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Introduction Childhood-onset obesity poses significant health risks, including early-onset type 2 diabetes, cardiovascular disease, and reduced quality of life. Hospital-based non-pharmacological obesity care can reduce childhood obesity, but 25% of children do not respond. Therefore, this study investigates the effect of the glucagon-like peptide-1 receptor agonist, semaglutide, as an add-on to hospital-based obesity care in youth who still have obesity following hospital-based obesity care as children. Furthermore, biomedical and psychosocial factors linked to treatment response will be investigated, alongside an exercise-based strategy to prevent weight regain and maintain a healthy body composition after semaglutide treatment.Methods and analysis This is an investigator-initiated, randomised, placebo-controlled, double-blind trial. We will enrol expectedly 180–270 young adults aged 18–28 years based on their previous response to a paediatric obesity management programme and their current body mass index (BMI). Participants are categorised into four groups: low treatment response (BMI SD score (SDS) reduction 0.25; BMI ≥30 kg/m2); high treatment response (BMI SDS reduction >0.50; BMI

Summary: Inhibitors of neprilysin improve glycemia in patients with heart failure and type 2 diabetes (T2D). The effect of weight loss by diet, surgery, or pharmacotherapy on neprilysin activity (NEPa) is unknown. We investigated circulating NEPa and neprilysin protein concentrations in obesity, T2D, metabolic dysfunction-associated steatotic liver disease (MASLD), and following bariatric surgery, or GLP-1-receptor-agonist therapy. NEPa, but not neprilysin protein, was enhanced in obesity, T2D, and MASLD. Notably, MASLD associated with NEPa independently of BMI and HbA1c. NEPa decreased after bariatric surgery with a concurrent increase in OGTT-stimulated GLP-1. Diet-induced weight loss did not affect NEPa, but individuals randomized to 52-week weight maintenance with liraglutide (1.2 mg/day) decreased NEPa, consistent with another study following 6-week liraglutide (3 mg/day). A 90-min GLP-1 infusion did not alter NEPa. Thus, MASLD may drive exaggerated NEPa, and lowered NEPa following bariatric surgery or liraglutide therapy may contribute to the reported improved cardiometabolic effects.

Active front-end converters are part of high power installations for regenerative energy systems, feeding the regenerated energy into the utility. Under the island mode operation of the regenerative energy system, the load characteristics are difficult to detect, and the change of the load characteristics will cause the corresponding resonance. V/f control is usually used to ensure the harmonic quality. At high switching frequency, it has a good control effect. However, high switching frequency causes high switching loss. In order to reduce the switching loss, it will produce more harmonic distortion. Furthermore, the commonly used modulation strategies in this case face the problem of low real-time performance. Therefore, in order to avoid the harm caused by circuit resonance under the condition of reducing the switching frequency, this paper proposes a specific harmonic suppression algorithm with high real-time performance, which can be used as an optional control algorithm in the island operation state of power system. At the same time, aiming at the difficulty of adjusting the weight factors, this paper proposes a weight factor automatic tuner, which automatically adjusts the weight factors according to the harmonic component.