Consensus statements for management of Barrett's dysplasia and early-stage esophageal adenocarcinoma, based on a Delphi process

Esophageal adenocarcinoma (EA) is increasingly common among patients with Barrett's esophagus (BE). We aimed to provide consensus recommendations based on the medical literature that clinicians could use to manage patients with BE and low-grade dysplasia, high-grade dysplasia (HGD), or early-stage EA.

Serial chimerism analyses indicate that mixed haemopoietic chimerism influences the probability of graft rejection and disease recurrence following allogeneic stem cell transplantation (SCT) for severe aplastic anaemia (SAA): indication for routine assessment of chimerism post SCT for SAA

Ninety-one patients were studied serially for chimeric status following allogeneic stem cell transplantation (SCT) for severe aplastic anaemia (SAA) or Fanconi Anaemia (FA). Short tandem repeat polymerase chain reaction (STR-PCR) was used to stratify patients into five groups: (A) complete donor chimeras (n = 39), (B) transient mixed chimeras (n = 15) (C) stable mixed chimeras (n = 18), (D) progressive mixed chimeras (n = 14) (E) recipient chimeras with early graft rejection (n = 5). As serial sampling was not possible in Group E, serial chimerism results for 86 patients were available for analysis. The following factors were analysed for association with chimeric status: age, sex match, donor type, aetiology of aplasia, source of stem cells, number of cells engrafted, conditioning regimen, graft-versus-host disease (GvHD) prophylaxis, occurrence of acute and chronic GvHD and survival. Progressive mixed chimeras (PMCs) were at high risk of late graft rejection (n = 10, P <0.0001). Seven of these patients lost their graft during withdrawal of immunosuppressive therapy. STR-PCR indicated an inverse correlation between detection of recipient cells post-SCT and occurrence of acute GvHD (P = 0.008). PMC was a bad prognostic indicator of survival (P = 0.003). Monitoring of chimeric status during cyclosporin withdrawal may facilitate therapeutic intervention to prevent late graft rejection in patients transplanted for SAA.

Defining the role of common variation in the genomic and biological architecture of adult human height

Using genome-wide data from 253,288 individuals, we identified 697 variants at genome-wide significance that together explained one-fifth of the heritability for adult height. By testing different numbers of variants in independent studies, we show that the most strongly associated 1/42,000, 1/43,700 and 1/49,500 SNPs explained 1/421%, 1/424% and 1/429% of phenotypic variance. Furthermore, all common variants together captured 60% of heritability. The 697 variants clustered in 423 loci were enriched for genes, pathways and tissue types known to be involved in growth and together implicated genes and pathways not highlighted in earlier efforts, such as signaling by fibroblast growth factors, WNT/I 2-catenin and chondroitin sulfate-related genes. We identified several genes and pathways not previously connected with human skeletal growth, including mTOR, osteoglycin and binding of hyaluronic acid. Our results indicate a genetic architecture for human height that is characterized by a very large but finite number (thousands) of causal variants.

New genetic loci link adipose and insulin biology to body fat distribution

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms.

Genetic studies of body mass index yield new insights for obesity biology

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

'Pues tanto se esconde': Elusion at (inter)play in Ana Caro's El conde Partinuplés

El conde Partinuplés (first published 1653) is one of only two extant plays written by the Sevillan poet/dramatist Ana Caro Mallén de Soto (‘la décima musa sevillana’). Despite McKendrick's dismissal of the play as ‘extremely bad’, it has been the object of substantial critical scrutiny since the 1970s, impelled in great part by the production of modern editions (Luna and Delgado) and by Kaminsky's bio-biographical study (1973). Two responses have dominated: analysis of the play's imaginative reconceptualization of source material (most notably the Classical myth of Cupid and Psyche as contained in Apuleius and transmitted via the anonymous French chivalric romance Portonopeus de Blois; and more contemporary models, such as Calderón's La vida es sueño); discussions of the play from a gender/feminist perspective. There is some inevitable entanglement in these approaches, areas of ideological concurrence, but also of contradiction. This article will offer a critical synthesis of these lines of enquiry around an analysis of the play's patterns of non-identical repetition and, following Hubert's theory of ‘double movement’, will move beyond these to consider the generative and potentially transcendent nature of the interplay of inscription (text) and transcription (interpretive performance). A subversive strategy of elusion underpins this interference, a dynamic, mobile frame within which ‘envidia’ (‘celos’) functions as a prominent dramatic catalyst, directed outwards, and mobilized both as a potent catalyst for the female dramatist's artistic creativity and as an antagonistic interrogation of broader socio-cultural forms of inequality. The play's (new) marvellous versions and inversions expand the functions of the sign beyond Renaissance resemblance and repetition, challenging its promotion of unity and stable identity, and opening up an interactive space between the represented (world/product) and the representing (stage/process). The power of authorities, as figured in/through the dramatic and rhetorical devices of the play, is self-consciously precarious, but it is this very anxious articulation that challenges the very authority of power.

Asynchrony in key Holocene chronologies: Evidence from Irish bog pines

The Greenland Ice Core Chronology 2005 (GICC05) and the radiocarbon calibration curve (IntCal) are the foremost time scales used in paleoclimatic and paleoenvironmental studies of the most recent 10 k.y. Due to varying and often insufficient dating resolution, opportunities to test the synchrony of these two influential chronologies are rare. Here we present evidence for a phase of major pine recruitment on Irish bogs at ca. 8160 yr B.P. Dendrochronological dating of subfossil trees from three sites reveals synchronicity in germination across the study area, indicative of a regional forcing. The concurrent colonization of pine on peatland is interpreted in terms of drier surface conditions and provides the first substantive proxy data in support of a significant hydroclimatic change in the north of Ireland accompanying the 8.2 ka climate cooling event. The date of pine establishment does not overlap with the GICC05 age range for the event, and possible lags between responses are unlikely to explain the full difference. In light of recent studies highlighting a possible offset in GICC05 and IntCal dates, the Irish pine record supports the notion of ice core dates being too early during the period of study. If the suggested discrepancy in timing is an artifact of chronological error, it is likely to have affected interpretations of previous proxy comparisons and alignments.