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DAILY DOSE: What happens when new obesity guidance meets are potentially game-changing obesity drug?


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Guidance for addressing childhood obesity in the United States has changed. According to the Associated Press,

Children struggling with obesity should be evaluated and treated early and aggressively, including with medications for kids as young as 12 and surgery for those as young as 13, according to new guidelines released Monday.

The longstanding practice of “watchful waiting,” or delaying treatment to see whether children and teens outgrow or overcome obesity on their own only worsens the problem that affects more than 14.4 million young people in the U.S. Left untreated, obesity can lead to lifelong health problems, including high blood pressure, diabetes and depression.

“Waiting doesn’t work,” said Dr. Ihuoma Eneli, co-author of the first guidance on childhood obesity in 15 years from the American Academy of Pediatrics. “What we see is a continuation of weight gain and the likelihood that they’ll have (obesity) in adulthood.”

For the first time, the group’s guidance sets ages at which kids and teens should be offered medical treatments such as drugs and surgery — in addition to intensive diet, exercise and other behavior and lifestyle interventions, said Eneli, director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital.

It will be interesting to see how the above guidance is altered in light of the next story…

A recent study of a potential obesity drug has left researchers speechless. According to Nature,

The hotel ballroom was packed to near capacity with scientists when Susan Yanovski arrived. Despite being 10 minutes early, she had to manoeuvre her way to one of the few empty seats near the back. The audience at the ObesityWeek conference in San Diego, California, in November 2022, was waiting to hear the results of a hotly anticipated drug trial.

The presenters — researchers affiliated with pharmaceutical company Novo Nordisk, based in Bagsværd, Denmark — did not disappoint. They described the details of an investigation of a promising anti-obesity medication in teenagers, a group that is notoriously resistant to such treatment. The results astonished researchers: a weekly injection for almost 16 months, along with some lifestyle changes, reduced body weight by at least 20% in more than one-third of the participants1. Previous studies2,3 had shown that the drug, semaglutide, was just as impressive in adults.

The presentation concluded like no other at the conference, says Yanovski, co-director of the Office of Obesity Research at the US National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland. Sustained applause echoed through the room “like you were at a Broadway show”, she says.

This energy has pervaded the field of obesity medicine for the past few years. After decades of work, researchers are finally seeing signs of success: a new generation of anti-obesity medications that drastically diminish weight without the serious side effects that have plagued previous efforts.

An obscene amount of the world’s drugs are manufactured in India. This would be great had the country implemented stricter regulations on its pharmaceutical companies. In particular, lax oversight has resulted in unwanted chemicals making their way into drugs. Per STAT News,

Cough medicine tainted with ethylene glycol that killed at least 19 children in Uzbekistan in late December 2022 has once again revealed lax oversight and regulation of pharmaceutical companies based in India.

That preventable tragedy, which involves products made by Marion Biotech, based in Noida, India, echoes earlier cases. In the summer of 2022, at least 70 children in Gambia died from kidney failure after using cough medicine made by India-based Maiden Pharmaceuticals that contained ethylene glycol and diethylene glycol, toxic chemicals often used in manufacturing as dissolving agents that can damage the heart, brain, and kidneys.

India has had plenty of time to learn about — and control — tainted drugs, but hasn’t done so. The outbreak in Gambia became public just days after a new book, “The Truth Pill: The Myth of Drug Regulation in India,” was published. The book, written by Dinesh S. Thakur, a former pharmaceutical executive whose revelations of fraud led to a huge and successful U.S. Department of Justice lawsuit against Indian drugmaker Ranbaxy in 2013, and his colleague Prashant Reddy T, a lawyer specializing in intellectual property and drug regulatory law, opens with descriptions of five previous episodes of people dying after using cough medicine.

The state of some of the manufacturing factories is something to behold, and not in a good way.

SpaceX and BlueOrigin may have some private sector competition in the next few weeks. Sir Richard Branson’s Virgin Orbit is set to make history and shepherd Europe into the world of reusable rockets. Per,

The launch, which could still be hampered by bad weather or technical glitches, will be Virgin Orbit's first from a location other than the company's U.S. homebase in California's Mojave Desert. It will also be the first-ever orbital launch from the U.K., although the country previously launched a satellite into orbit atop a homegrown rocket from Australia in the early 1970s. The new mission, called "Start Me Up," after a song by legendary British band the Rolling Stones, will see Virgin Orbit's converted Boeing 747-400 airplane Cosmic Girl take off from an airport in Newquay, a popular tourist town on the picturesque Atlantic Coast of the Cornwall region in southwest England. 

If all goes to plan, Cosmic Girl, with Virgin Orbit's two-stage Launcher One rocket tucked beneath its wing, will take off from the the Newquay Airport, now dubbed Spaceport Cornwall, between 4:40 and 6 p.m. EST (2140 and 2300 GMT) tonight. Then, it will ascend to an altitude of 35,000 feet (10.6 kilometers) above the Atlantic Ocean before releasing the rocket about an hour into the flight. Launcher One will perform one orbital burn with each of its two stages before releasing its cargo of nine small satellites. You can watch the launch in the window above beginning at 4 p.m. EST (2100 GMT), courtesy of Virgin Orbit, or directly at the company's YouTube.

Expect more countries and companies to join the reusable rocket party.

Scientists may have gotten to the bottom of the mystery of how many ancient Roman structures have concrete that seem immune to harm. Per Ars Technica,

The famous Pantheon in Rome boasts the world's largest unreinforced concrete dome—an architectural marvel that has endured for millennia, thanks to the incredible durability of ancient Roman concrete. For decades, scientists have been trying to determine precisely what makes the material so durable. A new analysis of samples taken from the concrete walls of the Privernum archaeological site near Rome has yielded insights into those elusive manufacturing secrets. It seems the Romans employed "hot mixing" with quicklime, among other strategies, that gave the material self-healing functionality, according to a new paper published in the journal Science Advances.

As we've reported previously, like today's Portland cement (a basic ingredient of modern concrete), ancient Roman concrete was basically a mix of a semi-liquid mortar and aggregate. Portland cement is typically made by heating limestone and clay (as well as sandstone, ash, chalk, and iron) in a kiln. The resulting clinker is then ground into a fine powder, with just a touch of added gypsum—the better to achieve a smooth, flat surface. But the aggregate used to make Roman concrete was made up of fist-sized pieces of stone or bricks.

In his treatise De architectura (circa 30 CE), the Roman architect and engineer Vitruvius wrote about how to build concrete walls for funerary structures that could endure for a long time without falling into ruins. He recommended the walls be at least two feet thick, made of either "squared red stone or of brick or lava laid in courses." The brick or volcanic rock aggregate should be bound with mortar composed of hydrated lime and porous fragments of glass and crystals from volcanic eruptions (known as volcanic tephra).

Amazing stuff. You get the feeling that ancient civilizations weren’t as primitive as their timeline and names would indicate.

Thanks for reading. Let’s be careful out there.


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