Decoding Obesity Management Medications and the Journey to Informed Treatment Choices for Patients.

Incretin-based obesity management medications (OMMs) fill a treatment gap in a stepped-care model between lifestyle change alone and metabolic bariatric surgery, resulting in weight loss of 15% to 20% of body weight. Public interest in and demand for OMMs has recently increased dramatically. Unfortunately, cost and access to OMMs remain a significant barrier for many patients.

Role of Adverse Childhood Experiences in the Onset of Overweight/Obesity.

Purpose Of Review: The goal of this chapter was to summarize the literature on childhood adversity and obesity, discuss treatment implications with a case example, and provide recommendations for trauma-informed care for clinicians who work with individuals living with obesity.

Recent Findings: Adversity in childhood is related directly and indirectly to obesity development. Upstream contributors like adverse childhood experiences (ACEs) and other factors can lead to experiences of toxic stress and increased allostatic load, resulting in downstream effects of obesity and other chronic health conditions.

Loneliness, immunological recovery patterns, and health-related quality of life (HRQOL) outcomes in patients receiving hematopoietic stem cell transplantation.

Purpose: Loneliness may compromise health-related quality of life (HRQOL) outcomes and the immunological impacts of loneliness via neuroendocrinological mechanisms likely have consequences for patients who have undergone a hematopoietic stem cell transplantation (HSCT).

Research Approach And Measures: Loneliness (pre-transplant), immunological recovery (Day 30, Day 100, 1-year post-transplant), and HRQOL (Day 100, 1 year) were measured in a sample of 205 patients completing a HSCT (127 autologous, 78 allogenic).

Results: Greater levels of pre-transplant loneliness predicted poorer HRQOL at Day 100 and 1-year follow-up.

Food cravings after bariatric surgery: comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass.

Background: Research suggests that food choices, preferences, and tastes change after bariatric surgery, but evidence regarding changes in food cravings is mixed.

Objectives: The primary aim of this cohort study was to compare food cravings during the first year following bariatric surgery in patients who had undergone sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB).

Setting: Integrated multispecialty health system, United States.

A prospective study of the relationship between illness perception, depression, anxiety, and quality of life in hematopoietic stem cell transplant patients.

Aim: The aim of study was to investigate whether depression and anxiety symptoms and illness perception prior to hematopoietic stem cell transplantation (HSCT) predict health related quality of life (HRQOL) at Day 100 and 1 year following HSCT.

Methods: A total of 205 patients who underwent HSCT (N = 127 autologous transplants, N = 78 allogeneic transplants) were included in this prospective study. Baseline assessment was assessed prior to transplantation and post HSCT data were collected at Day 100 and 1 year.

EEG Based Cortico-Muscular Connectivity During Standing Early Post Stroke.

In this exploratory study we studied brain activation and corticomuscular connectivity during standing in healthy individuals and persons with stroke within 40 days of cerebrovascular accident (CVA). EEG and EMG data were acquired during standing and analysis showed a trend of higher EEG power (hyper activation) in the stroke group. Direct corticomuscular connectivity between sensorimotor cortices and contralateral lower extremity muscles showed lower connectivity between affected motor, premotor, and sensory cortices, and contralateral lower extremity peripheral muscles with moderate effect size.

Intensity Modulated Exoskeleton Gait Training Post Stroke.

Stroke is a leading cause of long-term disability. While major advances have been made in early intervention for the treatment of patients post stroke, the majority of survivors have residual mobility challenges. Recovery of motor function is dependent on the interrelationship between dosing, intensity, and task specific practice applied during rehabilitation.

Endoscopic sleeve gastroplasty and postprocedural nutritional deficiencies: results from a single center exploratory study.

Nutritional deficiencies following endoscopic sleeve gastroplasty (ESG) are unknown. We retrospectively studied nutritional deficiencies in 20 patients who underwent ESG at our institution. No subjects had preprocedural anemia, whereas 22.

Effect of robotic exoskeleton gait training during acute stroke on functional ambulation.

Background: Stroke is a leading cause of disability resulting in long-term functional ambulation deficits. Conventional therapy can improve ambulation, but may not be able to provide consistent, high dose repetition of movement, resulting in variable recovery with residual gait deviations.

Objective: The objective of this preliminary prospective investigation is to evaluate the ability of a robotic exoskeleton (RE) to provide high dose gait training, and measure the resulting therapeutic effect on functional ambulation in adults with acute stroke.

Addiction Transfer and Other Behavioral Changes Following Bariatric Surgery.

Despite its important treatment implications for obesity and related comorbidities, bariatric surgery requires several behavioral changes that warrant comprehensive evaluation and support before and after surgery. This article outlines emerging scientific and anecdotal evidence for addiction transfer after bariatric surgery. Other common behavioral changes that impact adherence, weight loss, and psychiatric risk after surgery are also reviewed.

Validation of the Yale Food Addiction Scale 2.0 in Patients Seeking Bariatric Surgery.

Background: The Yale Food Addiction Scale (YFAS) was developed in 2009 to assess food addiction (FA); a revised version was released in 2016 (YFAS 2.0). The objective of this study was to determine the statistical and clinical validity of the YFAS 2.

Intraspecific trait variability shapes leaf trait response to altered fire regimes.

Background And Aims: Understanding impacts of altered disturbance regimes on community structure and function is a key goal for community ecology. Functional traits link species composition to ecosystem functioning. Changes in the distribution of functional traits at community scales in response to disturbance can be driven not only by shifts in species composition, but also by shifts in intraspecific trait values.

Rethinking Patient and Medical Professional Perspectives on Bariatric Surgery as a Medically Necessary Treatment.

The prevalence of class 3 obesity (body mass index ≥40 kg/m) is 7.7% of the United States adult population; thus, more than 25 million people may be medically appropriate for consideration of bariatric surgery as therapy for severe obesity. Although bariatric surgery is the most effective therapy for patients with severe obesity, the surgery is performed in less than 1% of patients annually for whom it may be appropriate.

Functional trait similarity predicts survival in rare plant reintroductions.

Rare species reintroductions are an increasingly common conservation strategy, but often result in poor survival of reintroduced individuals. Reintroduction sites are chosen primarily based on historical occupancy and/or abiotic properties of the site, with much less consideration given to properties of the larger biotic community. However, ecological niche theory suggests that the ability to coexist with other species is determined in part by the degree of functional similarity between species.

Preoperative high respiratory quotient correlates with lower weight loss after bariatric surgery.

Background: The respiratory coefficient (RQ), as determined by indirect calorimetry (IC), classifies diet as being carbohydrate rich (RQ = 0.7-0.8), fat rich (RQ = 0.

Sleep disturbances after deployment: National Guard soldiers' experiences and strategies.

Sleep deprivation and sleep disturbance are pervasive among military personnel during and after combat deployment. However, occupational and other constraints often influence military workers to decline behavioral health services and prescription pharmaceutical sleep aids. This article, drawing on ethnographic interviews with National Guard veterans of combat deployment, demonstrates that soldiers with sleep disturbance frequently manage symptoms without medical supervision and by using ad hoc methods including alcohol use.

Association of Adverse Childhood Experiences and Food Addiction to Bariatric Surgery Completion and Weight Loss Outcome.

Introduction/purpose: Adverse childhood experiences (ACEs) are known risk factors for obesity and poor outcomes following weight loss interventions. ACEs are also associated with addictive behaviors and, potentially, food addiction (FA). This study examined the relationship between ACEs and FA, and their association to undergoing bariatric surgery and post-surgical weight loss outcomes.

Species' traits do not converge on optimum values in preferred habitats.

Plant trait expression is shaped by filters, which can alter trait means and variances, theoretically driving species toward an "optimum" trait value for a set of environmental conditions. Recent research has highlighted the ubiquity of intraspecific variation in functional traits, which can cause plants to diverge from a hypothesized "optimum". We examined whether species occurring in "core" habitats (where they occur frequently, abundantly, and consistently) express traits that are nearer to "optimum", as captured by the community-weighted mean (CWM).

Guiding Patients Toward the Appropriate Surgical Treatment for Obesity: Should Presurgery Psychological Correlates Influence Choice Between Roux-en-Y Gastric Bypass and Vertical Sleeve Gastrectomy?

Background: Helping patients determine which type of bariatric surgery, Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG), may be the best treatment can be challenging. This study investigated psychological correlates and their influence on weight loss for patients who underwent RYGB or VSG.

Methods: Four hundred twenty-two patients (RYGB = 305; VSG = 117) completed screening questionnaires presurgery and underwent surgery between August 2012 and April 2015.

Functional traits of the understory plant community of a pyrogenic longleaf pine forest across environmental gradients.

Understanding and predicting the response of plant communities to environmental changes and disturbances such as fire requires an understanding of the functional traits present in the system, including within and across species variability, and their dynamics over time. These data are difficult to obtain as few studies provide comprehensive information for more than a few traits or species, rarely cover more than a single growing season, and usually present only summary statistics of trait values. As part of a larger study seeking to understand the dynamics of plant communities in response to different prescribed fire regimes, we measured the functional traits of the understory plant communities located in over 140 permanent plots spanning strong gradients in soil moisture in a pyrogenic longleaf pine forest in North Carolina, USA, over a four-year period from 2011 and 2014.

Variation in Plant Response to Herbivory Underscored by Functional Traits.

The effects of herbivory can shape plant communities and evolution. However, the many forms of herbivory costs and the wide variation in herbivory pressure, including across latitudinal gradients, can make predicting the effects of herbivory on different plant species difficult. Functional trait approaches may aid in contextualizing and standardizing the assessment of herbivory impacts.

Trait space of rare plants in a fire-dependent ecosystem.

The causes of species rarity are of critical concern because of the high extinction risk associated with rarity. Studies examining individual rare species have limited generality, whereas trait-based approaches offer a means to identify functional causes of rarity that can be applied to communities with disparate species pools. Differences in functional traits between rare and common species may be indicative of the functional causes of species rarity and may therefore be useful in crafting species conservation strategies.

Conducting Qualitative Research on Stigmatizing Conditions with Military Populations.

This article addresses the conduct of qualitative research regarding sensitive or stigmatizing topics with military populations, and provides suggestions for implementing culturally responsive and effective data collection with these groups. Given high rates of underreporting of sensitive and stigmatizing conditions in the military, qualitative methods have potential to shed light on phenomena that are not well understood. Drawing on a study of U.

The more things change, the more they stay the same? When is trait variability important for stability of ecosystem function in a changing environment.

The importance of intraspecific trait variability for community dynamics and ecosystem functioning has been underappreciated. There are theoretical reasons for predicting that species that differ in intraspecific trait variability will also differ in their effects on ecosystem functioning, particularly in variable environments. We discuss whether species with greater trait variability are likely to exhibit greater temporal stability in their population dynamics, and under which conditions this might lead to stability in ecosystem functioning.