Comparing Waist Circumference, Sagittal Abdominal Diameter, and BMI As Predictors of Cardiovascular Disease in 11,449 U.S. Adults

Although the body mass index (BMI) is a good indicator of weight for height and cardiometabolic risk, indices of abdominal adiposity may be better screening tools for cardiovascular disease (CVD) risk. PURPOSE: This study compared the sagittal abdominal diameter, with correction for height (SADHtR), and waist circumference, with correction for height (WHtR), and BMI, which includes a height correction, as predictors of CVD. METHODS: A total of 11,449 randomly selected adults from the National Health and Nutrition Examination Survey (NHANES) were included. SADHtR and WHtR were measured by trained technicians. For SADHtR, the subject was in the supine position and a sliding-beam abdominal caliper with a built-in bubble was used to ensure a vertical measurement. WHtR was assessed by extending a measuring tape around the waist in a horizontal plane at the upper level of the iliac crest. For both SADHtR and WHtR, the measured values were divided by height. Additionally, subjects were asked to report if a doctor or other health care professional had ever told them that they had congestive heart failure, coronary heart disease, angina, heart attack, and/or stroke. Subjects were divided into quartiles based on their separate SADHtR, WHtR, and BMI values and logistic regression was employed to analyze the data. RESULTS: With age, sex, and race controlled, odds ratios for having or not having CVD were: Q1 vs Q2: SADHtR: 1.31 (95% CI: 1.00-1.73); WHtR: 1.05 (0.72-1.53) and BMI: 1.07 (0.81-1.41). Q1 vs Q3: SADHtR: 1.81 (95% CI: 1.44-2.28); WHtR: 1.38 (1.01-1.88) and BMI: 1.26 (0.95-1.67). Q1 vs Q4: SADHtR: 2.65 (95% CI: 2.07-3.38); WHtR: 2.11 (1.53-2.92) and BMI: 1.86 (1.34-2.58). Overall, SADHtR was the best predictor of CVD, followed by WHtR, and BMI was the weakest of the three, for each quartile comparison. Effect modification was evaluated with BMI divided into sex-specific quartiles and SADHtR was a strong predictor of CVD within each quartile. WHtR was a significant predictor of CVD within each BMI quartile except the first. CONCLUSION: Clinicians and epidemiologists should seriously consider including WHtR or SADHtR, particularly the latter, as a screening tool within their programs

The Immunoglobulin Superfamily Members syg-2 and syg-1 Regulate Neurite Development in C. elegans

Neurons form elaborate networks by guiding axons and dendrites to appropriate destinations. Neurites require information about the relative body axes during the initial projection from the cell body, and failure to receive or interpret those cues correctly can result in outgrowth errors. We identified a mutation in the Ig superfamily member syg-2 in a screen for animals with anterior/posterior (A/P) axon guidance defects. We found that syg-2 and its cognate Ig family member syg-1 appear to function in a linear genetic pathway to control the outgrowth of GABAergic axons. We determined that this pathway works in parallel to Wnt signaling. Specifically, mutations in syg-2 or syg-1 selectively affected the embryonically derived Dorsal D-type (DD) GABAergic neurons. We found no evidence that these mutations affected the Ventral D-type neurons (VD) that form later, during the first larval stage. In addition, mutations in syg-1 or syg-2 could result in the DD neurons forming multiple processes, becoming bipolar, rather than the expected pseudounipolar morphology. Given SYG-2′s essential function in synaptogenesis of the hermaphrodite-specific neurons (HSNs), we also examined DD neuron synapses in syg-2 mutants. We found syg-2 mutants had a decreased number of synapses formed, but synaptic morphology was largely normal. These results provide further evidence that the GABAergic motorneurons use multiple guidance pathways during development

Concert recording 2022-11-11

[Track 1]: Sonata in C minor, HWV 366. I. Adagio ; [Track 2]: II. Bourrée / Georg Frideric Handel -- [Track 3]: Sonata in G Major. I. Andante / Giovanni Sammartini -- [Track 4 and 5]: Sonata in E minor Francesco Geminiani (1687–1762) -- [Track 6]: Sonata in A minor. I. Siciliana ; II. Sprirtuoso / Georg Phillipp Telemann -- [Track 7]: Trois pieces, Op. 31. II. Mélodie / Arthur Foote -- [Track 8]: Souvenir de Madrid / Pedro Soler -- [Track 9]: Concerto for oboe and strings. I. Pastorale / Ralph Vaughan Williams

Concert recording 2022-11-11

[Track 1]: Sonata in C minor, HWV 366. I. Adagio ; [Track 2]: II. Bourrée / Georg Frideric Handel -- [Track 3]: Sonata in G Major. I. Andante / Giovanni Sammartini -- [Track 4 and 5]: Sonata in E minor Francesco Geminiani (1687–1762) -- [Track 6]: Sonata in A minor. I. Siciliana ; II. Sprirtuoso / Georg Phillipp Telemann -- [Track 7]: Trois pieces, Op. 31. II. Mélodie / Arthur Foote -- [Track 8]: Souvenir de Madrid / Pedro Soler -- [Track 9]: Concerto for oboe and strings. I. Pastorale / Ralph Vaughan Williams

A mixed-method investigation of patient monitoring and enhanced feedback in routine practice: Barriers and facilitators

Objective: To investigate the barriers and facilitators of an effective implementation of an outcome monitoring and feedback system in a UK National Health Service psychological therapy service. Method: An outcome monitoring system was introduced in two services. Enhanced feedback was given to therapists after session 4. Qualitative and quantitative methods were used, including questionnaires for therapists and patients. Thematic analysis was carried out on written and verbal feedback from therapists. Analysis of patient outcomes for 202 episodes of therapy was compared with benchmark data of 136 episodes of therapy for which feedback was not given to therapists. Results: Themes influencing the feasibility and acceptability of the feedback system were the extent to which therapists integrated the measures and feedback into the therapy, availability of administrative support, information technology, and complexity of the service. There were low levels of therapist actions resulting from the feedback, including discussing the feedback in supervision and with patients. Conclusions: The findings support the feasibility and acceptability of setting up a routine system in a complex service, but a number of challenges and barriers have to be overcome and therapist differences are apparent. More research on implementation and effectiveness is needed in diverse clinical settings

Epigenetic scores for the circulating proteome as tools for disease prediction

Protein biomarkers have been identified across many age-related morbidities. However, characterising epigenetic influences could further inform disease predictions. Here, we leverage epigenome-wide data to study links between the DNA methylation (DNAm) signatures of the circulating proteome and incident diseases. Using data from four cohorts, we trained and tested epigenetic scores (EpiScores) for 953 plasma proteins, identifying 109 scores that explained between 1% and 58% of the variance in protein levels after adjusting for known protein quantitative trait loci (pQTL) genetic effects. By projecting these EpiScores into an independent sample (Generation Scotland; n = 9537) and relating them to incident morbidities over a follow-up of 14 years, we uncovered 137 EpiScore-disease associations. These associations were largely independent of immune cell proportions, common lifestyle and health factors, and biological aging. Notably, we found that our diabetes-associated EpiScores highlighted previous top biomarker associations from proteome-wide assessments of diabetes. These EpiScores for protein levels can therefore be a valuable resource for disease prediction and risk stratification

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Early development of infants with neurofibromatosis type 1: a case series

Background Prospective studies of infants at familial risk for autism spectrum disorder (ASD) have yielded insights into the earliest signs of the disorder but represent heterogeneous samples of unclear aetiology. Complementing this approach by studying cohorts of infants with monogenic syndromes associated with high rates of ASD offers the opportunity to elucidate the factors that lead to ASD. Methods We present the first report from a prospective study of ten 10-month-old infants with neurofibromatosis type 1 (NF1), a monogenic disorder with high prevalence of ASD or ASD symptomatology. We compared data from infants with NF1 to a large cohort of infants at familial risk for ASD, separated by outcome at age 3 of ASD (n = 34), atypical development (n = 44), or typical development (n = 89), and low-risk controls (n = 75). Domains assessed at 10 months by parent report and examiner observation include cognitive and adaptive function, sensory processing, social engagement, and temperament. Results Infants with NF1 showed striking impairments in motor functioning relative to low-risk infants; this pattern was seen in infants with later ASD from the familial cohort (HR-ASD). Both infants with NF1 and the HR-ASD group showed communication delays relative to low-risk infants. Conclusions Ten-month-old infants with NF1 show a range of developmental difficulties that were particularly striking in motor and communication domains. As with HR-ASD infants, social skills at this age were not notably impaired. This is some of the first information on early neurodevelopment in NF1. Strong inferences are limited by the sample size, but the findings suggest implications for early comparative developmental science and highlight motor functioning as an important domain to inform the development of relevant animal models. The findings have clinical implications in indicating an important focus for early surveillance and remediation in this early diagnosed genetic disorder

Moving in the anthropocene: global reductions in terrestrial mammalian movements

Animal movement is fundamental for ecosystem functioning and species survival, yet the effects of the anthropogenic footprint on animal movements have not been estimated across species. Using a unique GPS-tracking database of 803 individuals across 57 species, we found that movements of mammals in areas with a comparatively high human footprint were on average one-half to one-third the extent of their movements in areas with a low human footprint. We attribute this reduction to behavioral changes of individual animals and to the exclusion of species with long-range movements from areas with higher human impact. Global loss of vagility alters a key ecological trait of animals that affects not only population persistence but also ecosystem processes such as predator-prey interactions, nutrient cycling, and disease transmission