Genetic predisposition to metabolically unfavourable adiposity and prostate cancer risk:A Mendelian randomization analysis

BACKGROUND The associations of adiposity with aggressive prostate cancer risk are unclear. Using two-sample Mendelian randomization, we assessed the association of metabolically unfavourable adiposity (UFA), favourable adiposity (FA) and for comparison body mass index (BMI), with prostate cancer, including aggressive prostate cancer. METHODS We examined the association of these genetically predicted adiposity-related traits with risk of prostate cancer overall, aggressive and early onset disease using outcome summary statistics from the PRACTICAL consortium (including 15,167 aggressive cases). RESULTS In inverse-variance weighted models, there was little evidence that genetically predicted one standard deviation higher UFA, FA and BMI were associated with aggressive prostate cancer [OR: 0.85 (95% CI:0.61-1.19), 0.80 (0.53-1.23) and 0.97 (0.88-1.08), respectively]; these associations were largely consistent in sensitivity analyses accounting for horizontal pleiotropy. There was no strong evidence that genetically determined UFA, FA or BMI were associated with overall prostate cancer or early age of onset prostate cancer. CONCLUSIONS We did not find differences in the associations of UFA and FA with prostate cancer risk, which suggest that adiposity is unlikely to influence prostate cancer via the metabolic factors assessed; however, these did not cover some aspects related to metabolic health that may link obesity with aggressive prostate cancer, which should be explored in future studies

Volume 12

Introduction, Dr. Roger A. Byrne, Dean From the Editor, Dr. Larissa Kat Tracy From the Designers, Rachel English, Rachel Hanson Immortality in the Mortal World: Otherworldly Intervention in Lanval and The Wife of Bath\u27s Tale by Haleigh James Analysis of Phenolic Compounds in Moroccan Olive Oils by HPLC by Hannah Meyls Art by Hope Irvin The Effects of Cell Phone Use on Gameplay Enjoyment and Frustration by Megan E. Hlavaty, Samara L. Gall, and Austin J. Funk Care, No Matter What: Planned Parenthood\u27s Use of Organizational Rhetoric to Expand its Reputation by Karyn Keane Analysis of Petroleum Products for Forensic and Environmental Applications by Sarah Ghali, Antonio Harvey, and Katelynn McCrillis Art by Andrew Jones The Triangle Shirtwaist Factory Fire by Rachel Hazelwood Art by Madison Schmitz Ercilla y la imitacion: Araucanos al estilo europeo by Marija Venta Design by Haley Tebo Design by Jeremiah Gilmer White Supremacist\u27s Appropriation of the Persuasion of Passivity in Marvel\u27s Captain America by Bridget Dunn Design by Benjamin Sullivan Art by McKenzie Johnso

MLSys: The New Frontier of Machine Learning Systems

Machine learning (ML) techniques are enjoying rapidly increasing adoption. However, designing and implementing the systems that support ML models in real-world deployments remains a significant obstacle, in large part due to the radically different development and deployment profile of modern ML methods, and the range of practical concerns that come with broader adoption. We propose to foster a new systems machine learning research community at the intersection of the traditional systems and ML communities, focused on topics such as hardware systems for ML, software systems for ML, and ML optimized for metrics beyond predictive accuracy. To do this, we describe a new conference, MLSys, that explicitly targets research at the intersection of systems and machine learning with a program committee split evenly between experts in systems and ML, and an explicit focus on topics at the intersection of the two

The Australasian Resuscitation In Sepsis Evaluation : fluids or vasopressors in emergency department sepsis (ARISE FLUIDS), a multi-centre observational study describing current practice in Australia and New Zealand

Objectives: To describe haemodynamic resuscitation practices in ED patients with suspected sepsis and hypotension. Methods: This was a prospective, multicentre, observational study conducted in 70 hospitals in Australia and New Zealand between September 2018 and January 2019. Consecutive adults presenting to the ED during a 30-day period at each site, with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation, were eligible. Data included baseline demographics, clinical and laboratory variables and intravenous fluid volume administered, vasopressor administration at baseline and 6- and 24-h post-enrolment, time to antimicrobial administration, intensive care admission, organ support and in-hospital mortality. Results: A total of 4477 patients were screened and 591 were included with a mean (standard deviation) age of 62 (19) years, Acute Physiology and Chronic Health Evaluation II score 15.2 (6.6) and a median (interquartile range) systolic blood pressure of 94 mmHg (87–100). Median time to first intravenous antimicrobials was 77 min (42–148). A vasopressor infusion was commenced within 24 h in 177 (30.2%) patients, with noradrenaline the most frequently used (n = 138, 78%). A median of 2000 mL (1500–3000) of intravenous fluids was administered prior to commencing vasopressors. The total volume of fluid administered from pre-enrolment to 24 h was 4200 mL (3000–5661), with a range from 1000 to 12 200 mL. Two hundred and eighteen patients (37.1%) were admitted to an intensive care unit. Overall in-hospital mortality was 6.2% (95% confidence interval 4.4–8.5%). Conclusion: Current resuscitation practice in patients with sepsis and hypotension varies widely and occupies the spectrum between a restricted volume/earlier vasopressor and liberal fluid/later vasopressor strategy

Wait times are not the problem! Detailed analysis of unsolicited patient complaints from a metropolitan Australian emergency department

Objective To describe characteristics of ED admissions that resulted in unsolicited complaints and compare with overall ED admissions. The site utilised is an inner city tertiary hospital, with 630 beds, with approximately 82 600 annual presentations, where 32.5% were children. Methods Complaints between the dates of 27 November 2012 and 10 March 2016 were reviewed. Performance indicators and the distribution of presentations by diagnostic code were reviewed. Results A total of 572 different complaint reasons were found and grouped into 12 categories. The most common reasons for complaints were treatment (33.2%) and communication (28.3%), and most complaints concerned medical staff. Other variables including wait times have no effect on patient complaints. Utilising aggregate numbers, the overall paediatric complaint ratio was 0.98:1000 presentations, and the total adult department complaints were 1.78:1000 presentations. Conclusion As seen in this study the vast majority of patient complaints were associated with treatment and communication issues and skewed towards doctors. It may be feasible for medical staff to undertake communication training as clinician‐patient communication in the ED is an important aspect in the improvement of patient satisfaction and in decreasing patient complaints as waiting times and triage categories had no major influence on patient complaints

Identifying patients presenting in pain to the adult emergency department: A binary classification task and description of prevalence

Highlights• A retrospective methodology for the identification of patients presenting in pain.• The prevalence of pain on arrival to this ED over a three-year period was 55.2%.• Pain is identifiable from triage assessments

Blinded, Multicenter Comparison of Methods To Detect a Drug-Resistant Mutant of Human Immunodeficiency Virus Type 1 at Low Frequency

We determined the abilities of 10 technologies to detect and quantify a common drug-resistant mutant of human immunodeficiency virus type 1 (lysine to asparagine at codon 103 of the reverse transcriptase) using a blinded test panel containing mutant-wild-type mixtures ranging from 0.01% to 100% mutant. Two technologies, allele-specific reverse transcriptase PCR and a Ty1HRT yeast system, could quantify the mutant down to 0.1 to 0.4%. These technologies should help define the impact of low-frequency drug-resistant mutants on response to antiretroviral therapy