Search

AbstractObesity alters lipid and carbohydrate metabolism, which has an impact on micronutrient status. Zinc affects lipid and glucose metabolism while also acting as an anti-inflammatory and antioxidant in various physiological processes. It has a direct effect on the insulin-signaling system and acts as an insulin mimic. In this study we predicted that zinc deficiency in obese Serbian adults affects anthropometric parameters, lipid and glucose metabolic profiles, inflammation, and atherosclerotic markers. We conducted a case-control study with 31 adult obese individuals and 31 controls. Different methods were used to determine the values of anthropometric and biochemical parameters. Obese participants had significantly decreased serum zinc levels compared to controls (p < .01). In obese subjects, there is a significant negative correlation between zinc and body weight (ρ = −0.324, p < .05), body mass index (ρ = −0.351, p < .05), body fat mass (%) (ρ = −0.431, p = .006), and triglycerides (ρ = −0.317, p < .05), as well as a positive correlation between zinc and high-density lipoproteins (ρ = +0.453, p < .01) and lipoprotein (a) (ρ = +0.417, p < .01). Atherosclerotic index and lipoprotein (a) were significantly related to zinc (p = .0022 and p = .0016, respectively) independently of each other in obese subjects. Our results suggest that the determination of zinc levels in obese persons and their correlation with anthropometric and metabolic parameters could help in the identification of individuals at higher risk for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is a worldwide epidemic, with up to 17% of French population affected. European guidelines recommend surgical management at specific weight and comorbidity level; however, less than 2% of eligible patients undergo surgical bariatric interventions. To extend the benefits of bariatric interventions to the untreated population with obesity, endoscopic techniques such as endoscopic sleeve gastroplasty (ESG) have been developed. Analysis of costs and long-term benefits of ESG across stakeholders is needed. This work aimed to assess the healthcare economic and outcomes for ESG in the French healthcare system. Methods: A cost-utility analysis study was conducted to evaluate class II obesity patients, stratified into ESG and lifestyle modifications or lifestyle modifications alone groups. Health benefits were measured as quality-adjusted life years (QALY) and costs benefits expressed as incremental cost-effectiveness ratio (ICER). A 6-state Markov model was used and base case scenario analysis was used to assess ESG benefits against lifestyle modifications only. One-way sensitivity analysis (OWSA) and probabilistic sensitivity analysis were performed to evaluate uncertainty on health care interventions and worse case scenarios, respectively. Results: ESG population from the France center included 59 patients, lifestyle modification group was drawn from the MERIT cohort. The base case scenario showed higher costs for ESG procedure compared to lifestyle modifications alone; however, gain in terms of QALY (+ 1,3) is observed maintaining ICER below the set threshold. Also OWSA and probabilistic analysis confirmed ESG cost-effectiveness. OWSA allowed identification of ICER-influencing factors; probabilistic sensitivity analysis confirmed ESG to be cost-effective in 99.29% of iterations. Conclusion: ESG is cost-effective in the French healthcare system. Its potential to reach an untreated portion of the population living with obesity should prompt its uptake into clinical practice. The results of this study should sustain ESG implementation throughout France and possible integration of its reimbursement by the public healthcare system. [ABSTRACT FROM AUTHOR]

Background: Overweight is thought to affect the outcome of minimally invasive surgery. There is still a lack of controlled studies of laparoscopic pancreaticoduodenectomy (LPD) versus open pancreaticoduodenectomy (OPD) in overweight patients. This study was designed to compare short-term and long-term outcomes in overweight patients treated with LPD and OPD. Methods: Clinical and follow-up data on overweight patients who received LPD or OPD at Shandong Provincial Hospital from January 2015 to December 2022 were analyzed retrospectively. The bias between groups were balanced by 1:1 propensity score matching (PSM). Kaplan–Meier survival curves described long-term survival outcomes in overweight pancreatic ductal adenocarcinoma (PDAC) patients. Results: A total of 502 overweight patients were enrolled in the study. There were 276 patients in the LPD group and 226 in the OPD group. After matching, 196 patients were enrolled in each group. Compared with the OPD group, the LPD group had fewer estimated blood loss (EBL) (140 vs. 200 mL, P < 0.001), more lymph node dissection (14 vs. 12, P = 0.010), and shorter postoperative length of stay (LOS) (13 vs. 16 days, P < 0.001). There were no significant differences in severe complications, 90-day readmission and mortality rates (all P > 0.05). The subgroup analysis of obese patients also showed that the LPD group had fewer intraoperative EBL, more lymph node dissection, and shorter LOS. The survival analysis showed that overweight patients with PDAC who underwent LPD or OPD had similar overall survival (OS) (23.8 vs.25.7 months, P = 0.963) after PSM. Conclusion: It is safe and feasible for overweight patients undergoing LPD to have less EBL, more lymph node harvesting, and a shorter LOS. There was no statistically significant difference in long-term survival outcomes among overweight PDAC patients between the two approaches. [ABSTRACT FROM AUTHOR]

Aims: The SURMOUNT‐1 trial investigated effects of tirzepatide, a glucose‐dependent insulinotropic polypeptide and glucagon‐like peptide‐1 receptor agonist, on body weight in participants with obesity or overweight. This analysis evaluated changes in patient‐reported outcomes (PROs) assessing physical function, psychosocial well‐being, and overall health aspects of participants' health‐related quality of life (HRQoL) in SURMOUNT‐1. Methods: PRO instruments included the Impact of Weight on Quality of Life‐Lite Clinical Trials version (IWQOL‐Lite‐CT), Short Form Survey‐36 version 2 (SF‐36v2) and EQ‐5D‐5L. Scores were analysed by treatment group and by categorical degree of weight reduction group: >0 to <5%, ≥5 to <10%, ≥10 to <20% and ≥20%. Relevant PROs were evaluated for participants with or without physical or psychosocial limitations at baseline, as measured by Patient Global Impression of Status for physical activity (PGIS) and Patient Health Questionnaire‐2 (PHQ‐2), respectively. Results: All tirzepatide groups demonstrated significant improvements in PRO scores versus placebo. There was a consistent trend of incremental PRO improvement with greater degrees of weight reduction, starting from ≥5% weight reduction. Participants achieving ≥20% weight reduction demonstrated the greatest changes from baseline to week 72 (SF‐36v2 Physical Component Summary, 4.60; SF‐36v2 Mental Component Summary, 0.80; IWQOL‐Lite CT Total score, 24.7). Those with baseline physical and psychosocial limitations experienced greater improvements than those without. Conclusions: Tirzepatide treatment was associated with improved HRQoL compared to placebo in people with overweight or obesity. Higher percentages of weight reduction were associated with greater improvements. Clinical trial registration number for SURMOUNT‐1: NCT04184622. [ABSTRACT FROM AUTHOR]

Background: Despite all the advances in our knowledge regarding obesity, our understanding of its etiology is still far from complete. This study aimed to evaluate the association of serum irisin levels with physical activity and some of the metabolic syndrome-related biomarkers among obese people with low-calorie intake and non-obese people with high-calorie intake. Methods: Obese and non-obese healthy individuals with respectively low and high-calorie intakes were recruited. Irisin and other biomarkers were measured using standard biochemical methods. Participants' physical activity was evaluated by administering the International Physical Activity Questionnaire (IPAQ). To analyze the body composition of the participants, a standard body composition device (ioi 353) was applied. Logistic regression was used to calculate the odds ratio (OR) and to examine the effect of confounders such as age, sex, genetics, and activity. Results: Data from the seventy-seven participants were included in the final analysis. The mean age of the participants in the obese and non-obese groups was 38.33 ± 14.88 and 30.24 ± 13.37 years, respectively. Participants in the obese group had lower physical activity compared to the non-obese group (3395.38 ± 2801 MET-min/week vs. 6015.18 ± 3178 MET-min/week; p < 0.001). The Irisin concentration in the obese and non-obese groups was 7.84 ± 2.49 ng/ml and 8.06 ± 1.89 ng/ml, respectively, which wasn't significantly different (p = 0.66). We observed a noteworthy and favorable association between irisin concentration and total body water (TBW), lean body mass (LBM), and soft lean mass (SLM) in the non-obese group. Conclusions: These data indicated that although obese participants were relatively inactive compared to non-obese individuals, circulating irisin level wasn't significantly different between the two groups. Highlights: No irisin difference between obese and non-obese groups. Physical activity unrelated to irisin levels. Positive irisin correlation with lean mass in non-obese group. Triglycerides and cholesterol lower in non-obese group. Irisin linked to TSH and glucose levels in obesity. [ABSTRACT FROM AUTHOR]

Mass communications frame fatness and COVID-19 as a dual threat. This discourse furthers well-established tendencies to degrade bodies labelled overweight or obese, positioning them as deficient and requiring correction. Empirically, this article draws from an online US right-wing news media platform, Campus Reform, including readers' comments (n = 135) on an article denouncing professors working in fat studies during the COVID-19 lockdown. This status degradation ceremony—backed by 'big money' that funds campus culture wars—not only targeted fat people but also academic disciplines, expertise, universities and social justice agenda. Analytically, this study draws from ethnomethodology and literature on media and bodyweight, meddling or health fascism, weaponized stigma and the politics of cruelty. Going beyond the flesh and a particular case study, it also challenges the ways in which cruelty enacted towards those deemed fat (especially women) can spiral into corrosive nationalist discourse in pandemic times. [ABSTRACT FROM AUTHOR]

Text-based person re-identification aims to find the target person from a large pedestrian gallery with the given natural language description. Previous works mainly focus on embedding salient textual and visual representations in a common latent space by utilizing the dual-path structure or parameter-shared network. However, they still lack the ability to effectively extract fine-grained unimodal features as well as fuse the cross-modal data, leading to the increase of misaligned cases. To settle these issues, we propose a text-and-image implicit learning Transformer (TILT) to eliminate textual anisotropy and enhance the cross-modal alignment from both domains based on the bi-direction multi-modal encoders. Specifically, we apply the pre-trained multi-modal embedding module to overcome the unimodal anisotropy problem with contrastive learning, and map fine-grained features with dual encoder in bi-directional masking. Then, we design the cross-modal interaction encoder to comprehensively mine implicit cross-modal relations by reconstructing masked tokens, and fuse rich multi-modal knowledge in a common space. In addition, the cross-modal similarity matching module is proposed to optimize the intra-domain classification and decrease the inter-domain divergence. Extensive experiments are conducted on three public benchmarks CUHK-PEDES, ICFG-PEDES, and RSTPReid to verify the effectiveness of our proposed framework. Results prove that our model outperforms state-of-the-art methods on all metrics. [ABSTRACT FROM AUTHOR]

This qualitative study aimed to describe users' experiences and needs related to wearing, donning, and doffing compression hosiery, and the provision process of compression hosiery and associated assistive products for donning and doffing. Adults who have been advised to wear compression hosiery participated in semi-structured interviews. Existing frameworks about the provision process and acceptance of assistive technology guided the topic list. The interviews were analyzed using directed content analysis. After 19 interviews, data saturation was reached. Three main themes were revealed: (1) becoming and being a compression hosiery wearer (or not), (2) wearing compression hosiery, and (3) donning and doffing compression hosiery. In cases of acute conditions, the participants reported feeling overwhelmed when they were first prescribed compression hosiery. In contrast, those with long-term complaints felt relieved. Participants considered advantages and disadvantages and then decided whether to wear compression hosiery. Despite mentioned beneficial effects from wearing compression hosiery, participants had to cope with a range of discomforts, including pinching, straining, sagging, and heat. Additionally, participants had difficulties with the appearance, and often tried to hide the compression hosiery. They mentioned problems with donning and doffing, which can result in dependency of home or informal care, which stopped some participants from wearing. In general, participants were not aware of the full range of assistive products for donning and doffing, but were interested in them. In conclusion, wearing compression hosiery has a large impact on a person's life because of its lack of comfort, unattractive appearance, and possible loss of independence through the need of donning and doffing support. These are expressed reasons for non-adherence, in addition to a lack of understanding of the importance of wearing and the consequences of not wearing compression hosiery. Easy-to-find independent information and more attention to donning and doffing during the fitting appointment of compression hosiery are recommended. [ABSTRACT FROM AUTHOR]

Background: Obesity, depressive symptoms, and periodontitis are major worldwide health concerns. Despite separate studies on both illnesses, no research has directly examined the link between depressive symptoms and periodontitis in obese people. Given the close correlation between obesity and chronic illnesses, as well as the possibility of a bidirectional impact between depressive symptoms and periodontitis, this study aims to investigate the link between depressive symptoms and periodontitis in an obese population. Methods: This study analyzed data from the NHANES database (2009–2014), including 4,820 persons aged 30 years or older with a BMI over 30. The severity of periodontitis was assessed by clinical attachment loss and probing depth, while symptoms of depressive symptoms were measured using the PHQ-9 questionnaire. After gender, age, race, education, ratio of family income to poverty, sleep duration, diabetes, and cardiovascular illnesses were controlled for, the independent connection between depressive symptoms and periodontitis was investigated using multivariable logistic regression. Results: The modified models indicated a significant negative correlation between depressive symptoms and periodontitis (effect size: -0.13, 95% CI: -0.24 to -0.01, p = 0.0266), indicating that depressive symptoms may operate as a protective factor against periodontitis. Interaction studies did not indicate substantial impact modification by factors like age, gender, or education level. Conclusion: This study is the first investigation demonstrating a negative link between depressive symptoms and periodontitis in obese persons, indicating a significant interaction between mental health and dental health in this demographic. The results highlight the importance of comprehensive psychological and oral health care in obese individuals, providing a new avenue for future research and therapeutic applications. [ABSTRACT FROM AUTHOR]

Background/Objectives: Several social vulnerability index (SVI) components have been associated with adverse obstetrical outcomes and provider bias. The objective of this study is to assess whether betamethasone administration timing among patients at risk for preterm birth differs by social vulnerability index. Methods: A multicenter retrospective cohort study of pregnant people at a large academic healthcare system between January 2019 and January 2023. Patients with live singleton gestations at risk for preterm birth who received at least one dose of intramuscular betamethasone for fetal lung maturity from 22 to 34 weeks were included. Patients aged less than 18, who received late-preterm corticosteroids and/or had scheduled delivery at 34 weeks were excluded. We analyzed the association between patient SVI quartile and maternal demographic factors on betamethasone timing, with optimal timing defined as the receipt of two doses of betamethasone within 2 to 7 days of delivery. Results: 1686 patients met the inclusion criteria. Only 22.4% of patients had optimally timed betamethasone administration. Among those who did not receive optimal betamethasone timing, 360 patients delivered less than 48 h from the first dose and 948 delivered greater than 7 days from the first dose. Optimal betamethasone timing within 2 to 7 days of delivery was more common in patients with higher SVI values. Patients with lower social vulnerability were more likely to deliver greater than one week from betamethasone administration. Conclusions: Patients in higher SVI quartiles are more likely to have optimally timed betamethasone. This is likely attributed to overtreatment with betamethasone of less socially vulnerable populations. [ABSTRACT FROM AUTHOR]

Overweight and obesity are considered the greatest public health problem in this emerging country, which worldwide has the second-highest percentage of overweight people among its population. The objective of this work was to analyse to what extent factors traditionally used in the study of overweight and obesity (such as sociodemographic and behavioural) and new variables proposed in the literature (such as stress, financial stress and emotional support) explain this disease in the adult population of Chile. Data were obtained from the III National Health Survey (ENS) administered by the Ministry of Health of Chile in 2017. The ENS collected a large amount of data with extensive geographic coverage. The survey comprised 4 questionnaires with a total of 576 questions, which were applied to a representative sample of the population in Chile. A double complementary methodological approach was adopted. A random forest (RF) classification model was used, and based on the results obtained, an econometric model of the censored dependent variable, specifically the Heckman sample selection model, was specified and estimated. The RF results allowed, for each of the factors considered in the research, the selection of variables with the greatest power to classify the individuals in the sample on the basis of nutritional state (normal weight, overweight or obese). Subsequently, the estimation of the parameters of the Heckman model made it possible to quantify the variables that most affected overweight and obesity. Most of the variables that make up the factors were found to be significant. Interestingly, psychosocial variables effectively influence overweight and obesity. In addition, the results for reviewing nutritional information and reviewing food warnings allow us to reflect on the impact that recent food policies have had on the Chilean population. The combination of RF and an econometric model allowed us to capitalize on the strength of both models to better explain the complex phenomenon of overweight and obesity. This approach allowed us to more accurately confirm the impact of traditional factors on overweight and obesity but to show also that other psychosocial factors are relevant and should be consider in future studies. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT: Background and Objective: Morbidly obese persons often get gastritis after laparoscopic sleeve gastrectomy (LSG). The study examined the prevalence of gastritis and associated risk factors after LSG at a tertiary hospital in Saudi Arabia. Materials and Methods: The present retrospective cross-sectional study comprised patients with obesity aged 18 and older who received LSG between 2019 and 2023. Pre- and post-operative gastritis symptoms, results, and risk factors were examined. Results: The study involved 343 patients. Gastritis was common after LSG, affecting 70.3% of patients. Gastritis was approximately twice as likely in women as in men. Hypothyroidism and cesarean section history increased gastritis risk by five-fold and three-fold, respectively. H. pylori infection increased the risk of gastritis seventeen-fold after surgery. Conclusion: Significant risk variables were female gender, hypothyroidism, cesarean section history, and H. pylori infection. [ABSTRACT FROM AUTHOR]

Tiberiu Olah's Evenimente 1907 (Events 1907), originally the music for the film Răscoala (The Uprising) after Liviu Rebreanu's novel, can be considered a work inspired by a page in Romanian national history involving a large mass of people, and as such in tune with the themes pushed by the Communist ideology. But this layer of meaning runs in parallel with another one, indicative of the modern, elitist music from outside Romania, more precisely of works by composers of the Second Viennese School. The two layers, to all appearances completely contradictory, prove to be parts of a single whole. By managing, like some Till Eulenspiegel (or his Romanian relative Păcală), to dissimulate the nod to modernism in the clothes of the music for a historical film, Olah offers a model both of pluristratification of meaning and of harmonization of opposites. [ABSTRACT FROM AUTHOR]

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as game-changers across the cardiovascular–kidney–metabolic (CKM) spectrum: overweight/obesity, type 2 diabetes mellitus (T2DM) and associated chronic kidney disease (CKD) and cardiovascular disease (CVD). Liraglutide, semaglutide and tirzepatide are European Medicines Agency approved to improve metabolic control in T2DM and to decrease weight in persons with obesity [body mass index (BMI) ≥30 kg/m2] or with overweight (BMI ≥27 kg/m2) associated with weight-related comorbidities such as hypertension, dyslipidaemia, CVD and others. Additionally, liraglutide and semaglutide are approved to reduce CVD risk in patients with CVD and T2DM. Semaglutide is also approved to reduce CVD risk in patients with CVD and either obesity or overweight and in phase 3 clinical trials showed kidney and cardiovascular protection in patients with T2DM and albuminuric CKD (FLOW trial) as well as in persons without diabetes that had CVD and overweight/obesity (SELECT trial). Thus, nephrologists should consider prescribing GLP-1 RAs to improve metabolic control, reduce CVD risk or improve kidney outcomes in three scenarios: patients with overweight and a related comorbid condition such as hypertension, dyslipidaemia or CVD, patients with obesity and patients with T2DM. This review addresses the promising landscape of GLP-1 RAs to treat persons with overweight or obesity, with or without T2DM, within the context of CKD, assessing their safety and impact on weight, metabolic control, blood pressure and kidney and cardiovascular outcomes, as part of a holistic patient-centred approach to preserve CKM health. [ABSTRACT FROM AUTHOR]

The agentive structures in JE and ON identified in the AS2-HP corpus (a corpus of caregivers' speech) refer to groups of people of different sizes, ranging from unity (mainly represented by JE) to internal plurality (specific to ON), or even totality in the case of generic uses. By questioning the notions of indefiniteness, collective agentivity and massive perception, this article reveals a continuum that organizes the 'agent-action' relationship, which varies according to the pronoun used in the agentive structure: those in ON alone make the event predicate more salient than the enunciator. The latter, which in this corpus always refers to a group of caregivers, is intended to highlight the action rather than the people performing the action. Conversely, agentivity in NOUS ON emphasizes the enunciator: the subject is presented as a class, which takes precedence over the event predicate. Halfway between these two ends of the gradient, we find agentive structures in JE, where agent and action are perfectly equal: the agent takes full responsibility for his action and does so on an individual basis. [ABSTRACT FROM AUTHOR]

To explore if individuals living with obesity participate, have interest, and benefit from circuit resistance training (RT+) and evaluate if the RT+ reaches moderate aerobic intensity and the association between oxygen consumption and heart rate while performing the RT+. Ten inactive adults living with obesity participated in the RT+ program for 12 weeks. Participants performed 150 min of the RT+ program using four exercises (squats, chest press, lunges and lat-pull down) for three sessions of 50 min each week. Measured outcomes included attendance, fitness, lipids, anthropometrics body composition. Oxygen consumption and heart rate were captured during a single session of the RT+ program using portable indirect calorimetry. Participants attended 90% of offered sessions (32.5/36.0 sessions). A significant improvement was observed in the body mass index (P = 0.03). The RT+ program was permitted to reach moderate intensity regardless of the indicator used to establish moderate intensity (3METs, 46%VO 2peak , 40%VO 2reserve , 64%HR max and 40%HR reserve). The association between HR and VO 2 while performing the RT+ program was 0.27; P < 0.01. This study suggests that people with obesity achieve moderate intensity when performing RT+. As a result, performing RT in a circuit manner could contribute to the aerobic portion of the guidelines for adults living with obesity. [ABSTRACT FROM AUTHOR]

Bariatric surgery is globally stigmatized. There's a lack of international comparative research on public perceptions of this procedure, and existing studies often overlook public perceptions of individuals undergoing it. Our cross-sectional survey investigated attitudes toward obesity, bariatric surgery, and individuals undergoing it in the Netherlands, France, and the United Kingdom. Of 1807 respondents, the UK displayed more negative attitudes, possibly due to differing beliefs on personal responsibility or national perspectives on obesity treatment. Surprisingly, respondents had positive attitudes toward bariatric surgery patients despite prevailing negative attitudes toward obesity. Perceptions of personal responsibility significantly impacted attitudes toward these patients. Our study challenges the idea of universally negative attitudes toward bariatric surgery and its patients, underlining the importance of understanding these differences to tackle stigma. Further research on cultural, social, and individual influences is essential. [ABSTRACT FROM AUTHOR]

The expanding numbers of returned persons in need of international protection have led the UN Committee against Torture to indicate obligations of post-return monitoring for sending states. In its general practice and a well-known infamous case against the Republic of Serbia, the Committee gradually, yet inconsistently, put forward the contents of this obligation. The article explores several intriguing legal and policy questions that this decision raises since it essentially binds Serbia to act outside of its jurisdiction to monitor the rejected asylum seeker's well-being upon return to the country of origin. It questions migration policy implications of such an obligation for the states involved, with repercussions also for other states in the region that lay on the current migratory routes. Through an analysis of current state practice, the authors inquire into the potentials of post-return monitoring to outweigh its presumable role of a rather weak redress and to instead serve as a valuable tool for non-refoulement prevention used to the benefit of larger numbers of persons seeking international protection. [ABSTRACT FROM AUTHOR]

Background: Individuals with overweight or obesity often endure significant weight‐based prejudice and discrimination in various settings. Experiencing weight‐related stigma is linked to many adverse psychosocial outcomes. Weight self‐stigma is when an individual internalizes and identifies with negative attributes ascribed to people with larger bodies and has self‐devaluing thoughts because of their weight and is associated with poorer health outcomes. Aims: This study explored how weight self‐stigma may impact weight management efforts and outcomes for adults participating in an onlight weight‐loss intervention. Materials and Methods: 508 adults (86.2% female, 84.6% White) with overweight or obesity participated in an asynchronous 12‐week online weight‐loss intervention with computer‐generated feedback. Weight and weight self‐stigma were measured at baseline and 3 months later. Results: Thirty‐one point five percent of the sample reported high levels of stigma, which was associated with greater program dropout than those who did not report high stigma (32.5% vs. 21.6%). Program completers reporting high self‐stigma showed better treatment engagement (77.0% vs. 69.7% lessons viewed) and weight loss (M = −6.31% vs. −5.08%); these differences were not observed when using intent‐to‐treat assumptions. When analyzed as a continuous variable, weight self‐stigma showed no association with treatment engagement and outcome. Discussion: These findings highlight the complexity of understanding how self‐stigma affects treatment engagement and outcome in behavioral weight loss and the need for more targeted research in this understudied area. Conclusion: Results suggest that weight self‐stigma plays a role in weight management during an online weight‐loss intervention, affecting engagement and outcomes. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Managing the airway presents a significant challenge in anesthesia, particularly in obese patients, and is a leading cause of morbidity and mortality associated with anesthesia. Although increased tongue thickness in the obese is generally assumed to be associated with a difficult intubation. So that aim of this study was to evaluate ultrasound guided measurement of tongue thickness in predicting difficult tracheal intubation in obese patients. MATERIALS AND METHODS: Study included 45 patients aged 18 to 65 of any gender. These patients, classified as American Society of Anesthesiologists Grade I and II, had a Body mass index exceeding 30 kg/m2. Tongue thickness was evaluated using ultrasound, measuring the distance from the tongue surface to the submental skin, while also documenting the modified Mallampatti score (MMP). Number of attempts for intubation, time taken for intubation and use of any alternate device or technique were noted. RESULTS: The tongue thickness cutoff for predicting difficult intubation was determined to be 6.5 cm. The Receiver operating characteristic (ROC) curve analysis revealed an AUC (Area under the ROC Curve) of 0.920 (Standard Error: 0.230, 95% Confidence interval: 0.850-0.950) for a cutoff value exceeding 6.5 cm, indicating excellent predictive capability. Tongue thickness demonstrated a combined diagnostic accuracy of 95.5%, with sensitivity and specificity of 75% and 97.5% respectively. MMP grade was compared with tongue thickness, a positive correlation was seen with co-efficient of 0.45. There was a statistically significance (p value <0.001). CONCLUSIONS: This study concludes that ultrasound guided measurement of tongue thickness > 6.5 cm can reliably predict difficult tracheal intubation in obese patients. [ABSTRACT FROM AUTHOR]

Aims: To describe weight management and perceptions in China. Materials and methods: Data were from the Adelphi Real World Obesity Disease Specific Programme™, a cross-sectional survey between April and July 2022 of physicians managing people with obesity or overweight (PwO) and PwO in real-world clinical practice in China. At data collection, eligible PwO were aged ≥18 years, under weight management and/or had a body mass index (BMI) ≥28 kg/m2. Results: In total, 100 physicians and 801 PwO were enrolled. More than two thirds of PwO (70.7%; 531/751) were not diagnosed with obesity until a BMI ≥30 kg/m2. Most PwO (78%; 625/801) were on treatment for at least one obesity-related complication (ORC). Physicians commonly initiated weight loss discussions with PwO who already had an ORC (48.0%; 48/100). According to physicians and PwO, the mean target BMI was set at 25.8 kg/m2 and 24.3 kg/m2, and the mean target percentage weight loss was 19.6% and 23.7%, respectively. Over a median 6.4 months of weight management, the mean percentage weight loss was 4.1%. Few PwO achieved the weight loss target set by their physician (9.9%; 69/695) or themselves (2.0%; 14/696). Most physicians and PwO were unsatisfied with the current weight loss (92.3% [739/801] and 82.0% [650/793], respectively). Conclusions: These findings suggest that earlier intervention may be needed to address obesity as a disease. Most physicians and PwO recognized the importance of normal weight, but few PwO achieved weight loss targets, which may suggest an unmet need for improved weight management. [ABSTRACT FROM AUTHOR]

Background: Obesity is a serious health problem with increasing incidence. worldwide and remains one of the most important causes of preventable deaths. We aimed to examine the relationship between Vitamin B12 and Folic acid, which have an important role for human life, and homocysteine is widely recognized for its association with the development of cardiovascular disease, although its role as an independent risk factor remains a topic of ongoing debate. Materials and methods: We evaluated 126 patients who underwent bariatric metabolic surgery between September 2019-September 2020. In addition to demographic characteristics of the patients, weight, Vitamin B12, folate, HbA1c, cholesterol, triglyceride, ferritin, serum iron, albumin levels at preoperative, postoperative 1st month, 6th month, 12th month follow-ups were analyzed. Results: Patients with the desired biochemical parameters at the determined follow-up points were identified and two groups were formed as RYGB(n = 43) and SG(n = 7) patients. When biochemical parameters were analyzed between the groups, homocysteine, HbA1c, HDL Cholesterol, VLDL Cholesterol, Total Cholesterol, Triglycerides, Ferritin, Serum Iron levels showed a statistical difference (p < 0.001). Folate (p = 0.064) and albumin (p = 0.257) did not show a significant difference over time. The change in vitamin B12 (p = 0.409) over time was not significant in the SG group, whereas a significant difference was observed in the RYGB group (p < 0.001). When we established a marginal model to determine the factors affecting the change in homocysteine over time, vitamin B12 and folate values. Conclusions: The relationship between Vitamin B12, folate and homocysteine is important in order to better understand the complications that develop in bariatric metabolic surgery patients, to prevent possible complications and to better manage the process. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a disease characterized by chronic high blood sugar levels resulting from defects in insulin secretion, insulin action, or both. Prolonged high blood glucose can increase production of reactive oxygen species, leading to elevated oxidative stress. The enzyme paraoxonase-1 (PON1), made in the liver and transported on high-density lipoprotein (HDL), acts as an antioxidant and can counter oxidative stress. This study aimed to compare PON1 activity between healthy controls, obese type 2 diabetics, and non-obese type 2 diabetics. There were 30 healthy controls, 30 obese type 2 diabetics (group I), and 30 non-obese type. Additionally, fasting lipid profiles, fasting plasma glucose, uric acid, albumin, and total bilirubin levels were determined using a clinical chemistry analyzer. The goal was to evaluate differences in PON1 activity as well as metabolic parameters between the three study groups. The results In comparison to the healthy control group, the diabetes group had Significantly higher blood sugar, serum cholesterol, serum triglycerides, serum LDL, and serum uric acid levels, Compared to the healthy control group, PON was Significantly lower in group II patients, Conclusion that Obese type 2 DM patients had significantly lower PON1 and HDL-C levels, which may indicate That the overweight has lessened biochemical functions for these substances. As dyslipidemia, insulin resistance, and high blood pressure are thought to be crucial factors in the cause of metabolic conditions in obese people, the reduced paraoxonase level may increase their likelihood of developing these conditions. [ABSTRACT FROM AUTHOR]

Much of the worldwide population is obese or overweight. However, the effects of body fat on a person's workplace success, especially in the long term, are not well known. Further, we have little insight on the dominant mechanisms by which body fat influences career outcomes. Aiming to understand if, how, and when employee body fat impacts career success over time, we challenge prior theory (i.e. stigma theory) and employ a novel medical perspective to suggest that an employee's health – in the form of illnesses like cardiovascular disease and diabetes – determines the relationship between employee body fat levels and long-term work success. Furthermore, we integrate research from evolutionary biology to consider the moderating role of employee sex in the health process and probe effects by industry. Longitudinal results from a nationally representative, multi-wave sample (across 20 years) show that employee health – but not stigmatization or other explanations – mediates the negative relationship between employee body fat levels and career success. Moreover, findings reveal that employee sex does not moderate this indirect effect, indicating that high body fat men and women equally experience adverse career effects due to the serious medical impairments they incur. Industry further qualifies these effects. [ABSTRACT FROM AUTHOR]

Emotions powerfully, predictably, and pervasively influence decision making. The risk-as-feelings hypothesis states that two kinds of emotions are important in decision-making, anticipatory emotions and anticipated emotions. We empirically investigated whether and how anticipatory and anticipated emotions may change as a function of outcome values and whether anticipatory or anticipated emotions may explain the influence of outcome values on risky choice. To study the effects of value on emotions and choice, we offered people hypothetical large amounts ($100, $200, $300, $400) and incentivized moderate amounts ($10, $20, $30, $40) as prospects in gambles over two consecutive studies. Using a representative sample from the US to ensure the generalizability of the findings, each participant in our two studies made choices in gain and loss domains. Overall, anticipatory and anticipated emotions responded very similarly to changes in value for the sure gains in both studies. The findings also indicated that both anticipatory and anticipated emotions explained the effects of the value on choice for the sure gain and sure losses, while both mediated the effect of framing on choice towards the sure and the gamble option. Although anticipatory emotions mediated a larger portion of the effect, anticipated emotions also show some mediation. [ABSTRACT FROM AUTHOR]

To substantiate the methodology and develop the software of the automated system of testing and monitoring the knowledge of ZELIS students. Methodology. Examination papers contain text, tables, pictures, formulas, etc., that is, all the possibilities of the MS WORD editor. Questions and answer options are generated randomly. As the operation showed, the most effective number is 30 questions and 5 answers to them. When working with forms, a large number of people are tested. Each form is scanned to receive a raster file in *.jpg format. To recognize these files, a mathematical apparatus has been developed that accurately determines the number of the correct answer based on the form. In online mode, students receive input data through the Internet, which is relevant in the conditions of martial law, as well as when testing students’ knowledge during the educational process without additional use of laboratory time. Findings. The ZELIS software is updated in the Visual Studio 2019 environment in the C# programming language using the MS ACCESS or SQL SERVER DBMS, as well as the FireBase RealTime DataBase cloud DBMS. Originality. Input information for creating tests comes in a single RTF format that allows you to use tables, figures, formulas, etc. The system also provides the possibility of simultaneous testing of a large number of persons. This process uses proprietary recognition algorithms and takes only a few minutes to process a large number of forms. Practical value. The article describes the automated system of testing and monitoring the knowledge of ZELIS students, which was developed by the authors. The system was developed at the State University of Economics and Technology and has been operating since 2015. Approximately 250 exams are conducted in one online paperbased testing session, with approximately 1,200 students participating. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The objective of the study is to examine the work-life balance of married female nurses during the COVID period. Methodology: Psychotherapists believe that middle class women professionals are having more work-life imbalances and especially nursing profession is facing numerous challenges especially in this pandemic situation which are the key hurdles in the progress of nursing. As a result, the research was conducted with 200 respondents comprised of married women nurses from Western Districts of Tamil Nadu and both primary and secondary data are used. Questionnaire is the major data collection tool and a statistical model factor analysis has been used to find the significant variables in work life balance of the nurses. Findings: The results of the study revealed that flexible guidelines and procedures can be adopted by hospital management to ensure a smooth work life balance among the nurses. Novelty: Women nurses are striving to serve their best for the sake of the society people at large during COVID pandemic, relatedly their work life related problems have to be addressed and resolved to ensure their healthy life and continued service. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Baghdad Science Journal is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In Nationalism and Culture, now a largely forgotten book, the anarchist thinker Rudolf Rocker offers a compelling account of the nationalist phenomenon, from its origins and development to its influence (or lack thereof) over the linguistic and cultural practices of the large groups of people that typically encompass a nation‐state. The present paper aims to revisit and update Rocker's book, highlighting its relevance and potential contribution to the modern study of nationalism. In particular, I employ the tools of Noam Chomsky's generative study of language to characterise the roles language and culture play in the formation of national identities, in so doing unearthing some of the psychological underpinnings of nationalist beliefs and thus, furthermore, clarifying the actual effects of nationalist policies on language, culture, and artistic creativity. [ABSTRACT FROM AUTHOR]

This paper considers the experiences of transition for young people from alternative provision (AP) to post-16 mainstream settings, drawing on an online survey distributed via Headteachers of AP/ post-16 institutions to staff and young people in a large local authority in the Northwest of England. It reflects on previous transition research and argues that transition can be viewed as a site of vulnerability for young people, with consideration of transition from a lens of vulnerability apparently absent in previous research. The pervasive narratives describing young people in alternative provision as “vulnerable” are critiqued, as well as some of the issues in conceptualising vulnerability. “Toblerone model” of relational spaces of vulnerability has been reconceptualised in this paper to model the possible sites of vulnerability that impact on the transitions young people make from alternative provision to post-16 mainstream settings. The paper concludes by presenting an adapted model of vulnerability which could be used to reconsider some of the issues which may impact on young people’s transition to post-16 settings, before and after the point of administrative transfer, and provide the staff who support them, both in alternative provision and in the transfer setting, with new possibilities for action. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery offers effective treatment for morbid obesity and associated medical comorbidities, with excellent short- and long-term outcomes. Although it has been well documented that racial minority bariatric patients have worse outcomes than White patients, it remains unclear whether this recognition has led to improvement. Herein, we assess recent trends in bariatric surgery among Black and White patients and compare early postoperative outcomes by race. Methods: Primary sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) patients from 2015 to 2021 reported to the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program were studied. Bariatric patients were stratified by race (Black and White) and perioperative outcomes were compared between matched Black and White patients. Primary outcome was 30-day mortality. Secondary outcomes included hospital readmissions, hospital length of stay (LOS), reoperation, and postoperative complications. Results: Overall, there were 193,071 Black and 645,224 White primary bariatric patients, with a higher volume of SG and RGYB performed among White patients. A total of 219,566 Black and White bariatric patients were matched and included in the case–control. Black patients were found to have higher rates of 30-day mortality (0.02% vs. 0.01%; p = 0.03) and readmissions (3.68% vs. 2.65%; p < 0.001). There were no significant differences in LOS, reoperations, or overall postoperative complications. However, there was a higher postoperative pulmonary thromboembolism rate (0.16% vs 0.08%; p < 0.001).). The differences in perioperative outcomes stratified by race persisted over the study period (Fig. 1). Conclusion: Black bariatric surgery patients continue to have worse perioperative outcomes compared with their White counterparts. Further work must be done to determine contributing factors in order to effect improvement in outcomes in bariatric surgical care for racial minority patients. [ABSTRACT FROM AUTHOR]

The older segment of the global population is increasing at a rapid pace. Advancements in public health and modern medicine lengthened life expectancy and reduced the burden of disease in communities worldwide. Concurrent with this demographic change is the rise in overweight people and obesity, which is evident in all age groups. There is also an aging-related reduction in muscle mass and function, or sarcopenia, that is exacerbated by sedentary lifestyle and poor nutrition. The coexistence of muscle loss and elevated body mass index, termed "sarcopenic obesity", has particularly deleterious consequences in older individuals. Worsening insulin resistance and a proinflammatory state operate at the pathophysiologic level and lead to adverse health outcomes such as a proclivity to cardiovascular disease, type 2 diabetes, and even cognitive dysfunction. Although the concept of sarcopenic obesity as a disease construct is being increasingly recognized, a clearer understanding is warranted in order to define its components and health impact. Research is needed at the molecular-cellular level to tie together derangements in insulin action, cytokines, myokines, and endothelial dysfunction with clinical outcomes. Lifestyle modifications as well as targeted nonpharmacologic approaches, such as supplements and antioxidants, appear to have a promising role in reducing the chronic burden of this emerging disorder. Breakthroughs in drug therapies that retard or even reverse the underlying dynamics of sarcopenia and obesity in older persons are being actively explored. [ABSTRACT FROM AUTHOR]

ABSTRACT The experiences of displaced persons, currently particularly from Ukraine, are reflected in the concept of temporary protection as an immediate response to mass displacement. This article proposes a consideration of temporary protection from the perspective of ‘openness’, ‘in‐betweenness’ and the various forms of insecurities in people's lives in new societies and on their journeys. Refugees are connected in multi‐layered networks along their routes; forced migration goes in all directions; therefore, fluidity, situational dependency and macro factors determine its dynamics. The empirical data on Ukrainian refugees in Slovenia and the consideration of the situation of Bosnian refugees in the period of the Yugoslav wars show a complex interplay of structural and individual factors that determine the position of temporarily protected persons in larger transnational networks. The article also reflects on the relational question of international protection from the perspective of ‘deservedness’ and hierarchies among different migrant groups. [ABSTRACT FROM AUTHOR]

Introduction: Despite having sufficient formal education, a large group of people cannot complete everyday tasks like reading, writing, or making basic calculations. Regarding reading, millions of people are not able to understand more complex texts despite the ability to read simple words or sentences; they have low literacy skills. Even though this problem has been known for decades, the causes and predictors of their poor reading comprehension skills are not fully explored. Socioeconomic, sociodemographic, and reading-related (i.e., linguistic) factors, especially of English-speaking participants and thus users of an opaque orthography, were often assessed. The goal of this study was to examine which linguistic, domain-general, or numerical factors predict substandard complex text reading as the core symptom of low literacy skills in adulthood. Methods: To this end, we assessed a group of German-speaking participants--users of a transparent orthography--who are at risk for complex text reading deficits. Results: The results indicated that linguistic variables (reduced word/pseudoword reading, weaker oral semantic and grammatical comprehension), working memory, and age predicted lower performance in text comprehension. This model explained 73% of the total variance, indicating that most of the deficits in complex text reading can be explained by a group of basic underlying linguistic and domain-general factors. Discussion: We conclude that interventions for adults with low literacy skills and others at risk for complex text reading deficits should address word/pseudoword reading and focus on both written and oral comprehension. [ABSTRACT FROM AUTHOR]

Background: There is a growing burden of non-obese people with diabetes mellitus (DM). However, their cardiovascular risk (CV), especially in the presence of cardiovascular-kidney-metabolic (CKM) comorbidities is poorly characterised. The aim of this study was to analyse the risk of major CV adverse events in people with DM according to the presence of obesity and comorbidities (hypertension, chronic kidney disease, and dyslipidaemia). Methods: We analysed persons who were enrolled in the prospective Silesia Diabetes Heart Project (NCT05626413). Individuals were divided into 6 categories according to the presence of different clinical risk factors (obesity and CKM comorbidities): (i) Group 1: non-obese with 0 CKM comorbidities; (ii) Group 2: non-obese with 1–2 CKM comorbidities; (iii) Group 3: non-obese with 3 CKM comorbidities (non-obese "extremely unhealthy"); (iv) Group 4: obese with 0 CKM comorbidities; (v) Group 5: obese with 1–2 CKM comorbidities; and (vi) Group 6: obese with 3 CKM comorbidities (obese "extremely unhealthy"). The primary outcome was a composite of CV death, myocardial infarction (MI), new onset of heart failure (HF), and ischemic stroke. Results: 2105 people with DM were included [median age 60 (IQR 45–70), 48.8% females]. Both Group 1 and Group 6 were associated with a higher risk of events of the primary composite outcome (aHR 4.50, 95% CI 1.20-16.88; and aHR 3.78, 95% CI 1.06–13.47, respectively). On interaction analysis, in "extremely unhealthy" persons the impact of CKM comorbidities in determining the risk of adverse events was consistent in obese and non-obese ones (Pint=0.824), but more pronounced in individuals aged < 65 years compared to older adults (Pint= 0.028). Conclusion: Both non-obese and obese people with DM and 3 associated CKM comorbidities represent an "extremely unhealthy" phenotype which are at the highest risk of CV adverse events. These results highlight the importance of risk stratification of people with DM for risk factor management utilising an interdisciplinary approach. [ABSTRACT FROM AUTHOR]

Introduction: anxiety and depression disorders represent important pathological mental health conditions with an increasing prevalence worldwide. As well as obesity, which has an estimated prevalence of 18.9% in the Brazilian population. Such pathological situations are quite harmful to health, and may or may not be associated with each other. However, the identification of the occurrence of both disorders in obese people is negatively affected due to the need for more expanded diagnostic studies. Given this pathological potential to derogate health, the coexistence between the aforementioned disorders in obese people deserves an in-depth look by health professionals, especially those involved in primary care. Objective: was to analyze the evidence on the prevalence of anxiety and depression disorders in obese patients. Methods: scope review, registered in PROSPERO and prepared according to PRISMA-ScR, based on the research question structured in the acronym PVO, from which the descriptors used in the Boolean search for scientific articles were extracted, which were evaluated and selected blindly among the evaluators, based on in the eligibility criteria. The databases consulted in January 2023 were Pubmed (Medline), Web of Science and Scopus. The assessment of the methodological quality or risk of bias of the articles was carried out using the Critical Assessment of Studies with Prevalence Data (CASPD-JBI) tool. Results: nine articles were included, bringing together female participants (64%) and men (36%) with different classes of obesity, aged between 20 and 40 years. The simultaneous coexistence of anxiety and depression in obese people has been identified. Among the studies included, 56% were evaluated with high methodological quality and 44% were with moderate quality. Conclusion: although more studies with greater methodological rigor are still needed, we consider that the concomitant prevalence of anxiety and depression disorders is high in patients with different levels of obesity, especially in those with severe obesity. This suggests the inclusion of the evaluation of these psychological disorders in the evaluation portfolio of obese people, for a better therapeutic approach. [ABSTRACT FROM AUTHOR]

Quality glucose-like peptide-1 receptor agonist (GLP-1 RA)-supported digital weight-loss services (DWLSs) have the potential to play a significant role in shifting the alarming global obesity rate. Previous studies have demonstrated various aspects of their utility in Australian and British populations, but nothing has hitherto been investigated in real-world European settings, where GLP-1 RA weight therapy and digital healthcare are widely used. This study retrospectively analysed the 5-month (Mean = 160.14 days) weight-loss outcomes in a cohort of patients who received email-based health coaching and Semaglutide therapy via the Juniper Germany DWLS (n = 833). Mean weight loss was 9.52 (±5.46) percent, with 81.51% of the cohort losing a 'meaningful' (5% or more) amount of weight. Females (Mean = 9.75) tended to lose more weight than males (Mean = 8.41) and patients from the lowest two BMI categories (27.5–29.99 kg/m2 Mean = 10.1; 30–34.99 kg/m2 Mean = 9.74) lost significantly more weight than those in the highest BMI category (≥40 kg/m2 Mean = 8.11). These findings indicate that GLP-1 RA-supported DWLSs can contribute to meaningful weight loss in Germany. Future research should seek to conduct a dedicated adherence analysis of the Juniper Germany DWLS and measure the effect of subsidisation and baseline body mass index on general DWLS effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: Management of gastroesophageal reflux disease after bariatric procedures can be challenging. There are very few long-term studies in this arena. This study aims to evaluate the long-term outcomes of the magnetic sphincter augmentation (MSA) reflux management system in a cohort of bariatric patients who had previously undergone sleeve gastrectomy and Roux-en-Y gastric bypass, with a focus on assessing gastroesophageal reflux disease (GERD) scores, medication use, and patient-reported symptoms. Methods: We conducted a retrospective chart review of 16 consecutive bariatric patients who received MSA implants following sleeve gastrectomy (n = 14) or gastric bypass (n = 2) surgeries. Data were collected regarding BMI, GERD quality of life assessments (GERD-HRQL), reflux symptoms, and use of PPIs in the sleeve/RGB patients through an extended period with a mean follow-up of 48 months. Results: Patients were followed up for a range of.5–84 months. Preoperative assessments included upper gastrointestinal imaging (UGI), high-resolution manometry, Bravo pH studies, and esophagogastroduodenoscopy (EGD). Three patients exhibited reflux on UGI, and 13/13 patients had positive Bravo studies preoperatively. Sixteen patients had a lower esophageal sphincter (LES) pressure under 18 mmHg, and eight patients had biopsy-proven esophagitis. Long-term outcomes are as follows. Daily PPI use fell from 88 to 25% at greater than three years. GERD-HRQL scores fell from 50.6 at baseline (range 27–70) and normalized at long-term follow-up. GERD symptom of regurgitation completely resolved. At long term, two patients had dysphagia and two patients had ongoing reflux. No adverse events were noted. Conclusion: This is the first long-term outcomes study of magnetic sphincter augmentation placement after bariatric surgery. Our study showed the majority of patients had long-term improvement in GERD-HRQL scores and resolution/ relief of their reflux symptoms, with decreased use of PPIs. MSA is a safe, effective and durable management tool for reflux after bariatric surgery in carefully selected patients. [ABSTRACT FROM AUTHOR]