Towards precision medicine: defining and characterizing adipose tissue dysfunction to identify early immunometabolic risk in symptom-free adults from the GEMM family study

Interactions between macrophages and adipocytes are early molecular factors influencing adipose tissue (AT) dysfunction, resulting in high leptin, low adiponectin circulating levels and low-grade metaflammation, leading to insulin resistance (IR) with increased cardiovascular risk. We report the characterization of AT dysfunction through measurements of the adiponectin/leptin ratio (ALR), the adipo-insulin resistance index (Adipo-IRi), fasting/postprandial (F/P) immunometabolic phenotyping and direct F/P differential gene expression in AT biopsies obtained from symptom-free adults from the GEMM family study. AT dysfunction was evaluated through associations of the ALR with F/P insulin-glucose axis, lipid-lipoprotein metabolism, and inflammatory markers. A relevant pattern of negative associations between decreased ALR and markers of systemic low-grade metaflammation, HOMA, and postprandial cardiovascular risk hyperinsulinemic, triglyceride and GLP-1 curves was found. We also analysed their plasma non-coding microRNAs and shotgun lipidomics profiles finding trends that may reflect a pattern of adipose tissue dysfunction in the fed and fasted state. Direct gene differential expression data showed initial patterns of AT molecular signatures of key immunometabolic genes involved in AT expansion, angiogenic remodelling and immune cell migration. These data reinforce the central, early role of AT dysfunction at the molecular and systemic level in the pathogenesis of IR and immunometabolic disorders

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Energy development reveals blind spots for ecosystem conservation in the Amazon Basin

Energy development – as manifested by the proliferation of hydroelectric dams and increased oil and gas exploration – is a driver of change in Amazonian ecosystems. However, prevailing approaches to Amazonian ecosystem conservation that focus on terrestrial protected areas and Indigenous territories do not offer sufficient insurance against the risks associated with energy development. Here, we explore three related areas of concern: the exclusion of subsurface rights on Indigenous lands; the absence of frameworks for freshwater ecosystem conservation; and downgrading, downsizing, degazettement (loss of protection), and reclassification of protected areas. We consider these issues from the perspectives of multiple countries across the Amazon Basin, and link them directly to energy development. Finally, we offer suggestions for addressing the challenges of energy development for Amazon ecosystem conservation through existing policies, new approaches, and international collaboration.Interdisciplinary Research in Earth Sciences program [NNX14AD29G]; MacArthur Foundation under the Living Andean Rivers initiative [16-1607-151053-CSD]Open access articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]