Design and rationale of DISCOVER global registry in type 2 diabetes:Real-world insights of treatment patterns and its relationship with cardiovascular, renal, and metabolic multimorbidities

10.1016/j.jdiacomp.2021.108077Journal of Diabetes and its Complications351210807

DNA methylation and body mass index from birth to adolescence : meta-analyses of epigenome-wide association studies

Background DNA methylation has been shown to be associated with adiposity in adulthood. However, whether similar DNA methylation patterns are associated with childhood and adolescent body mass index (BMI) is largely unknown. More insight into this relationship at younger ages may have implications for future prevention of obesity and its related traits. Methods We examined whether DNA methylation in cord blood and whole blood in childhood and adolescence was associated with BMI in the age range from 2 to 18 years using both cross-sectional and longitudinal models. We performed meta-analyses of epigenome-wide association studies including up to 4133 children from 23 studies. We examined the overlap of findings reported in previous studies in children and adults with those in our analyses and calculated enrichment. Results DNA methylation at three CpGs (cg05937453, cg25212453, and cg10040131), each in a different age range, was associated with BMI at Bonferroni significance, P <1.06 x 10(-7), with a 0.96 standard deviation score (SDS) (standard error (SE) 0.17), 0.32 SDS (SE 0.06), and 0.32 BMI SDS (SE 0.06) higher BMI per 10% increase in methylation, respectively. DNA methylation at nine additional CpGs in the cross-sectional childhood model was associated with BMI at false discovery rate significance. The strength of the associations of DNA methylation at the 187 CpGs previously identified to be associated with adult BMI, increased with advancing age across childhood and adolescence in our analyses. In addition, correlation coefficients between effect estimates for those CpGs in adults and in children and adolescents also increased. Among the top findings for each age range, we observed increasing enrichment for the CpGs that were previously identified in adults (birth P-enrichment = 1; childhood P-enrichment = 2.00 x 10(-4); adolescence P-enrichment = 2.10 x 10(-7)). Conclusions There were only minimal associations of DNA methylation with childhood and adolescent BMI. With the advancing age of the participants across childhood and adolescence, we observed increasing overlap with altered DNA methylation loci reported in association with adult BMI. These findings may be compatible with the hypothesis that DNA methylation differences are mostly a consequence rather than a cause of obesity.Peer reviewe

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Supplementary tables from A practical view of fine-mapping and gene prioritization in the post-genome-wide association study era

Tables containing a description of current functional and computational fine-mapping tools and database

Tracking Adolescents' Individual Lives Survey ( TRAILS ) T4 Clinical Cohort

The overall objective of the study is to contribute to the understanding of the determinants of adolescents’ mental (ill-)health and social development during adolescence and young adulthood, as well as the mechanisms underlying the associations between determinants and these outcomes. A particular aim is to focus on the interplay between individual characteristics and environmental factors. In addition to this major objective, a number of participants investigate the course and determinants of somatic (ill-)health, covering topics such as overweight, lung disease, sports, physical activity, and more

TRAILS T4CC

The overall objective of the study is to contribute to the understanding of the determinants of adolescents’ mental (ill-)health and social development during adolescence and young adulthood, as well as the mechanisms underlying the associations between determinants and these outcomes. A particular aim is to focus on the interplay between individual characteristics and environmental factors. In addition to this major objective, a number of participants investigate the course and determinants of somatic (ill-)health, covering topics such as overweight, lung disease, sports, physical activity, and more

Tracking Adolescents' Individual Lives Survey ( TRAILS ) T5 Clinical Cohort

The overall objective of the study is to contribute to the understanding of the determinants of adolescents’ mental (ill-)health and social development during adolescence and young adulthood, as well as the mechanisms underlying the associations between determinants and these outcomes. A particular aim is to focus on the interplay between individual characteristics and environmental factors. In addition to this major objective, a number of participants investigate the course and determinants of somatic (ill-)health, covering topics such as overweight, lung disease, sports, physical activity, and more

Dataset belonging to 'Diagnostic Accuracy of Symptoms, Physical Signs, and Laboratory Tests for Giant Cell Arteritis: A Systematic Review and Meta-analysis'

This dataset contains data underlying Table 2 and Table 3 in the following study: van der Geest KSM, Sandovici M, Brouwer E, Mackie SL. Diagnostic Accuracy of Symptoms, Physical Signs, and Laboratory Tests for Giant Cell Arteritis: A Systematic Review and Meta-analysis. JAMA Intern Med. 2020;180(10):1295–1304. doi:10.1001/jamainternmed.2020.3050 KEY POINTS OF THE AFOREMENTIONED STUDY: Question: In patients with suspected giant cell arteritis, which clinical and laboratory findings can help to identify the disease? Findings: This systematic review and meta-analysis of 68 unique diagnostic cohort studies (14 037 unique patients) identified combinations of symptoms, physical signs, and laboratory tests that were informative with regard to the presence or absence of giant cell arteritis, but no single feature taken alone. Headache and scalp tenderness were poorly informative in this population. Meaning: These findings suggest that in patients with suspected giant cell arteritis, no single clinical or laboratory feature is sufficient to rule in or rule out the disease; therefore, additional investigations (vascular imaging and/or temporal artery biopsy) are required

PICKA-NH: Sensitivity and Gender categorization

The data presented here was collected as part of the PICKA project: gen_db_responses.csv: CSV file with results of normal-hearing school-age children's and adults' just noticeable differences in fundamental frequency (F0) and vocal tract length (VTL) jvo_db_results.csv: CSV file with results of normal-hearing school-age children's and adults' categorizations of voice gender as a function of F0 and VTL. Demographics.csv: CSV file with demographic data of participants (subject number, age, age group, gender, and vocabulary score) </dl

Supplementary Material for: Criteria for Continuous Kidney Replacement Therapy Cessation in ICU Patients

Introduction: In intensive care unit (ICU) patients with acute kidney injury, specific recommendations to guide the decision to cease continuous kidney replacement therapy (CKRT) are lacking. Methods: We performed a survey to identify criteria currently used to cease CKRT in real-life clinical practice in the Netherlands. We used an online questionnaire with multiple choice questions designed with web-based software from SurveyMonkey. Results: We received 169 completed questionnaires from intensivists (n = 126) and nephrologists (n = 43). Essential determinants for the cessation of CKRT were a spontaneously increasing diuresis (indicated by 92% of the respondents), absence of fluid overload (indicated by 88% of the respondents), and improvement in creatinine clearance (indicated by 61% of the respondents; intensivists 56%; nephrologists 77%, p = 0.03). Most often mentioned cut-off values used for increase in diuresis were 0.25 and 0.5 mL/kg/h (35% and 33%, respectively). Actual CKRT cessation was often postponed until the filter clots or until circuit disconnection is needed because of patient transport for diagnostic or intervention procedures (indicated by 58% of the respondents). Expected discharge from the ICU was the most frequently reported determinant to switch from CKRT to hemodialysis (indicated by 67% of the respondents). Conclusions: CKRT cessation in clinical practice is mostly based on spontaneously increasing diuresis, absence of fluid overload, and improvement in creatinine clearance and is often delayed until filter clotting or disconnection of the circuit because of logistic reasons