Type 2 diabetes from pediatric to geriatric age: analysis of gender and obesity among 120,183 patients from the German/Austrian DPV database

AIM

To characterize the clinical phenotype of type 2 diabetes mellitus (T2DM) with respect to age, gender, and BMI.

METHOD

Anonymized data of 120,183 people with T2DM from the German/Austrian multicenter Diabetes Patienten Verlaufsdokumentation database were analyzed based on chronological age or age at diagnosis (0-19, 20-39, 40-59, 60-79, and ≥80 years). Age, gender, and BMI comparisons with clinical phenotype were made using χ(2) and Kruskal-Wallis tests (SAS V9.2).

RESULTS

Of all the patients, 51.3% were male, average age was 67.112.7 years, and average disease duration was 9.99.1 years. More girls than boys were diagnosed during adolescence and more men than women during adulthood (2060 years). No gender differences existed when age at diagnosis was 60 years. Patients were obese on average (BMI: 30.5±6.1 kg/m(2)) and had significantly higher BMI values than German population peers. The BMI gap was widest in the younger age categories and closed with increasing age. Adult women were significantly more obese than men. Obese patients more often had elevated HbA1c (≥7.5%), hypertension or dyslipidemia (irrespective of age), microalbuminuria (adults), or retinopathy (elderly) than nonobese patients. More men than women (20-60 years) had hypertension, dyslipidemia, or microalbuminuria while more women than men (≥60 years) had hypertension or dyslipidemia.

CONCLUSION

During puberty, more girls than boys were diagnosed with T2DM while during adulthood males predominated. T2DM manifested at comparatively lower BMI in males, and younger patients were more obese at diagnosis. Age, gender, and BMI were also associated with poor metabolic control and cardiovascular disease comorbidities/complications.

Association of childhood type 1 diabetes mellitus with a variant of PAX4: possible link to beta cell regenerative capacity

AIMS/HYPOTHESIS

Loss of pancreatic beta cells is the crucial event in the development of type 1 diabetes. It is the result of an imbalance between autoimmune destruction and insufficient regeneration of islet cells. To study the role of islet cell regeneration in the pathogenesis of type 1 diabetes, we focused on PAX4, a paired homeodomain transcriptional repressor that is involved in islet cell growth.

METHODS

The study included 379 diabetic children and 1,070 controls from two distinct populations, and a cohort of children who had not developed type 1 diabetes, despite the presence of islet cell antibodies. Genomic DNA analysis of PAX4 was carried out via direct sequencing of PCR-amplified fragments and allelic discrimination. We compared the transrepression potential of the PAX4 variants in betaTC3 cells and analysed their influence on beta cell growth.

RESULTS

The type 1 diabetic subjects are different from the normal individuals in terms of the genotype distribution of the A1168C single nucleotide polymorphism in PAX4. The C/C genotype is frequent among type 1 diabetic children (73%) and rare among the control population (32%). Conversely, the A/C genotype is prevalent among control subjects (62%) and antibody-positive children without type 1 diabetes (73.6%), but uncommon among subjects with type 1 diabetes (17.5%). The combination of PAX4A and PAX4C is functionally more active than PAX4C alone (the "diabetic" variant). Beta cells expressing PAX4A and PAX4C efficiently proliferate when stimulated with glucose, whereas cells expressing the PAX4C variant alone do not.

CONCLUSIONS/INTERPRETATION

We have identified a link between beta cell regenerative capacity and susceptibility to type 1 diabetes. This finding could explain the fact that not all of the individuals who develop autoimmunity against beta cells actually contract the disease. The C/C genotype of the A1168C polymorphism in PAX4 can be viewed as a predisposition marker that can help to detect individuals prone to develop type 1 diabetes.

High Estradiol Levels are Associated with Increased Mortality in Older Men Referred to Coronary Angiography

There is evidence showing an important role of estrogens in men’s health. We aimed to evaluate whether estradiol levels are associated with overall mortality and specific fatal events.

We measured estradiol levels in 2 078 men who were routinely referred for coronary angiography (1997–2000).

The main outcome measures were Cox proportional hazard ratios (HRs) for mortality from all causes, from cardiovascular and non-cardiovascular causes including cancer according to estradiol levels.

Multivariable HRs (with 95% confidence intervals) for all-cause, non-cardiovascular, and cancer mortality were 1.43 (1.08–1.91), 2.11 (1.34–3.34), and 2.27 (1.00–5.19), respectively, in the fourth estradiol quartile as compared to the first. There was no significant association of estradiol levels with cardiovascular mortality. In multivariate adjusted analyses, higher estradiol levels in men were significantly associated with prevalent strokes, peripheral vascular disease, and carotid artery stenosis compared to lower estradiol levels.

High levels of estradiol are associated with all-cause and non-cardiovascular mortality in a large cohort of older men referred to coronary angiography. Further studies are warranted to confirm our results and to elucidate the underlying mechanisms.

Histologically validated scoring system for the assessment of hock burn in broilers

The assessment of bird-based welfare indicators plays an important role in the evaluation of bird welfare. The aim of the study was to histologically validate a visual scoring system for hock burn in broilers and to detect threshold values of a visual score to define welfare-relevant alterations in terms of mild lesions or ulcers of the hock. We collected 200 hocks of 39- to 42-day-old Ross 308 broilers after the slaughter process. Each hock was scored visually ("macro scores" 0-4) and evaluated histologically ("micro scores" 0-3), with high scores representing more severe lesions. Although we found a tendency for higher micro scores with increasing macro scores, an exact allocation of macro to micro scores was not possible. For example, macro score 1 could represent micro scores 1, 2 and 3, whereas macro scores 3 and 4 always represented micro score 3 (ulcer). The conditional probability of certain micro scores for given macro scores was estimated using a multinomial logistic regression model. Ulcer showed the highest probability at macro score 1, whereas mild lesions were not found to have an estimated highest probability at any macro score. The depth of inflammation of hock burn lesions increased with increasing macro scores up to macro score 3 with an average depth of 1019 µm. Visually more severe and deeper lesions were also histologically rated with higher scores. Thus, considering limitations, the herein validated macroscopic assessment scheme for hock burn allows an estimation of histological alterations in hocks of broilers.RESEARCH HIGHLIGHTS Histological validation of a visual assessment scheme for hock burn in broilers.Tendency for higher micro scores with increasing macro scores.Estimation of histological score via macro score possible with limitations.Histological depth of inflammation increased with an increasing macro score.

Magnetic damping: domain wall dynamics versus local ferromagnetic resonance

Magnetic relaxation is one of the dominating features of magnetization dynamics. Depending on the magnetic structure and the experimental approach, different magnitudes of the damping parameter are reported even for a given material. In this study, we experimentally address this issue by accessing the damping parameter in the same magnetic nanotracks using different approaches: local ferromagnetic resonance (α=0.0072) and field-driven domain wall dynamics (α=0.023). The experimental results cannot fully be accounted for by modeling only roughness in micromagnetic simulations. Consequently, we have included nonlocal texture induced damping to the micromagnetic code. We find excellent agreement with the observed increased damping in the vortex structures for the same input Gilbert alpha when texture-induced nonlocal damping is included.

No association of the IRS1 and PAX4 genes with type I diabetes

To reassess earlier suggested type I diabetes (T1D) associations of the insulin receptor substrate 1 (IRS1) and the paired domain 4 gene (PAX4) genes, the Type I Diabetes Genetics Consortium (T1DGC) evaluated single-nucleotide polymorphisms (SNPs) covering the two genomic regions. Sixteen SNPs were evaluated for IRS1 and 10 for PAX4. Both genes are biological candidate genes for T1D. Genotyping was performed in 2300 T1D families on both Illumina and Sequenom genotyping platforms. Data quality and concordance between the platforms were assessed for each SNP. Transmission disequilibrium testing neither show T1D association of SNPs in the two genes, nor did haplotype analysis. In conclusion, the earlier suggested associations of IRS1 and PAX4 to T1D were not supported, suggesting that they may have been false positive results. This highlights the importance of thorough quality control, selection of tagging SNPs, more than one genotyping platform in high throughput studies, and sufficient power to draw solid conclusions in genetic studies of human complex diseases.

Validation of histological and visual scoring systems for foot-pad dermatitis in broiler chickens

In this study, an appropriate visual scoring system for foot-pad dermatitis was validated, considering the histologically measured depth of the inflammation zone and the histopathological grade (no lesion, mild lesion, ulcer). The aim being to evaluate whether the visual, macroscopic scoring of foot-pad dermatitis can represent the histological, microscopic findings. Two hundred Ross 308 broiler chicken feet (birds aged 39–42 fattening days) were collected at a slaughterhouse and scored macroscopically according to a modified version of the Welfare Quality® Assessment Protocol for Poultry. Afterwards, 200 histological slides (one per foot) were prepared, the extent of the inflammation measured and all slides scored by veterinarian pathologists using Michel et al's modified scheme. The statistical relationship between microscopic and macroscopic score and depth of inflammation were estimated via regression models. Increasing macroscopic score was found to be linked with an increase in microscopic score and the depth of inflammation. In particular, feet without lesions and feet with ulcers were identifiable using the macroscopic score. Macroscopic scoring of foot-pad dermatitis can mirror histological findings once certain limitations are taken into account (superficial lesions were not clearly identifiable). Foot-pad dermatitis is considered a useful indicator of animal welfare and our findings suggest that visual, macroscopic scoring could be a practicable assessment tool.

Odontogene Tumoren bei Hund und Katze

Gegenstand und Ziel: Odontogene Tumoren kommen bei Hund und Katze, wie auch bei den übrigen Haustierarten und beim Menschen, selten vor und können schwer zu diagnostizieren sein. In der vorliegenden Studie wurde eine größere Anzahl odontogener Tumoren von Hund und Katze histopathologisch untersucht und klassifiziert mit dem Ziel, eine verlässliche Grundlage für die Diagnostik dieser Tumoren zu schaffen. Material und Methoden: In der retrospektiven Studie wurden von 1390 kaninen und 317 felinen oralen Tumoren aus den Jahren 1977 bis 2007 die odontogenen Neoplasien selektiert, histopathologisch charakterisiert und anhand der aktuellen human-und veterinärmedizinischen WHO-(World Health Organization) Klassifikationen odontogener Tumoren (2005 bzw. 2003) eingeteilt. Ergebnisse: 18% (n = 250) der kaninen und 3,2% (n = 10) der felinen oralen Tumoren erwiesen sich als odontogen. Sie ließen sich in benigne (epitheliale, epitheliale und ektomesenchymale sowie ektomesenchymale) und maligne odontogene Tumoren (Karzinome und Sarkome) mit insgesamt 12 Entitäten unterteilen. Sowohl beim Hund wie auch bei der Katze war das odontogene Fibrom der am häufigsten diagnostizierte Tumor (n = 167 bzw. n = 4). An zweiter Stelle folgte beim Hund das Ameloblastom (n = 74), bei der Katze das ameloblastische Fibrom (n = 2). Vier der 12 Entitäten konnten anhand beider, sieben lediglich anhand der human-, zwei lediglich anhand der veterinärmedizinischen WHO-Klassifikation klassifiziert werden. Schlussfolgerung und klinische Relevanz: Die prognostische Bewertung von Tumorerkrankungen ist von größter klinischer Relevanz und setzt eine eindeutige Diagnose voraus. Insbesondere bei seltenen und histomorphologisch komplexen odontogenen Tumoren genügt die aktuelle veterinärmedizinische WHO-Klassifikation diesem Anspruch nicht und bedarf einer Überarbeitung und Erweiterung. Wirkungsvoller im Einsatz erwies sich die humanmedizinische WHO-Klassifikation.

Search for New Phenomena in Two-Body Invariant Mass Distributions Using Unsupervised Machine Learning for Anomaly Detection at sqrt[s]=13 TeV with the ATLAS Detector

Searches for new resonances are performed using an unsupervised anomaly-detection technique. Events with at least one electron or muon are selected from 140  fb^{-1} of pp collisions at sqrt[s]=13  TeV recorded by ATLAS at the Large Hadron Collider. The approach involves training an autoencoder on data, and subsequently defining anomalous regions based on the reconstruction loss of the decoder. Studies focus on nine invariant mass spectra that contain pairs of objects consisting of one light jet or b jet and either one lepton (e,μ), photon, or second light jet or b jet in the anomalous regions. No significant deviations from the background hypotheses are observed. Limits on contributions from generic Gaussian signals with various widths of the resonance mass are obtained for nine invariant masses in the anomalous regions.

Observation of an Excess of Dicharmonium Events in the Four-Muon Final State with the ATLAS Detector

A search is made for potential ccc[over ¯]c[over ¯] tetraquarks decaying into a pair of charmonium states in the four muon final state using proton-proton collision data at sqrt[s]=13  TeV, corresponding to an integrated luminosity of 140  fb^{-1} recorded by the ATLAS experiment at LHC. Two decay channels, J/ψ+J/ψ→4μ and J/ψ+ψ(2S)→4μ, are studied. Backgrounds are estimated based on a hybrid approach involving Monte Carlo simulations and data-driven methods. Statistically significant excesses with respect to backgrounds dominated by the single parton scattering are seen in the di-J/ψ channel consistent with a narrow resonance at 6.9 GeV and a broader structure at lower mass. A statistically significant excess is also seen in the J/ψ+ψ(2S) channel. The fitted masses and decay widths of the structures are reported.

Observation of quantum entanglement with top quarks at the ATLAS detector

Entanglement is a key feature of quantum mechanics1-3, with applications in fields such as metrology, cryptography, quantum information and quantum computation4-8. It has been observed in a wide variety of systems and length scales, ranging from the microscopic9-13 to the macroscopic14-16. However, entanglement remains largely unexplored at the highest accessible energy scales. Here we report the highest-energy observation of entanglement, in top-antitop quark events produced at the Large Hadron Collider, using a proton-proton collision dataset with a centre-of-mass energy of √s = 13 TeV and an integrated luminosity of 140 inverse femtobarns (fb)-1 recorded with the ATLAS experiment. Spin entanglement is detected from the measurement of a single observable D, inferred from the angle between the charged leptons in their parent top- and antitop-quark rest frames. The observable is measured in a narrow interval around the top-antitop quark production threshold, at which the entanglement detection is expected to be significant. It is reported in a fiducial phase space defined with stable particles to minimize the uncertainties that stem from the limitations of the Monte Carlo event generators and the parton shower model in modelling top-quark pair production. The entanglement marker is measured to be D = -0.537 ± 0.002 (stat.) ± 0.019 (syst.) for 340 GeV < m t t ¯ < 380 GeV . The observed result is more than five standard deviations from a scenario without entanglement and hence constitutes the first observation of entanglement in a pair of quarks and the highest-energy observation of entanglement so far.

Technical mishaps as easily avoidable causes of treatment failure when using pumps for pulsatile administration of gonadotropin-releasing hormone

A patient (19 years old) with Kallmann's syndrome was treated with gonadotropin-releasing hormone (2.5-16 micrograms) administered subcutaneously every 2 h using a portable infusion pump. During 42 weeks of treatment testosterone levels and testicular size did not increase sufficiently although no reasons for this insufficient response were detectable. Therefore the regime of controlling and changing the catheter system was intensified. By this means partial occlusions of the catheter were detected and could be corrected. Afterwards testosterone levels increased immediately and persistently to normal values.

Scanning Thermal Microscopy and Ballistic Phonon Transport in Lateral Spin Valves

Using scanning thermal microscopy, we have mapped the spatial distribution of temperatures in an operating nanoscale device formed from a magnetic injector, an Ag connecting wire, and a magnetic detector. An analytical model explained the thermal diffusion over the measured temperature range (2-300 K) and injector-detector separation (400-3000 nm). The characteristic diffusion lengths of the Peltier and Joule heat differ remarkably below 60 K, a fact that can be explained by the onset of ballistic phonon heat transfer in the substrate.

Observation of WZγ Production in pp Collisions at sqrt[s]=13 TeV with the ATLAS Detector

This Letter reports the observation of WZγ production and a measurement of its cross section using 140.1±1.2  fb^{-1} of proton-proton collision data recorded at a center-of-mass energy of 13 TeV by the ATLAS detector at the Large Hadron Collider. The WZγ production cross section, with both the W and Z bosons decaying leptonically, pp→WZγ→ℓ^{'}^{±}νℓ^{+}ℓ^{-}γ (ℓ^{(^{'})}=e, μ), is measured in a fiducial phase-space region defined such that the leptons and the photon have high transverse momentum and the photon is isolated. The cross section is found to be 2.01±0.30(stat)±0.16(syst)  fb. The corresponding standard model predicted cross section calculated at next-to-leading order in perturbative quantum chromodynamics and at leading order in the electroweak coupling constant is 1.50±0.06  fb. The observed significance of the WZγ signal is 6.3σ, compared with an expected significance of 5.0σ.

Observation of tt[over ¯] Production in Pb+Pb Collisions at sqrt[s_{NN}]=5.02 TeV with the ATLAS Detector

Top-quark pair production is observed in lead-lead (Pb+Pb) collisions at sqrt[s_{NN}]=5.02  TeV at the Large Hadron Collider with the ATLAS detector. The data sample was recorded in 2015 and 2018, amounting to an integrated luminosity of 1.9  nb^{-1}. Events with exactly one electron and one muon and at least two jets are selected. Top-quark pair production is measured with an observed (expected) significance of 5.0 (4.1) standard deviations. The measured top-quark pair production cross section is σ_{tt[over ¯]}=3.6 _{-0.9}^{+1.0}(stat) _{-0.5}^{+0.8}(syst)  μb, with a total relative uncertainty of 31%, and is consistent with theoretical predictions using a range of different nuclear parton distribution functions. The observation of this process consolidates the evidence of the existence of all quark flavors in the preequilibrium stage of the quark-gluon plasma at very high energy densities, similar to the conditions present in the early Universe.

Combined Measurement of the Higgs Boson Mass from the H→γγ and H→ZZ^{*}→4ℓ Decay Channels with the ATLAS Detector Using sqrt[s]=7, 8, and 13 TeV pp Collision Data

A measurement of the mass of the Higgs boson combining the H→ZZ^{*}→4ℓ and H→γγ decay channels is presented. The result is based on 140  fb^{-1} of proton-proton collision data collected by the ATLAS detector during LHC run 2 at a center-of-mass energy of 13 TeV combined with the run 1 ATLAS mass measurement, performed at center-of-mass energies of 7 and 8 TeV, yielding a Higgs boson mass of 125.11±0.09(stat)±0.06(syst)=125.11±0.11  GeV. This corresponds to a 0.09% precision achieved on this fundamental parameter of the Standard Model of particle physics.