Impact of metabolic bariatric surgery on outcomes and the 10-year risk of major adverse cardiovascular events during a 7-year period: a retrospective cohort study.

BACKGROUND: Metabolic bariatric surgery offers enduring weight reduction and alleviation of obesity-related comorbidities, including dyslipidemia, diabetes, hypertension, and major adverse cardiovascular events (MACE). Long-term data on one-anastomosis gastric bypass (OAGB) and single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG) is lacking, necessitating this investigation. MATERIALS AND METHODS: In this multicenter prospectively-collected retrospective observational study, 830 adult Taiwanese patients (682 OAGB, 148 SADJB-SG) who underwent surgery from January 1, 2011, to December 31, 2017, were initially identified. Following protocol, 224 patients (177 OAGB, 47 SADJB-SG) with complete follow-up data at various intervals up to three years after surgery were included in the final analysis. The study's primary focus is to evaluate the long-term safety, efficacy, and durability of OAGB and SADJB-SG in promoting weight loss and diabetes remission. Additionally, changes in 10-year and lifetime risks of MACE before and 3-year after surgery are assessed using Taiwan MACE risk prediction model and the China-PAR project model. RESULTS: SADJB-SG patients exhibit higher diabetes prevalence, lower body mass index, and more severe diabetes compared to OAGB. Both groups demonstrate significant improvements in body mass index, diabetes, hypertension, and dyslipidemia three years after surgery, with the most substantial improvements occurring in the second year. The Taiwan MACE risk model reveals a significant reduction in 10-year MACE and stroke risks for both groups. The China-PAR project model indicates a synchronized reduction in atherosclerotic cardiovascular disease 10-year and lifetime risk in both OAGB and SADJB-SG groups. CONCLUSIONS: OAGB and SADJB-SG exhibit sustained improvements in weight reduction and obesity-related comorbidities over three years after surgery. Notably, both procedures contribute to a substantial reduction in 10-year MACE, stroke, and atherosclerotic cardiovascular disease risks. These findings underscore the efficacy of OAGB and SADJB-SG in the context of metabolic bariatric surgery.

Sr2HgGe2OS6: A Hg-Based Oxychalcogenide Infrared Nonlinear Optical Material Exhibiting Favorable Balance between a Large Band Gap and Strong Second Harmonic Generation Response.

Currently, oxychalcogenides with mixed-anion groups that integrate the property advantages of oxides (wide optical band gap) and chalcogenides [strong second harmonic generation (SHG) response] through chemical substitution engineering have attracted widespread interest and are considered to be important candidates for infrared (IR) nonlinear optical (NLO) materials. Herein, the first Hg-based oxychalcogenide Sr2HgGe2OS6 with mixed anion [GeOS3] units has been successfully synthesized through a spontaneous crystallization method, which exhibits a favorable balance between the strong SHG response (0.7 × AgGaS2) and large optical band gap (2.9 eV). In addition, Sr2HgGe2OS6 shows high laser-induced damage threshold (LIDT, 2.1 × AgGaS2) as well as phase-matching (PM) performance. Theoretical calculations indicate that the Sr2HgGe2OS6 encompasses large birefringence of 0.128@2090 nm (3.3 × AgGaS2) and its SHG density mainly comes from [HgS4] tetrahedra and [GeOS3] units. This work not only demonstrates that Sr2HgGe2OS6 is a promising IR NLO material but also provides new ideas for the exploration of Hg-based oxychalcogenide IR NLO materials.

Orbital Occupancy Modulation to Optimize Intermediate Absorption for Efficient Electrocatalysts in Water Electrolysis and Zinc-Ethanol-Air Battery.

Spin engineering is a promising way to modulate the interaction between the metal d-orbital and the intermediates and thus enhance the catalytic kinetics. Herein, an innovative strategy is reported to modulate the spin state of Co by regulating its coordinating environment. o-c-CoSe2-Ni is prepared as pre-catalyst, then in situ electrochemical impedance spectroscopy (EIS) and in situ Raman spectroscopy are employed to prove phase transition, and CoOOH/Co3O4 is formed on the surface as active sites. In hybrid water electrolysis, the voltage has a negative shift, and in zinc-ethanol-air battery, the charging voltage is lowered and the cycling stability is greatly increased. Coordinated atom substitution and crystalline symmetry change are combined to regulate the absorption ability of reaction intermediates with balanced optimal adsorption. Coordinated atom substitution weakens the adsorption while the crystalline symmetry change strengthens the adsorption. Importantly, the tetrahedral sites are introduced by Ni doping which enables the co-existence of four-coordinated sites and six-coordination sites in o-c-CoSe2-Ni. The dz2 + dx2-y2 orbital occupancy decreases after the atomic substitution, while increases after replacing the CoSe6-Oh field with CoSe6-Oh/CoSe4-Td. This work explores a new direction for the preparation of efficient catalysts for water electrolysis and innovative zinc-ethanol-air battery.

Novel antimony phosphates with enlarged birefringence induced by lone pair cations.

Phosphates, whose obvious disadvantage is the relatively small birefringence, can be overcome by the introduction of post-transition metal cations containing stereochemically active lone-pair electrons. In this paper, two new compounds were successfully explored in the A-Sb-P-O system, i.e. Cs2Sb3O(PO4)3 (CsSbPO) and (NH4)2Sb4O2(H2O)(PO4)2[PO3(OH)]2 (NH4SbPOH). Transmission spectra show that CsSbPO has a surprising transmission range with a UV cutoff edge of 213 nm. First-principles calculations show that both compounds have a wide band gap (5.02 eV for CsSbPO and 5.30 eV for NH4SbPOH) and enlarged birefringence (Δn = 0.034@1064 nm for CsSbPO and Δn = 0.045@1064 nm for NH4SbPOH). The results of real-space atom-cutting investigations show that the distorted [SbOx] polyhedra originating from the asymmetric lone pair electrons give the main contribution to the total birefringence and overcome the disadvantage of small birefringence of phosphates but maintain wide transition windows.

Cobalt-Doping Induced Formation of Five-Coordinated Nickel Selenide for Enhanced Ethanol Assisted Overall Water Splitting.

To overcome the low efficiency of overall water splitting, highly effective and stable catalysts are in urgent need, especially for the anode oxygen evolution reaction (OER). In this case, nickel selenides appear as good candidates to catalyze OER and other substitutable anodic reactions due to their high electronic conductivity and easily tunable electronic structure to meet the optimized adsorption ability. Herein, an interesting phase transition from the hexagonal phase of NiSe (H-NiSe) to the rhombohedral phase of NiSe (R-NiSe) induced by the doping of cobalt atoms is reported. The five-coordinated R-NiSe is found to grow adjacent to the six-coordinated H-NiSe, resulting in the formation of the H-NiSe/R-NiSe heterostructure. Further characterizations and calculations prove the reduced splitting energy for R-NiSe and thus the less occupancy in the t2g orbits, which can facilitate the electron transfer process. As a result, the Co2 -NiSe/NF shows a satisfying catalytic performance toward OER, hydrogen evolution reaction, and (hybrid) overall water splitting. This work proves that trace amounts of Co doping can induce the phase transition from H-NiSe to R-NiSe. The formation of less-coordinated species can reduce the t2g occupancy and thus enhance the catalytic performance, which might guide rational material design.

Positive and Negative Contribution from Lead-Oxygen Groups and Halogen Atoms to Birefringence: A First Principles Investigation.

Oxyhalides, containing oxygen and halogen atoms and combining the advantages of oxides and halides in geometry and optical response, have great potential in optical materials. In this study, the electronic structures and the optical properties of the Pb3O2X2 (X = Cl, Br, I) compounds have been investigated using the first principles method. The results show that these compounds have birefringence at 0.076, 0.078, and 0.059 @ 1064 nm, respectively. And, the asymmetric stereochemical active lone pair electrons were found around lead atoms, which were confirmed by the projected density of states, the electronic localization functions, and the crystal orbitals. The contribution of atoms and polyhedra to birefringence was further evaluated using the Born effective charge. The results show that halogen atoms give negative contribution, and lead-oxygen polyhedra give positive contribution. The spin-orbit coupling effect is also investigated, and the downshift of the conduction band and variation in the valence band are found after relevant spin-orbit coupling (SOC), which leads to a reduction in the band gap and birefringence.

N-Doping Induced Lattice Expansion of 1D Template Confined Ultrathin MoS2 Sheets to Significantly Enhance Lithium Polysulfides Redox Kinetics for Li-S Battery.

Preparing MoS2 -based materials with reasonable structure and catalytic activity to enhance the sluggish kinetics of lithium polysulfides (LiPSs) conversion is of great significance for Li-S batteries (LSBs) but still remain a challenge. Hence, hollow nanotubes composed of N-doped ultrathin MoS2 nanosheets (N-MoS2 NHTs) are fabricated as efficient S hosts for LSBs by using CdS nanorods as a sacrifice template. Characterization and theoretical results show that the template effectively inhibits the excessive growth of MoS2 sheets, and N doping expands the interlayer spacing and modulates the electronic structure, thus accelerating the mass/electron transfer and enhancing the LiPSs adsorption and transformation. Benefiting from the merits, the N-MoS2 NHTs@S cathode exhibits an excellent initial capacity of 887.8 mAh g-1 and stable cycling performances with capacity fading of only 0.0436% per cycle at 1.0 C (500 cycles). Moreover, even at high S loading that of 7.5 mg cm-2 , the N-MoS2 NHTs@S cathode also presents initial excellent areal capacity of 7.80 mAh cm-2 at 0.2 C. This study offers feasible guidance for designing advanced MoS2 -based cathode materials in LSBs.

From Our One Anastomosis Gastric Bypass (OAGB) Experience to Establishing Single Anastomosis Sleeve Ileal (SASI) Bypass Procedure: A Single-Center Report.

BACKGROUND: Bariatric surgery has been proven to be the most effective treatment for obesity with or without metabolic syndrome. One anastomosis gastric bypass (OAGB) is a well-established bariatric procedure developed over the past 20 years with excellent outcomes. Single anastomosis sleeve ileal (SASI) bypass is introduced as a novel bariatric and metabolic procedure. There is some similarity between these two operations. This study aimed to present our SASI procedure based on the past experience of the OAGB in our center. METHOD: Thirty patients with obesity underwent SASI surgery from March 2021 to June 2022. Herein, we demonstrated our techniques step by step and key points of techniques learned from our experience with OAGB (shown in the video) with satisfying surgical outcomes. The clinical characteristics, peri-operative variables, and short-term outcomes were reviewed. RESULTS: There was no case of conversion to open surgery. The mean operative time, volume of blood loss, and hospital stay were 135.2 ± 39.2 min, 16.5 ± 6.2 mL, and 3.6 ± 0.8 days, respectively. There is no postoperative leakage, bleeding, or mortality. The percentage of total weight loss and excess weight loss at 6 months were 31.2 ± 6.5 and 75.3 ± 14.9, respectively. Improvement in type 2 diabetes (11/11, 100%), hypertension (14/26, 53.8%), dyslipidemia (16/21, 76.2%), and obstructive sleep apnea (9/11, 81.8%) were observed at 6 months after surgery. CONCLUSION: Our experience showed that our proposed SASI technique is feasible and may help surgeons perform this promising bariatric procedure without encountering many obstacles.

Two non-centrosymmetric mixed alkali metal and alkaline earth metal scandium borate nonlinear optical materials with short ultraviolet cutoff edges.

Rare earth borates, a subset of the essential nonlinear optical (NLO) materials, have sparked a significant amount of attention in recent years. In self-fluxing systems, two non-centrosymmetric scandium borates with classical B5O10 groups, namely Rb7SrSc2B15O30 (I) and Rb7CaSc2B15O30 (II), were successfully discovered. Both I and II exhibit a short ultraviolet (UV) cutoff edge (<200 nm) and appropriate second-harmonic generation efficiency (∼0.76 × KH2PO4, ∼0.88 × KH2PO4 at 1064 nm, respectively). According to theoretical calculations, it is speculated that the band gap and NLO characteristics of these two compounds are mostly derived from the B5O10 group and the ScO6 octahedron. Due to the short cutoff edges of I and II, they may be considered as potential NLO materials in the UV and even deep UV spectral ranges. Furthermore, the advent of I and II adds to the diversity of rare earth borates.

Li3B8O13X (X = Cl and Br): Two New Noncentrosymmetric Crystals with Large Birefringence Induced by BO3 Units.

Enthusiasm for the exploration of nonlinear alkali metal borates remains high. Focusing on the Li-B-O-X (X = Cl and Br) system, two examples of noncentrosymmetric borates, Li3B8O13Cl and Li3B8O13Br, were obtained using a high-temperature solution method under vacuum conditions. Structurally, the Li3B8O13X crystals exhibit two independent alternately arranged three-dimensional B-O network structures formed by the basic building block unit B8O16. The performance measurements demonstrate their short ultraviolet cutoff edges. The theoretical calculation indicates that the BO3 units dominate the contribution to their large optical anisotropy with the birefringence, 0.094 and 0.088@1064 nm for Li3B8O13Cl and Li3B8O13Br, respectively.

Bariatric surgery trends and progress in Taiwan: 2010-2021.

INTRODUCTION: Taiwan is a leading country regarding bariatric surgery in Asia-Pacific. Since 2010, the Taiwan Society for Metabolic and Bariatric Surgery (TSMBS) has been accountable for the national evolution of bariatric surgery and inaugurated a national database accordingly. This study aimed to analyze the bariatric surgery trends and progress in Taiwan from 2010 to 2021. MATERIALS AND METHODS: The TSMBS database was collected on the basis of structured inquiries filled out by bariatric surgeons in Taiwan. All patients involving bariatric surgery were included. The data were stratified with the following objectives, including the types of bariatric procedures, demographic characteristics, and perioperative variables. A nationwide database was comprehensively analyzed and evaluated to determine the trends in the applications of the procedure. RESULTS: Data of 30,026 patients were enrolled. A 2.5-fold increase was observed in bariatric procedures, from 1218 in 2010 to 3005 in 2021. Within 12 years, female accounts for 61.8 %. The revisional rate was 3.40 % during the exploration stage (2010-2013), 2.77 % during the maturity stage (2013-2018), and 5.10 % during the expansion stage (2019-2021). The top five of primary bariatric surgery is sleeve gastrectomy (SG, 63.05 %), gastric clipping surgery (GC, 11.17 %), Roux-en-Y gastric bypass (RYGB, 9.34 %), one anastomosis gastric bypass (OAGB, 8.80 %), and sleeve plus surgery (SG plus, 4.43 %). CONCLUSION: The trends and progress of Taiwan's bariatric surgery within recent decades are presented in this article. Taiwan's bariatric surgery case number has increased steadily from 2010 to 2021. Amongst all, SG has become the most dominant procedure since 2011 while OAGB takes up second place in 2020.

Structure and Characterization of K2Na3B2P3O13, a New Nonlinear Optical Borophosphate with One-Dimensional Chain Structure and Short Ultraviolet Cutoff Edge.

Nonlinear optical (NLO) crystals, being the primary medium for laser wavelength conversion, are crucial in all-solid-state lasers. Borophosphates offer more structural varieties than pure borates and phosphates, and they have become popular as NLO crystal candidates. Through spontaneous crystallization, we acquired a noncentrosymmetric alkali metal borophosphate crystal material, K2Na3B2P3O13 (KNBPO). KNBPO crystallizes in the orthorhombic Cmc21 space group with the following unit cell parameters: a = 13.9238(18) Å, b = 6.7673(8) Å, c = 12.1298(15) Å, and Z = 4, and its structure is characterized by a fundamental building unit 1∞ [B2P3O13] chain structure made up of bridging oxygen linkages between BO4 and PO4 tetrahedra. KNBPO has a short ultraviolet (UV) cut-off edge (<186 nm), a congruent melting characteristic, good thermal stability, and a moderate second harmonic generation response roughly 0.42 times that of KH2PO4. Theoretical calculations reveal that the optical properties of the compound mainly originate from BO4 and PO4 units. Due to the short UV cut-off edge, KNBPO can be used as a potential NLO material in the UV and even deep UV regions, and it enhances the structural variety of borophosphates, which has a reference value for scholars investigating similar materials.

Outcomes of laparoscopic revisional conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: Diff erent strategies for obese and non-obese Asian patients.

BACKGROUND: Sleeve gastrectomy (SG) is the most performed bariatric procedure now. Some patients would necessitate a revision to Roux-en-Y gastric bypass (RYGB) as a salvage procedure for intractable gastroesophageal reflux disease (GERD). However, outcome of the revision in Asians with co-existed obesity and those non-obese is not clear. METHODS: We retrospectively reviewed the data of patients who underwent revisional laparoscopic RYGB after SG between 2007 and 2019 for intractable GERD with data of one year follow-up. Pre-operative clinical data, perioperative outcomes, GERD symptoms, weight loss and medication details were analyzed. Patients were classified into those with body mass index (BMI) ≥ 25 and < 25 kg/m2. RESULTS: Fifty-five patients (44 women, 11 men; mean age 42.5 years) were included. Mean interval from the initial SG to revision surgery was 51.2 months (range, 5-132). Mean body mass index before SG was 34.6 kg/m2, whereas that before revision surgery was 27.6 kg/m2. All the patients required continue proton pump inhibitor (PPI) to control the GERD symptoms before surgery. Among them, 36 (65.4%) patients in the obese group received long BP limb (>100 cm) RYGB for associated obesity but the common channel was assured to ≥ 400 cm or 70% of small bowel length, the other 19 (34.6%) patients in the non-obese group received standard BP limb (<100 cm) RYGB. There was no difference in basic characters between the two groups before revision surgery except a higher mean BMI (30.0 vs. 22.2 kg/m2, p < 0.001), blood pressure and triglyceride in obese group. One year after revision surgery, all the patients had improved GERD symptoms but only 33 (60%) can completely wave PPI, without difference between the 2 groups. Obese group with a long BP limb RYGB had a significant higher % total weight loss (TWL) than non-obese group (%TWL 9.1% vs. -3.1%, p = 0.005). CONCLUSION: Laparoscopic revision to RYGB is a safe and effective treatment for patients with intractable GERD after SG but some patients may still have residual GERD symptoms. Using a modified RYGB technique in revision surgery may help in weight reduction for obese Asian patients.

Growth, Structure, and Optical Properties of a Nonlinear Optical Niobium Borate Crystal CsNbOB2O5 with Distorted NbO5 Square Pyramids.

In this paper, a revised structure determination of an already known compound CsNbOB2O5 with new structural insights was performed and the detailed characterization of its optical properties was reported for the first time. CsNbOB2O5 was synthesized by spontaneous crystallization. It crystallizes in the Pmn21 space group, and the unit lattice parameters are a = 7.5220(7) Å, b = 3.9881(4) Å, c = 9.7167(9) Å, and Z = 2. In the structure of CsNbOB2O5, a [NbO5] square pyramid and [B2O5] unit are linked to constitute an infinitely extended two-dimensional ∞2[NbOB2O5] layer via sharing oxygen atoms. Between these two-dimensional layers, there are no covalent bonds perpendicular to their planes based on Mulliken bond order analysis. CsNbOB2O5 has a wide band gap (4.52 eV) and a large second-harmonic-generation (SHG) response (1.2 × KDP) and demonstrates type-I phase-matchable behavior. First-principles simulations reveal that the birefringence is approximately 0.10. Moreover, SHG-weighted charge density analysis shows that the primary source of the nonlinearity of the title compound is the distorted NbO5 square pyramids.

Bridging oxygen atoms in trigonal prism units driven strong second-harmonic-generation efficiency in Sr3Ge2O4Te3.

Herein, a novel IR NLO oxytelluride Sr3Ge2O4Te3 was successfully designed and synthesized through a "partial O-to-Te substitution" strategy. Compared with the parent oxide, Sr3Ge2O4Te3 not only successfully achieves a phase-matchability transition (from NPM to PM), but also greatly improves the linear and NLO performances, including a wide band gap (2.26 eV), strong SHG response (1.3 × AgGaSe2) and large optical anisotropy (Δn = 0.152@2090 nm). The analyses of the structure-property relationship and SHG-density indicate that the bridging oxygen in the [O3Ge-O-GeTe3] prism unit plays the most important role in the multiplication SHG effect. This work provides some insights into the design and exploration of novel IR NLO materials.

A Theoretical Perspective to Study the Optical Properties of Tetrafluoroborates.

In this study, a series of tetrafluoroborates with non-π-conjugated [BF4 ] tetrahedra are investigated systematically by first-principles calculations. Theoretical studies demonstrate that tetrafluoroborates with alkali and/or alkaline-earth metals are more favorable for deep-ultraviolet transmission and are comparable to the classical deep-ultraviolet (deep-UV) material, MgF2 . Furthermore, bandgap decrease with the increasing of ionic radii in alkali and/or alkaline-earth metals. Introducing highly polarizable cations with d10 -configuration or cations with lone pair electrons into the structure will decrease the bandgaps. The birefringence and second harmonic generation effects are not large enough in tetrafluoroborates because polarizability anisotropy and hyperpolarizability in non-π-conjugated [BF4 ] tetrahedra are much smaller than those in π-conjugated groups. However, the second harmonic generation effect for [BF4 ] tetrahedra has a higher contribution in comparison with that due to birefringence. To effectively synthesize the borate fluorides or fluorooxoborates in the deep-UV region, raw materials with B-F bonds are preferred.

Probiotics for gallstone prevention in patients with bariatric surgery: A prospective randomized trial.

BACKGROUND: Gall stone disease was known to increase after bariatric surgery. Ursodeoxycholic acid (UDCA) might reduce the gallstone formation rate after bariatric surgery. However, other option for gallstone prevention was unclear. We reported the result of a randomized trial comparing the gallstone prevention efficacy of probiotics and digestive enzyme versus UDCA. METHODS: This prospective, randomized trial was held in an institute of Taiwan. Patients were eligible for inclusion if their body-mass index (BMI) was 32.5 kg/m2 or higher with the presence of comorbidity, or 27.5 kg/mw or higher with not-well controlled type 2 diabetes, and were aged 18-65 years. Participant were randomized assigned (1:1:1) to probiotic, digestive enzyme or UDCA. The primary endpoint was assessed in the incidence of gallstone disease at 6 months after surgery. This study is registered with ClinicalTrials.gov. number NCT03247101, and is now completed. RESULTS: From January 2016 to December 2018, of 186 patients screened for eligibility, 152 were randomly assigned to probiotic (52) or digestive enzyme (52) or UDCA (52). In the per-protocol population, mean age was 35.9 years (SD 10.6), mean BMI was 40.3 kg/m2 (SD 6.9), 57(58.2%) were female. After 6 months, the incidence of gall bladder diseased was 15.2%, in the probiotics group, 17.6% in UDCA group and 29.1% in digestive enzyme groups, confirming non-inferiority of probiotic (p = 0.38). Female gender was identified as a risk factor for gall bladder disease after bariatric surgery (odds ratio = 4.61, 95% confidence interval = 1.05, 20.3, p = 0.04). The poor drug compliance rate was 19.5%, 22.7% and 26.2% in probiotics, UDCA and digestive enzyme group respectively. UDCA group had a higher drug adverse effect than probiotic group (15.9% vs. 2.4%, p = 0.03). CONCLUSION: Probiotic is not inferior to UDCA regarding gall bladder disease prevention after bariatric surgery at 6 months.

Change of cardiovascular risk associated serologic biomarkers after gastric bypass: A comparison of diabetic and non-diabetic Asian patients.

BACKGROUND: While clinical findings demonstrate a superior benefit of cardiovascular (CV) risk reduction in obese patients with type 2 diabetes mellitus (T2D) receiving bariatric surgery over non-T2D patients, the mechanism is unclear. This study aimed to investigate the changes in the CV risk score and five CV-associated biomarkers after gastric bypass surgery. METHOD: We enrolled 80 obese subjects who underwent gastric bypass (40 T2D and 40 non-T2D). CV risks were assessed using the United Kingdom Prospective Diabetes Study (UKPDS) engine before and after surgery. Levels of five biomarkers -fasting serum fibroblast growth factor (FGF)-19, FGF-21, corin, oxidized low-density lipoprotein (ox-LDL), and soluble receptor for advanced glycation end-products (sRAGE)-were measured before surgery and one year after surgery. RESULTS: The T2D group was significantly older and had a higher CV risk score than the non-T2D group, but body mass index (BMI) was similar between the groups. Preoperative biomarker levels were similar in both the T2D and the non-T2D groups. One year after surgery, the percentage of total weight loss (%TWL) was similar between the two groups (32.2 ± 19.5% versus 34.1% ± 8.8%, p = 0.611). Complete T2D remission (hemoglobin A1c (HbA1c) < 6.0%) was achieved in 29 patients (72.5%). The 10-year CV risk scores by the UKPDS risk engine reduced significantly in both the T2D and the non-T2D groups, but more in the T2D group. Three of five biomarkers changed significantly after surgery: the FGF-19 increased from 195.6 ± 249.1 pg/mL to 283.2 ± 211.8 pg/mL, corin increased from 3.3 ± 2.3 ng/mL to 4.6 ± 3.7 ng/mL, and ox-LDL decreased from 148.5 ± 71.7-107.9 U/L; the P values were 0.002, 0.002 and < 0.001, respectively. The T2D group showed a significantly different change in FGF-19 increase and FGF-21 decrease compared to the non-T2D group. The changes in corin and ox-LDL levels were not different between the T2D and non-T2D groups. CONCLUSION: Gastric bypass surgery resulted in a higher UKPDS CV risk score reduction in obese T2D Asians than in those without. FGF-19 and FGF-21 may be associated with the underlying mechanism of this difference.

Distinctive modulation of optical anisotropy by halogens in α/ß-Cd-P-X (X = Cl, Br, and I).

Birefringent materials are widely applied as photoelectric functional field devices to modulate the polarization of lasers. The introduction of a halogen into the structure of crystals could balance the relationship between the band gap Eg and nonlinear optical (NLO) coefficient owing to their outstanding electronegativity and control the optical anisotropy. In this work, the optical properties of phosphohalides α/ß-Cd2P3X (X = Cl, Br, I) were studied. It was found that the birefringences of α/ß-Cd2P3Cl (0.23/0.24 @ 1064 nm) are unexpectedly 8 times larger than those of α/ß-Cd2P3I (0.04/0.03 @ 1064 nm). To find the optical property origins and explore the contributions of microscopic groups to the optical anisotropy and NLO responses in Cd-P-X (X = Cl, Br, I), the first-principles, real-space atom-cutting, and polarizability anisotropy analysis methods were used. This reveals that the electron distribution is susceptible to halogen electronegativity. Halogen atoms can modulate the polarization anisotropy of the active polyhedron and influence the birefringence significantly, owing to the synergistic effect of the anion size and strong covalent interactions between halogens and metal cations. This work clarifies the optical anisotropy origin mechanism and provides a general strategy for finding promising birefringent crystals in phosphohalide systems.

Long-Term Efficacy of Bariatric Surgery for the Treatment of Super-Obesity: Comparison of SG, RYGB, and OAGB.

BACKGROUND: The most appropriate procedure for the treatment of super obesity (BMI > 50 kg/m2) is unknown. We aimed to evaluate the safety, long-term (> 5 years) weight loss, and adverse events between three commonly performed procedures, sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB) in super-obese patients. METHODS: Between January 2002 and December 2015, 498 successive patients with super morbid obesity (BMI > 50), who underwent SG or RYGB or OAGB, were recruited. Surgical outcome, weight loss, resolution of co-morbidities, and late complications were followed and compared between the 3 groups. All data derived from a prospective bariatric database and a retrospective analysis was conducted. RESULTS: The average patient age was 32.1 ± 10.4 years, with a mean body mass index (BMI) of 56.0 ± 6.7 kg/m2. Of them, 190 (38.9%) underwent SG, 62 (12.4%) RYGB, and 246 (49.4%) OAGB. There was no difference in basic characters between the 3 groups except SG had fewer diabetic patients. RYGB group had higher intraoperative blood loss, longer operating time, and hospital stay than the other 2 groups. RYGB had a higher 30-days post-operative major complication rate (4.8%) than SG (0.5%) and OAGB (0.8%). The follow-up rate at 1 and 5 years was 89.4% and 52.0%. At post-operative 5 years, OAGB had a higher total weight loss (40.8%) than SG (35.1%), but not RYGB (37.2%). SG had a lower remission rate in dyslipidemia comparing to OAGB and RYGB, but T2DM remission rate was no different between the groups. The overall revision rate is 5.4% (27/498) of the whole group, and SG had a lower revision rate (2.6%) than RYGB (8.1%) and OAGB (6.9%). CONCLUSION: SG is an effective and durable primary bariatric procedure for the treatment of super obesity and metabolic disorders. OAGB had a similar operation risk to SG but resulted in a better weight loss than SG.