Mega-analysis of association between obesity and cortical morphology in bipolar disorders:ENIGMA study in 2832 participants

Background: Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact. Methods: We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations. Results: BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI. Conclusions: We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.</p

Climate extremes and their impacts on agriculture across the Eastern Corn Belt Region of the U.S.

The Eastern Corn Belt Region (ECBR) is an important agricultural sector for the U.S. This study analyzes the climate extremes over the contemporary (1980–2018) and future (2036–2099) periods over the ECBR. We evaluated the performance of 32 downscaled models from the U.S. Global Change Research Program's Localized Constructed Analogs (LOCA) of the Coupled Model Intercomparison Project (CMIP5) to simulate extreme temperature and precipitation indices. The LOCA downscaled models were evaluated for the recent past against the National Aeronautics and Space Administration (NASA)-supported gridded observational dataset DAYMET. Results reveal key trends throughout the region that are consistent with previous studies, including significant increases in extreme minimum temperatures, reduction of cold nights, increase of warm nights, and decreases in diurnal temperature ranges. Much of the region demonstrates extreme warming trends in the coldest night of the year (more than 5 °C) and an increase in the heaviest precipitation events over 1980–2018. An optimal model ensemble (OME) was constructed using a Kling-Gupta Efficiency and Bhattacharyya coefficient evaluation to construct a comprehensive ranking procedure. Having outperformed a standard multi-model ensemble approach, the OME was used to evaluate the future changes of extreme climate indices under RCP4.5 and RCP8.5 scenarios. Though the OME showed consistently strong warming throughout the ECBR, variability among the optimal models and across watersheds is quite significant, especially for precipitation indices. Thus, constraining the uncertainty in future climate models, specifically as it relates to agriculture decisions that support climate-resilience, remains a challenge.Inlcuye referencias bibliográficas

Does the El Niño-Southern Oscillation Affect the Combined Impact of the Atlantic Multidecadal Oscillation and Pacific Decadal Oscillation on the Precipitation and Surface Air Temperature Variability over South America?

Previous studies have shown that the Atlantic Multidecadal Oscillation (AMO) and Pacific Decadal Oscillation (PDO) have combined effects on the precipitation (PRP) variability over South America. The combined impacts have been assessed considering four mean states as the averages of the variable anomalies during sub-periods overlapping time intervals of the PDO and AMO phases. Since these sub-periods include years under El Niño-Southern Oscillation (ENSO) extremes, the extent to which these years’ occurrence affects the averaged anomaly patterns during different mean states is investigated. The analyses are done for the PRP and surface air temperature (SAT) during the austral winter (June to August) and summer (December to February) of the 1901–2014 period using a composite technique. The nonlinear ENSO response in each mean state for a variable corresponds to the sum of the anomaly composites of the El Niño and La Niña events. In each mean state, the nonlinear PRP and SAT anomalies are not negligible and show similar patterns of the corresponding mean state, with larger magnitudes. For both seasons and all mean states, these similarities are more pronounced for SAT than for PRP. Thus, the ENSO variability affects the mean state’s PRP and SAT anomaly patterns in different ways. As far as we know, analyses of the nonlinear ENSO response of the South American climate during distinct mean states were not performed before. Our results also indicate that the ENSO variability should be considered in the studies of the low-frequency modes and their effects on the mean state over South America. The results presented could be relevant for climate monitoring and modeling studies

Mega-analysis of association between obesity and cortical morphology in bipolar disorders:ENIGMA study in 2832 participants

Background: Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact. Methods: We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations. Results: BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI. Conclusions: We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.</p

Association between body mass index and subcortical brain volumes in bipolar disorders–ENIGMA study in 2735 individuals

10.1038/s41380-021-01098-xMolecular Psychiatry26116806-681

Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices

Background: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide. Methods: During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, &gt;5000; intermediate risk, 100-5000; low risk, &lt;100). Results: A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P &lt; 0.001). Of the 295 centers that experienced in-hospital COVID-19 infection, 122 (41.4%) failed to trace it and 58 (19.7%) reported the infection originating from asymptomatic patients/staff members. Higher risk countries adopted more preventive measures including universal testing, routine testing of hospital staff and use of dedicated personal protective equipment in operation theatres, but there were remarkable discrepancies across the countries. Conclusions: This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions

Surgeons' fear of getting infected by COVID19: A global survey.

Surgeons' fear of getting infected by COVID19: A global surve

Impact of asymptomatic COVID-19 patients in global surgical practice during the COVID-19 pandemic.

CorrespondenceImpact of asymptomatic COVID-19patients in global surgical practiceduring the COVID-19 pandemi

Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices

Background In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide.Methods During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, &gt;5000; intermediate risk, 100-5000; low risk, &lt;100).Results A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P&lt;0.001). Of the 295 centers that experienced in-hospital COVID-19 infection, 122 (41.4%) failed to trace it and 58 (19.7%) reported the infection originating from asymptomatic patients/staff members. Higher risk countries adopted more preventive measures including universal testing, routine testing of hospital staff and use of dedicated personal protective equipment in operation theatres, but there were remarkable discrepancies across the countries.Conclusions This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions