Transition From Pediatric to Adult Care for Youth Diagnosed With Type 1 Diabetes in Adolescence

Youth with type 1 diabetes mellitus are at risk for poor glycemic control as they age into adulthood. The aim of this study was to describe sociodemographic and clinical correlates of poor glycemic control associated with the transfer of care from pediatric to adult diabetes providers among a cohort of youth with type 1 diabetes diagnosed in adolescence

Mapping autism risk loci using genetic linkage and chromosomal rearrangements.

International audienceAutism spectrum disorders (ASDs) are common, heritable neurodevelopmental conditions. The genetic architecture of ASDs is complex, requiring large samples to overcome heterogeneity. Here we broaden coverage and sample size relative to other studies of ASDs by using Affymetrix 10K SNP arrays and 1,181 [corrected] families with at least two affected individuals, performing the largest linkage scan to date while also analyzing copy number variation in these families. Linkage and copy number variation analyses implicate chromosome 11p12-p13 and neurexins, respectively, among other candidate loci. Neurexins team with previously implicated neuroligins for glutamatergic synaptogenesis, highlighting glutamate-related genes as promising candidates for contributing to ASDs

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

A novel mechanism to explain success of invasive herbaceous species at the expense of natives in eastern hardwood forests

Among the more intriguing topics in general ecology courses are the symbiotic relationships (the ‘-isms’ as I sometimes present them – mutualism, commensalism, and parasitism). Of these, mutualism is typically the most appealing to students. The scenario that different species can not only co-exist, but can also provide essential resources/services for one another, resonates well with all but the least interested in the course. Ultimately, however, there is also the palpable degree of dismay when they discover that these relationships arise from mutual exploitation, rather than from some benign force of nature. A flip-side of this, in many ways a type of dark side of nature, is something most ecology students have experienced directly – the degrading effects of invasive plant species on plant communities. Whether it is a verdant blanket of kudzu (Pueraria lobata) on Carolina pines, Japanese knotweed (Microstegium vimineum) extending beyond paths of the Appalachian Trail, or garlic mustard (Alliaria petiolata) creating a monospecific carpet on the forest floor of a temperate hardwood forest, most students have witnessed this phenomenon, with the more curious asking: why? Why is it that invasive species attain, and then maintain, the edge over their native counterparts? Building on earlier work published out of the same laboratory (Cantor et al., 2011; Brouwer et al., 2015), Hale et al., in this issue of New Phytologist (pp. 542–549) address this very important question, and do so in a creative way, ultimately elucidating a novel explanation that answers this question – at least in part – for eastern hardwood forests, and they do so by invoking one of the more well-known mutualistic relationships: mycorrhizas