Nima Saeidi, an assistant professor of surgery at Harvard Medical School and Massachusetts General Hospital and a member of the Center for Engineering in Medicine, had started down one career path when a lecture on Roux-en-Y gastric bypass surgery redirected him.The MGH lecture outlined not just the procedure’s striking effectiveness for weight loss — averaging 40 percent — but also its promise against diabetes, high blood pressure, cholesterol, and fatty-food cravings. Saeidi, an assistant in bioengineering at MGH, halted his work in tissue engineering and began to study gastric bypass.“To me, it’s really a mystery,” said Saeidi, “and it seems to be like a miracle.”The idea of a compound that mimics the positives of Roux-en-Y is particularly enticing amid twin national epidemics of obesity and diabetes. A therapy that conferred the surgery’s benefits while avoiding its less healthy side effects — brittle bones, vitamin deficiency, anemia, and increased rates of alcoholism — would likely add significantly to the 45,000 morbidly obese patients the procedure helps annually.The problem is scientists still don’t know how it works.In Roux-en-Y, physicians make a small pouch out of the upper portion of the stomach and then cut and reattach the small intestine to the pouch, bypassing the entire lower stomach and the first few feet of the small intestine. This transformation of the stomach into a pouch makes patients feel full quickly, while food’s rapid passage into the intestine alters digestion and absorption of calories — as well as of minerals and vitamins, the cause of some of the surgery’s negative side effects.The surgery was developed decades ago as a treatment for stomach ulcers, and was first used as a correction for morbid obesity by University of Iowa physicians in 1967. Follow-up research uncovered dramatic benefits independent of weight loss.For example, though Type 2 diabetes risk is tied to obesity, post-Roux-en-Y resolution of the disease — more than 80 percent of patients are cured — is not solely a weight-loss phenomenon.“We see effects happening within two to three days,” Saeidi said. “Patients get surgery and they’re completely diabetic, they need insulin or metformin medication. And many of them leave the hospital without any medication. It is just puzzling how this is happening and what is causing it.”There were 64 Roux-en-Y procedures at MGH last year. The surgery has been shown to affect insulin sensitivity and production of the hunger hormones ghrelin and leptin. It also alters the composition of a patient’s microbiome, the intestinal bacteria that scientists are beginning to understand play a major role in health. Harvard researchers are targeting obesity and its cousin, diabetes Alcohol abuse after weight loss surgery? Study suggests possible alternative to gastric bypass surgery Researchers gather at Radcliffe to investigate gut-brain communication Related Obesity? Diabetes? We’ve been set up Major weight loss tied to microbes Initially, Saeidi said, researchers searched for a single enzyme or hormone responsible for the changes. But consensus has gradually turned away from a “silver bullet” for what appears to be a fundamental shift in metabolism.“The previous work was on single tissue, but it became very apparent it’s not just a story about one single organ or one single tissue,” Saeidi said. “It is the crosstalk and interaction between different organs that really drives the systemic effects.”That crosstalk is likely to involve a network of cascading changes in fat, muscle, the liver, and intestines. To better probe that complexity, Saeidi and colleagues have turned to new rodent models, spectroscopic instruments, and novel informatics techniques that shift inquiry from a traditional hypothesis-based, step-by-step exploration to one that seeks to reverse-engineer the problem, by searching broadly for postoperative chemical changes in the body and then working to understand them.“This is an agnostic, hypothesis-generation tool,” said Gautham Sridharan, a recent fellow in Saeidi’s lab and first author of a paper on their work published in the journal Technology. “Post RYGB, we see all these changes … in metabolism. It gives us some clue that maybe we should further investigate that pathway.”In a Roux-en-Y rodent model, Saeidi’s team identified more than 1,300 liver proteins and searched for changes in their concentration 30 days later. Eighty-two had changed and two of them, Thrsp and Acot13, appeared to be potential drug targets. Though that may seem a promising start, Sridharan noted that the study examined only one organ and at just one point in what appears to be a dynamic post-surgery process involving several organs.Future research, Saeidi said, will examine compounds whose altered concentrations in one organ move through the blood to where they can affect others.“Ideally, we want to have a sense of the dynamics of the changes that occur in different organs and how different organs interact with each other,” Saeidi said.
The Nikkei had dipped on Friday after Prime Minister Shinzo Abe’s resignation stirred doubts about future fiscal and monetary stimulus policies.Those concerns were eased somewhat by news Chief Cabinet Secretary Yoshihide Suga, and a close ally of Abe, would join the race to succeed his boss. A slimmed-down leadership contest is likely around Sept. 13 to 15.The next event of note in Asia will be China’s official manufacturing PMI survey for August which is forecast to show a slight improvement to 51.2 as the recovery there continues.The United States ISM manufacturing survey is also expected to show a continued pick up in activity in August, while August payrolls on Friday are forecast to rise 1.4 million with the unemployment rate dipping to a still painfully-high 9.8 percent. Asian shares notched a fresh two-year high on Monday as investors wagered monetary and fiscal policies globally would stay super stimulatory for a protracted period, keeping the safe-haven dollar on the defensive.MSCI’s broadest index of Asia-Pacific shares outside Japan added 0.2 percent to reach its highest since June 2018, extending a 2.8 percent rise last week.Tokyo’s Nikkei rallied 1.4 percent aided by news Warren Buffett’s Berkshire Hathaway had bought more than 5 percent stakes in each of the five leading Japanese trading companies. A host of Federal Reserve officials are set to speak this week, kicking off with Vice Chair Richard Clarida later Monday as they put more flesh on the bank’s new policy frameworkFed Chair Jerome Powell boosted stock markets last week by committing to keep inflation at 2 percent on average, allowing prices to run hotter to balance periods when they undershot.The risk of higher inflation in the future, assuming the Fed can get it there, was enough to push up longer-term Treasury yields and sharply steepen the yield curve.Yields on 30-year bonds jumped almost 16 basis points last week to stand at 1.508 percent, 137 basis points above the two-year yield. The spread was now approaching the June gap of 146 basis points which was the largest since late 2017.That shift was of little benefit to the US dollar given the prospect of short rates staying super-low for longer, and the currency fell broadly.Early Monday, the dollar index was down at 92.211 and just a whisker above the recent two-year low of 92.127. The euro edged higher to US$1.1915, having climbed 0.9 percent last week.Marshall Gittler, head of investment research at BDSwiss Group, noted speculators had already built up record levels of long positions in the euro which could work to limit further gains.“A truly crowded trade that will take more news to push higher,” he argued.The dollar did steady a little on the yen at 105.47, after dropping 1.1 percent on Friday before finding support in the 105.10/20 zone.In commodity markets, the drop in the dollar helped gold bounce to $1,974 an ounce.Oil prices steadied, having dipped on Friday after Hurricane Laura passed the heart of the US oil industry without causing any widespread damage.Brent crude futures rose 15 cents to $45.96 a barrel, while US crude gained 6 cents to $43.03.Topics :
Carrying 611 crew and no guests, Rotterdam departed from Puerto Vallarta, Mexico, on Sunday and is scheduled to meet with MS Zaandam’s crew on Thursday evening off the coast of Panama.The U.S. Centers for Disease Control and Prevention, the Florida Department of Health in Broward County, U.S. Coast Guard, and U.S. Customs & Border Protection and the Port Everglades Pilots Association are assessing the situation.Broward County had 412 confirmed cases of coronavirus, officially known as COVID-19, as of Wednesday evening. Holland America Line, a subsidiary of Carnival Corporation, has deployed one of its ships to deliver coronavirus test kits to its sister ship, the MS Zaandam, which is en route to Port Everglades.The MS Zaandam’s voyage has continued with 1,829 people on board, including 30 guests and 47 crew members who have reported coronavirus symptoms and have been on the ship since March 14 in Chile.As all ports along Zaandam’s route are closed to cruise ships, Holland America Line has deployed Rotterdam from Puerto Vallarta to rendezvous with Zaandam and provide extra supplies, staff, COVID-19 test kits and other support as needed. Read more >> https://t.co/ImxkYYkwCT— Holland America Line (@HALcruises) March 24, 2020 “Holland America Line has deployed Rotterdam to rendezvous with Zaandam and provide extra supplies, staff, COVID-19 test kits and other support as needed,” a representative wrote in a statement.The officers and crew of Rotterdam came together to thank medical professionals and first responders who are working around the clock, taking care of our friends, neighbors and communities. #WeApplaud #CruiseStrong #WeWillBeBack pic.twitter.com/JxEgRkfMiW— Holland America Line (@HALcruises) March 23, 2020