Searching for Explanations for Cryptogenic Stroke in the Young : Revealing the Etiology, Triggers, and Outcome (SECRETO): echocardiography performance protocol

Background: The incidence of ischemic stroke in young patients is increasing and associated with unfavorable prognosis due to high risk of recurrent cardiovascular events. In many young patients the cause of stroke remains unknown, referred to as cryptogenic stroke. Neuroimaging frequently suggests a proximal source of embolism in these strokes. We developed a comprehensive step-by-step echocardiography protocol for a prospective study with centralized reading to characterize preclinical cardiac changes associated with cryptogenic stroke. Methods and study design: SECRETO (Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome; NCT01934725) is an ongoing multicenter case-control study enrolling patients (target n = 600) aged 18-49 years hospitalized due to first-ever ischemic stroke of undetermined etiology and age- and sex-matched controls (target n = 600). A comprehensive assessment of cardiovascular risk factors and extensive cardiac imaging with transthoracic and transesophageal echocardiography, electrocardiography and neurovascular imaging is performed. Transthoracic and transesophageal echocardiograms will be centrally read, following an extensive protocol particularly emphasizing the characteristics of left atrium, left atrial appendage and interatrial septum. Conclusions: A detailed assessment of both conventional and unconventional vascular risk factors and cardiac imaging with transthoracic and transesophageal echocardiography are implemented in SECRETO, aiming to establish indirect and direct risk factors and causes for cryptogenic stroke and novel pathophysiological brain-heart pathways. This may ultimately enable more personalized therapeutic options for these patients.Peer reviewe

Mapping of nutrients, food additives and contaminants in plant-based and gluten-free food products and their meat, dairy and gluten-containing counterparts

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Scoping review of research on gastrointestinal effects of selected emulsifiers, stabilisers, and thickeners

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Higher vitamin B12 levels in neurodevelopmental disorders than in healthy controls and schizophrenia: A comparison among participants between 2 and 53 years

Author´s accepted manuscript.This is the peer reviewed version of the following article: Hope, S., Nærland, T., Høyland, A. L., Torske, T., Malt, E., Abrahamsen, T. G., Nerhus, M., Wedervang-Resell, K., Lonning, V. L. H., Johannessen, J., Steen, N. E., Agartz, I., Stenberg, N., Hundhausen, T. E., Mørkrid, L. & Andreassen, O. A. (2020). Higher vitamin B12 levels in neurodevelopmental disorders than in healthy controls and schizophrenia : A comparison among participants between 2 and 53 years. The FASEB Journal, 34(6), 8114-8124, which has been published in final form at https://doi.org/10.1096/fj.201900855RRR. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Recent studies suggest that both high and low levels of vitamin B12 (vitB12) may have negative health impacts. We measured VitB12 in patients with the Neurodevelopmental disorders (ND) (n = 222), comprised of Autism Spectrum Disorders, specific Developmental disorders, and Intellectual Disability (aged 2-53 years), schizophrenia (n = 401), and healthy controls (HC) (n = 483). Age-and gender-adjusted vitB12 z-scores were calculated by comparisons with a reference population (n = 76 148). We found higher vitB12 in ND (median 420 pmol/L, mean z-score: 0.30) than in HC (316 pmol/L, z-score: 0.06, P < .01) and schizophrenia (306 pmol/L, z-score: −0.02, P < .001), which was significant after adjusting for age, gender, vitB12 supplement, folate, hemoglobin, leukocytes, liver, and kidney function (P < .02). In ND, 20% (n = 44) had vitB12 above 650 pmol/L, and 1% (n = 3) had below 150 pmol/L (common reference limits). In 6.3% (n = 14) of ND, vitB12 was above 2SD of mean in the age-and gender-adjusted reference population, which was more frequent than in HC (n = 8, 1.6%), OR: 4.0, P = .001. Low vitB12 was equally frequent as in HC, and vitB12 z-scores were equal across the age groups. To conclude, vitB12 was higher in ND than in HC and schizophrenia, suggesting a specific feature of ND, which warrants further studies to investigate the underlying mechanisms.acceptedVersio

Mental illness and COVID-19 vaccination: a multinational investigation of observational & register-based data

Individuals with mental illness are at higher risk of severe COVID-19 outcomes. However, previous studies on the uptake of COVID-19 vaccination in this population have reported conflicting results. Using data from seven cohort studies (N = 325,298) included in the multinational COVIDMENT consortium, and the Swedish registers (N = 8,080,234), this study investigates the association between mental illness (defined using self-report measures, clinical diagnosis and prescription data) and COVID-19 vaccination uptake. Results from the COVIDMENT cohort studies were pooled using meta-analyses, the majority of which showed no significant association between mental illness and vaccination uptake. In the Swedish register study population, we observed a very small reduction in the uptake of both the first and second dose of a COVID-19 vaccine among individuals with vs. without mental illness; the reduction was however greater among those not using psychiatric medication. Here we show that uptake of the COVID-19 vaccine is generally high among individuals both with and without mental illness, however the lower levels of vaccination uptake observed among subgroups of individuals with unmedicated mental illness warrants further attention

The Norwegian Stroke in the Young Study (NOR-SYS): Rationale and design

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Mudanças climáticas e o fitoplâncton marinho : uma revisão

Orientador: Prof. Dr. Carlos Roberto SanquettaMonografia (especialização) - Universidade Federal do Paraná, Setor de Ciências Agrárias, Curso de Especialização em Projetos Sustentáveis, Mudanças Climáticas e Mercado de CarbonoInclui referênciasResumo: Uma revisão bibliográfica de artigos nacionais e internacionais foi realizada objetivando avaliar os principais impactos e respostas provocados pelas mudanças climáticas sobre o fitoplâncton marinho. Compreender como o ambiente marinho é afetado pelas alterações ambientais é fundamental, pois os oceanos são responsáveis pela absorção de mais de 80% do calor adicionado ao clima. A busca dos artigos foi realizada nas bases de dados Portal de Periódicos Capes, SciELO e Sciencedirect, entre maio e agosto de 2012 para o período compreendido entre 1980 e 2012. O fitoplâncton, além de bioindicador ambiental, é a base da cadeia alimentar e quaisquer alterações em sua composição ou abundância podem provocar graves consequências para os demais níveis tróficos, inclusive o homem. Dentre os impactos no ambiente marinho, observa-se o aquecimento da superfície da água do mar, provocando a estratificação da coluna de água e impedindo a ciclagem dos nutrientes; o aumento da temperatura atmosférica, favorecendo maiores índices de precipitação, o derretimento das geleiras e o aumento do nível do mar; a acidificação e a desoxigenação da água do mar. As respostas do fitoplâncton às mudanças climáticas compreendem alterações na taxa de crescimento, mudanças na composição específica e distribuição biogeográfica das espécies, maior risco de ocorrência de florações nocivas e de bioinvasões, dentre outras. Apesar de crescente o número de publicações sobre mudanças climáticas nos últimos anos, muitas são as incertezas sobre a real extensão desses impactos e quais outras ameaças podem decorrer das mudanças climáticas sobre o fitoplâncton marinho

Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Triggers, Causes, and Outcome (SECRETO): Rationale and design

Background: Worldwide, about 1.3 million annual ischaemic strokes (IS) occur in adults aged <50 years. Of these early-onset strokes, up to 50% can be regarded as cryptogenic or associated with conditions with poorly documented causality like patent foramen ovale and coagulopathies. Key hypotheses/aims: (1) Investigate transient triggers and clinical/sub-clinical chronic risk factors associated with cryptogenic IS in the young; (2) use cardiac imaging methods exceeding state-of-the-art to reveal novel sources for embolism; (3) search for covert thrombosis and haemostasis abnormalities; (4) discover new disease pathways using next-generation sequencing and RNA gene expression studies; (5) determine patient prognosis by use of phenotypic and genetic data; and (6) adapt systems medicine approach to investigate complex risk-factor interactions. Design: Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725) is a prospective multi-centre case–control study enrolling patients aged 18–49 years hospitalised due to first-ever imaging-proven IS of undetermined etiology. Patients are examined according to a standardised protocol and followed up for 10 years. Patients are 1:1 age- and sex-matched to stroke-free controls. Key study elements include centralised reading of echocardiography, electrocardiography, and neurovascular imaging, as well as blood samples for genetic, gene-expression, thrombosis and haemostasis and biomarker analysis. We aim to have 600 patient– control pairs enrolled by the end of 2018. Summary: SECRETO is aiming to establish novel mechanisms and prognosis of cryptogenic IS in the young and will provide new directions for therapy development for these patients. First results are anticipated in 2019