Programmed cell death-1, PD-1, is dysregulated in T cells from children with new onset type 1 diabetes

Programmed death cell 1 (PD-1) is an inhibitor of T cell activation and is also functionally linked to glycolysis. We hypothesized that PD-1 expression is defective in activated T cells from children with type 1 diabetes (T1D), resulting in abnormal T cell glucose metabolism

The Telehealth Enhancement of Adherence to Medication (TEAM) in pediatric IBD trial: Design and methodology

Medication nonadherence is a significant health care issue requiring regular behavioral treatment. Lack of sufficient health care resources and patient/family time commitment for weekly treatment are primary barriers to receiving appropriate self-management support. We describe the methodology of the Telehealth Enhancement of Adherence to Medication (TEAM) trial for medication nonadherence in pediatric inflammatory bowel disease (IBD). For this trial, participants 11–18 years of age will be recruited from seven pediatric hospitals and will complete an initial 4-week run in to assess adherence to a daily medication. Those who take less than 90% of their prescribed medication will be randomized. A total of 194 patients with IBD will be randomized to either a telehealth behavioral treatment (TBT) arm or education only (EO) arm. All treatment will be delivered via telehealth video conferencing. Patients will be assessed at baseline, post-treatment, 3-, 6-, and 12-months. We anticipate that participants in the TBT arm will demonstrate a statistically significant improvement at post-treatment and 3-, 6-, and 12-month follow-up compared to participants in the EO arm for both medication adherence and secondary outcomes (i.e., disease severity, patient quality of life, and health care utilization). If efficacious, the TEAM intervention could be disseminated broadly and reduce health care access barriers so that patients could receive much needed self-management intervention

Report of the CCFA Pediatric Bone, Growth and Muscle Health Workshop, New York City, November 11-12, 2011, With Updates

Growth retardation, delayed puberty, decreased bone mass, altered bone architecture, hypovitaminosis D and skeletal muscle mass deficits are common in children with inflammatory bowel diseases. The Crohn's and Colitis Foundation of America sponsored a multidisciplinary workshop on the subject of Bone and Skeletal Growth in Pediatric IBD, held in New York City in November 2011. The topic of the workshop was a key recommendation of the Foundation's Pediatric Challenges meeting in 2005. The Litwin Foundation provided a generous grant to support this crucial research and workshop through the CCFA. The workshop featured 15 presentations by researchers from the United States, Canada, Switzerland, Germany, and the United Kingdom and a number of posters elucidating diverse aspects of the problem of growth retardation and compromised bone health in pediatric Crohn's disease and ulcerative colitis. The workshop comprised original, basic, and clinical research and relevant reviews of underlying genetics, molecular biology, endocrinology, immunology, and bone physiology research. Investigators funded by CCFA and the Litwin Family Foundation are marked by an asterisk after their name in the text. Workshop presentations fell under 3 broad categories: Mechanisms of Suppression and Growth of Bone Cell Function by Inflammation, Impact of IBD on Growth and Bone Health, and Approaches to Address Growth Failure and Low Bone Mass in Children with IBD, summarized herein. We have cited the publications that resulted from this granting mechanism in the appropriate section and references for pertinent updates on each topic

Environment and shipping drive environmental DNA beta-diversity among commercial ports

The spread of nonindigenous species by shipping is a large and growing global problem that harms coastal ecosystems and economies and may blur coastal biogeographical patterns. This study coupled eukaryotic environmental DNA (eDNA) metabarcoding with dissimilarity regression to test the hypothesis that ship-borne species spread homogenizes port communities. We first collected and metabarcoded water samples from ports in Europe, Asia, Australia and the Americas. We then calculated community dissimilarities between port pairs and tested for effects of environmental dissimilarity, biogeographical region and four alternative measures of ship-borne species transport risk. We predicted that higher shipping between ports would decrease community dissimilarity, that the effect of shipping would be small compared to that of environment dissimilarity and shared biogeography, and that more complex shipping risk metrics (which account for ballast water and stepping-stone spread) would perform better. Consistent with our hypotheses, community dissimilarities increased significantly with environmental dissimilarity and, to a lesser extent, decreased with ship-borne species transport risks, particularly if the ports had similar environments and stepping-stone risks were considered. Unexpectedly, we found no clear effect of shared biogeography, and that risk metrics incorporating estimates of ballast discharge did not offer more explanatory power than simpler traffic-based risks. Overall, we found that shipping homogenizes eukaryotic communities between ports in predictable ways, which could inform improvements in invasive species policy and management. We demonstrated the usefulness of eDNA metabarcoding and dissimilarity regression for disentangling the drivers of large-scale biodiversity patterns. We conclude by outlining logistical considerations and recommendations for future studies using this approach.Fil: Andrés, Jose. Cornell University. Department Of Ecology And Evolutionary Biology;Fil: Czechowski, Paul. Cornell University. Department Of Ecology And Evolutionary Biology; . University of Otago; Nueva Zelanda. Helmholtz Institute for Metabolic, Obesity and Vascular Research; AlemaniaFil: Grey, Erin. University of Maine; Estados Unidos. Governors State University; Estados UnidosFil: Saebi, Mandana. University of Notre Dame; Estados UnidosFil: Andres, Kara. Cornell University. Department Of Ecology And Evolutionary Biology;Fil: Brown, Christopher. California State University Maritime Academy; Estados UnidosFil: Chawla, Nitesh. University of Notre Dame; Estados UnidosFil: Corbett, James J.. University of Delaware; Estados UnidosFil: Brys, Rein. Research Institute for Nature and Forest; BélgicaFil: Cassey, Phillip. University of Adelaide; AustraliaFil: Correa, Nancy. Ministerio de Defensa. Armada Argentina. Instituto Universitario Naval de la Ara. Escuela de Ciencias del Mar; Argentina. Ministerio de Defensa. Armada Argentina. Servicio de Hidrografía Naval; ArgentinaFil: Deveney, Marty R.. South Australian Research And Development Institute; AustraliaFil: Egan, Scott P.. Rice University; Estados UnidosFil: Fisher, Joshua P.. United States Fish and Wildlife Service; Estados UnidosFil: vanden Hooff, Rian. Oregon Department of Environmental Quality; Estados UnidosFil: Knapp, Charles R.. Daniel P. Haerther Center for Conservation and Research; Estados UnidosFil: Leong, Sandric Chee Yew. National University of Singapore; SingapurFil: Neilson, Brian J.. State of Hawaii Division of Aquatic Resources; Estados UnidosFil: Paolucci, Esteban Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia"; ArgentinaFil: Pfrender, Michael E.. University of Notre Dame; Estados UnidosFil: Pochardt, Meredith R.. M. Rose Consulting; Estados UnidosFil: Prowse, Thomas A. A.. University of Adelaide; AustraliaFil: Rumrill, Steven S.. Oregon Department of Fish and Wildlife; Estados UnidosFil: Scianni, Chris. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Instituto para el Estudio de la Biodiversidad de Invertebrados; Argentina. Marine Invasive Species Program; Estados UnidosFil: Sylvester, Francisco. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Instituto para el Estudio de la Biodiversidad de Invertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; ArgentinaFil: Tamburri, Mario N.. University of Maryland; Estados UnidosFil: Therriault, Thomas W.. Pacific Biological Station; CanadáFil: Yeo, Darren C. J.. National University of Singapore; SingapurFil: Lodge, David M.. Cornell University. Department Of Ecology And Evolutionary Biology

Biometric conversion factors as a unifying platform for comparative assessment of invasive freshwater bivalves

Invasive bivalves continue to spread and negatively impact freshwater ecosystems worldwide. As different metrics for body size and biomass are frequently used within the literature to standardise bivalve-related ecological impacts (e.g. respiration and filtration rates), the lack of broadly applicable conversion equations currently hinders reliable comparison across bivalve populations. To facilitate improved comparative assessment among studies originating from disparate geographical locations, we report body size and biomass conversion equations for six invasive freshwater bivalves (or species complex members) worldwide: Corbicula fluminea, C. largillierti, Dreissena bugensis, D. polymorpha, Limnoperna fortunei and Sinanodonta woodiana, and tested the reliability (i.e. precision and accuracy) of these equations. Body size (length, width and height) and biomass metrics of living-weight (LW), wet-weight (WW), dry-weight (DW), dry shell-weight (SW), shell free dry-weight (SFDW) and ash-free dry-weight (AFDW) were collected from a total of 44 bivalve populations located in Asia, the Americas and Europe. Relationships between body size and individual biomass metrics, as well as proportional weight-to-weight conversion factors, were determined. For most species, although inherent variation existed between sampled populations, body size directional measurements were found to be good predictors of all biomass metrics (e.g. length to LW, WW, SW or DW: R2 = 0.82–0.96), with moderate to high accuracy for mean absolute error (MAE): ±9.14%–24.19%. Similarly, narrow 95% confidence limits and low MAE were observed for most proportional biomass relationships, indicating high reliability for the calculated conversion factors (e.g. LW to AFDW; CI range: 0.7–2.0, MAE: ±0.7%–2.0%). Synthesis and applications. Our derived biomass prediction equations can be used to rapidly estimate the biologically active biomass of the assessed species, based on simpler biomass or body size measurements for a wide range of situations globally. This allows for the calculation of approximate average indicators that, when combined with density data, can be used to estimate biomass per geographical unit-area and contribute to quantification of population-level effects. These general equations will support meta-analyses, and allow for comparative assessment of historic and contemporary data. Overall, these equations will enable conservation managers to better understand and predict ecological impacts of these bivalves.Fil: Coughlan, Neil E.. The Queens University of Belfast; Irlanda. University College Cork; IrlandaFil: Cunningham, Eoghan M.. The Queens University of Belfast; IrlandaFil: Cuthbert, Ross N.. The Queens University of Belfast; Irlanda. Geomar-Helmholtz Centre for Ocean Research Kiel; AlemaniaFil: Joyce, Patrick W. S.. The Queens University of Belfast; IrlandaFil: Anastácio, Pedro. Universidade de Évora; PortugalFil: Banha, Filipe. Universidade de Évora; PortugalFil: Bonel, Nicolás. Université Montpellier II; Francia. Centre National de la Recherche Scientifique; Francia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Bradbeer, Stephanie J.. University of Leeds; Reino UnidoFil: Briski, Elizabeta. Geomar-Helmholtz Centre for Ocean Research Kiel; AlemaniaFil: Butitta, Vince L.. University of Wisconsin; Estados UnidosFil: Cadková, Zuzana. Czech University of Life Sciences; República ChecaFil: Dick, Jaimie T. A.. The Queens University of Belfast; IrlandaFil: Douda, Karel. Czech University of Life Sciences; República ChecaFil: Eagling, Lawrence E.. The Queens University of Belfast; IrlandaFil: Ferreira Rodríguez, Noé. Universidad de Vigo; EspañaFil: Hünicken, Leandro Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia"; ArgentinaFil: Johansson, Mattias L.. University of North Georgia; Estados UnidosFil: Kregting, Louise. The Queens University of Belfast; IrlandaFil: Labecka, Anna Maria. Jagiellonian University; PoloniaFil: Li, Deliang. Hunan Agricultural University; ChinaFil: Liquin, Florencia Fernanda. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Instituto para el Estudio de la Biodiversidad de Invertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; ArgentinaFil: Marescaux, Jonathan. University of Namur; Bélgica. e-biom; BélgicaFil: Morris, Todd J.. Fisheries and Ocean Canada; CanadáFil: Nowakowska, Patrycja. University of Gdansk; PoloniaFil: Ozgo, Malgorzata. Kazimierz Wielki University; PoloniaFil: Paolucci, Esteban Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia"; ArgentinaFil: Peribáñez, Miguel A.. Universidad de Zaragoza; EspañaFil: Riccardi, Nicoletta. Consiglio Nazionale delle Ricerche; ItaliaFil: Smith, Emily R. C.. University College London; Estados UnidosFil: Sylvester, Francisco. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Instituto para el Estudio de la Biodiversidad de Invertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; Argentin

Risk Prediction Scores for Recurrence and Progression of Non-Muscle Invasive Bladder Cancer: An International Validation in Primary Tumours

Abstract Objective: We aimed to determine the validity of two risk scores for patients with non-muscle invasive bladder cancer in different European settings, in patients with primary tumours. Methods: We included 1,892 patients with primary stage Ta or T1 non-muscle invasive bladder cancer who underwent a transurethral resection in Spain (n = 973), the Netherlands (n = 639), or Denmark (n = 280). We evaluated recurrence-free survival and progression-free survival according to the European Organisation for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) risk scores for each patient and used the concordance index (c-index) to indicate discriminative ability. Results: The 3 cohorts were comparable according to age and sex, but patients from Denmark had a larger proportion of patients with the high stage and grade at diagnosis (p,0.01). At least one recurrence occurred in 839 (44%) patients and 258 (14%) patients had a progression during a median follow-up of 74 months. Patients from Denmark had the highest 10- year recurrence and progression rates (75% and 24%, respectively), whereas patients from Spain had the lowest rates (34% and 10%, respectively). The EORTC and CUETO risk scores both predicted progression better than recurrence with c-indices ranging from 0.72 to 0.82 while for recurrence, those ranged from 0.55 to 0.61. Conclusion: The EORTC and CUETO risk scores can reasonably predict progression, while prediction of recurrence is more difficult. New prognostic markers are needed to better predict recurrence of tumours in primary non-muscle invasive bladder cancer patients.This research received funding from the European Community's Seventh Framework program FP7/2007-2011 under grant agreement 201663 (Uromol project, http://www.uromol.eu/

Prediction of complicated disease course for children newly diagnosed with Crohn's disease: a multicentre inception cohort study

Stricturing and penetrating complications account for substantial morbidity and health-care costs in paediatric and adult onset Crohn’s disease. Validated models to predict risk for complications are not available, and the effect of treatment on risk is unknown

Cloning and variation of ground state intestinal stem cells

Stem cells of the gastrointestinal tract, pancreas, liver, and other columnar epithelia collectively resist cloning in their elemental states. Here we demonstrate the cloning and propagation of highly clonogenic, “ground state” stem cells of the human intestine and colon. We show that derived stem cell pedigrees sustain limited copy number and sequence variation despite extensive serial passaging and display exquisitely precise, cell-autonomous commitment to epithelial differentiation consistent with their origins along the intestinal tract. This developmentally patterned and epigenetically maintained commitment of stem cells likely enforces the functional specificity of the adult intestinal tract. Using clonally-derived colonic epithelia, we show that toxins A or B of the enteric pathogen C. difficile recapitulate the salient features of pseudomembranous colitis. The stability of the epigenetic commitment programs of these stem cells, coupled with their unlimited replicative expansion and maintained clonogenicity, suggests certain advantages for their use in disease modeling and regenerative medicine

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised