Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Comparative study measuring the dilatory effect of a mydriatic device (Mydriasert(®)) versus topical drops

AIM: To compare the mydriatic efficacy of an ophthalmic insert (Mydriasert, MY) versus phenylephrine and tropicamide (PT) eye drops. METHODS: Two controlled, prospective, randomized, single-blind studies were performed. In the first study, a total of 80 eyes from 40 outpatient-clinic patients were analyzed. PT drops were applied to the right eye, and a MY device was inserted in the left eye for 30min. Time until maximal pupil dilation for each eye was then assessed. In the second study, 80 eyes from 80 patients undergoing cataract surgery were analyzed. Pupil dilation was achieved using either PT drops three-times for one hour prior to surgery (40 patients), or a MY device was inserted one hour prior to surgery (40 patients). RESULTS: In the first study, MY achieved superior mydriasis compared to PT eye drops at 90min (9.04 +/- 1.33mm vs 8.78 +/- 1.37mm, P=0.012). However MY took longer than PT drops to achieve maximal dilation, and mydriasis was inferior in eyes with MY compared to PT drops at 30min (7.21 +/- 1.73mm vs8.22 +/- 1.43mm, P < 0.001), the two groups only becoming similar by 60min (8.85 +/- 1.44mm vs8.71 +/- 1.27mm, P=0.236). In the second study, both MY and PT achieved similar levels of mydriasis at the beginning of surgery (8.75 +/- 0.76mm with MY vs8.77 +/- 0.63mm with PT), and also at the end of surgery (7.96 +/- 1.06mm with MY vs 8.32 +/- 0.72mm with PT), with no significant difference between groups (P=0.08). MY was well tolerated and cardiovascular effects were not influenced by dilation method. CONLUSION: MY could be a safe and efficacious alternative for mydriasis. The mydriatic effect of MY is as good as conventional PT eye drops after 60min, and is superior after 90min. MY also maintains good pupil dilation during cataract surgery

Comparative study measuring the dilatory effect of a mydriatic device (Mydriasert(®)) versus topical drops

AIM: To compare the mydriatic efficacy of an ophthalmic insert (Mydriasert, MY) versus phenylephrine and tropicamide (PT) eye drops. METHODS: Two controlled, prospective, randomized, single-blind studies were performed. In the first study, a total of 80 eyes from 40 outpatient-clinic patients were analyzed. PT drops were applied to the right eye, and a MY device was inserted in the left eye for 30min. Time until maximal pupil dilation for each eye was then assessed. In the second study, 80 eyes from 80 patients undergoing cataract surgery were analyzed. Pupil dilation was achieved using either PT drops three-times for one hour prior to surgery (40 patients), or a MY device was inserted one hour prior to surgery (40 patients). RESULTS: In the first study, MY achieved superior mydriasis compared to PT eye drops at 90min (9.04 +/- 1.33mm vs 8.78 +/- 1.37mm, P=0.012). However MY took longer than PT drops to achieve maximal dilation, and mydriasis was inferior in eyes with MY compared to PT drops at 30min (7.21 +/- 1.73mm vs8.22 +/- 1.43mm, P < 0.001), the two groups only becoming similar by 60min (8.85 +/- 1.44mm vs8.71 +/- 1.27mm, P=0.236). In the second study, both MY and PT achieved similar levels of mydriasis at the beginning of surgery (8.75 +/- 0.76mm with MY vs8.77 +/- 0.63mm with PT), and also at the end of surgery (7.96 +/- 1.06mm with MY vs 8.32 +/- 0.72mm with PT), with no significant difference between groups (P=0.08). MY was well tolerated and cardiovascular effects were not influenced by dilation method. CONLUSION: MY could be a safe and efficacious alternative for mydriasis. The mydriatic effect of MY is as good as conventional PT eye drops after 60min, and is superior after 90min. MY also maintains good pupil dilation during cataract surgery

Neratinib + fulvestrant + trastuzumab for HR-positive, HER2-negative, HER2-mutant metastatic breast cancer: outcomes and biomarker analysis from the SUMMIT trial

International audienceBackground: HER2 mutations are targetable alterations in patients with hormone receptor-positive (HR+) metastatic breast cancer (MBC). In the SUMMIT basket study, patients with HER2-mutant MBC received neratinib monotherapy, neratinib + fulvestrant, or neratinib + fulvestrant + trastuzumab (N + F + T). We report results from 71 patients with HR+, HER2-mutant MBC, including 21 (seven in each arm) from a randomized substudy of fulvestrant versus fulvestrant + trastuzumab (F + T) versus N + F + T. Patients and methods: Patients with HR+ HER2-negative MBC with activating HER2 mutation(s) and prior cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) therapy received N + F + T (oral neratinib 240 mg/day with loperamide prophylaxis, intramuscular fulvestrant 500 mg on days 1, 15, and 29 of cycle 1 then q4w, intravenous trastuzumab 8 mg/kg then 6 mg/kg q3w) or F + T or fulvestrant alone. Those whose disease progressed on F + T or fulvestrant could cross-over to N + F + T. Efficacy endpoints included investigator-assessed objective response rate (ORR), clinical benefit rate (RECIST v1.1), duration of response, and progression-free survival (PFS). Plasma and/or formalin-fixed paraffin-embedded tissue samples were collected at baseline; plasma was collected during and at end of treatment. Extracted DNA was analyzed by next-generation sequencing. Results: ORR for 57 N + F + T-treated patients was 39% [95% confidence interval (CI) 26% to 52%); median PFS was 8.3 months (95% CI 6.0-15.1 months). No responses occurred in fulvestrant- or F + T-treated patients; responses in patients crossing over to N + F + T supported the requirement for neratinib in the triplet. Responses were observed in patients with ductal and lobular histology, 1 or ≥1 HER2 mutations, and co-occurring HER3 mutations. Longitudinal circulating tumor DNA sequencing revealed acquisition of additional HER2 alterations, and mutations in genes including PIK3CA, enabling further precision targeting and possible re-response. Conclusions: The benefit of N + F + T for HR+ HER2-mutant MBC after progression on CDK4/6is is clinically meaningful and, based on this study, N + F + T has been included in the National Comprehensive Cancer Network treatment guidelines. SUMMIT has improved our understanding of the translational implications of targeting HER2 mutations with neratinib-based therapy

Datasets related to a study aimed to identify genetic markers of CDA by subphenotypes associated with cardiotoxicity

Who produced the data? The data has been created by the authors listed above. Is the title specific enough? "Datasets related to a study aimed to identify genetic markers of CDA by subphenotypes associated with cardiotoxicity." Why has the data been created? These datasets are supplementary material with which the principal and supplementary figures and tables of our indicated work were generated. What limitations do the data have (for example, sensitive data has been deleted)? All confidential patient information is not present. We have not had access to that information, following current legal regulations. How should the data be interpreted? These data sets should not be separated from the main article in which they were utilized. Thus, to better understand their context, researchers should see them in the global scenario of our work. Are there gaps in the data, or do they give a complete picture of the topic studied? As indicated above, data should be considered and interpreted in the global context of our study. What processes have generated the data? The processes that generated the data are indicated in the summary of the data above and individually for each of them. Thus, each dataset is accompanied by a legend within the document. What does the data measure in the columns of the files? As indicated, each dataset individually shows the information contained in the legend of each dataset. What software is required to be able to read the data? The datasets are in Excel format. How should the data be quoted? Researchers should cite the data in the context of the work they belong to once it is published and free of the embargo. Can the data be reused? What use licenses are assigned to you? In principle, yes. If additional clinical information is required, these data were previously published by some of us, and the references are included in our manuscript. These data are available from the principal investigators of the references listed in our work upon reasonable request. Are there more versions of the data? Where? I do not think so beyond our files and copies. Have the technical terms and acronyms referenced by the data been defined? A legend with the appropriate descriptions accompanies each dataset. Have the geographic and chronological parameters of the data been qualified? The authors of the work have generated the data. Elsewhere, we indicate the authors of the work, their contributions, and affiliations. Are keywords sufficiently data-specific? Are they based on any thesaurus? Keywords are based on our study. We include cardiotoxicity due to anthracyclines, missing heritability, subphenotype, pathophenotype, complex trait. What is the name of the research project in which the data are framed? The main research project in which the data is prepared is: Títle: "Chemotherapy cardiotoxicity in the elderly: a translational and personnel approach." Ref.: PIE14/00066 Who has financed data production and management? Each of the authors of the study has its funding. The grants are included in the acknowledgments section of our manuscript.Here we present a series of supplemental datasets that complement our study entitled "A Systems Genetics approach to identify genetic markers of cardiotoxicity due to anthracyclines in cancer patients." The datasets presented here were used to generate the main and supplementary figures and tables of the indicated study. The study consists of the identification of genetic markers of cardiotoxicity due to anthracyclines (CDA). CDA is a complex genesis disease or complex trait, and because of this, there is a component of missing heritability. Therefore, it is not possible to identify genetic markers associated with CDA risk. Here, we propose that molecular subphenotypes associated with the CDA may be a strategy for identifying some of this missing heritability and risk markers associated with it. A similar strategy could be applied to identify markers of other diseases of complex genesis. This study is done using a genetically heterogeneous cohort of mice that developed breast cancer and was treated with doxorubicin or a combined treatment of doxorubicin and docetaxel. The mouse cohort was generated by backcrossing, so each mouse is genetically unique. Post-chemotherapy heart damage was assessed by quantifying fibrosis's cardiac area and the thickness of myocardial fibers. The genetic regions associated with CDA were assessed by massive genotyping and genetic linkage analysis. Several molecular subphenotypes were quantified in the myocardium, and their association with the CDA was evaluated. Subsequently, we identified which of them were most statistically associated with CDA in multivariate models. Moreover, which complex trait loci (QTLs) associated with molecular subphenotypes best explained CDA. This strategy served to identify in the cohort of mice genes whose allelic forms could be candidates for the risk of CDA. Allelic variants of these genes were evaluated in four cohorts of cancer patients treated with anthracyclines and whose CDA was evaluated by echocardiography or cardiac magnetic resonance imaging (CMR).JPL laboratory was partially supported by the European Regional Development Fund (ERDF) and the Ministry of Science, Innovation, and Universities (SAF2014-56989-R, SAF2017-88854R), the Carlos III Health Institute (PIE14/00066), "Proyectos Integrados IBSAL 2015" (IBY15/00003), the Regional Government of Castile and Leon (CSI234P18), and "We can be heroes" Foundation. AGN laboratory and human patients' study are supported by funds from the ISCIII project grant (PI18/01242). The Human Genotyping unit is a member of CeGen, PRB3, and is supported by grant PT17/0019, of the PE I+D+i 2013-2016, funded by ISCIII and ERDF. SCLL was the recipient of a Ramón y Cajal research contract from the Spanish Ministry of Economy and Competitiveness, and the work was supported by MINECO/FEDER research grants (RTI2018-094130-B-100). The Proteomics Unit belongs to ProteoRed, PRB3-ISCIII, supported by grant PT17/0019/0023, of the PE I + D + I 2017-2020, funded by ISCIII and FEDER. RCC is funded by fellowships from the Spanish Regional Government of Castile and León. NGS is a recipient of an FPU fellowship (MINECO/FEDER). hiPSC-CM studies were funded in part by the "la Caixa" Banking Foundation under the project code HR18-00304" and Severo Ochoa CNIC Intramural Project (Expediente 12-2016 IGP) to JJ.Supplemental Dataset 1: CDA pathophenotypes after doxorubicin treatment. We treated 71 mice carrying breast cancer with doxorubicin. Each mouse was generated by backcrossing; thus, each one is genetically unique. Cardiotoxicity due to anthracyclines (CDA) was evaluated by automatically quantifying the heart fibrosis area and the average area of myocardial fibers as pathophenotypes of cardiotoxicity using the Ariol slide scanner. The histopathological damage was evaluated in the subendocardium and subepicardium from five randomly chosen regions of each sample (averages in μm2 are shown).-- Supplemental Dataset 2: CDA pathophenotypes after the combined therapy. We treated 61 mice carrying breast cancer with the combined therapy with doxorubicin and docetaxel. Each mouse was generated by backcrossing; thus, each one is genetically unique. Cardiotoxicity due to anthracyclines (CDA) was evaluated by automatically quantifying the heart fibrosis area and the average area of myocardial fibers as pathophenotypes of cardiotoxicity using the Ariol slide scanner. The histopathological damage was evaluated in the subendocardium and subepicardium from five randomly chosen regions of each sample (averages in μm2 are shown).-- Supplemental Dataset 3: CDA subphenotypes after doxorubicin therapy. Myocardium molecular subphenotypes after doxorubicin therapy. Proteins were quantified by a multiplex bead array (Luminex). TGFβ units are shown in pg/mL. The rest of the protein levels are shown in molecular fluorescence intensity (MFI) Units. The telomeric length was quantified by QPCR (RQ units). miRNAs were quantified by QPCR (RQ units). QPCR analyses were assessed by the ΔΔCT method; we show the averages of triplicates.-- Supplemental Dataset 4: CDA subphenotypes after the combined therapy. Myocardium molecular subphenotypes after the combined therapy with doxorubicin and docetaxel. Proteins were quantified by a multiplex bead array (Luminex). TGFβ units are shown in pg/mL. The rest of the protein levels are shown in molecular fluorescence intensity (MFI) Units. The telomeric length was quantified by QPCR (RQ units). miRNAs were quantified by QPCR (RQ units). QPCR analyses were assessed by the ΔΔCT method; we show the averages of triplicates.-- Supplemental Dataset 5: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after doxorubicin therapy in all mice.-- Supplemental Dataset 6: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after doxorubicin therapy in young mice. Correlation of Spearman.-- Supplemental Dataset 7: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after doxorubicin therapy in old mice. Correlation of Spearman.-- Supplemental Dataset 8: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after the combined therapy in all mice. Correlation of Spearman.-- Supplemental Dataset 9: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after the combined therapy in young mice. Correlation of Spearman.-- Supplemental Dataset 10: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after the combined therapy in old mice. Correlation of Spearman.-- Supplemental Dataset 11: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after doxorubicin therapy in all mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 12: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after doxorubicin therapy in young mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 13: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after doxorubicin therapy in old mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 14: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after the combined therapy in all mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 15: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after the combined therapy in young mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 16: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after the combined therapy in old mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 17: Massive genotyping of mouse cohort treated with doxorubicin. The genome-wide scan was carried out at the Spanish National Centre of Genotyping (CeGEN) at the Spanish National Cancer Research Centre (CNIO, Madrid, Spain). The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution.-- Supplemental Dataset 18: Massive genotyping of mouse cohort treated with the combined therapy. The genome-wide scan was carried out at the Spanish National Centre of Genotyping (CeGEN) at the Spanish National Cancer Research Centre (CNIO, Madrid, Spain). The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution.-- Supplemental Dataset 19: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after doxorubicin therapy in all mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 20: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after doxorubicin therapy in young mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 21: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after doxorubicin therapy in old mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 22: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after the combined therapy in all mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 23: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after the combined therapy in young mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 24: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after the combined therapy in old mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 25: Human breast cancer cohort-1 genotyping. The association of genetic variants with CDA was evaluated in four patient cohorts p

Evaluation of European-based polygenic risk score for breast cancer in Ashkenazi Jewish women in Israel

International audienceTo date, most BC GWASs have been performed Background Polygenic risk score (PRS), calculated in individuals of European (EUR) ancestry, and based on genome-wide association studies (GWASs), the generalisation of EUR-based PRS to other can improve breast cancer (BC) risk assessment. populations is a major challenge. In this study, we examined the performance of EUR-based BC PRS models in Ashkenazi Jewish (AJ) women. Methods We generated PRSs based on data on EUR women from the Breast Cancer Association Consortium (BCAC). We tested the performance of the PRSs in a cohort of 2161 AJ women from Israel (1437 cases and 724 controls) from BCAC (BCAC cohort from Israel (BCAC-IL)). In addition, we tested the performance of these EUR-based BC PRSs, as well as the established 313-SNP EUR BC PRS, in an independent cohort of 181 AJ women from Hadassah Medical Center (HMC) in Israel. Results In the BCAC-IL cohort, the highest OR per 1 SD was 1.56 (±0.09). The OR for AJ women at the top 10% of the PRS distribution compared with the middle quintile was 2.10 (±0.24). In the HMC cohort, the OR per 1 SD of the EUR-based PRS that performed best in the BCAC-IL cohort was 1.58±0.27. The OR per 1 SD of the commonly used 313-SNP BC PRS was 1.64 (±0.28). Conclusions Extant EUR GWAS data can be used for generating PRSs that identify AJ women with markedly elevated risk of BC and therefore hold promise for improving BC risk assessment in AJ women

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat