Association between attention-deficit/hyperactivity disorder symptoms and obesity and hypertension in early adulthood: a population-based study.

OBJECTIVE: To examine the associations between attention-deficit/hyperactivity disorder (ADHD) symptoms, obesity and hypertension in young adults in a large population-based cohort. DESIGN, SETTING AND PARTICIPANTS: The study population consisted of 15,197 respondents from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents followed from 1995 to 2009 in the United States. Multinomial logistic and logistic models examined the odds of overweight, obesity and hypertension in adulthood in relation to retrospectively reported ADHD symptoms. Latent curve modeling was used to assess the association between symptoms and naturally occurring changes in body mass index (BMI) from adolescence to adulthood. RESULTS: Linear association was identified between the number of inattentive (IN) and hyperactive/impulsive (HI) symptoms and waist circumference, BMI, diastolic blood pressure and systolic blood pressure (all P-values for trend <0.05). Controlling for demographic variables, physical activity, alcohol use, smoking and depressive symptoms, those with three or more HI or IN symptoms had the highest odds of obesity (HI 3+, odds ratio (OR)=1.50, 95% confidence interval (CI) = 1.22-2.83; IN 3+, OR = 1.21, 95% CI = 1.02-1.44) compared with those with no HI or IN symptoms. HI symptoms at the 3+ level were significantly associated with a higher OR of hypertension (HI 3+, OR = 1.24, 95% CI = 1.01-1.51; HI continuous, OR = 1.04, 95% CI = 1.00-1.09), but associations were nonsignificant when models were adjusted for BMI. Latent growth modeling results indicated that compared with those reporting no HI or IN symptoms, those reporting 3 or more symptoms had higher initial levels of BMI during adolescence. Only HI symptoms were associated with change in BMI. CONCLUSION: Self-reported ADHD symptoms were associated with adult BMI and change in BMI from adolescence to adulthood, providing further evidence of a link between ADHD symptoms and obesity.

Genome-wide association study of perioperative myocardial infarction after coronary artery bypass surgery.

OBJECTIVES: Identification of patient subpopulations susceptible to develop myocardial infarction (MI) or, conversely, those displaying either intrinsic cardioprotective phenotypes or highly responsive to protective interventions remain high-priority knowledge gaps. We sought to identify novel common genetic variants associated with perioperative MI in patients undergoing coronary artery bypass grafting using genome-wide association methodology. SETTING: 107 secondary and tertiary cardiac surgery centres across the USA. PARTICIPANTS: We conducted a stage I genome-wide association study (GWAS) in 1433 ethnically diverse patients of both genders (112 cases/1321 controls) from the Genetics of Myocardial Adverse Outcomes and Graft Failure (GeneMAGIC) study, and a stage II analysis in an expanded population of 2055 patients (225 cases/1830 controls) combined from the GeneMAGIC and Duke Perioperative Genetics and Safety Outcomes (PEGASUS) studies. Patients undergoing primary non-emergent coronary bypass grafting were included. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome variable was perioperative MI, defined as creatine kinase MB isoenzyme (CK-MB) values ≥10× upper limit of normal during the first postoperative day, and not attributable to preoperative MI. Secondary outcomes included postoperative CK-MB as a quantitative trait, or a dichotomised phenotype based on extreme quartiles of the CK-MB distribution. RESULTS: Following quality control and adjustment for clinical covariates, we identified 521 single nucleotide polymorphisms in the stage I GWAS analysis. Among these, 8 common variants in 3 genes or intergenic regions met p<10(-5) in stage II. A secondary analysis using CK-MB as a quantitative trait (minimum p=1.26×10(-3) for rs609418), or a dichotomised phenotype based on extreme CK-MB values (minimum p=7.72×10(-6) for rs4834703) supported these findings. Pathway analysis revealed that genes harbouring top-scoring variants cluster in pathways of biological relevance to extracellular matrix remodelling, endoplasmic reticulum-to-Golgi transport and inflammation. CONCLUSIONS: Using a two-stage GWAS and pathway analysis, we identified and prioritised several potential susceptibility loci for perioperative MI.

Paleoenvironmental reconstruction of the coastal Monte Léon and Santa Cruz formations (Early Miocene) at Rincón del Buque, Southern Patagonia: A revisited locality

© 2015 Elsevier Ltd.Sedimentological, ichnological and paleontological analyses of the Early Miocene uppermost Monte León Formation and the lower part of the Santa Cruz Formation were carried out in Rincón del Buque (RDB), a fossiliferous locality north of Río Coyle in Santa Cruz Province, Patagonia, Argentina. This locality is of special importance because it contains the basal contact between the Monte Léon (MLF) and the Santa Cruz (SCF) formations and because it preserves a rich fossil assemblage of marine invertebrates and marine trace fossils, and terrestrial vertebrates and plants, which has not been extensively studied. A ~90m-thick section of the MLF and the SCF that crops out at RDB was selected for this study. Eleven facies associations (FA) are described, which are, from base to top: subtidal-intertidal deposits with Crassotrea orbignyi and bioturbation of the Skolithos-Cruziana ichnofacies (FA1); tidal creek deposits with terrestrial fossil mammals and Ophiomorpha isp. burrows (FA2); tidal flat deposits with Glossifungites ichnofacies (FA3); deposits of tidal channels (FA4) and tidal sand flats (FA5) both with and impoverish Skolithos ichnofacies associated; marsh deposits (FA6); tidal point bar deposits recording a depauperate mixture of both the Skolithos and Cruziana ichnofacies (FA7); fluvial channel deposits (FA8); fluvial point bar deposits (FA9); floodplain deposits (FA10); and pyroclastic and volcaniclastic deposits of the floodplain where terrestrial fossil mammal remains occur (FA11).The transition of the MLF-SCF at RDB reflects a changing depositional environment from the outer part of an estuary (FA1) through the central (FA2-6) to inner part of a tide-dominated estuary (FA7). Finally a fluvial system occurs with single channels of relatively low energy and low sinuosity enclosed by a broad, low-energy floodplain dominated by partially edaphized ash-fall, sheet-flood, and overbank deposits (FA8-11). Pyroclastic and volcaniclastic materials throughout the succession must have been deposited as ash-fall distal facies in a fluvial setting and also were carried by fluvial streams and redeposited in both estuarine and fluvial settings. These materials preserve most of the analyzed terrestrial fossil mammals that characterize the Santacrucian age of the RDB's succession. Episodic sedimentation under volcanic influence, high sedimentation rates and a relatively warm and seasonal climate are inferred for the MLF and SCF section.Lateral continuity of the marker horizons at RDB serve for correlation with other coastal localities such as the lower part of the coastal SCF south of Río Coyle (~17.6-17.4Ma) belonging to the Estancia La Costa Member of the SCF.

Eliciting and Aggregating Forecasts When Information is Shared

Using the wisdom of crowds---combining many individual forecasts to obtain an aggregate estimate---can be an effective technique for improving forecast accuracy. When individual forecasts are drawn from independent and identical information sources, a simple average provides the optimal crowd forecast. However, correlated forecast errors greatly limit the ability of the wisdom of crowds to recover the truth. In practice, this dependence often emerges because information is shared: forecasters may to a large extent draw on the same data when formulating their responses.

To address this problem, I propose an elicitation procedure in which each respondent is asked to provide both their own best forecast and a guess of the average forecast that will be given by all other respondents. I study optimal responses in a stylized information setting and develop an aggregation method, called pivoting, which separates individual forecasts into shared and private information and then recombines these results in the optimal manner. I develop a tailored pivoting procedure for each of three information models, and introduce a simple and robust variant that outperforms the simple average across a variety of settings.

In three experiments, I investigate the method and the accuracy of the crowd forecasts. In the first study, I vary the shared and private information in a controlled environment, while the latter two studies examine forecasts in real-world contexts. Overall, the data suggest that a simple minimal pivoting procedure provides an effective aggregation technique that can significantly outperform the crowd average.

Dynamics of Delta/Notch signaling on endomesoderm segregation in the sea urchin embryo.

Endomesoderm is the common progenitor of endoderm and mesoderm early in the development of many animals. In the sea urchin embryo, the Delta/Notch pathway is necessary for the diversification of this tissue, as are two early transcription factors, Gcm and FoxA, which are expressed in mesoderm and endoderm, respectively. Here, we provide a detailed lineage analysis of the cleavages leading to endomesoderm segregation, and examine the expression patterns and the regulatory relationships of three known regulators of this cell fate dichotomy in the context of the lineages. We observed that endomesoderm segregation first occurs at hatched blastula stage. Prior to this stage, Gcm and FoxA are co-expressed in the same cells, whereas at hatching these genes are detected in two distinct cell populations. Gcm remains expressed in the most vegetal endomesoderm descendant cells, while FoxA is downregulated in those cells and activated in the above neighboring cells. Initially, Delta is expressed exclusively in the micromeres, where it is necessary for the most vegetal endomesoderm cell descendants to express Gcm and become mesoderm. Our experiments show a requirement for a continuous Delta input for more than two cleavages (or about 2.5 hours) before Gcm expression continues in those cells independently of further Delta input. Thus, this study provides new insights into the timing mechanisms and the molecular dynamics of endomesoderm segregation during sea urchin embryogenesis and into the mode of action of the Delta/Notch pathway in mediating mesoderm fate.

Quantifying data quality for clinical trials using electronic data capture.

BACKGROUND: Historically, only partial assessments of data quality have been performed in clinical trials, for which the most common method of measuring database error rates has been to compare the case report form (CRF) to database entries and count discrepancies. Importantly, errors arising from medical record abstraction and transcription are rarely evaluated as part of such quality assessments. Electronic Data Capture (EDC) technology has had a further impact, as paper CRFs typically leveraged for quality measurement are not used in EDC processes. METHODS AND PRINCIPAL FINDINGS: The National Institute on Drug Abuse Treatment Clinical Trials Network has developed, implemented, and evaluated methodology for holistically assessing data quality on EDC trials. We characterize the average source-to-database error rate (14.3 errors per 10,000 fields) for the first year of use of the new evaluation method. This error rate was significantly lower than the average of published error rates for source-to-database audits, and was similar to CRF-to-database error rates reported in the published literature. We attribute this largely to an absence of medical record abstraction on the trials we examined, and to an outpatient setting characterized by less acute patient conditions. CONCLUSIONS: Historically, medical record abstraction is the most significant source of error by an order of magnitude, and should be measured and managed during the course of clinical trials. Source-to-database error rates are highly dependent on the amount of structured data collection in the clinical setting and on the complexity of the medical record, dependencies that should be considered when developing data quality benchmarks.