterns within core reward value-related regions but rather depended on larger-scale patterns. Overall, this work shows that a reward-related pattern of whole-brain activity is related to health information sharing, advancing neuroscience model s of the mechanisms underlying the spread of health information through a population.
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Evaluating association of vaccine response to low serum zinc and vitamin D levels in children of a birth cohort study in Dhaka.

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Via Vaccine

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CONCLUSION: In the MAL-ED birth cohort, where children were followed for five years, serum zinc level had a positive impact on tetanus vaccine titers. PMID: 33121844 [PubMed - as supplied by publisher] (Source: Vaccine)
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Pneumococcal conjugate vaccine primes mucosal immune responses to pneumococcal polysaccharide vaccine booster in Papua New Guinean children.

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Via Vaccine

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CONCLUSIONS: PCV may protect high-risk children against pneumococcal colonization and mucosal disease by inducing mucosal antibody responses and priming for mucosal immune memory that results in mucosal immune responses after booster PPV. Saliva can be a convenient alternative sample to serum to study PCV-induced systemic IgG responses. PMID: 33121845 [PubMed - as supplied by publisher] (Source: Vaccine)
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Acute Hiatal Hernia with Incarcerated Proximal Half of Recent Sleeve Gastrectomy: Super Rare Complication

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Abstract

Background

Vertical sleeve gastrectomy (VSG) has become the most commonly performed operation for the treatment of morbid obesity (JAMA. 312(9):959–61, 2014). Nevertheless, VSG is still associated with some early postoperative complications (JAMA. 312(9):959–61, 2014; Surg Obes Relat Dis. 9(5):816–29, 2013; Obes Surg. 27(8):1944–1951, 2017). Hiatal hernia is a complication that has been widely described in the literature, but not in the immediate postoperative course (Obes Surg. 17(7):962–9, 2007). We, herein, report a case of an acute postoperative hiatal hernia after sleeve gastrectomy.

Methods

A 29-year-old female (BMI 38.54 kg/m2) presented to our center and her options for metabolic surgery were discussed. Laparoscopic sleeve gastrectomy (LSG) was the chosen procedure. Preoperative assessment includes a chest x-ray, and standard lab-work up was within a normal limit. Barium swallow did not show any evidence of hiatal hernia. She underwent a LSG. On POD 1, she was able to pass the bariatric clears trial and was discharged home. Three days after discharge, the patient was complaining of constant nausea and vomiting, and chest pain, and was diagnosed with acute hiatal hernia with the incarceration of the proximal sleeve. The patient was taken to the operating room.

Results

Postoperatively, the patient started on the usual bariatric clinical pathway which she tolerated well and was discharged on the POD 4. The operative time was 156 min. The estimated blood loss was 50 ml.

Conclusions

Our report highlights the need for more broad differential diagnosis in early post sleeve gastrectomy patients. Those who are presented with nausea and vomiting in the early postoperative period should be evaluated for possible post sleeve hiatal hernia with a potential risk of strangulation.

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Cell therapy in Huntington's disease: taking stock of past studies to move the field forward

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Cell therapy in Huntington's disease: taking stock of past studies to move the field forward

An overview of the iterative process needed to address current biological and clinical challenges in order to improve reliability of future cell therapy trials in Huntington's disease.


Abstract

Huntington's disease (HD) is a rare inherited neurodegenerative disease that manifests mostly in adulthood with progressive cognitive, behavioral and motor dysfunction. Neuronal loss occurs predominantly in the striatum but also extends to other brain regions, notably the cortex. Most patients die around twenty years after motor onset, although there is variability in the rate of progression and some phenotypic heterogeneity. The most advanced experimental therapies currently are huntingtin‐lowering strategies, some of which are in Stage 3 clinical trials. However, even if these approaches are successful, it is unlikely that they will be applicable to all patients or will completely halt continued loss of neural cells in all cases. On the other hand, cellular therapies have the potential to restore atrophied tissues and may therefore provide an important complementary therapeutic avenue. Pilot studies of fetal cell grafts in the 2000s reported the most dramatic clinical improvem ents yet achieved for this disease, but subsequent studies have so far failed to identify methodology to reliably reproduce these results. Moving forward, a major challenge will be to generate suitable donor cells from (non‐fetal) cell sources, but in parallel there are a host of procedural and trial design issues that will be important for improving reliability of transplants and so urgently need attention. Here we consider findings that have emerged from clinical transplant studies in HD to date, in particular new findings emerging from the recent multi‐site MIG‐HD study, and consider how this data may be used to inform future cell therapy trials.

© AlphaMed Press 2020

Significance Statement

Cell therapy is the only approach currently focused on structural and functional restoration in Huntington's disease. The lack of benefit shown in the largest fetal cell transplant trial to date, the Multicenter Intracerebral Transplant in Huntington's Disease (MIG‐HD), cautions against uncontrolled cell therapy treatments. However, MIG‐HD resulted in new procedures which significantly improved patient safety and enlightened upcoming cell transplant protocols. Stem cells should dramatically change the landscape by permitting better control of the quantity and homogeneity of the donor cell product. Here, we propose ways to improve future trials, thereby increasing their chance for success.

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Fine-tuning the impairment argument against abortion

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By Bruce Blackshaw and Perry Hendricks

Why is it immoral to deliberately give a fetus fetal alcohol syndrome (FAS)? In our paper Strengthening the Impairment Argument Against Abortion, we provided one possible answer: it is wrong because it deprives the fetus of a future of value. In other words, the future of an unimpaired fetus is more valuable than its future after being impaired by FAS. Using this explanation, we tried to strengthen Perry Hendricks' impairment argument, which purports to derive the immorality of abortion from the immorality of non-lethally impairing a fetus (e.g. by giving it FAS). Basically, Hendricks argues that since it is immoral to non-lethally impair a fetus, it is also immoral to lethally impair a fetus, since that's more severe.

Some critics objected to Hendricks' argument by claiming that there are important differences between abortion and non-lethally impairing a fetus. For example, abortion can achieve valuable goods that non-lethal impairment can't, such as avoiding a burdensome pregnancy. By explaining the wrongness of non-lethal impairment by deprivation of a future of value, we tried to solve this problem. The idea was this: since the reason non-lethally impairing a fetus is immoral (i.e. it deprives the fetus of a future of value) is also present in cases of abortion (i.e. aborting a fetus deprives it (even more) of a future of value), there are no important differences. In other words, since the reason for the wrongness of non-lethal impairment is also present in cases of lethal impairment, it is sufficient to show that abortion is immoral. No other facts are relevant.

Unfortunately, things weren't as simple as we'd hoped: Dustin Crummett and Alex Gillham raised distinct, serious objections to our argument. The project of this essay is to answer their criticisms by fine-tuning the principles we made use of.

Crummett showed that if a lethal impairment was justified (for example, because it saved lives), then a principle our argument relies on is false. However, we show that the principle in question can be easily amended to circumvent this problem.

Gillham criticized our use of the deprivation of a future of value to explain the wrongness of non-lethal impairment. He argued that this explanation fails because there are some cases in which a fetus doesn't have a future of which it can be deprived. He also claims that if we explain the wrongness of non-lethal impairment in terms of a deprivation of a future of value, our argument doesn't add anything significant to the abortion debate: it will ultimately reduce to Don Marquis' well-known argument against abortion.

On Gillham's first point, we show that there are very few cases in which his criticism is relevant: in the vast majority of abortions, the fetus has a future of value. And so, his criticism is inconsequential. And secondly, we show that our argument does not reduce to Marquis' argument. In fact, it can succeed even if Marquis' argument fails. Additionally, we use a future of value merely as a possible explanation of the wrongness of non-lethal impairment. This alone is sufficient to show that our argument doesn't reduce to his.

We are grateful to our critics for pointing out these difficulties our argument faces and forcing us to revise our views. The result, we believe, is a more robust argument for the immorality of abortion. Our only regret is that we had not discovered these issues sooner!

 

Paper title: Fine-Tuning the Impairment Argument

Author(s): Bruce P. Blackshaw*, Perry Hendricks**

Affiliations: * University of Birmingham, United Kingdom. ** Purdue University.

Competing interests: None

 

 

The post Fine-tuning the impairment argument against abortion appeared first on Journal of Medical Ethics blog.

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Why ‘gestaticide’ is morally equivalent to infanticide

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By Daniel Rodger, Nicholas Colgrove, Bruce P. Blackshaw

Artificial womb technology may one day permit a fetus to be surgically removed from its mother's body and placed into an artificial environment, mimicking life in utero. Following Elizabeth Chloe Romanis, let's call the subjects living inside artificial wombs 'gestatelings.' An important question that arises is how should gestatelings be treated?

Debates over this question are already underway, and we have been actively involved in them. For example, Colgrove argues that gestatelings should generally be treated like newborns. This, he argues, is because they are newborns (see articles here and here, as well as blogs here and here). Romanis and Elselijn Kingma disagree (see here and here, respectively). While the question of whether or not gestatelings are newborns is an important one, this paper builds upon the views listed here without declaring any one in particular the winner.

Specifically, we center our essay around answering two questions:

  • When (if ever) is it permissible to kill the gestateling (an act Rodger terms, 'gestaticide'), and
  • When (if ever) is it permissible to let the gestateling die (e.g., by withdrawing life-sustaining care)?

We argue that (1) gestaticide is as hard to justify (morally speaking) as standard cases of infanticide and (2) letting gestatelings die will be justifiable only under the same conditions in which it is permissible to remove life-sustaining treatment from newborns in the NICU or nursery. In other words, we show that gestaticide is as impermissible as infanticide and that it is permissible to withdraw life-sustaining treatment from gestatelings only when continued treatment is futile, death is imminent and unavoidable, and/or treatment itself is overly burdensome. Importantly, these claims hold whether Colgrove is right (when claiming that gestatelings are newborns) or Romanis and Kingma are right (when denying that claim).

Defending these claims is critical, because as artificial womb technology becomes available, we believe it is inevitable that people will defend the permissibility of gestaticide. Already Räsänen, for example, has defended the right of (genetic) parents to commit gestaticide (though Blackshaw and Rodger; Kaczor and others have provided responses).

Our project serves as a preventive measure against gestaticide and against letting gestatelings die for arbitrary reasons. Gestatelings, like newborns, must not be killed for economic reasons, or because biological parents change their mind about raising a child, and so on. Put differently, legal authorities and healthcare professionals have good reason to protect the lives of gestatelings as they would protect the lives of newborns in the NICU. Our case places the burden of proof on those who would argue that gestaticide should be permissible.

 

Paper titleGestaticide: Killing the Subject of the Artificial Womb

Author(s): Daniel Rodger, Nicholas Colgrove, Bruce P. Blackshaw

Affiliations: London South Bank University. Wake Forest University. University of Birmingham.

Competing interests: None

The post Why 'gestaticide' is morally equivalent to infanticide appeared first on Journal of Medical Ethics blog.

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