Microalbuminuria and Cardiovascular Autonomic Dysfunction Are Independently Associated With Cardiovascular Mortality: Evidence for Distinct Pathways: The Hoorn Study

) or microalbuminuria (1.76 [1.05-2.94]), respectively. CONCLUSIONS: Both microalbuminuria and C-AD are independently associated with cardiovascular mortality, and the excess mortality attributable to microalbuminuria cannot be explained by C-A

Origin of Madagascan Scarabaeini dung beetles (Coleoptera : Scarabaeidae) : dispersal from Africa

Madagascar, the world’s fourth largest island, has a long history of isolation (160 MY) and a wide range of climates and ecosystems which have in turn resulted in high levels of endemism across different taxonomic levels. Although Madagascar has a rich dung beetle fauna that belongs to various tribes only three species of the Scarabaeini are found there, namely Scarabaeus viettei, S. radama and S. sevoistra. These three species are superficially quite distinctive and have, consequently, had a relatively tortured taxonomic history since the first was described in1896. The morpholgical differences between these species resulted in them being placed in different genera at different times. However, currently, based on cladistic analysis, they are all classified in the genus Scarabaeus. In this study, two of the species, S. viettei and S. radama, were included in a phylogenetic analysis based on two mitochondrial gene regions - cytochrome oxidase I (COI) and 16S rRNA - and a 247 morphological and behavioural dataset of 23 members of the Scarabaeinae. A Bayesian phylogram supports the monophyly of the genus Scarabaeus, with the two species from Madagascar appearing sister to three species of Scarabaeus from southwest Africa. Estimated times of divergence based on published mutation rates of 0.012 and 0.0075 for COI indicate that a shared African/Madagascan origin occurred around 15.18 or 24.15 MYA, respectively. This study is another example in support of Madagascan fauna having an African origin with colonisation having occurred via dispersal as opposed to ancient vicariant events.http://www.brill.nl/iseab201

Identification and mapping real-world data sources for heart failure, acute coronary syndrome, and atrial fibrillation

BACKGROUND: Transparent and robust real-world evidence sources are increasingly important for global health, including cardiovascular diseases. We aimed to identify global real-world data (RWD) sources for heart failure (HF), acute coronary syndrome (ACS), and atrial fibrillation (AF). METHODS: We conducted a systematic review of publications with RWD pertaining to HF, ACS, and AF (2010-2018), generating a list of unique data sources. Metadata were extracted based on the source type (e.g. electronic health records, genomics, clinical data), study design, population size, clinical characteristics, follow-up duration, outcomes, and assessment of data availability for future studies and linkage. RESULTS: Overall, 11,889 publications were retrieved for HF, 10,729 for ACS, and 6,262 for AF. From these, 322 (HF), 287 (ACS), and 220 (AF) data sources were selected for detailed review. Majority of data sources had near complete data on demographic variables (HF: 94%, ACS: 99%, and AF: 100%) and considerable data on comorbidities (HF: 77%, ACS: 93%, and AF: 97%). The least reported data categories were drug codes (HF, ACS, and AF: 10%) and caregiver involvement (HF: 6%, ACS: 1%, and AF: 1%). Only a minority of data sources provided information on access to data for other researchers (11%) or whether data could be linked to other data sources to maximize clinical impact (20%). The list and metadata for the RWD sources are publicly available at www.escardio.org/bigdata. CONCLUSIONS: This review has created a comprehensive resource of cardiovascular data sources, providing new avenues to improve future real-world research and to achieve better patient outcomes

Surgical and oncological results after rectal resections with or without previous treatment for prostate cancer

IntroductionPrevious treatment for prostate cancer (PC) may potentially affect the surgical and oncological outcomes of subsequent rectal cancer surgery, but there are only a few studies regarding this particular group. In this study, we present the 3-year surgical and oncological results of rectal cancer patients who had received previous treatment for PC at a single Finnish tertiary referral centre.Material and methodsData regarding all male patients diagnosed with rectal cancer and treated at Tampere University Hospital (TAUH) between 1997 and 2016 were gathered from medical records. In total, this study included 553 rectal cancer patients who underwent curative surgery, and 54 of them (9.8%) had a prior history of treatment for prostate cancer.ResultsPatients in the PC group were older and had more comorbidities compared with those in the non-PC group. The PC patients had a significantly higher risk of permanent stoma compared with the non-PC patients (61.5% vs. 45.2%, respectively, p = 0.025). The PC patients seemed to have lower tumours than the non-PC patients (87% vs. 75%, respectively, p = 0.05). Overall, the 3-year overall survival (OS) for the PC and non-PC patients was 74.1% and 80.6%, respectively. No significant differences were observed between the study groups even in the age-adjusted comparison [hazard ratio (HR): 1.07, confidence interval (CI) 95%: 0.60–1.89]. In the univariable analysis, radically operated patients without a history of PC exhibited an improved overall survival, (HR: 2.46, 95% CI: 1.34–4.53, p = 0.004). However, only a higher age-adjusted Charlson comorbidity index (CCI) and a low tumour location (<10 cm) were found to have an independent prognostic impact on worse OS in the multivariable analysis (HR: 1.57, 95% CI: 1.36–1.82, p < 0.001 and HR: 2.74, 95% CI: 1.32–5.70, p = 0.007, respectively). No significant differences were observed between the groups in terms of disease-free or local recurrence-free survival.ConclusionRectal cancer is more frequently found in the middle or lower part of the rectum in patients who have previously received treatment for prostate cancer. These patients also have a higher likelihood of requiring a permanent stoma. In radically operated rectal cancer, the PC group had a worse OS rate, according to the univariable analysis. However, the only independent prognostic factors for a worse OS that were highlighted in the multivariable analysis included a higher CCI and a low tumour location

Large kidneys predict poor renal outcome in subjects with diabetes and chronic kidney disease

<p>Abstract</p> <p>Background</p> <p>Renal hypertrophy occurs early in diabetic nephropathy, its later value is unknown. Do large kidneys still predict poor outcome in patients with diabetes and Chronic Kidney Disease (CKD)?</p> <p>Methods</p> <p>Seventy-five patients with diabetes and CKD according to a Glomerular Filtration Rate (GFR, by 51Cr-EDTA clearance) below 60 mL/min/1.73 m²or an Albumin Excretion Rate above 30 mg/24 H, had an ultrasound imaging of the kidneys and were cooperatively followed during five years by the Diabetology and Nephrology departments of the Centre Hospitalier Universitaire de Bordeaux.</p> <p>Results</p> <p>The patients were mainly men (44/75), aged 62 ± 13 yrs, with long-standing diabetes (duration:17 ± 9 yrs, 55/75 type 2), and CKD: initial GFR: 56.5 (8.5-209) mL/min/1.73 m², AER: 196 (20-2358) mg/24 H. Their mean kidney lenght (108 ± 13 mm, 67-147) was correlated to the GFR (r = 0.23, p < 0.05). During the follow-up, 9/11 of the patients who had to start dialysis came from the half with the largest kidneys (LogRank: p < 0.05), despite a 40% higher initial isotopic GFR. Serum creatinine were initially lower (Small kidneys: 125 (79-320) μmol/L, Large: 103 (50-371), p < 0.05), but significantly increased in the "large kidneys" group at the end of the follow-up (Small kidneys: 129 (69-283) μmol/L, Large: 140 (50-952), p < 0.005 vs initial). The difference persisted in the patients with severe renal failure (KDOQI stages 4,5).</p> <p>Conclusions</p> <p>Large kidneys still predict progression in advanced CKD complicating diabetes. In these patients, ultrasound imaging not only excludes obstructive renal disease, but also provides information on the progression of the renal disease.</p

Cross-oncopanel study reveals high sensitivity and accuracy with overall analytical performance depending on genomic regions

BackgroundTargeted sequencing using oncopanels requires comprehensive assessments of accuracy and detection sensitivity to ensure analytical validity. By employing reference materials characterized by the U.S. Food and Drug Administration-led SEquence Quality Control project phase2 (SEQC2) effort, we perform a cross-platform multi-lab evaluation of eight Pan-Cancer panels to assess best practices for oncopanel sequencing.ResultsAll panels demonstrate high sensitivity across targeted high-confidence coding regions and variant types for the variants previously verified to have variant allele frequency (VAF) in the 5-20% range. Sensitivity is reduced by utilizing VAF thresholds due to inherent variability in VAF measurements. Enforcing a VAF threshold for reporting has a positive impact on reducing false positive calls. Importantly, the false positive rate is found to be significantly higher outside the high-confidence coding regions, resulting in lower reproducibility. Thus, region restriction and VAF thresholds lead to low relative technical variability in estimating promising biomarkers and tumor mutational burden.ConclusionThis comprehensive study provides actionable guidelines for oncopanel sequencing and clear evidence that supports a simplified approach to assess the analytical performance of oncopanels. It will facilitate the rapid implementation, validation, and quality control of oncopanels in clinical use.Peer reviewe

Indirect interactions in the High Arctic

Peer reviewe

Origin of Madagascan Scarabaeini dung beetles (Coleoptera: Scarabaeidae): dispersal from Africa

Madagascar, the world’s fourth largest island, has a long history of isolation (160 MY) and a wide range of climates and ecosystems which have in turn resulted in high levels of endemism across different taxonomic levels. Although Madagascar has a rich dung beetle fauna that belongs to various tribes only three species of the Scarabaeini are found there, namely Scarabaeus viettei, S. radama and S. sevoistra. These three species are superficially quite distinctive and have, consequently, had a relatively tortured taxonomic history since the first was described in1896. The morpholgical differences between these species resulted in them being placed in different genera at different times. However, currently, based on cladistic analysis, they are all classified in the genus Scarabaeus. In this study, two of the species, S. viettei and S. radama, were included in a phylogenetic analysis based on two mitochondrial gene regions - cytochrome oxidase I (COI) and 16S rRNA - and a 247 morphological and behavioural dataset of 23 members of the Scarabaeinae. A Bayesian phylogram supports the monophyly of the genus Scarabaeus, with the two species from Madagascar appearing sister to three species of Scarabaeus from southwest Africa. Estimated times of divergence based on published mutation rates of 0.012 and 0.0075 for COI indicate that a shared African/Madagascan origin occurred around 15.18 or 24.15 MYA, respectively. This study is another example in support of Madagascan fauna having an African origin with colonisation having occurred via dispersal as opposed to ancient vicariant events.http://www.brill.nl/iseab201