There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p < 0.001), and a lower rate of readmission due to recurrent AP episodes (p = 0.005). There was no difference in median discharge CRP level among the international cohorts (p = 0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (n = 35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients' care.
- MeSH
- akutní nemoc MeSH
- hospitalizace MeSH
- kohortové studie MeSH
- lidé MeSH
- pankreatitida * terapie MeSH
- propuštění pacienta * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Wood formation consumes around 15% of the anthropogenic CO2 emissions per year and plays a critical role in long-term sequestration of carbon on Earth. However, the exogenous factors driving wood formation onset and the underlying cellular mechanisms are still poorly understood and quantified, and this hampers an effective assessment of terrestrial forest productivity and carbon budget under global warming. Here, we used an extensive collection of unique datasets of weekly xylem tissue formation (wood formation) from 21 coniferous species across the Northern Hemisphere (latitudes 23 to 67°N) to present a quantitative demonstration that the onset of wood formation in Northern Hemisphere conifers is primarily driven by photoperiod and mean annual temperature (MAT), and only secondarily by spring forcing, winter chilling, and moisture availability. Photoperiod interacts with MAT and plays the dominant role in regulating the onset of secondary meristem growth, contrary to its as-yet-unquantified role in affecting the springtime phenology of primary meristems. The unique relationships between exogenous factors and wood formation could help to predict how forest ecosystems respond and adapt to climate warming and could provide a better understanding of the feedback occurring between vegetation and climate that is mediated by phenology. Our study quantifies the role of major environmental drivers for incorporation into state-of-the-art Earth system models (ESMs), thereby providing an improved assessment of long-term and high-resolution observations of biogeochemical cycles across terrestrial biomes.
- MeSH
- biologické modely MeSH
- cévnaté rostliny genetika růst a vývoj MeSH
- dřevo růst a vývoj MeSH
- ekosystém MeSH
- fotoperioda MeSH
- globální oteplování MeSH
- klimatické změny MeSH
- lesy MeSH
- podnebí MeSH
- roční období MeSH
- stromy růst a vývoj MeSH
- teplota MeSH
- xylém růst a vývoj MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
Elevated serum urate levels cause gout and correlate with cardiometabolic diseases via poorly understood mechanisms. We performed a trans-ancestry genome-wide association study of serum urate in 457,690 individuals, identifying 183 loci (147 previously unknown) that improve the prediction of gout in an independent cohort of 334,880 individuals. Serum urate showed significant genetic correlations with many cardiometabolic traits, with genetic causality analyses supporting a substantial role for pleiotropy. Enrichment analysis, fine-mapping of urate-associated loci and colocalization with gene expression in 47 tissues implicated the kidney and liver as the main target organs and prioritized potentially causal genes and variants, including the transcriptional master regulators in the liver and kidney, HNF1A and HNF4A. Experimental validation showed that HNF4A transactivated the promoter of ABCG2, encoding a major urate transporter, in kidney cells, and that HNF4A p.Thr139Ile is a functional variant. Transcriptional coregulation within and across organs may be a general mechanism underlying the observed pleiotropy between urate and cardiometabolic traits.
- MeSH
- ABC transportér z rodiny G, člen 2 genetika MeSH
- celogenomová asociační studie MeSH
- dna (nemoc) krev epidemiologie genetika MeSH
- genetická predispozice k nemoci MeSH
- genetické lokusy MeSH
- genetické markery * MeSH
- hepatocytární jaderný faktor 1-alfa genetika MeSH
- hepatocytární jaderný faktor 4 genetika MeSH
- játra metabolismus patologie MeSH
- jednonukleotidový polymorfismus * MeSH
- kardiovaskulární nemoci krev epidemiologie genetika MeSH
- kohortové studie MeSH
- kyselina močová krev MeSH
- ledviny metabolismus patologie MeSH
- lidé MeSH
- metabolické nemoci krev epidemiologie genetika MeSH
- nádorové proteiny genetika MeSH
- orgánová specificita MeSH
- signální transdukce * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Global warming is expected to increase the frequency and intensity of severe water scarcity (SWS) events, which negatively affect rain-fed crops such as wheat, a key source of calories and protein for humans. Here, we develop a method to simultaneously quantify SWS over the world's entire wheat-growing area and calculate the probabilities of multiple/sequential SWS events for baseline and future climates. Our projections show that, without climate change mitigation (representative concentration pathway 8.5), up to 60% of the current wheat-growing area will face simultaneous SWS events by the end of this century, compared to 15% today. Climate change stabilization in line with the Paris Agreement would substantially reduce the negative effects, but they would still double between 2041 and 2070 compared to current conditions. Future assessments of production shocks in food security should explicitly include the risk of severe, prolonged, and near-simultaneous droughts across key world wheat-producing areas.
Chronic kidney disease (CKD) is responsible for a public health burden with multi-systemic complications. Through trans-ancestry meta-analysis of genome-wide association studies of estimated glomerular filtration rate (eGFR) and independent replication (n = 1,046,070), we identified 264 associated loci (166 new). Of these, 147 were likely to be relevant for kidney function on the basis of associations with the alternative kidney function marker blood urea nitrogen (n = 416,178). Pathway and enrichment analyses, including mouse models with renal phenotypes, support the kidney as the main target organ. A genetic risk score for lower eGFR was associated with clinically diagnosed CKD in 452,264 independent individuals. Colocalization analyses of associations with eGFR among 783,978 European-ancestry individuals and gene expression across 46 human tissues, including tubulo-interstitial and glomerular kidney compartments, identified 17 genes differentially expressed in kidney. Fine-mapping highlighted missense driver variants in 11 genes and kidney-specific regulatory variants. These results provide a comprehensive priority list of molecular targets for translational research.
- MeSH
- běloši MeSH
- celogenomová asociační studie MeSH
- chronická renální insuficience genetika patofyziologie moč MeSH
- fenotyp MeSH
- genetická predispozice k nemoci * MeSH
- genetické asociační studie metody MeSH
- hodnoty glomerulární filtrace MeSH
- jednonukleotidový polymorfismus MeSH
- kvantitativní znak dědičný * MeSH
- lidé MeSH
- lokus kvantitativního znaku * MeSH
- mapování chromozomů MeSH
- typy dědičnosti MeSH
- uromodulin moč MeSH
- vyšetření funkce ledvin MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
