Protective role of exercise on breast cancer-related osteoporosis in women undergoing aromatase inhibitors: A narrative review.

Hormone therapy following surgery reduces the risk of breast cancer (BC) recurrence and progression of hormone-sensitive BC, especially in postmenopausal women. Despite the antitumor efficacy of hormone therapy, particularly of aromatase inhibitors, they cause long-term side effects, mainly bone density reduction. Exercise can slow the rate of bone loss, which reduces the risk of fractures from osteoporosis, and could be an integrative treatment able to mitigate the BC treatment side effects positively impacting bone health. This narrative review aims to discuss studies on the effect of exercise on bone health in BC women undergoing aromatase inhibitors, highlighting the possible role of exercise as complementary to conventional therapies. Additionally, according to the literature revision, exercise practical applications to improve bone health in these patients are summarized.

Frontiers in Photoelectrochemical Catalysis: A Focus on Valuable Product Synthesis.

Photoelectrochemical (PEC) catalysis provides the most promising avenue for producing value-added chemicals and consumables from renewable precursors. Over the last decades, PEC catalysis, including reduction of renewable feedstock, oxidation of organics, and activation and functionalization of C─C and C─H bonds, are extensively investigated, opening new opportunities for employing the technology in upgrading readily available resources. However, several challenges still remain unsolved, hindering the commercialization of the process. This review offers an overview of PEC catalysis targeted at the synthesis of high-value chemicals from sustainable precursors. First, the fundamentals of evaluating PEC reactions in the context of value-added product synthesis at both anode and cathode are recalled. Then, the common photoelectrode fabrication methods that have been employed to produce thin-film photoelectrodes are highlighted. Next, the advancements are systematically reviewed and discussed in the PEC conversion of various feedstocks to produce highly valued chemicals. Finally, the challenges and prospects in the field are presented. This review aims at facilitating further development of PEC technology for upgrading several renewable precursors to value-added products and other pharmaceuticals.

Highly Efficient Solar-Light-Driven Photodegradation of Metronidazole by Nickel Hexacyanoferrate Nanocubes Showing Enhanced Catalytic Performances.

Environmental pollution is a complex problem that threatens the health and life of animal and plant ecosystems on the planet. In this respect, the scientific community faces increasingly challenging tasks in designing novel materials with beneficial properties to address this issue. This study describes a simple yet effective synthetic protocol to obtain nickel hexacyanoferrate (Ni-HCF) nanocubes as a suitable photocatalyst, which can enable an efficient photodegradation of hazardous anthropogenic organic contaminants in water, such as antibiotics. Ni-HCF nanocubes are fully characterized and their optical and electrochemical properties are investigated. Preliminary tests are also carried out to photocatalytically remove metronidazole (MDZ), an antibiotic that is difficult to degrade and has become a common contaminant as it is widely used to treat infections caused by anaerobic microorganisms. Under simulated solar light, Ni-HCF displays substantial photocatalytic activity, degrading 94.3% of MDZ in 6 h. The remarkable performance of Ni-HCF nanocubes is attributeto a higher ability to separate charge carriers and to a lower resistance toward charge transfer, as confirmed by the electrochemical characterization. These achievements highlight the possibility of combining the performance of earth-abundant catalysts with a renewable energy source for environmental remediation, thus meeting the requirements for sustainable development.

Unraveling the optoelectronic properties of CoSbx intrinsic selective solar absorber towards high-temperature surfaces.

The combination of the ability to absorb most of the solar radiation and simultaneously suppress infrared re-radiation allows selective solar absorbers (SSAs) to maximize solar energy to heat conversion, which is critical to several advanced applications. The intrinsic spectral selective materials are rare in nature and only a few demonstrated complete solar absorption. Typically, intrinsic materials exhibit high performances when integrated into complex multilayered solar absorber systems due to their limited spectral selectivity and solar absorption. In this study, we propose CoSbx (2 < x < 3) as a new exceptionally efficient SSA. Here we demonstrate that the low bandgap nature of CoSbx endows broadband solar absorption (0.96) over the solar spectral range and simultaneous low emissivity (0.18) in the mid-infrared region, resulting in a remarkable intrinsic spectral solar selectivity of 5.3. Under 1 sun illumination, the heat concentrates on the surface of the CoSbx thin film, and an impressive temperature of 101.7 °C is reached, demonstrating the highest value among reported intrinsic SSAs. Furthermore, the CoSbx was tested for solar water evaporation achieving an evaporation rate of 1.4 kg m-2 h-1. This study could expand the use of narrow bandgap semiconductors as efficient intrinsic SSAs with high surface temperatures in solar applications.

Dropout and compliance to physical exercise in menopausal osteopenic women: the European "happy bones" project.

Introduction: Decline in muscle mass and bone density seem to be two of the most disabling side effects of menopause that negatively affect women's quality of life. Promoting physical activity protocols in the workplace can represent a focal point in the prevention and management of several diseases. The study aims to evaluate the compliance and drop-out of menopausal osteopenic women engaged in combined training performed inside and outside the workplace. Strength and balance were analyzed to evaluate the effect of this protocol on osteoporosis prevention and the risk of falling. Methods: 73 menopausal women were enrolled in 5 European countries. They performed 72 lessons of a combined training proposed in the working place (IW) or sport center (SC). Results: Out of the total 39 women enrolled in the IW, 12.8% had to leave the program, while out of the 34 women enrolled in SC, 41.2% did not complete the training. According to the compliance results, 47% of women that completed the trained IW and 85% in the SC recorded high compliance (p = 0.019). Moreover, the strength of the lower limbs (p < 0.001) and static balance (p = 0.001) significantly improved in the whole group. Discussion: In conclusion, proposing well-structured training in the workplace for menopausal women seems to reduce drop-out. Strength and balance results suggest its positive impact on bone health and risk of falls, despite where it is performed.

Confinement Accelerates Water Oxidation Catalysis: Evidence from In Situ Studies.

Basic insight into the structural evolution of electrocatalysts under operating conditions is of substantial importance for designing water oxidation catalysts. The first-row transition metal-based catalysts present state-of-the-art oxygen evolution reaction (OER) performance under alkaline conditions. Apparently, confinement has become an exciting strategy to boost the performance of these catalysts. The van der Waals (vdW) gaps of transition metal dichalcogenides are acknowledged to serve as a suitable platform to confine the first-row transition metal catalysts. This study focuses on confining Ni(OH)2 nanoparticle in the vdW gaps of 2D exfoliated SnS2 (Ex-SnS2 ) to accelerate water oxidation and to guarantee long term durability in alkaline solutions. The trends in oxidation states of Ni are probed during OER catalysis. The in situ studies confirm that the confined system produces a favorable environment for accelerated oxygen gas evolution, whereas the un-confined system proceeds with a relatively slower kinetics. The outstanding OER activity and excellent stability, with an overpotential of 300 mV at 100 mA cm-2 and Tafel slope as low as 93 mV dec-1 results from the confinement effect. This study sheds light on the OER mechanism of confined catalysis and opens up a way to develop efficient and low-cost electrocatalysts.

Plasma-derived extracellular vesicles released after endurance exercise exert cardioprotective activity through the activation of antioxidant pathways.

Cardiovascular diseases (CVD) can cause various conditions, including an increase in reactive oxygen species (ROS) levels that can decrease nitric oxide (NO) availability and promote vasoconstriction, leading to arterial hypertension. Physical exercise (PE) has been found to be protective against CVD by helping to maintain redox homeostasis through a decrease in ROS levels, achieved by increased expression of antioxidant enzymes (AOEs) and modulation of heat shock proteins (HSPs). Extracellular vesicles (EVs) circulating in the body are a major source of regulatory signals, including proteins and nucleic acids. Interestingly, the cardioprotective role of EVs released after PE has not been fully described. The aim of this study was to investigate the role of circulating EVs, obtained through Size Exclusion Chromatography (SEC) of plasma samples from healthy young males (age: 26.95 ± 3.07; estimated maximum oxygen consumption rate (VO2max): 51.22 ± 4.85 (mL/kg/min)) at basal level (Pre_EVs) and immediately after a single bout of endurance exercise (30' treadmill, 70% heart rate (HR) -Post_EVs). Gene ontology (GO) analysis of proteomic data from isolated EVs, revealed enrichment in proteins endowed with catalytic activity in Post_EVs, compare to Pre_EVs, with MAP2K1 being the most significantly upregulated protein. Enzymatic assays on EVs derived from Pre and Post samples showed increment in Glutathione Reductase (GR) and Catalase (CAT) activity in Post_EVs. At functional level, Post_EVs, but not Pre_EVs, enhanced the activity of antioxidant enzymes (AOEs) and reduced oxidative damage accumulation in treated human iPS-derived cardiomyocytes (hCM) at basal level and under stress conditions (Hydrogen Peroxide (H2O2) treatment), resulting in a global cardioprotective effect. In conclusion, our data demonstrated, for the first time, that a single 30-min endurance exercise is able to alter the cargo of circulating EVs, resulting in cardioprotective effect through antioxidant activity.

Synthesis of tetrahydrocarbazoles through a radical cation [4+2] cycloaddition reaction of 2-vinylindoles.

A redox umpolung strategy for the synthesis of complex tetrahydrocarbazoles is reported. The reaction involves a visible light promoted radical cation [4+2] cycloaddition between 2-vinylindoles and conjugated alkenes that proceeds with good yields and diastereoselectivity.

Facile Electron Transfer in Atomically Coupled Heterointerface for Accelerated Oxygen Evolution.

An efficient and cost-effective approach for the development of advanced catalysts has been regarded as a sustainable way for green energy utilization. The general guideline to design active and efficient catalysts for oxygen evolution reaction (OER) is to achieve high intrinsic activity and the exposure of more density of the interfacial active sites. The heterointerface is one of the most attractive ways that plays a key role in electrochemical water oxidation. Herein, atomically cluster-based heterointerface catalysts with strong metal support interaction (SMSI) between WMn2 O4 and TiO2 are designed. In this case, the WMn2 O4 nanoflakes are uniformly decorated by TiO2 particles to create electronic effect on WMn2 O4 nanoflakes as confirmed by X-ray absorption near edge fine structure. As a result, the engineered heterointerface requires an OER onset overpotential as low as 200 mV versus reversible hydrogen electrode, which is stable for up to 30 h of test. The outstanding performance and long-term durability are due to SMSI, the exposure of interfacial active sites, and accelerated reaction kinetics. To confirm the synergistic interaction between WMn2 O4 and TiO2 , and the modification of the electronic structure, high-resolution transmission electron microscopy (HR-TEM), X-ray photoemission spectroscopy (XPS), and X-ray absorption spectroscopy (XAS) are used.

Discovery of Clinical Candidate CHF-6366: A Novel Super-soft Dual Pharmacology Muscarinic Antagonist and ß2 Agonist (MABA) for the Inhaled Treatment of Respiratory Diseases.

The development of molecules embedding two distinct pharmacophores acting as muscarinic antagonists and ß2 agonists (MABAs) promises to be an excellent opportunity to reduce formulation issues and boost efficacy through cross-talk and allosteric interactions. Herein, we report the results of our drug discovery campaign aimed at improving the therapeutic index of a previous MABA series by exploiting the super soft-drug concept. The incorporation of a metabolic liability, stable at the site of administration but undergoing rapid systemic metabolism, to generate poorly active and quickly eliminated fragments was pursued. Our SAR studies yielded MABA 29, which demonstrated a balanced in vivo profile up to 24 h, high instability in plasma and the liver, as well as sustained exposure in the lung. In vitro safety and non-GLP toxicity studies supported the nomination of 29 (CHF-6366) as a clinical candidate, attesting to the successful development of a novel super-soft MABA compound.

Designing Soluble PROTACs: Strategies and Preliminary Guidelines.

Solubility optimization is a crucial step to obtaining oral PROTACs. Here we measured the thermodynamic solubilities (log S) of 21 commercial PROTACs. Next, we measured BRlogD and log kwIAM (lipophilicity), EPSA, and Δ log kwIAM (polarity) and showed that lipophilicity plays a major role in governing log S, but a contribution of polarity cannot be neglected. Two-/three-dimensional descriptors calculated on conformers arising from conformational sampling and steered molecular dynamics failed in modeling solubility. Infographic tools were used to identify a privileged region of soluble PROTACs in a chemical space defined by BRlogD, log kwIAM and topological polar surface area, while machine learning provided a log S classification model. Finally, for three pairs of PROTACs we measured the solubility, lipophilicity, and polarity of the building blocks and identified the limits of estimating PROTAC solubility from the synthetic components. Overall, this paper provides promising guidelines for optimizing PROTAC solubility in early drug discovery programs.

Nanofiltration as a robust method contributing to viral safety of plasma-derived therapeutics: 20 years' experience of the plasma protein manufacturers.

BACKGROUND: Nanofiltration entails the filtering of protein solutions through membranes with pores of nanometric sizes that have the capability to effectively retain a wide range of viruses. STUDY DESIGN AND METHODS: Data were collected from 754 virus validation studies (individual data points) by Plasma Protein Therapeutics Association member companies and analyzed for the capacity of a range of nanofilters to remove viruses with different physicochemical properties and sizes. Different plasma product intermediates were spiked with viruses and filtered through nanofilters with different pore sizes using either tangential or dead-end mode under constant pressure or constant flow. Filtration was performed according to validated scaled-down laboratory conditions reflecting manufacturing processes. Effectiveness of viral removal was assessed using cell culture infectivity assays or polymerase chain reaction (PCR). RESULTS: The nanofiltration process demonstrated a high efficacy and robustness for virus removal. The main factors affecting nanofiltration efficacy are nanofilter pore size and virus size. The capacity of nanofilters to remove smaller, nonenveloped viruses was dependent on filter pore size and whether the nanofiltration process was integrated and designed with the intention to provide effective parvovirus retention. Volume filtered, operating pressure, and total protein concentration did not have a significant impact on the effectiveness of virus removal capacity within the investigated ranges. CONCLUSIONS: The largest and most diverse nanofiltration data collection to date substantiates the effectiveness and robustness of nanofiltration in virus removal under manufacturing conditions of different plasma-derived proteins. Nanofiltration can enhance product safety by providing very high removal capacity of viruses including small non-enveloped viruses.

Au-Decorated Ce-Ti Mixed Oxides for Efficient CO Preferential Photooxidation.

We investigated the photocatalytic behavior of gold nanoparticles supported on CeO2-TiO2 nanostructured matrixes in the CO preferential oxidation in H2-rich stream (photo-CO-PROX), by modifying the electronic band structure of ceria through addition of titania and making it more suitable for interacting with free electrons excited in gold nanoparticles through surface plasmon resonance. CeO2 samples with different TiO2 concentrations (0-20 wt %) were prepared through a slow coprecipitation method in alkaline conditions. The synthetic route is surfactant-free and environmentally friendly. Au nanoparticles (<1.0 wt % loading) were deposited on the surface of the CeO2-TiO2 oxides by deposition-precipitation. A benchmarking sample was also considered, prepared by standard fast coprecipitation, to assess how a peculiar morphology can affect the photocatalytic behavior. The samples appeared organized in a hierarchical needle-like structure, with different morphologies depending on the Ti content and preparation method, with homogeneously distributed Au nanoparticles decorating the Ce-Ti mixed oxides. The morphology influences the preferential photooxidation of CO to CO2 in excess of H2 under simulated solar light irradiation at room temperature and atmospheric pressure. The Au/CeO2-TiO2 systems exhibit much higher activity compared to a benchmark sample with a non-organized structure. The most efficient sample exhibited CO conversions of 52.9 and 80.2%, and CO2 selectivities equal to 95.3 and 59.4%, in the dark and under simulated sunlight, respectively. A clear morphology-functionality correlation was found in our systematic analysis, with CO conversion maximized for a TiO2 content equal to 15 wt %. The outcomes of this study are significant advancements toward the development of an effective strategy for exploitation of hydrogen as a viable clean fuel in stationary, automotive, and portable power generators.

Photocatalyzed preferential oxidation of CO under simulated sunlight using Au-transition metal oxide-sepiolite catalysts.

In the present study a series of Au-transition metal oxides supported on a clay mineral such as sepiolite were tested in the preferential oxidation of CO in an excess of H2 under simulated solar light irradiation and in the absence of light, at 30 °C and atmospheric pressure. Transition metal oxides (ZnO, Fe2O3, NiO, MnO2, and Co3O4) were dispersed over the sepiolite surface where, subsequently, Au nanoparticles with an average particle size between 2 and 3 nm were successfully deposited-precipitated. The obtained photocatalysts were characterized by XRD, XRF, DRUV-Vis, N2 adsorption-desorption and HRTEM in order to evaluate the optical, structural and chemical properties of the prepared samples. Despite the low amount of gold (nominal 1.0 wt%), the catalysts exhibited an outstanding behavior under light irradiation, with reaction rates between 4.5 and 5.2 mmol COox gcat-1 h-1 for the Au-NiSep, Au-CoSep and Au-ZnSep samples. These photocatalysts exhibited a high dispersion of the respective transition metal oxides over the sepiolite support and the presence of low-coordinated hemispherical gold nanoparticles. The superior photocatalytic efficiency of these samples was ascribed to the reduction of the electron-hole pair recombination of photogenerated charge carriers by the excitation of the localized surface plasmon resonance of the Au nanoparticles. The BET surface area and the gold particle size seemed to be relevant factors affecting the catalytic performance.

Grapevine water relations and rooting depth in karstic soils.

Environmental sustainability of viticulture is negatively affected by prolonged droughts. In limestone dominated regions, there is limited knowledge on grapevine water status and on methods for accurate evaluation of actual water demand, necessary to appropriately manage irrigation. During a dry vintage, we monitored plant and soil water relations in old and young vines of Istrian Malvasia on Karst red soil. The vineyard with young vines was additionally subdivided into two areas, based on their soil type, 1) karst silty-clay loam, and 2) mixture of crushed rocks and karst silty-clay loam (stony soil). Seasonal changes in exploited water resources were estimated via analysis of oxygen isotope composition (δ18O) of rainfall, deep soil water, and xylem sap. We hypothesized that plants are able to thrive during drought thanks to the water stored in deep soil layers, while they rely less on superficial soil horizons. Our results show that vines growing on karstic substrates have deep roots securing the use of stable water sources during summer, with consequent favourable plant water status. In fact, both young and mature vines approached the threshold of severe water stress, but never surpassed it, as midday leaf water potentials were >-1.3MPa in all study sites. Vines roots showed flexible water uptake, i.e. the ability to absorb water from deep or shallow soil horizons during drought and after late-summer thunderstorms, which was particularly evident in vines growing on the stony soil. In fact, precipitations of 20mm were enough for plant water status recovery, due to fast infiltration. On the other hand, at least 50mm of rainfall were necessary to induce water status recovery in more compact soil (karst silty-clay loam). Our findings provide new knowledge on the rooting depth and water needs of vines growing on shallow soils overlying fractured limestone bedrock.

CO Preferential Photo-Oxidation in Excess of Hydrogen in Dark and Simulated Solar Light Irradiation over AuCu-Based Catalysts on SBA-15 Mesoporous Silica-Titania.

In this work, SBA-15 silica and silica-titania have been used as supports for photocatalysts based on AuCu alloy (Au:Cu = 1) to be used in the preferential oxidation of CO (CO-PROX) in excess of hydrogen at room temperature and atmospheric pressure both in the dark and under simulated solar light irradiation. To study their textural, structural, chemical and optical properties, the samples were characterized by X-ray diffraction (XRD), high-resolution transmission electron microscopy (HR-TEM), adsorption-desorption of N2 at -196 °C, 13C and 29Si solid state nuclear magnetic resonance (NMR), X-ray photoelectron spectroscopy (XPS) and diffuse reflectance ultraviolet-visible (DRUV-vis) spectroscopy. Titanium was present mainly in the form of titania aggregates, but also as small particles interacting with the SBA support. In both catalysts, the metal alloy nanoparticles displayed an average size of 4 nm as demonstrated by TEM measurements. AuCu/Ti-SBA turned out to be photoactive and selective in the photo-CO-PROX reaction showing the highest activity, with conversion and selectivity towards CO2 of 80%, due both to the presence of titania incorporated in SBA-15 and to the synergistic effect of Cu when alloyed with Au.

Au and AuCu Nanoparticles Supported on SBA-15 Ordered Mesoporous Titania-Silica as Catalysts for Methylene Blue Photodegradation.

The photocatalytic degradation of methylene blue (MB) dye has been performed under UV irradiation in aqueous suspension, employing photocatalysts based on Au (1.5 wt %) and AuCu (Au/Cu = 1, 2.0 wt %), and supported on SBA-15-ordered mesoporous silica, with and without titania (Si/Ti = 3), in order to evaluate the versatility of this mesoporous support in this type of reaction of great impact from the environmental point of view. Samples were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), N2 adsorption-desorption at -196 °C, and X-ray photoelectron spectroscopy (XPS), so as to study their structural, optical, and chemical properties. All the prepared catalysts were found to be active in the test reaction. The bimetallic AuCu-based catalysts attained very high MB degradation values, in particular AuCu/SBA-15 titania-silica sample reached 100% of dye oxidation after the monitored reaction period (120 min).

Noninvasive Fetal Electrocardiography Part I: Pan-Tompkins' Algorithm Adaptation to Fetal R-peak Identification.

BACKGROUND: Indirect fetal electrocardiography is preferable to direct fetal electrocardiography because of being noninvasive and is applicable also during the end of pregnancy, besides labor. Still, the former is strongly affected by noise so that even R-peak detection (which is essential for fetal heart-rate evaluations and subsequent processing procedures) is challenging. Some fetal studies have applied the Pan-Tompkins' algorithm that, however, was originally designed for adult applications. Thus, this work evaluated the Pan-Tompkins' algorithm suitability for fetal applications, and proposed fetal adjustments and optimizations to improve it. METHOD: Both Pan-Tompkins' algorithm and its improved version were applied to the "Abdominal and Direct Fetal Electrocardiogram Database" and to the "Noninvasive Fetal Electrocardiography Database" of Physionet. R-peak detection accuracy was quantified by computation of positive-predictive value, sensitivity and F1 score. RESULTS: When applied to "Abdominal and Direct Fetal Electrocardiogram Database", the accuracy of the improved fetal Pan-Tompkins' algorithm was significantly higher than the standard (positive-predictive value: 0.94 vs. 0.79; sensitivity: 0.95 vs. 0.80; F1 score: 0.94 vs. 0.79; P<0.05 in all cases) on indirect fetal electrocardiograms, whereas both methods performed similarly on direct fetal electrocardiograms (positive-predictive value, sensitivity and F1 score all close to 1). Improved fetal Pan-Tompkins' algorithm was found to be superior to the standard also when applied to "Noninvasive Fetal Electrocardiography Database" (positive-predictive value: 0.68 vs. 0.55, P<0.05; sensitivity: 0.56 vs. 0.46, P=0.23; F1 score: 0.60 vs. 0.47, P=0.11). CONCLUSION: In indirect fetal electrocardiographic applications, improved fetal Pan-Tompkins' algorithm is to be preferred over the standard, since it provides higher R-peak detection accuracy for heart-rate evaluations and subsequent processing.

Gastric bypass-induced weight loss alters obesity-associated patterns of plasma pentraxin-3 and systemic inflammatory markers.

BACKGROUND: Systemic inflammation contributes to obesity-associated complications. The short pentraxin C-reactive protein (CRP) is a validated inflammatory marker, whereas long pentraxin-3 (PTX3) limits inflammation and is adaptively stimulated by proinflammatory cytokines in vitro. Severely obese (SO) patients (body mass index [BMI]>40] have the highest obesity-associated complications and increasingly undergo surgical treatment. SO-associated changes in plasma PTX3 and their interactions with systemic inflammation are, however, unknown. OBJECTIVE: We sought to determine potential alterations in plasma PTX3 and their associations with changes in inflammatory markers before and after weight loss induced by laparoscopic Roux-en-Y gastric bypass (LRYGB). SETTING: University hospital in Trieste, Italy. METHODS: Plasma PTX3, CRP, and cytokines, including tumor necrosis factor α and interleukin 6 were measured in (1) 24 individuals with severe, class III obesity (SO; age = 42 ± 1 yr, female/male = 18/6, BMI = 45 ± 1 kg/m(2)) before and 3, 6, and 12 months after LRYGB; and (2) age- and sex-matched normal-weight (N; n = 56, BMI = 22 ± .2 kg/m(2)) or class I obese individuals (O; n = 44, BMI = 31.2 ± .3 kg/m(2)). RESULTS: SO, but not O, had higher plasma PTX3 compared with N, associated with highest proinflammatory cytokines and CRP (P<.05 versus N-O). In all patients, plasma interleukin 6 and tumor necrosis factor α were associated positively with PTX3 (P<.05). Plasma CRP and proinflammatory cytokines declined during LRYGB-induced weight loss. In contrast, high PTX3 further increased and remained elevated (P<.05 versus basal). CONCLUSIONS: Obesity level and energy balance modulate interactions between PTX3 and systemic inflammation. Elevated PTX3 is a novel, potentially adaptive alteration associated with proinflammatory cytokines in SO. Their differential changes conversely suggest circulating PTX3 as a novel negative inflammatory marker in SO undergoing LRYGB-induced weight loss.