ABSTRACT
Obesity represents a growing public health concern, affecting more than 15% of the global adult population and involving a multi-billion market that comprises nutritional, surgical, psychological, and multidisciplinary interventions. The objective of this retrospective study was to evaluate the short-term efficacy and body weight measurements associated with differing levels of physical activity following the use of Allurion's ingestible gastric balloon that was designed to increase feelings of fullness and decrease food consumption, being naturally eliminated after approximately 16 weeks. This study involved 571 individuals who qualified for the intervention for being older than 20 years with a body mass index (BMI) of 27 kg/m2 or more. Utilizing the Scale App Health Tracker and Allurion's smartwatch, this study was able to track vital signs and physical activity in real time. The participants had an average initial BMI of 34.1 kg/m2 and a median age of 41 years. Notable outcomes were observed in both study groups, "Less Active" and "More Active", which were classified by achieving less or more than a median number of 8000 daily steps. Specifically, body fat percentage saw a reduction from 33.1 ± 9.4 to 28.3 ± 10.2 in the less active group and from 32.2 to 27.5 in the more active group, with both groups achieving statistical significance (p < 0.001). Additionally, there was a significant reduction in average weight, dropping from 98.2 ± 22.8 kg to 84.6 ± 19.3 kg in the less active group and from 97.7 ± 21.0 kg to 82.1 ± 22.9 kg in the more active group (both p < 0.001). Interestingly, those in the more active group also experienced a significant increase in lean mass compared to their less active counterparts (p = 0.045), although no substantial differences in weight loss, BMI reduction, and total body fat decrease were observed between the two groups. This investigation confirms the hypothesis that Allurion's ingestible gastric balloon significantly reduces weight in the short term and enhances several physical health metrics, demonstrating effectiveness as an autonomous method for challenging weight management, regardless of the level of daily physical activity.
ABSTRACT
Background: This systematic review examines the efficacy of multiorgan resection (MOR) in treating locally advanced gastric cancer (LAGC), focusing on survival outcomes, postoperative morbidity, and mortality. Methods: We conducted a comprehensive search of studies in PubMed, Scopus, and Embase up to November 2023, based on the PRISMA guidelines. The inclusion criteria focused on clinical trials, observational studies, case-control studies, and qualitative research, involving patients of any age and gender diagnosed with LAGC undergoing MOR aimed at R0 resection, with secondary outcomes focusing on survival rates, postoperative outcomes, and the effects of adjuvant and neoadjuvant therapies. Exclusion criteria ruled out non-human studies, research not specifically focused on LAGC patients undergoing MOR, and studies lacking clear, quantifiable outcomes. The quality assessment was performed using the Newcastle-Ottawa Scale. The final analysis included twenty studies, involving a total of 2489 patients across a time span from 2001 to 2023. Results highlighted a significant variation in median survival times ranging from 10 to 27 months and R0 resection rates from 32.1% to 94.3%. Survival rates one-year post-R0 resection varied between 46.7% and 84.8%, with an adjusted weighted mean of 66.95%. Key predictors of reduced survival included esophageal invasion and peritoneal dissemination, the presence of more than six lymph nodes, and tumor sizes over 10 cm. Nevertheless, the meta-analysis revealed a significant heterogeneity (I2 = 87%), indicating substantial variability across studies, that might be caused by differences in surgical techniques, patient demographics, and treatment settings which influence survival outcomes. Results: The review underlines the important role of achieving R0 resection status in improving survival outcomes, despite the high risks associated with MOR. Variability across studies suggests that local practice patterns and patient demographics significantly influence results. Conclusions: The findings emphasize the need for aggressive surgical strategies to improve survival in LAGC treatment, highlighting the importance of achieving curative resection despite inherent challenges.
ABSTRACT
Monitoring the indoor microclimate in old buildings of cultural heritage and significance is a practice of great importance because of the importance of their identity for local communities and national consciousness. Most aged heritage buildings, especially those made of wood, develop an indoor microclimate conducive to the development of microorganisms. This study aims to analyze one wooden church dating back to the 1710s in Romania from the microclimatic perspective, i.e., temperature and relative humidity and the fungal load of the air and surfaces. One further aim was to determine if the internal microclimate of the monument is favorable for the health of parishioners and visitors, as well as for the integrity of the church itself. The research methodology involved monitoring of the microclimate for a period of nine weeks (November 2020-January 2021) and evaluating the fungal load in indoor air as well as on the surfaces. The results show a very high contamination of air and surfaces (>2000 CFU/m3). In terms of fungal contamination, Aspergillus spp. (two different species), Alternaria spp., Cladosporium spp., Mucor spp., Penicillium spp. (two different species) and Trichopyton spp. were the genera of fungi identified in the indoor wooden church air and Aspergillus spp., Cladosporium spp., Penicillium spp. (two different species) and Botrytis spp. on the surfaces (church walls and iconostasis). The results obtained reveal that the internal microclimate not only imposes a potential risk factor for the parishioners and visitors, but also for the preservation of the wooden church as a historical monument, which is facing a crisis of biodeterioration of its artwork.
