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Individuals following bariatric surgery are considered at high risk for the development of sarcopenic obesity (excess fat mass, low muscle mass and low physical function), and exercise may play an important role in its prevention and treatment. We systematically reviewed 5 scientific databases (Embase, Medline, Scopus, SPORTDiscus, and Web of Science) and 2 grey literature databases (ProQuest and Google Scholar) for clinical trials that evaluated the effect of exercise on muscle strength in adults following bariatric surgery and conducted a separate meta-analysis for studies that used different muscle strength tests. Random-effect models, restricted maximum likelihood method and Hedges’ g were used. The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020152142). Fifteen studies were included (638 patients), none had a low risk of bias, and all were included in at least 1 of the 5 meta-analyses (repetition maximum [lower and upper limbs], sit-to-stand, dynamometer, and handgrip tests). Exercise interventions improved both upper (effect size, 0.71; 95% CI, 0.41–1.01; I 2 = 0%) and lower (effect size, 1.37; 95% CI, 0.84–1.91; I 2 = 46.14) limb muscle strength, as measured by repetition maximum tests. Results were similar for the sit-to-stand (effect size, 0.60; 95% CI, 0.20–1.01; I 2 = 68.89%) and dynamometer (effect size, 0.46; 95% CI, 0.06–0.87; I 2 = 31.03%), but not for the handgrip test (effect size, 0.11; 95% CI, -0.42–0.63; I 2 = 73.27%). However, the certainty level of the meta-analyses was very low. Exercise with a resistance training component performed post bariatric surgery may improve muscle strength, which is related to sarcopenic obesity, functional capacity, and mortality risk, therefore should be included in the follow-up.

The adverse effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are not limited to the related infectious disease. In children and adolescents, serious risks due to the coronavirus disease 2019 (COVID-19) pandemic are also related to its indirect effects. These include an unbalanced diet with an increased risk of weight excess or nutritional deficiencies, increased sedentary lifestyle, lack of schooling, social isolation, and impaired mental health. Pediatricians should be aware of the side effects of the COVID-19 pandemic on children’s diet, physical mental health and advise the families according to their nutritional needs and financial resources. Moreover, the lack of a targeted therapy able to offer protection against the deleterious effects of SARS-CoV-2 infection should require a greater effort by scientific societies to find a more effective prevention strategy. In this context, much interest should be given to nutritional support, able to contrast malnutrition and to stimulate the immune system.

Gas supply to the stars Star formation requires the presence of cold molecular gas, which makes up only a small fraction of the total mass of the Milky Way and nearby galaxies where only a few new stars are formed per year. To establish whether the rapid star formation occurring in distant massive galaxies reflects a greater supply of cold gas or a more efficient process of star formation, gas content was surveyed in massive-star-forming galaxies at two cosmic epochs — at redshifts of approximately 1.2 and 2.3, when the Universe was 40% and 24% of its current age. The results reveal that distant star-forming galaxies were indeed gas rich and that the star-formation efficiency is not strongly dependent on cosmic epoch. The average fraction of cold gas relative to total galaxy mass is three to ten times higher in distant galaxies than in today's massive spiral galaxies. Stars form from cold molecular interstellar gas, which is relatively rare in the local Universe, such that galaxies like the Milky Way form only a few new stars per year. However, typical massive galaxies in the distant Universe formed stars much more rapidly, suggesting that young galaxies were more rich in molecular gas. The results of a survey of molecular gas in samples of typical massive star-forming galaxies when the Universe was 40% and 24% of its current age now reveal that distant star-forming galaxies were indeed gas rich. Stars form from cold molecular interstellar gas. As this is relatively rare in the local Universe, galaxies like the Milky Way form only a few new stars per year. Typical massive galaxies in the distant Universe formed stars an order of magnitude more rapidly 1 , 2 . Unless star formation was significantly more efficient, this difference suggests that young galaxies were much more molecular-gas rich. Molecular gas observations in the distant Universe have so far largely been restricted to very luminous, rare objects, including mergers and quasars 3 , 4 , 5 , and accordingly we do not yet have a clear idea about the gas content of more normal (albeit massive) galaxies. Here we report the results of a survey of molecular gas in samples of typical massive-star-forming galaxies at mean redshifts < z > of about 1.2 and 2.3, when the Universe was respectively 40% and 24% of its current age. Our measurements reveal that distant star forming galaxies were indeed gas rich, and that the star formation efficiency is not strongly dependent on cosmic epoch. The average fraction of cold gas relative to total galaxy baryonic mass at z = 2.3 and z = 1.2 is respectively about 44% and 34%, three to ten times higher than in today’s massive spiral galaxies 6 . The slow decrease between z  ≈ 2 and z  ≈ 1 probably requires a mechanism of semi-continuous replenishment of fresh gas to the young galaxies.

BackgroundDynapenic abdominal obesity (D/AO) has been associated with negative outcomes in older people, including trait of falls.AimsTo assess the association between D/AO and the incidence of falls over 18 months in older community-dwelling women.MethodsA total of 201 older women (67.97 ± 6.02 years; 27.70 kg/m2) underwent waist circumference measurement, and had handgrip strength assessed using a hydraulic dynamometer. Dynapenia was classified using the lower tertile of handgrip strength, while abdominal obesity was considered as a waist circumference > 88 cm. D/AO was the combination of both aforementioned criteria. Volunteers were classified into four groups: normal, abdominal obesity, dynapenic, and D/AO. Participants were then tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Chi-square and multivariable Cox proportional regressions were conducted.ResultsThe overall incidence of falls over the follow-up was 27.5%; and for normal, dynapenic, abdominal obesity, and D/AO were 14.7%, 17.2%, 27.5%, and 40.4% (X2 = 8.341; P = 0.039), respectively. D/AO was associated with a higher risk of falls (hazard ratio: 3.595 [95% CI: 1.317–9.815], even after adjustments for age, body mass index, physical activity level, regular use of medications, peripheral sensation, chronic diseases, and history of lower-limbs pain.ConclusionsD/AO is more closely related to falls than either dynapenia or abdominal obesity alone, and is independently associated with an increased incidence of falls in older women. These results provide support for the concept that the combined evaluation of muscle strength and central obesity may be clinically relevant in this population.

Abstract Knowledge of specific enzyme activity, along with animal habits and digestive capacity is essential in formulating an appropriate diet for any species. In this study, we evaluated and characterized the activity of digestive enzymes present in the liver, intestine, and stomach of Paralichthys orbignyanus. The effects of pH and temperature on enzyme activity were also evaluated via the use of specific substrates. The use of specific substrates and inhibitors showed strong evidence of the presence of trypsin (BApNA= 0.51 ± 0.2 mU mg-1), chimotrypsin (SApNA= 2.62 ± 1.8 mU mg-1), and aminopeptidases (Leu-p-Nan =0.9709 ± 0.83 mU mg-1) in the intestine. Optimum pH for the activity of trypsin, chemotrypsin, leucino aminopeptidase, amilase, and pepsin were 9.5, 9.0, 8.0, 7.5, and 3.5, respectively, while optimum temperatures were 50, 50, 50, 40, and 45 °C, respectively. These results provide additional information regarding the biology of Brazilian flounder and can be used as a basis for further studies regarding fish feeding physiology. Resumo O conhecimento da atividade enzimática é essencial para formular uma correta dieta específica para espécie, além de estarem correlacionadas com o hábito da alimentação e capacidade digestive. Neste estudo determinamos e caracterizamos a atividade enzimática presente no intestino, estômago e fígado do linguado Paralichthys orbignyanus. Os efeitos da temperatura e pH sobre a atividade enzimática também foram avaliados utilizando substratos específicos. O uso de substratos e inibidores específicos mostrou uma forte evidência da presença da tripsina (BApNA = 0,51 ± 0,2 mU mg-1), quimotripsina (SAPNA = 2,62 ± 1,8 mU mg-1), e as aminopeptidases (Leu-p-Nan = 0,97 ± 0,83 mU mg-1) no intestino. O pH ótimo observado para a atividade de tripsina, quimotripsina, leucino aminopeptidase, amilase e pepsina foi 9,5, 9,0, 8,0, 7,5 e 3,5, respectivamente. A temperatura ótima observada foi 50, 50, 50, 40 e 45 °C, respectivamente. Estes resultados fornecem informações adicionais sobre a biologia do linguado brasileiro e pode ser usado como base para novos estudos sobre fisiologia alimentar.

BackgroundBehçet’s syndrome (BS) is a systemic vasculitis, typically characterised by recurrent oro-genital ulcers, ocular inflammation and skin manifestations; articular, vascular, gastro-enteric and neurological involvement may also occur.The complex pattern of BS profile can effect negatively on patients‘ quality of life.ObjectivesThe primary aim of this study was to explore the role of quality of life in BD patients by means of patient reported outcome (PRO); the secondary aim was to study any correlation between disease activity and quality of life.MethodsThe study enrolled 130 patients (71 M, 59 F), all fulfilling the International Study Group (ISG) criteria for BS. Their mean age was 42±8 years, 18–77 while the mean age at disease onset was 11±4 years 5–18 and the mean follow-up of 8±2 years. Disease activity was evaluated by means of the Behçet’s Disease Current Activity Form (BDCAF), while Short-form-36 (SF-36) was used to evaluate quality of life. Disease activity was compared with the global SF-36 score and with each dimension, that includes: physical functioning, physical disability, body pain, general health, vitality, social functioning, emotional disability, mental health. The statistical analysis was performed using Student t-test, Mann-Whitney-U test, ANOVA and Pearson correlationResultsAt time of evaluation, according BDCAF, 51 BS patients (39%) had clinically active disease (36 muco-cutaneous involvement, 21 ocular involvement 10 joint involvement, 6 neurological involvement, 4 gastro-enteric). As expected, the overall SF-36 scores were significantly lower in patients with clinically active disease. Moreover, female BS patients had statistically significant lower scores in all SF-36 domains compared with male patients. When each domain of SF-36 was evaluated, we found that physical disability (p=0.004), body pain (p=0.006), general health (p=0.001), and vitality (p=0.001) were significantly lower in patients with disease activity. Notably, vitality (p=0.001), physical disability(p=0.004), social functioning (p=0.001), emotional disability (p=0.003) and mental health (p=0.001) were significantly lower in patients with muco-cutaneous active disease, compared with the other patients with active disease.ConclusionsThe clinicians who take care of any chronic disease would like to correctly know the current status of a patient to manage him properly. In this regard, the combination data of PRO measures and disease activity have been demonstrated to add more information compared to the evaluation of disease activity alone. These consideration suggest that the correct assessment of BS needs a multi-dimensional approach, that fairly includes disease activity, disease damage and quality of lifeDisclosure of InterestNone declared

The prevalence of low bone mineral density (LBMD) in people with chronic kidney disease (CKD) remains unknown. We identified a high prevalence of LBMD in CKD population. Thus, public health strategies should include efforts to prevent, early detect, and manage LBMD in CKD patients, especially in patients undergoing kidney replacement therapy. Mineral and bone disorders are common among patients with CKD, which affects bone mineral density. We conducted a systematic review and meta-analysis to estimate the prevalence of low bone mineral density (LBMD) in adults with CKD. We searched MEDLINE, EMBASE, Web of Science, CINAHL, and LILACS databases from inception to February 2021. Observational studies that reported the prevalence of LBMD in adults with CKD stages 3a–5D were included. The LBMD was defined according to the World Health Organization criterion (T-score ≤  − 2.5). Random-effect model meta-analyses were used to estimate the pooled prevalence of LBMD. Meta-regressions and subgroup analyses were conducted for stages of CKD, dialysis modality, gender, bone sites and morphology, and geographical region. This study was registered in PROSPERO, number CRD42020211077. One-hundred and fifty-three studies with 78,092 patients were included. The pooled global prevalence of LBMD in CKD was 24.5% (95% CI, 21.3 − 27.8%). Subgroup analyses indicated a higher prevalence of LBMD in dialysis patients (30%, 95% CI 25 − 35%) compared with non-dialysis CKD patients (12%, 95% CI 8 − 16%), cortical bone sites (28%, 95% CI 23 − 35%) relative to trabecular sites (19%, 95% CI 14 − 24%), while similar estimates in the European and the Asiatic continents (26%, 95% CI 21 − 30% vs 25%, 95% CI 21 − 29). The prevalence of LBMD in CKD patients is high, particularly in those undergoing dialysis and in cortical bone sites. Therefore, efforts to early diagnosis and management strategies should be implemented in clinical routine for an epidemiological control of LBMD in CKD patients.

Background:Muscle involvement is the most frequent clinical feature in patients with idiopathic inflammatory myopathies (IIM). In addition to muscular enzymes, muscular magnetic resonance has been investigated for the assessment of disease activity, but it is limited by high costs and it is not readily available. Muscle ultrasound (MUS) has been recently proposed as a valuable tool for the diagnosis and activity assessment of muscle involvement in IIM patients.Objectives:To define the role of MUS in the diagnosis and assessment of disease activity in IIM through quantitative analysis of MUSMethods:This was a prospective study conducted from February 2019 to November 2019. 41 patients with IIM: 17 men and 24 women, median age 61.4 years, of which 20 were polymyositis (PM), 16 dermatomyositis (DM) and 5 inclusion body myositis (IBM) were included. 30 healthy subjects (HS), comparable in age and gender to patients, were recruited as controls. In every patient and control MUS of upper and lower extremities was performed (in total 10 muscles per side) and digital images were saved. Quantitative muscle echo intensity (QME) was calculated using an image processing program (ImageJ) to obtain the mean value of greyscale (mGS) for each muscle. For patients with IIM creatine phosphokinase (CPK) levels were recorded, duration of disease (in months) was calculated and clinical evaluation tools for the assessment of disease activity were performed, such as manual muscle testing (MMT8), patient and physician visual analogue scales (pVAS, phVAS), health assessment questionnaire (HAQ) and myositis disease activity assessment tool (MDAAT).Results:Patients had higher values of mGS across all muscles examined than controls (p<0.001). Among patients QME showed a negative correlation with MMT8 (p<0.001, -0.641

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