Notes

Transformed hypothalamic Genetic make-up methylation along with stress-induced hyperactivity following formative years stress.
11-fold higher in women with prior GDM (95% confidence interval 1.16-3.85, P=0.014). Overweight/obesity, metabolic syndrome, prediabetes and homeostasis model of assessment of insulin resistance (a measure of insulin resistance) were positively associated with NAFLD, whereas the Matsuda index (a measure of insulin sensitivity) showed a negative association with NAFLD.

The prevalence of NAFLD is high in women with prior GDM. Such women also have a high burden of cardiometabolic risk factors. Future studies should evaluate the intermediate and long-term hepatic and cardiovascular risk, and the impact of lifestyle interventions in reducing morbidity in such women.
The prevalence of NAFLD is high in women with prior GDM. Such women also have a high burden of cardiometabolic risk factors. Future studies should evaluate the intermediate and long-term hepatic and cardiovascular risk, and the impact of lifestyle interventions in reducing morbidity in such women.
According to current guidelines, patients with aneurysmal subarachnoid haemorrhage (aSAH) are mostly managed in intensive care units (ICUs) regardless of baseline severity. We aimed to assess the prognostic and economic implications of initial admission of patients with low-grade aSAH into a stroke unit (SU) compared to initial ICU admission.

We reviewed prospectively registered data from consecutive aSAH patients with a World Federation of Neurosurgery Societies grade <3, admitted to our Comprehensive Stroke Centre between April 2013 and September 2018. Clinical and radiological baseline traits, in-hospital complications, length of stay (LOS) and poor outcome at 90days (modified Rankin Scale score >2) were compared between the ICU and SU groups in the whole population and in a propensity-score-matched cohort.

Of 131 patients, 74 (56%) were initially admitted to the ICU and 57 (44%) to the SU. In-hospital complication rates were similar in the ICU and SU groups and included rebleeding (10% vs. 7%; P=0.757), angiographic vasospasm (61% vs. 60%; P=0.893), delayed cerebral ischaemia (12% vs. 12%; P=0.984), pneumonia (6% vs. 4%; P=0.697) and death (10% vs. 5%; P=0.512). LOS did not differ between groups (median [interquartile range] 22 [16-30] vs. 19 [14-26] days; P=0.160). In adjusted multivariate models, the location of initial admission was not associated with long-term poor outcome either in the whole population (odds ratio [OR]1.16, 95% confidence interval [CI] 0.32-4.19; P=0.825) or in the matched cohort (OR 0.98, 95% CI 0.24-4.06; P=0.974).

A dedicated SU, with care from a multidisciplinary team, might be an optimal alternative to ICU for initial admission of patients with low-risk aSAH.
A dedicated SU, with care from a multidisciplinary team, might be an optimal alternative to ICU for initial admission of patients with low-risk aSAH.We assessed the burden of nonalcoholic fatty liver disease (NAFLD) related acute on chronic liver failure (ACLF) among transplant candidates in the United States (US), along with waitlist outcomes for this population. We analyzed the United Network for Organ Sharing (UNOS) registry from 2005-2017. Patients with ACLF were identified using the EASL-CLIF criteria and categorized into NAFLD, alcoholic liver disease (ALD), and hepatitis C virus (HCV) infection. We used linear regression and Chow's test to determine significance in trends and evaluated waitlist outcomes using Fine and Gray's competing risks regression and Cox proportional hazards regression. Between 2005 and 2017, waitlist registrants for NAFLD-ACLF rose by 331.6% from 134 to 574 candidates (p less then 0.001), representing the largest percentage increase in the study population. ALD-ACLF also increased by 206.3% (348 to 1,066 registrants, p less then 0.001), while HCV-ACLF declined by 45.2% (p less then 0.001). As of 2017, the NAFLD-ACLF population consisted primarily of individuals age 60 or older (54.1%), and linear regression demonstrated a significant rise in the proportion of patients age ≥ 65 in this group (β=0.90, p=0.011). Since 2014, NAFLD-ACLF grade 1 was associated with a greater risk of waitlist mortality relative to ALD-ACLF (SHR=1.24, 95% CI 1.05-1.44) and HCV-ACLF (SHR=1.35, 95% CI 1.08-1.71), among patients ≥ 60 years old. Mortality was similar among the three groups for patients with ACLF grade 2 or 3. click here CONCLUSION NAFLD is the fastest rising etiology of cirrhosis associated with ACLF among patients listed in the US. As the NAFLD population continues to grow and age, patients with NAFLD-ACLF will likely have the highest risk of waitlist mortality.Despite being widely used, habitat selection models are rarely reliable and informative when applied across different ecosystems or over time. One possible explanation is that habitat selection is context-dependent due to variation in consumer density and/or resource availability. The goal of this paper is to provide a general theoretical perspective on the contributory mechanisms of consumer and resource density-dependent habitat selection, as well as on our capacity to account for their effects. Towards this goal we revisit the ideal free distribution (IFD), where consumers are assumed to be omniscient, equally competitive and freely moving, and are hence expected to instantaneously distribute themselves across a heterogeneous landscape such that fitness is equalised across the population. Although these assumptions are clearly unrealistic to some degree, the simplicity of the structure in IFD provides a useful theoretical vantage point to help clarify our understanding of more complex spatial processes. Of equal importance, IFD assumptions are compatible with the assumptions underlying common habitat selection models. Here we show how a fitness-maximising space use model, based on IFD, gives rise to resource and consumer density-dependent shifts in consumer distribution, providing a mechanistic explanation for the context-dependent outcomes often reported in habitat selection analysis. Our model suggests that adaptive shifts in consumer distribution patterns would be expected to lead to nonlinear and often non-monotonic patterns of habitat selection. These results indicate that even under the simplest of assumptions about adaptive organismal behaviour, habitat selection strength should critically depend on system-wide characteristics. Clarifying the impact of adaptive behavioural responses may be pivotal in making meaningful ecological inferences about observed patterns of habitat selection and allow reliable transferability of habitat selection predictions across time and space.
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