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Ensure post-surgery success and win the weight loss battle for good. Packed with no-nonsense information on nutrition and transitional meal planning, and dozens of mouth-watering recipes, this guide gives you everything you need to win the weight loss battle.

Bariatric surgery is increasingly recognized as a highly effective treatment for individuals who are severely obese. Amount of weight loss and resolution of comorbidities surpass those of nonsurgical approaches; however, suboptimal weight loss and weight regain are not uncommon. These outcomes, though not fully understood, are likely at least partially explained by failure to make long-term behavioral and/or cognitive changes. We are unaware of any established clinical tools to guide providers in assessing postoperative behaviors and identifying those who may require specialized treatment. The goal of this paper is to introduce a brief screening tool, The WATCH, to help clinicians assess and identify patients who may be at risk for poor or untoward outcomes post bariatric surgery. We first review the literature on postoperative outcomes, including weight loss, resolution of comorbidities, suboptimal outcomes, and development of problematic eating behaviors. We then provide an easily-recalled, five-item tool that assesses outcomes, and discuss patient responses that may necessitate further intervention or referral.

BackgroundVitamin and mineral deficiencies are common following Roux-en-Y gastric bypass (RYGB) and can lead to significant morbidity, but little research on the efficacy of vitamin supplementation regimens exists. We compared the efficacy and tolerability of an investigational versus a standard multivitamin regimen in patients undergoing RYGB.MethodsFifty-six patients, aged 18 to 65, were randomized to an investigational versus a standard multivitamin. Plasma levels of vitamins A, B-12, D, E-α, E-β/γ, thiamine, folate, iron, iron-binding capacity, iron saturation, prealbumin, and parathyroid hormone (PTH) were measured at 3 and 6 months postoperatively. Proteins induced by vitamin K absence (PIVKA), beta-carotene, coenzyme Q10, and mixed tocopherols were measured at 3 months postoperatively. Primary outcomes were differences in plasma levels at 3 and 6 months. Secondary outcomes were palatability, ease of use, and adherence.ResultsTwenty-one patients were randomized to the standard regimen and 26 to the investigational multivitamin. Nine were lost to follow-up. At 3 months, plasma levels of PTH were lower (p = 0.042), and levels of vitamin D (p = 0.033), thiamine (p = 0.009), and beta-carotene (p = 0.033) were higher in the investigational multivitamin arm compared to those in the standard regimen arm. Patients receiving the investigational multivitamin reported higher taste satisfaction than those receiving the standard regimen (p = 0.035).ConclusionThe investigational multivitamin appears to be more effective than a standard multivitamin in maintaining therapeutic levels of clinically relevant vitamins and minerals, and was more palatable. Additional studies should be conducted to confirm these findings and refine the optimal dosing regimen.Trial Registrationwww.clinicaltrials.gov under identifier NCT01475617

The third version of the Regional Atmosphere and Land (RAL3) science configuration is documented. Developed through international partnerships, RAL configurations define settings for the Unified Model atmosphere and Joint UK Land Environment Simulator (JULES) when applied across timescales with kilometre and sub-kilometre-scale model grids. The RAL3 configuration represents a major advance compared to previous versions by delivering a common science definition suitable for application to tropical and mid-latitude regions. Developments within RAL3 include the introduction of a double-moment microphysics scheme and a bimodal cloud scheme, replacing use of a single-moment scheme and different cloud schemes for mid-latitudes and tropics in previous versions. Updates have been implemented to the boundary layer scheme and a consolidation of land model settings to be more consistent with global atmosphere and land (GAL) science configurations. Physics developments aimed to address priorities for model performance improvement identified by users. This paper documents the RAL3 science configuration, including a series of iterative revisions delivered since its first release, and their characteristics. Evidence is provided from the variety of assessments of RAL3, relative to the previous version (RAL2). Collaborative development and evaluation across organizations have enabled evaluation across a range of domains, grid spacing and timescales. The analysis indicates more realistic precipitation distributions, improved representation of clouds and of visibility, a continued trend to more realistic representation of convection, and reduced near-surface wind speeds but a persistent cold-temperature bias. Overall the convective-scale verification scores and climatological model distributions relative to observations improve for the majority of variables. Ensemble results show improvements to the spread–error relationship. User feedback from subjective assessment activities has also been positive. Differences between RAL3 revisions and RAL2 are further illustrated through a process-based analysis of a convective system over the UK. The latest RAL3 configuration (RAL3.3) is therefore recommended for research, operational numerical weather prediction, and climate production at kilometre and sub-kilometre scales.

That a substantial proportion of cell lines is mislabelled or replaced by cells derived from a different individual, tissue or species has been a long known, but largely ignored problem. The history of cell line misidentification and recent efforts to develop a standard for the authentication of human cell lines using short tandem repeat profiling is discussed in this article. Cell lines are used extensively in research and drug development as models of normal and cancer tissues. However, a substantial proportion of cell lines is mislabelled or replaced by cells derived from a different individual, tissue or species. The scientific community has failed to tackle this problem and consequently thousands of misleading and potentially erroneous papers have been published using cell lines that are incorrectly identified. Recent efforts to develop a standard for the authentication of human cell lines using short tandem repeat profiling is an important step to eradicate this problem.

Cell misidentification and cross-contamination have plagued biomedical research for as long as cells have been employed as research tools. Examples of misidentified cell lines continue to surface to this day. Efforts to eradicate the problem by raising awareness of the issue and by asking scientists voluntarily to take appropriate actions have not been successful. Unambiguous cell authentication is an essential step in the scientific process and should be an inherent consideration during peer review of papers submitted for publication or during review of grants submitted for funding. In order to facilitate proper identity testing, accurate, reliable, inexpensive, and standardized methods for authentication of cells and cell lines must be made available. To this end, an international team of scientists is, at this time, preparing a consensus standard on the authentication of human cells using short tandem repeat (STR) profiling. This standard, which will be submitted for review and approval as an American National Standard by the American National Standards Institute, will provide investigators guidance on the use of STR profiling for authenticating human cell lines. Such guidance will include methodological detail on the preparation of the DNA sample, the appropriate numbers and types of loci to be evaluated, and the interpretation and quality control of the results. Associated with the standard itself will be the establishment and maintenance of a public STR profile database under the auspices of the National Center for Biotechnology Information. The consensus standard is anticipated to be adopted by granting agencies and scientific journals as appropriate methodology for authenticating human cell lines, stem cells, and tissues.

During the course of a differential screen to identify transcripts specific for chick heart/hemangioblast precursor cells, we have identified Ccbe1 (Collagen and calcium-binding EGF-like domain 1). While the importance of Ccbe1 for the development of the lymphatic system is now well demonstrated, its role in cardiac formation remained unknown. Here we show by whole-mount in situ hybridization analysis that cCcbe1 mRNA is initially detected in early cardiac progenitors of the two bilateral cardiogenic fields (HH4), and at later stages on the second heart field (HH9-18). Furthermore, cCcbe1 is expressed in multipotent and highly proliferative cardiac progenitors. We characterized the role of cCcbe1 during early cardiogenesis by performing functional studies. Upon morpholino-induced cCcbe1 knockdown, the chick embryos displayed heart malformations, which include aberrant fusion of the heart fields, leading to incomplete terminal differentiation of the cardiomyocytes. cCcbe1 overexpression also resulted in severe heart defects, including cardia bifida. Altogether, our data demonstrate that although cardiac progenitors cells are specified in cCcbe1 morphants, the migration and proliferation of cardiac precursors cells are impaired, suggesting that cCcbe1 is a key gene during early heart development.