Weight Regain Outcomes After Bariatric Surgery in the Long-term Follow-up: Role of Preoperative Factors.

PURPOSE: Weight regain (WR) compromises the effectiveness of bariatric surgery. The objective of this study was to determine differences in long-term WR prevalence using different definitions and analyze possible preoperative predictors involved. METHODS: Single-center retrospective cohort study including 445 adults who underwent 3 modalities of bariatric surgery between 2009 and 2014. EXPOSURE: age, gender, ethnicity, body mass index (BMI), type 2 diabetes (T2D), hypertension (HTN), and type of surgery. MAIN OUTCOMES: WR at year 6 assessed by 4 definitions and 6 multivariate models based on common thresholds. RESULTS: Our cohort (71.1% female) had a mean age of 44.78 ± 11.94 years, and mean presurgery BMI of 44.94 ± 6.88 kg/m2, with a median follow-up of 6 years (IQR=5-8). The prevalences of T2D and HTN were 36.0% and 46.7% respectively. WR rates over thresholds ranged from 25.4 to 68.1%, with significant differences between groups in the WR measured as the percentage of maximum weight loss (MWL) and the increase in excess weight loss (EWL). Presurgery BMI was a significant predictor in 3 models; restrictive techniques were associated with WR in all the models except for those considering WR over 10 kg and WR over 15% from nadir as dependent variables. CONCLUSIONS: In this long-term study, WR defined as percentage of MWL and increase in EWL from nadir had the greatest significance in logistic regression models with preoperative BMI and type of surgery as independent variables. These findings could serve to establish a standardized outcome reporting WR in other longitudinal studies. KEY POINTS: • Lack of standardized outcome to measure weight regain after bariatric surgery. • Lowest rates of weight regain in malabsorptive techniques in all definitions applied. • Weight regain measured as percentage of maximum weight lost.

Developing creative and research skills through an open and interprofessional inquiry-based learning course.

BACKGROUND: Biomedicine needs innovative professionals. Inquiry-based learning (IBL) aims to develop higher order thinking skills, such as creativity and research. Stimulatory techniques and interprofessional education, which requires students from different fields to collaborate, also enhances creativity. In this study, the effectiveness of an interprofessional IBL course that introduces a creativity workshop based on stimulatory techniques to develop creative and research skills is examined. METHODS: 529 undergraduate human biology and medical students performed the interprofessional IBL course, 198 with the creativity workshop and 331 without. Students' perceptions of learning processes and outcomes were assessed in surveys and focus groups by the authors of this study. As well, the final learning results from both groups of students were analyzed by the teachers of the course and the researchers. RESULTS: The results show that the open IBL approach promoted the development of these skills, interprofessionality acted as a creativity enhancer and stimulatory techniques contributed to improve the learning outcomes. CONCLUSIONS: This study provides insight into how open interprofessional IBL fosters acquisition of complex skills and knowledge, pointing out the benefits and limitations of this approach in health sciences studies.