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Collagen has been widely used in biomedical applications, mainly to develop structures (cell scaffolds) that allow cell growth and differentiation processes. This biomolecule is also used in cosmetics because it is an essential ingredient of certain makeup and in pharmaceutics for bandages to treat wounds and burns. However, the use of collagen has been limited by the ethical and moral implications of the (typically animal) sources from which it is extracted. Therefore, alternative, more environmentally friendly sources should be found to obtain collagen. Extracting collagen from fishing industry waste (such as scales, bones, and fish skin) has been presented as an advantageous alternative to obtain this biomaterial, which has also shown promising results due to its biocompatibility with human structures (organs and tissues). The characteristics of this molecule and other sources from which it can be obtained should be further studied.

Este artículo presenta una reflexión alrededor de un ejercicio de corte investigativo, desarrollado por el semillero de investigación: Trabajo Social, Calidad de Vida y Bienestar, perteneciente al programa de Trabajo Social de la Universidad Católica Luis Amigó. El tema central es explorar la incidencia de la desigualdad social en la salud mental de los jóvenes del municipio de San Andrés de Cuerquia, Antioquia, durante el primer semestre de 2020.

In [David-Toro 15] and [David-Engelstein-Toro 19], (some of) the authors studied almost minimizers for functionals of the type first studied by Alt and Caffarelli in [Alt-Caffarelli 81] and Alt, Caffarelli and Friedman in [Alt-Caffarelli-Friedman 84]. In this paper we study the regularity of almost minimizers to energy functionals with variable coefficients (as opposed to [DT15, DET19. AC 81] and [ACF84] which deal only with the "Laplacian" setting). We prove Lipschitz regularity up to, and across, the free boundary, generalizing the results of [David-Toro 15] to the variable coefficient setting., Comment: 41 pages. Revised version has minor corrections and additions. To appear in Math Z

This study compared the ultrastructure, chemical composition, and proteases activity (PA) of sound (SD) and caries-affected dentin (CAD) in the dentin hybrid layer after using an experimental bonding system containing pyromellitic dianhydride glycerol methacrylate and biomimetic analogs. The bonding system used a three step and a total-etch procedure. Polyacrylic acid (5%) and sodium trimetaphosphate (5%) were added to the primer and monocalcium phosphate monohydrate (9%), beta-tricalcium phosphate (10.5%), and calcium hydroxide (0.5%) were added to the adhesive. Transmission electron microscopy (TEM) was used to evaluate the resultant structure, particularly the adhesive-dentin and the demineralized-SD interfaces. The chemical composition was evaluated through energy-dispersive X-ray spectroscopy (EDS) and selected area electron diffraction (SAED). The PA was measured with the Coomassie Blue-G250 coloring test, and the PA data were analyzed by ANOVA. EDS identified the presence of isolated calcium phosphate nanoparticles in the demineralized region; however, the SAED analysis did not show any evidences of hydroxyapatite (HA) neoformation in SD and CAD. The biomimetic analog-based adhesive system inhibited the activities of dentin proteases immediately after treatment. Additionally, the proteolytic activity on the affected dentin resembled that of the SD. In conclusion, no HA formed in the demineralized SD and CAD although there were calcium and phosphate deposits. The experimental adhesive system inhibited dentin proteases. The present study uses a new approach to investigate the hybrid layer behavior in dentin. The experimental adhesive system was synthesized and used on sound and affected-caries dentin as the substrate to reproduce real clinical conditions.

We generalize to the setting of 1-sided chord-arc domains, that is, to domains satisfying the interior Corkscrew and Harnack Chain conditions (these are respectively scale-invariant/quantitative versions of the openness and path-connectedness) and which have an Ahlfors regular boundary, a result of Kenig-Kirchheim-Pipher-Toro, in which Carleson measure estimates for bounded solutions of the equation $ Lu=-\operatorname {div}(A\nabla u) = 0$ with $ A$ being a real (not necessarily symmetric) uniformly elliptic matrix imply that the corresponding elliptic measure belongs to the Muckenhoupt $ A_\infty $ class with respect to surface measure on the boundary. We present two applications of this result. In the first one we extend a perturbation result recently proved by Cavero-Hofmann-Martell presenting a simpler proof and allowing non-symmetric coefficients. Second, we prove that if an operator $ L$ as above has locally Lipschitz coefficients satisfying certain Carleson measure condition, then $ \omega _L\in A_\infty $ if and only if $ \omega _{L^\top }\in A_\infty $. As a consequence, we can remove one of the main assumptions in the non-symmetric case of a result of Hofmann-Martell-Toro and show that if the coefficients satisfy a slightly stronger Carleson measure condition the membership of the elliptic measure associated with $ L$ to the class $ A_\infty $ yields that the domain is indeed a chord-arc domain., The first author was partially supported by “la Caixa”-Severo Ochoa international PhD Programme. The first and third authors acknowledge financial support from the Spanish Ministry of Economy and Competitiveness, through the “Severo Ochoa” Programme for Centres of Excellence in R&D” (SEV-2015-0554). They also acknowledge that the research leading to these results received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ ERC agreement no. 615112 HAPDEGMT The second author was supported by NSF grant DMS-1664047. The fourth author was partially supported by the Craig McKibben & Sarah Merner Professor in Mathematics, by NSF grant number DMS-1664867, and by the Simons Foundation Fellowship 614610.

We study the existence and structure of branch points in two-phase free boundary problems. More precisely, we construct a family of minimizers to an Alt- Caffarelli-Friedman type functional whose free boundaries contain branch points in the strict interior of the domain. We also give an example showing that branch points in the free boundary of almost-minimizers of the same functional can have very little structure. This last example stands in contrast with recent results of De Philippis- Spolaor-Velichkov on the structure of branch points in the free boundary of stationary solutions., Comment: 30 pages, 5 figures. Comments Welcome!

In non-variational two-phase free boundary problems for harmonic measure, we examine how the relationship between the interior and exterior harmonic measures of a domain Ω⊂Rn influences the geometry of its boundary. This type of free boundary problem was initially studied by Kenig and Toro in 2006, and was further examined in a series of separate and joint investigations by several authors. The focus of the present paper is on the singular set in the free boundary, where the boundary looks infinitesimally like zero sets of homogeneous harmonic polynomials of degree at least 2. We prove that if the Radon–Nikodym derivative of the exterior harmonic measure with respect to the interior harmonic measure has a Holder continuous logarithm, then the free boundary admits unique geometric blowups at every singular point and the singular set can be covered by countably many C1,β submanifolds of dimension at most n−3. This result is partly obtained by adapting tools such as Garofalo and Petrosyan’s Weiss type monotonicity formula and an epiperimetric inequality for harmonic functions from the variational to the non-variational setting.

OBJECTIVE This study aimed to determine whether controlling maternal gestational weight gain (GWG) influences adipose tissue distribution at 1 year postpartum. METHODS Women with overweight or obesity (n = 210, BMI ≥ 25 or ≥ 30) were randomized to a lifestyle intervention (LI) designed to control GWG or to usual obstetrical care (UC). Measures included anthropometry, whole-body magnetic resonance imaging for visceral (VAT), intermuscular, and subcutaneous adipose tissue, and cardiometabolic risk factors in pregnancy (15 and 35 weeks) and after delivery (15 and 59 weeks). RESULTS Baseline (15 weeks) characteristics were similar (mean [SD]: age, 33.8 [4.3] years; weight, 81.9 [13.7] kg; BMI, 30.4 [4.5]; gestational age at randomization, 14.9 [0.8] weeks). LI had less GWG (1.79 kg; P = 0.003) and subcutaneous adipose tissue gain at 35 weeks gestation (P

Cognitive-behavioral therapy (CBT) has shown efficacy in the treatment of eating disorders. The authors conducted a randomized controlled telemedicine trial of CBT-guided self-help (CBT-GSH) assisted with a smartphone app, Noom Monitor, for binge eating with or without purging. They hypothesized that coach-delivered CBT-GSH telemedicine sessions plus Noom Monitor would yield greater reductions in symptoms of binge eating, purging, and eating disorders compared with standard care.Fifty-two-week outcomes for CBT-GSH plus Noom Monitor (N=114) were compared with outcomes for standard care (N=111) among members of an integrated health care system in the Pacific Northwest. Patients in the health system who met inclusion criteria were ≥18 years old, had a body mass index ≥18.5, met criteria for DSM-5 binge eating disorder or bulimia nervosa, had 12 months of continuous health care enrollment in Kaiser Permanente Northwest, and had a personal smartphone. Participants received eight CBT-GSH telemedicine sessions over 12 weeks administered by health coaches, and outcomes were assessed at baseline and at weeks 4, 8, 12, 26, and 52. The use of available treatment offered within the Kaiser Permanente health care system was permitted for participants assigned to standard care.Participants who received CBT-GSH plus Noom Monitor reported significant reductions in objective binge-eating days (β=-0.66, 95% CI=-1.06, -0.25; Cohen's d=-1.46, 95% CI=-4.63, -1.09) and achieved higher rates of remission (56.7% compared with 30%; number needed to treat=3.74) at 52 weeks compared with participants in standard care, none of whom received any eating disorder treatment during the intervention period (baseline and weeks 1-12). Similar patterns emerged for compensatory behaviors (vomiting, use of laxatives, and excessive exercise; 76.3% compared with 56.8%; number needed to treat=5.11), eating disorder symptoms (body shape, weight, eating concerns, and dietary restraint), and clinical impairment (Cohen's d=-10.07, -2.15).These results suggest that CBT-GSH plus Noom Monitor delivered via telemedicine by routine-practice health coaches in a nonacademic health care system yields reductions in symptoms and impairment over 52 weeks compared with standard care.

Patient-centered communication (PCC) by healthcare professionals can contribute to enacting and facilitating patients' self-management of chronic health conditions. This study investigates the emerging patterns of PCC that occur in an mHealth-based diabetes prevention program for older adults. The analysis of user-coach communication data during the 16-week period of the program revealed four PCC strategies employed by coaches: (a) triggering reflections on users' routinized habits, (b) jointly determining a measurable health goal, (c) facilitating self-evaluations on recent behavior change, and (d) tailoring programs to adapt to users' lifestyle and health status. To advance these strategies, coaches utilized various mHealth features that helped them (a) engage in data-driven coaching, (b) increase situational awareness of users' health conditions and routines, (c) provide continuous support to users through regular and spontaneous in-app chats, and (d) foster user autonomy and engagement. The findings extend implications for developing technology-enabled healthcare practice to enhance self-management of chronic illness.

BACKGROUND: Currently available infant body composition measurement methods are impractical for routine clinical use. The study developed anthropometric equations (AE) to estimate fat mass (FM, kg) during the first year using air displacement plethysmography (PEA POD® Infant Body Composition System) and Infant Quantitative Magnetic Resonance (Infant-QMR) as criterion methods. METHODS: Multiethnic full-term infants (n=191) were measured at 3 days, 15 weeks, and 54 weeks. Sex, race/ethnicity, gestational age, age (days), weight-kg (W), length-cm (L), head circumferences-cm (HC), skinfold thicknesses mm [triceps (TRI), thigh (THI), subscapular (SCP), and iliac (IL)], and FM by PEA POD® and Infant-QMR were collected. Stepwise linear regression determined the model that best predicted FM. RESULTS: Weight, length, head circumference and skinfolds of triceps, thigh and subscapular, but not iliac, significantly predicted fat mass throughout infancy in both the Infant QMR and PEA POD models. Sex had an interaction effect at 3 days and 15 weeks for both the models. The coefficient of determination [R(2)] and root mean square error were 0.87 (66g) at 3 days, 0.92 (153g) at 15 weeks and 0.82 (278g) at 54 weeks for the Infant-QMR models; 0.77 (80g) at 3 days and 0.82 (195g) at 15 weeks for the PEA POD models respectively. CONCLUSIONS: Both PEAPOD and Infant-QMR derived models predict FM using skinfolds, weight, head circumference, and length with acceptable R(2) and residual patterns.

BACKGROUND There is large variance in weight loss outcomes of digital behavior change interventions (DBCIs). It has been suggested that different patterns of engagement in the program could be responsible for this variance in outcomes. Previous studies have found that the amount of engagement on DBCIs, such as the number of meals logged or articles read, is positively associated with weight loss. OBJECTIVE This retrospective study extends previous research by observing how important weight loss outcomes (high weight loss: 10% or greater body weight loss; moderate weight loss: between 5% to 10%; stable weight: 0 plus or minus 1%) are associated with engagement on a publicly available mobile DBCI (Noom) from 9 to 52 weeks. METHODS Engagement and weight data for eligible participants (N=11,252) were extracted from the Noom database. Engagement measures included the number of articles read, meals logged, steps recorded, messages to coach, exercise logged, weigh-ins, and days with 1 meal logged per week. Weight was self-reported on the program. Multiple linear regressions examined how weight loss outcome (moderate and high vs stable) was associated with each engagement measure across 3 study time periods: 9-16 weeks, 17-32 weeks, and 33-52 weeks. RESULTS At 9-16 weeks, among the 11,252 participants, 2594 (23.05%) had stable weight, 6440 (57.23%) had moderate weight loss, and 2218 (19.71%) had high weight loss. By 33-52 weeks, 525 (18.21%) had stable weight, 1214 (42.11%) had moderate weight loss, and 1144 (39.68%) had high weight loss. Regression results showed that moderate weight loss and high weight loss outcomes were associated with all engagement measures to a significantly greater degree than was stable weight (all P values CONCLUSIONS Our results suggest that these clinically important weight loss outcomes are related to the number of articles read, meals logged, steps recorded, messages to coach, exercise logged, weigh-ins, and days with 1 meal logged per week both in the short-term and long-term (ie, 1 year) on Noom. This provides valuable data on engagement patterns over time on a self-directed mobile DBCI, can help inform how interventions tailor recommendations for engagement depending on how much weight individuals have lost, and raises important questions for future research on engagement in DBCIs.

Let $\Omega\subset\mathbb{R}^{n+1}$, $n\ge 2$, be a 1-sided non-tangentially accessible domain (aka uniform domain), that is, $\Omega$ satisfies the interior Corkscrew and Harnack chain conditions, which are respectively scale-invariant/quantitative versions of openness and path-connectedness. Let us assume also that $\Omega$ satisfies the so-called capacity density condition, a quantitative version of the fact that all boundary points are Wiener regular. Consider $L_0 u=-\mathrm{div}(A_0\nabla u)$, $Lu=-\mathrm{div}(A\nabla u)$, two real (non-necessarily symmetric) uniformly elliptic operators in $\Omega$, and write $\omega_{L_0}$, $\omega_L$ for the respective associated elliptic measures. The goal of this program is to find sufficient conditions guaranteeing that $\omega_L$ satisfies an $A_\infty$-condition or a $RH_q$-condition with respect to $\omega_{L_0}$. In this paper we are interested in obtaining square function and non-tangential estimates for solutions of operators as before. We establish that bounded weak null-solutions satisfy Carleson measure estimates, with respect to the associated elliptic measure. We also show that for every weak null-solution, the associated square function can be controlled by the non-tangential maximal function in any Lebesgue space with respect to the associated elliptic measure. These results extend previous work of Dahlberg-Jerison-Kenig and are fundamental for the proof of the perturbation results in arXiv:1901.08261., Comment: This paper is part of the earlier submission arXiv:1901.08261(2)

Background: Mobile health (mHealth) technology can circumvent barriers to participation in weight loss programs faced by new mothers. The objective of this study was to assess weight change and pro...

Background LIFT (Lifestyle Intervention for Two) trial found that intervening in women with overweight and obesity through promoting healthy diet and physical activity to control gestational weight gain (GWG) resulted in neonates with greater weight, lean mass and head circumference and similar fat mass at birth. Whether these neonate outcomes are sustained at 1-year was the focus of this investigation. Methods Measures included body composition by PEA POD air displacement plethysmography (ADP) and Echo Infant quantitative magnetic resonance (QMR) and head circumference at birth (n = 169), 14 (n = 136) and 54 weeks (n = 137). Differences in fat and lean mass between lifestyle intervention (LI) and Usual care (UC) groups were examined using ANCOVA adjusting for maternal age and BMI, GWG, offspring sex and age. Results Compared to UC, LI infants had similar weight (112 ± 131 g; P = .40), fat mass (14 ± 80 g; P = .86), lean mass (100 ± 63 g; P = .12) at 14 weeks and similar weight (168 ± 183 g; P = .36), fat mass (148 ± 124 g; P = .24), lean mass (117 ± 92 g; P = .21) at 54 weeks. Head circumference was greater in LI at 54 weeks (0.46 ± 2.1 cm P = .03). Conclusions Greater lean mass observed at birth in LI offspring was not sustained at 14 and 54 weeks, whereas the greater head circumference in LI offspring persisted at 54 weeks.

Background The prevalence of obesity and diabetes among middle-aged and older adults is on the rise, and with an increase in the world population of adults aged 60 years and older, the demand for health interventions across age groups is growing. Noom is an mHealth behavior change lifestyle intervention that provides users with tracking features for food and exercise logging and weighing-in as well as access to a virtual 1:1 behavior change coach, support group, and daily curriculum that includes diet-, exercise-, and psychology-based content. Limited research has observed the effect of age on a mobile health (mHealth) lifestyle intervention. Objective The goal of the research was to analyze engagement of middle-aged and older adults using a mobile lifestyle or diabetes prevention intervention. Methods A total of 14,767 adults (aged 35 to 85 years) received one of two curricula via an mHealth intervention in a quasi-experimental study: the Healthy Weight program (HW) by Noom (84%) or the Noom-developed Diabetes Prevention Program (DPP), recognized by the US Centers for Disease Control and Prevention (CDC). The main outcome measure was weight over time, observed at baseline and weeks 16 and 52. Results Linear mixed modeling found age to be a significant predictor of weight at week 16 (F2,1398.4=9.20; P Conclusions Age and engagement are significant predictors of weight. Older adults lost more weight using an mHealth evidence-based lifestyle intervention compared with younger adults, despite their engagement. These preliminary findings suggest further clinical implications for adapting the program to older adults’ needs.

Objective The objective of this study was to determine the effectiveness of controlling maternal gestational weight gain (GWG) in the second and third trimesters on neonate body composition. Methods Two hundred ten healthy women with overweight (25 > BMI < 30) or obesity (BMI ≥ 30) were randomly assigned to a lifestyle intervention (LI) program focused on controlling GWG through nutrition and activity behaviors or to usual obstetrical care (UC). Infant fat and fat-free mass (FFM) at birth were measured by using air displacement plethysmography (PEA POD) and by using quantitative magnetic resonance (QMR). Results At baseline, there were no between-group differences in maternal characteristics (mean [SD]): age: 33.8 (4.3) years, weight: 81.9 (13.7) kg, BMI: 30.4 (4.5), and gestational age at randomization: 14.9 (0.8) weeks. GWG was less in the LI group by 1.79 kg (P = 0.003) or 0.0501 kg/wk (P = 0.002). Compared with UC infants, LI infants had greater weight (131 ± 59 g P = 0.03), FFM (98 ± 45 g; P = 0.03) measured by PEA POD, and lean mass (105 ± 38 g; P = 0.006) measured by QMR. Fat mass and percent fat were not significantly different. Conclusions Intervening in women with overweight and obesity through behaviors promoting healthy diet and physical activity to control GWG resulted in neonates with similar fat and greater FFM.

The objective of this study was to determine the effectiveness of controlling maternal gestational weight gain (GWG) in the second and third trimesters on neonate body composition.Two hundred ten healthy women with overweight (25BMI30) or obesity (BMI ≥ 30) were randomly assigned to a lifestyle intervention (LI) program focused on controlling GWG through nutrition and activity behaviors or to usual obstetrical care (UC). Infant fat and fat-free mass (FFM) at birth were measured by using air displacement plethysmography (PEA POD) and by using quantitative magnetic resonance (QMR).At baseline, there were no between-group differences in maternal characteristics (mean [SD]): age: 33.8 (4.3) years, weight: 81.9 (13.7) kg, BMI: 30.4 (4.5), and gestational age at randomization: 14.9 (0.8) weeks. GWG was less in the LI group by 1.79 kg (P = 0.003) or 0.0501 kg/wk (P = 0.002). Compared with UC infants, LI infants had greater weight (131 ± 59 g P = 0.03), FFM (98 ± 45 g; P = 0.03) measured by PEA POD, and lean mass (105 ± 38 g; P = 0.006) measured by QMR. Fat mass and percent fat were not significantly different.Intervening in women with overweight and obesity through behaviors promoting healthy diet and physical activity to control GWG resulted in neonates with similar fat and greater FFM.

There are inconsistent results for the effectiveness of using smartphone applications (apps) or websites on weight loss. We investigated the efficacy of a smartphone intervention using a designated app that utilizes a lifestyle intervention-focused approach, including a human coaching element, toward weight loss in overweight or obese Korean adults.One hundred four adults aged 20-60 years with a body mass index ≥23 kg/mParticipants showed a clinically significant weight loss effect of -7.5% at the end of the 15-week program (P 0.001), and at a 52-week follow-up, a weight loss effect of -5.2% was maintained. At 15 weeks, percent body fat and visceral fat decreased by -6.0 ± 5.4% and -3.4 ± 2.7 kg, respectively (both P 0.001). Fasting glucose level also decreased significantly by -5.7 ± 14.6 mg/dL at 15 weeks. Lipid parameters showed significant improvements, except for high-density lipoprotein cholesterol. The frequency of logging meals and exercise was associated with body fat loss.This advanced smartphone app was a useful tool to maintain weight loss in overweight or obese people.

OBJECTIVE The precision and accuracy of a quantitative magnetic resonance (EchoMRI Infants) system in newborns were determined. METHODS Canola oil and drinking water phantoms (increments of 10 g to 1.9 kg) were scanned four times. Instrument reproducibility was assessed from three scans (within 10 minutes) in 42 healthy term newborns (12-70 hours post birth). Instrument precision was determined from the coefficient of variation (CV) of repeated scans for total water, lean mass, and fat measures for newborns and the mean difference between weight and measurement for phantoms. In newborns, the system accuracy for total body water (TBW) was tested against deuterium dilution (D2 O). RESULTS In phantoms, the repeatability and accuracy of fat and water measurements increased as the weight of oil and water increased. TBW was overestimated in amounts >200 g. In newborns weighing 3.14 kg, fat, lean mass, and TBW were 0.52 kg (16.48%), 2.28 kg, and 2.40 kg, respectively. EchoMRI's reproducibility (CV) was 3.27%, 1.83%, and 1.34% for total body fat, lean mass, and TBW, respectively. EchoMRI-TBW values did not differ from D2 O; mean difference, -1.95 ± 6.76%, P = 0.387; mean bias (limits of agreement), 0.046 kg (-0.30 to 0.39 kg). CONCLUSIONS The EchoMRI Infants system's precision and accuracy for total body fat and lean mass are better than established techniques and equivalent to D2 O for TBW in phantoms and newborns.

BACKGROUND The prevalence of obesity and diabetes among middle-aged and older adults is on the rise, and with an increase in the world population of adults aged 60 years and older, the demand for health interventions across age groups is growing. Noom is an mHealth behavior change lifestyle intervention that provides users with tracking features for food and exercise logging and weighing-in as well as access to a virtual 1:1 behavior change coach, support group, and daily curriculum that includes diet-, exercise-, and psychology-based content. Limited research has observed the effect of age on a mobile health (mHealth) lifestyle intervention. OBJECTIVE The goal of the research was to analyze engagement of middle-aged and older adults using a mobile lifestyle or diabetes prevention intervention. METHODS A total of 14,767 adults (aged 35 to 85 years) received one of two curricula via an mHealth intervention in a quasi-experimental study: the Healthy Weight program (HW) by Noom (84%) or the Noom-developed Diabetes Prevention Program (DPP), recognized by the US Centers for Disease Control and Prevention (CDC). The main outcome measure was weight over time, observed at baseline and weeks 16 and 52. RESULTS Linear mixed modeling found age to be a significant predictor of weight at week 16 (F2,1398.4=9.20; Pβ=–.12, 95% CI –0.18 to –0.07), suggesting that as age increases by 1 year, weight decreased by 0.12 kg. An interaction between engagement and age was also found at week 52 (F1,14680.51=6.70; P=.01) such that engagement was more strongly associated with weight for younger versus older adults (age × engagement: β=.02, 95% CI 0.01 to 0.04). HW users lost 6.24 (SD 6.73) kg or 5.2% of their body weight and DPP users lost 5.66 (SD 7.16) kg or 8.1% of their body weight at week 52, meeting the CDC standards for weight loss effects on health. CONCLUSIONS Age and engagement are significant predictors of weight. Older adults lost more weight using an mHealth evidence-based lifestyle intervention compared with younger adults, despite their engagement. These preliminary findings suggest further clinical implications for adapting the program to older adults’ needs.

BACKGROUND The Centers for Disease Control and Prevention (CDC) diabetes prevention program (DPP) has formed the foundation for Type 2 Diabetes Mellitus (T2DM) prevention efforts and lifestyle change modifications in multiple care settings. To our knowledge, no randomized controlled trial has verified the efficacy of a fully mobile version of CDC’s diabetes prevention program (DPP). OBJECTIVE This study aimed to investigate the long-term weight loss and glycemic efficacy of a mobile-delivered DPP compared with a control group receiving usual medical care. METHODS Adults with prediabetes (N=202) were recruited from a clinic and randomized to either a mobile-delivered, coach-guided DPP (Noom) or a control group that received regular medical care including a paper-based DPP curriculum and no formal intervention. The intervention group learned how to use the Noom program, how to interact with their coach, and the importance of maintaining motivation. They had access to an interactive coach-to-participant interface and group messaging, daily challenges for behavior change, DPP-based education articles, food logging, and automated feedback. Primary outcomes included changes in weight and hemoglobin A1c (HbA1c) levels at 6 and 12 months, respectively. Exploratory secondary outcomes included program engagement as a predictor of changes in weight and HbA1c levels. RESULTS A total of 202 participants were recruited and randomized into the intervention (n=101) or control group (n=99). In the intention-to-treat (ITT) analyses, changes in the participants’ weight and BMI were significantly different at 6 months between the intervention and control groups, but there was no difference in HbA1c levels (mean difference 0.004%, SE 0.05; P=.94). Weight and BMI were lower in the intervention group by −2.64 kg (SE 0.71; PP=.001), respectively. These differences persisted at 12 months. However, in the analyses that did not involve ITT, program completers achieved a significant weight loss of 5.6% (SE 0.81; PPP=.85) and gained 0.33% (SE 0.70; P=.63) at 12 months. Those randomized to the intervention group who did not start the program had no meaningful weight or HbA1c level change, similar to the control group. At 1 year, the intervention group showed a 0.23% reduction in HbA1c levels; those who completed the intervention showed a 0.28% reduction. Those assigned to the control group had a 0.16% reduction in HbA1c levels. CONCLUSIONS This novel mobile-delivered DPP achieved significant weight loss reductions for up to 1 year compared with usual care. This type of intervention reduces the risk of overt diabetes without the added barriers of in-person interventions. CLINICALTRIAL ClinicalTrials.gov NCT03865342; https://clinicaltrials.gov/ct2/show/NCT03865342

Background The Centers for Disease Control and Prevention (CDC) diabetes prevention program (DPP) has formed the foundation for Type 2 Diabetes Mellitus (T2DM) prevention efforts and lifestyle change modifications in multiple care settings. To our knowledge, no randomized controlled trial has verified the efficacy of a fully mobile version of CDC’s diabetes prevention program (DPP). Objective This study aimed to investigate the long-term weight loss and glycemic efficacy of a mobile-delivered DPP compared with a control group receiving usual medical care. Methods Adults with prediabetes (N=202) were recruited from a clinic and randomized to either a mobile-delivered, coach-guided DPP (Noom) or a control group that received regular medical care including a paper-based DPP curriculum and no formal intervention. The intervention group learned how to use the Noom program, how to interact with their coach, and the importance of maintaining motivation. They had access to an interactive coach-to-participant interface and group messaging, daily challenges for behavior change, DPP-based education articles, food logging, and automated feedback. Primary outcomes included changes in weight and hemoglobin A1c (HbA1c) levels at 6 and 12 months, respectively. Exploratory secondary outcomes included program engagement as a predictor of changes in weight and HbA1c levels. Results A total of 202 participants were recruited and randomized into the intervention (n=101) or control group (n=99). In the intention-to-treat (ITT) analyses, changes in the participants’ weight and BMI were significantly different at 6 months between the intervention and control groups, but there was no difference in HbA1c levels (mean difference 0.004%, SE 0.05; P=.94). Weight and BMI were lower in the intervention group by −2.64 kg (SE 0.71; P Conclusions This novel mobile-delivered DPP achieved significant weight loss reductions for up to 1 year compared with usual care. This type of intervention reduces the risk of overt diabetes without the added barriers of in-person interventions. Trial Registration ClinicalTrials.gov NCT03865342; https://clinicaltrials.gov/ct2/show/NCT03865342

The present paper establishes the correspondence between the properties of the solutions of a class of PDEs and the geometry of sets in Euclidean space. We settle the question of whether (quantitative) absolute continuity of the elliptic measure with respect to the surface measure and uniform rectifiability of the boundary are equivalent, in an optimal class of divergence form elliptic operators satisfying a suitable Carleson measure condition in uniform domains with Ahlfors regular boundaries. The result can be viewed as a quantitative analogue of the Wiener criterion adapted to the singular Lp data case. The first step is taken in Part I, where we considered the case in which the desired Carleson measure condition on the coefficients holds with sufficiently small constant, using a novel application of techniques developed in geometric measure theory. In Part II we establish the final result, that is, the ¿large constant case¿. The key elements are a powerful extrapolation argument, which provides a general pathway to self-improve scale-invariant small constant estimates, and a new mechanism to transfer quantitative absolute continuity of elliptic measure between a domain and its subdomains., The first author was partially supported by NSF Grants DMS-1664047 and DMS-2000048. The second author acknowledges financial support from the Spanish Ministry of Science and Innovation, through the “Severo Ochoa Programme for Centres of Excellence in R&D” (CEX2019-000904-S) and Grant MTM PID2019-107914GB-I00. The second author also acknowledges that the research leading to these results has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013)/ERC Agreement No. 615112 HAPDEGMT. The third author was partially supported by the NSF INSPIRE Award DMS 1344235, the NSF RAISE-TAQ Grant DMS 1839077, and the Simons Foundation Grant 563916, SM. The fourth author was partially supported by the Craig McKibben & Sarah Merner Professor in Mathematics, by NSF Grant Numbers DMS-1664867 and and DMS-1954545, and by the Simons Foundation Fellowship 614610. The fifth author was partially supported by NSF Grants DMS-1361823, DMS-1500098, DMS-1664867, DMS-1902756 and by the Institute for Advanced Study.

We provide a potential theoretic characterization of vanishing chord-arc domains under minimal assumptions. In particular we show that, if a domain has Ahlfors regular boundary, the oscillation of the logarithm of the interior and exterior Poisson kernels yields a great deal of geometric information about the domain. We use techniques from the classical calculus of variations, potential theory, quantitative geometric measure theory to accomplish this. One feature of this work, compared to Bortz-Hofmann PAMS 16 and Kenig-Toro Crelle 06, is that a priori we only require that the domains in question are connected., 48 pages. Final version including many suggestions by the referee(s). To appear in IUMJ

Objetivo: Establecer la relación de los determinantes que intervienen en el cuidado familiar para la conservación de la capacidad funcional de la población adulta mayor. Metodología: Se realizó un estudio con enfoque cualitativo, observacional, de corte transversal. La muestra de la investigación estuvo conformada por diadas de adulto mayor con su respectivo cuidador. Resultados: Como aporte del estudio se obtiene que el cuidador asume de manera responsable su rol, con la aplicación de conocimiento y habilidades empíricas para proteger a la persona que permanece a su cuidado con la finalidad de asegurar la realización de actividades de la vida diaria con escasa o si ayuda de una manera independiente. Conclusión: La implementación de estrategias en base a actividades de prevención y promoción por parte del equipo de salud de la Parroquia será fundamental al momento de establecer a la familia como factor protector.

Let $\Omega\subset\mathbb{R}^{n+1}$, $n\ge 2$, be a 1-sided non-tangentially accessible domain (aka uniform domain), i.e., a set which satisfies the interior Corkscrew and Harnack chain conditions, respectively scale-invariant/quantitative versions of openness and path-connectedness. Assume that $\Omega$ satisfies the so-called capacity density condition. Let $L_0u=-\mathrm{div}(A_0\nabla u)$, $Lu=-\mathrm{div}(A\nabla u)$ be two real (non-necessarily symmetric) uniformly elliptic operators, and write $\omega_{L_0}$, $\omega_L$ for the associated elliptic measures. The goal of this program is to find sufficient conditions guaranteeing that $\omega_L$ satisfies an $A_\infty$-condition or a $RH_q$-condition with respect to $\omega_{L_0}$. We show that if the discrepancy of the two matrices satisfies a natural Carleson measure condition with respect to $\omega_{L_0}$, then $\omega_L\in A_\infty(\omega_{L_0})$. Moreover, $\omega_L\in RH_q(\omega_{L_0})$ for any given $1, Comment: This paper is part of the earlier submission arXiv:1901.08261v2

In order to manage the different types of financial risks to which the entities of the sector are exposed on a daily basis, different national and international regulatory organizations have developed a set of monitoring and control tools in which the quantification of risks is vital for financial institutions as this allows calculating their probable losses, and subsequently allows defining and implementing procedures that contemplate the definition of general policies and risk mitigation. In coordination with these tools at the University of Medellin, a software tool called SICRIF has been developed, which has been designed as a suite composed of specialized modules that allow the quantification of liquidity risk, market risk and operational risk.

Background: It is widely recognized that the prevalence of obesity and comorbidities including prediabetes and type 2 diabetes continue to increase worldwide. Results from a 24-week Diabetes Prevention Program (DPP) fully mobile pilot intervention were previously published showing promising evidence of the usefulness of DPP-based eHealth interventions on weight loss. Objective: This pilot study extends previous findings to evaluate weight loss results of core (up to week 16) and maintenance (postcore weeks) DPP interventions at 65 weeks from baseline. Methods: Originally, 140 participants were invited and 43 overweight or obese adult participants with a diagnosis of prediabetes signed up to receive a 24-week virtual DPP with human coaching through a mobile platform. At 65 weeks, this pilot study evaluates weight loss and engagement in maintenance participants by means of repeated measures analysis of variances and backward multiple linear regression to examine predictors of weight loss. Last observation carried forward was used for endpoint measurements. Results: At 65 weeks, mean weight loss was 6.15% in starters who read 1 or more lessons per week on 4 or more core weeks, 7.36% in completers who read 9 or more lessons per week on core weeks, and 8.98% in maintenance completers who did any action in postcore weeks (all P

Summary Background Ethnic differences in total body fat (fat mass [FM]) have been reported in adults and children, but the timing of when these differences manifest and whether they are present at birth are unknown. Objectives This study aimed to assess whether ethnic differences in body fat are present at birth in healthy infants born at term, where body fat is measured using air displacement plethysmography and fat distribution by skin-fold thickness. Methods Data were from a multiracial cross-sectional convenience sample of 332 term infants from four racial or ethnic groups based on maternal self-report (A, Asian; AA, non-Hispanic Black [African-American]; C, non-Hispanic White; and H, Hispanic). The main outcome measure was infant body fat at 1–3 days after birth, with age, birth weight, gestational age and maternal pre-pregnancy weight as covariates. Results Significant effects for race (P = 0.0011), sex (P = 0.0051) and a race by sex interaction (P = 0.0236) were found. C females had higher FM than C males (P = 0.0001), and AA females had higher FM than AA males (P = 0.0205). C males had less FM than A males (P = 0.0353) and H males (P = 0.0001). Conclusion Race/ethnic and sex differences in FM are present in healthy term newborns. Although the implications of these differences are unclear, studies beginning in utero and birth set the stage for a life course approach to understanding disease later in life.

The relationship between maternal body composition and foetal development is unclear.To determine the relationship between maternal body composition [fat mass (FM) and fat-free mass (FFM)] and foetal growth and birth weight, independent of potential confounding factors.This study consisted of 92 women, normal and overweight/obese, recruited from the Instituto Fernandes Figueira in Rio de Janeiro, Brazil. Body composition (FM and FFM) was estimated using bioelectrical impedance. Foetal growth was assessed using serial ultrasound measurements at the second and third trimester and infant's weight and length were measured at birth. Multiple linear regression analyses were used to determine the association between maternal FM and FFM and birth weight adjusted for gestational age (BWt) and change in estimated foetal weight (ΔEFW), controlling for infant gender, maternal serum glucose, energy intake, parity, height and income.Maternal FM, but not FFM, was positively associated with BWt (p = 0.02) and borderline with ΔEFW (p = 0.05). FM expressed as a percentage of body weight (%FM) showed a significant positive association with BWt (p 0.001) and ΔEFW (p 0.01). Using backward linear regression analysis, FM was a significant predictor of BWt (p 0.001) and ΔEFW (p = 0.03), but not change in femur length.In this small sample of normal and overweight/obese women, maternal FM at mid-pregnancy is associated with neonatal BW and foetal growth.

Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life.

We report the undescribed advertisement calls of Diasporus gularis and D. tinker from the Colombian Pacific region. The call of D. gularis is a “whistle” consisting of a tonal note with four harmonics emitted at a frequency range from 2.6 kHz (frequency 5%) to 3.0 kHz (frequency 95%) and a peak frequency of 2.8 kHz. The call of D. tinker is a “tink,” has a single peaked note with two harmonics, a frequency range from 3.2 kHz (frequency 5%) to 3.6 kHz (frequency 95%), and a peak frequency of 3.4 kHz. According to the call traits reported within the genus Diasporus, we propose that D. gularis and D. tinker are acoustically more similar to D. citrinobapheus and D. anthrax, respectively. However, due to the lack of a complete phylogenetic tree for this clade, we cannot hypothesize if the call similarities between these species owe to a close phylogenetic relationship or convergent evolution in similar habitats.

Let $$\mu $$ be a doubling measure in $${\mathbb {R}}^n$$ . We investigate quantitative relations between the rectifiability of $$\mu $$ and its distance to flat measures. More precisely, for $$x$$ in the support $$\Sigma $$ of $$\mu $$ and $$r > 0$$ , we introduce a number $$\alpha (x,r)\in (0,1]$$ that measures, in terms of a variant of the $$L^1$$ -Wasserstein distance, the minimal distance between the restriction of $$\mu $$ to $$B(x,r)$$ and a multiple of the Lebesgue measure on an affine subspace that meets $$B(x,r/2)$$ . We show that the set of points of $$\Sigma $$ where $$\int _0^1 \alpha (x,r) {dr \over r} < \infty $$ can be decomposed into rectifiable pieces of various dimensions. We obtain additional control on the pieces and the size of $$\mu $$ when we assume that some Carleson measure estimates hold.

We characterize Radon measures μ \mu in R n \mathbb {R}^{n} that are d d -rectifiable in the sense that their supports are covered up to μ \mu -measure zero by countably many d d -dimensional Lipschitz images and μ ≪ H d \mu \ll \mathcal {H}^{d} . The characterization is in terms of a Jones function involving the so-called α \alpha -numbers. This answers a question left open in a former work by Azzam, David, and Toro.

This pilot study evaluated the efficacy of a Hypertension Prevention Program (HPP) administered through a mobile application platform with human coaching (app) on reduction in blood pressure and weight in 50 adults with prehypertension or hypertension. Participants were recruited into a 24-week mobile application intervention to administer the HPP between January 2016 and July 2016. Dietary elements of the programme were based on the Dietary Approaches to Stop Hypertension. The programme included in-app human coaching with bi-weekly phone calls, meal logging, blood pressure tracking and educational material. Main outcome variables included change in systolic and diastolic blood pressure, hypertension category, and weight loss. Data were analysed between October 2016 and December 2016. The HPP yielded overall improvements in weight (−3.04±4.04 kg, P=

Objective To assess changes in total (TAT), subcutaneous (SAT), visceral (VAT), and intermuscular (IMAT) adipose tissue by whole-body MRI before surgery and at 12 months and 24 months post-surgery in a subset of participants of the Longitudinal Assessment of Bariatric Surgery-2. Methods From 0 to 12 months, n = 20 females and 3 males; from 12 to 24 months, n = 42 females and 7 males. Paired t-tests and GLM repeated measures examined changes in TAT, SAT, VAT, and IMAT at 12 and 24 months, with sex and age as covariates. Results Changes from 0 to 12 months included weight (−41.9 ± 12.1 kg; −36%), TAT (−33.5 ± 9.6 kg; −56%), SAT (−29.2 ± 8.2 kg; −55%), VAT (−3.3 ± 1.6 kg; −73%), and IMAT (−0.99 ± 0.68 kg; −50%), all P

In this paper we study the local regularity of almost minimizers of the functional $$\begin{aligned} J(u)=\int _\Omega |\nabla u(x)|^2 +q^2_+(x)\chi _{\{u>0\}}(x) +q^2_-(x)\chi _{\{u