IMPORTANCE Phase 3 trials have not compared semaglutide and liraglutide, glucagon-like peptide-1 analogues available for weight management.OBJECTIVE To compare the efficacy and adverse event profiles of once-weekly subcutaneous semaglutide, 2.4 mg, vs once-daily subcutaneous liraglutide, 3.0 mg (both with diet and physical activity), in people with overweight or obesity. DESIGN, SETTING, AND PARTICIPANTS Randomized, open-label, 68-week, phase 3b trial conducted at 19 US sites from September 2019 (enrollment: September 11-November 26) to May 2021 (end of follow-up: May 11) in adults with body mass index of 30 or greater or 27 or greater with 1 or more weight-related comorbidities, without diabetes (N = 338).INTERVENTIONS Participants were randomized (3:1:3:1) to receive once-weekly subcutaneous semaglutide, 2.4 mg (16-week escalation; n = 126), or matching placebo, or once-daily subcutaneous liraglutide, 3.0 mg (4-week escalation; n = 127), or matching placebo, plus diet and physical activity. Participants unable to tolerate 2.4 mg of semaglutide could receive 1.7 mg; participants unable to tolerate 3.0 mg of liraglutide discontinued treatment and could restart the 4-week titration. Placebo groups were pooled (n = 85). MAIN OUTCOMES AND MEASURESThe primary end point was percentage change in body weight, and confirmatory secondary end points were achievement of 10% or more, 15% or more, and 20% or more weight loss, assessed for semaglutide vs liraglutide at week 68. Semaglutide vs liraglutide comparisons were open-label, with active treatment groups double-blinded against matched placebo groups. Comparisons of active treatments vs pooled placebo were supportive secondary end points. RESULTSOf 338 randomized participants (mean [SD] age, 49 [13] years; 265 women [78.4%]; mean [SD] body weight, 104.5 [23.8] kg; mean [SD] body mass index, 37.5 [6.8]), 319 (94.4%) completed the trial, and 271 (80.2%) completed treatment. The mean weight change from baseline was -15.8% with semaglutide vs -6.4% with liraglutide (difference, -9.4 percentage points [95% CI, -12.0 to -6.8]; P < .001); weight change with pooled placebo was -1.9%. Participants had significantly greater odds of achieving 10% or more, 15% or more, and 20% or more weight loss with semaglutide vs liraglutide (70.9% of participants vs 25.6% [odds ratio, 6.3 {95% CI, 3.5 to 11.2}], 55.6% vs 12.0% [odds ratio, 7.9 {95% CI, 4.1 to 15.4}], and 38.5% vs 6.0% [odds ratio, 8.2 {95% CI, 3.5 to 19.1}], respectively; all P < .001). Proportions of participants discontinuing treatment for any reason were 13.5% with semaglutide and 27.6% with liraglutide. Gastrointestinal adverse events were reported by 84.1% with semaglutide and 82.7% with liraglutide.CONCLUSIONS AND RELEVANCE Among adults with overweight or obesity without diabetes, once-weekly subcutaneous semaglutide compared with once-daily subcutaneous liraglutide, added to counseling for diet and physical activity, resulted in significantly greater weight loss at 68 weeks.

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Active IBD is associated with increased risk of AF and stroke. These findings may be relevant to clinical practice.

Intensive farming generally needs large addition of organic matter to maintain fertility and enhance crop yields. Sewage sludge/biosolids are by-products of municipal and industrial wastewater treatment and a rich source of organic nutrients. Sewage sludge having high content of organic matter, macro- and micro-nutrients, can be used as fertilizer/soil conditioner for food, vegetable crop, horticultural plants and pasture, which in most cases can be beneficially recycled. In the past sewage sludge was regarded as a waste product due to expected high level of contaminants such as pathogens, pollutants and synthetic materials discharged in sewer from homes and industries, which were often incinerated, dumped in occasion or land fill. As a result of rapidly increasing population, urbanization and industrialization, wastewater production and sewage sludge generation have increased manifold. Due to high cost of mineral fertilizers and escalating trends in their prices, there is an increasing trend of using sewage sludge in agriculture, especially under intensive cropping in arid and semi arid regions of the country. Therefore, application of sewage sludge to agricultural soils may be sustainable and economical due to nutrient cycling and disposal of sewage sludge. However, there may be a risk in use of sewage sludge due to potentially harmful contents present in the sludge such as heavy metals and pathogens. This paper, therefore, presents a review on various aspects of sewage sludge used in agriculture

Background-We aim to quantify the relationship between the annual caseload (volume) and outcome from elective endovascular (EVR)