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Association of Urine Haptoglobin With Risk of All-Cause and Cause-Specific Mortality in Individuals With Type 2 Diabetes: A Transethnic Collaborative Work

OBJECTIVE

Haptoglobin is an acute-phase reactant with pleiotropic functions. We aimed to study whether urine haptoglobin may predict risk of mortality in people with type 2 diabetes.

RESEARCH DESIGN AND METHODS

We employed a transethnic approach with a cohort of Asian origin (Singapore) (N = 2,061) and a cohort of European origin (France) (N = 1,438) included in the study. We used survival analyses to study the association of urine haptoglobin with risk of all-cause and cause-specific mortality.

RESULTS

A total of 365 and 525 deaths were registered in the Singapore cohort (median follow-up 7.5 years [interquartile range 3.5–12.8]) and French SURDIAGENE cohort (median follow-up 6.8 years [interquartile range 4.3–10.5], respectively. Singapore participants with urine haptoglobin in quartiles 2 to 4 had higher risk for all-cause mortality compared with quartile 1 (unadjusted hazard ratio [HR] 1.47 [95% CI 1.02–2.11], 2.28 [1.62–3.21], and 4.64 [3.39–6.35], respectively). The association remained significant in quartile 4 after multiple adjustments (1.68 [1.15–2.45]). Similarly, participants in the French cohort with haptoglobin in quartile 4 had significantly higher hazards for all-cause mortality compared with quartile 1 (unadjusted HR 2.67 [2.09–3.42] and adjusted HR 1.49 [1.14–1.96]). In both cohorts, participants in quartile 4 had a higher risk of mortality attributable to cardiovascular disease and infection but not malignant tumor.

CONCLUSIONS

Urine haptoglobin predicts risk of mortality independent of traditional risk factors, suggesting that it may potentially be a novel biomarker for risk of mortality in patients with type 2 diabetes.




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Free ADA webinar offers education on how to receive electronic funds transfer payments

Dentists who have had a dental plan payment check lost in the mail could consider a way to receive safe and secure payment through electronic funds transfer payments.




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Dental plan transparency continues to drive advocacy efforts

A new California law is requiring dental benefit companies to be more transparent about the leasing of dental networks, making California the 20th state to pass or amend such legislation.




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ADA Practice Transitions offering promotional trial for dentists who sign up through March 1

ADA Practice Transitions, a service offered by the ADA focused on helping dentists make the process of joining or leaving a practice successful, is offering a free three-month trial.




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ADA releases interim guidance on minimizing COVID-19 transmission risk when treating dental emergencies

The American Dental Association has released interim guidance for dentists on how to minimize the risk of COVID-19 transmission before, during and after treating dental emergencies.




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ADA leadership answers members’ questions about minimizing risk of COVID-19 transmission

A panel of ADA experts answered members’ questions in a video released April 8 regarding the Association’s interim guidance for minimizing the risk of COVID-19 transmission while performing emergency and urgent dental care.




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BP to be more transparent about climate efforts amid investor concerns

BP on Friday announced plans to increase disclosure on its efforts to fight climate change after requests from two groups of investors.




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Long-term Metabolic and Socioeducational Outcomes of Transient Neonatal Diabetes: A Longitudinal and Cross-sectional Study

OBJECTIVE

Transient neonatal diabetes mellitus (TNDM) occurs during the 1st year of life and remits during childhood. We investigated glucose metabolism and socioeducational outcomes in adults.

RESEARCH DESIGN AND METHODS

We included 27 participants with a history of TNDM currently with (n = 24) or without (n = 3) relapse of diabetes, and 16 non-TNDM relatives known to be carriers of causal genetic defects and currently with (n = 9) or without (n = 7) diabetes. Insulin sensitivity and secretion were assessed by hyperinsulinemic-euglycemic clamp and arginine-stimulation testing in a subset of 8 TNDM participants and 7 relatives carrying genetic abnormalities, with and without diabetes, compared with 17 unrelated control subjects without diabetes.

RESULTS

In TNDM participants, age at relapse correlated positively with age at puberty (P = 0.019). The mean insulin secretion rate and acute insulin response to arginine were significantly lower in TNDM and relatives of participants with diabetes than in control subjects (4.7 [3.6–5.9] vs. 13.4 [11.8–16.1] pmol/kg/min, P < 0.0001; and 84.4 [33.0–178.8] vs. 399.6 [222.9–514.9] µIU/mL, P = 0.0011), but were not different between participants without diabetes (12.7 [10.4–14.3] pmol/kg/min and 396.3 [303.3–559.3] µIU/mL, respectively) and control subjects. Socioeducational attainment was lower in TNDM participants than in the general population, regardless of diabetes duration.

CONCLUSIONS

Relapse of diabetes occurred earlier in TNDM participants compared with relatives and was associated with puberty. Both groups had decreased educational attainment, and those with diabetes had lower insulin secretion capacity; however, there was no difference in insulin resistance in adulthood. These forms of diabetes should be included in maturity-onset diabetes of the young testing panels, and relatives of TNDM patients should be screened for underlying defects, as they may be treated with drugs other than insulin.




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Using the BRAVO Risk Engine to Predict Cardiovascular Outcomes in Clinical Trials With Sodium-Glucose Transporter 2 Inhibitors

OBJECTIVE

This study evaluated the ability of the Building, Relating, Assessing, and Validating Outcomes (BRAVO) risk engine to accurately project cardiovascular outcomes in three major clinical trials—BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), Canagliflozin Cardiovascular Assessment Study (CANVAS), and Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction (DECLARE-TIMI 58) trial—on sodium–glucose cotransporter 2 inhibitors (SGLT2is) to treat patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Baseline data from the publications of the three trials were obtained and entered into the BRAVO model to predict cardiovascular outcomes. Projected benefits of reducing risk factors of interest (A1C, systolic blood pressure [SBP], LDL, or BMI) on cardiovascular events were evaluated, and simulated outcomes were compared with those observed in each trial.

RESULTS

BRAVO achieved the best prediction accuracy when simulating outcomes of the CANVAS and DECLARE-TIMI 58 trials. For the EMPA-REG OUTCOME trial, a mild bias was observed (~20%) in the prediction of mortality and angina. The effect of risk reduction on outcomes in treatment versus placebo groups predicted by the BRAVO model strongly correlated with the observed effect of risk reduction on the trial outcomes as published. Finally, the BRAVO engine revealed that most of the clinical benefits associated with SGLT2i treatment are through A1C control, although reductions in SBP and BMI explain a proportion of the observed decline in cardiovascular events.

CONCLUSIONS

The BRAVO risk engine was effective in predicting the benefits of SGLT2is on cardiovascular health through improvements in commonly measured risk factors, including A1C, SBP, and BMI. Since these benefits are individually small, the use of the complex, dynamic BRAVO model is ideal to explain the cardiovascular outcome trial results.




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Africa Deepens its Approach to Migration Governance, But Are Policies Translating to Action?

While migration once was a lower-priority topic for African governments, the last decade has seen a deepening in governance. Policymakers have integrated migration into their national development strategies and mainstreamed it across policy domains such as health and education. The actions are promising on paper, yet questions remain about the extent to which they will translate to more effective migration management.




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Curbing the Influence of &quot;Bad Actors&quot; in International Migration (Transatlantic Council Statement)

This Transatlantic Council on Migration Statement assesses the continuum of policies needed to disrupt illegal migration-related activities and addresses the conditions that make them possible. It examines the role of migration "bad actors"—human traffickers and unscrupulous employers, among them—who operate and profit in this environment, and considers how governments can deploy resources to discourage their actions.




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[ Religion & Spirituality ] Open Question : Christians, why do some people keep lying by saying trans been using other Gender's room for long time but that lie?

i even got this from pro trans page that say they have laws banning men from women's room & trans aka GD was put into mad house, & even then there been alot of time where rapists &perverted freaks been using other Gender's bath room too doesn't make it right, they go to prison if they find out




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Equipping Immigrant Selection Systems for a Changing World of Work (Transatlantic Council Statement)

As technological developments—from automation to artificial intelligence and machine learning—reshape the world of work, governments face the challenge of updating how they attract, select, and retain economic-stream immigrants. This report, concluding a series on building migration systems for a new age of economic competitiveness, lays out the key considerations for "future-proofing" immigrant selection systems.




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The Role of Think Tanks in Times of (Migration) Crisis: A Transatlantic Perspective

As European policymakers and publics continue to grapple with the migration crisis, this conversation offers an opportunity to reflect on the role and responsibility of experts in these politically sensitive debates.




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Beyond Transactional Deals: Building Lasting Migration Partnerships in the Mediterranean

Since the 2015–16 refugee crisis, European policymakers have eagerly sought cooperation with origin and transit countries in the hopes of stemming unauthorized migration to Europe. This approach is neither new, nor without its limitations. By examining the evolution of two longstanding Mediterranean partnerships—between Spain and Morocco, and Italy and Tunisia—this report offers insights on what has and has not worked.




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MPI’s Transatlantic Council on Migration Launches Research Series on Lasting Effects of Mixed Migration Flows

First report examines Canadian challenges & solutions in housing Syrian refugees

WASHINGTON — Four years after the peak of the 2015–16 migration and refugee crisis in Europe and amid swelling arrivals at the U.S.-Mexico border and elsewhere, new evidence sheds light on how well countries have responded to an unprecedented surge in mixed flows of humanitarian, economic and family migrants.




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Rebuilding Community after Crisis: Striking a New Social Contract for Diverse Societies (Transatlantic Council Statement)

Addressing the deep-rooted integration challenges unearthed by large-scale migration and rapid social change will require a combination of strategies. Governments in Europe and North America must create a new social contract for increasingly diverse societies that are confronting cycles of disruption. This report sketches a blueprint for an adaptive process oriented by skill needs rather than national origins.




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Autologous Umbilical Cord Blood Transfusion in Young Children With Type 1 Diabetes Fails to Preserve C-Peptide

OBJECTIVE

We conducted an open-label, phase I study using autologous umbilical cord blood (UCB) infusion to ameliorate type 1 diabetes (T1D). Having previously reported on the first 15 patients reaching 1 year of follow-up, herein we report on the complete cohort after 2 years of follow-up.

RESEARCH DESIGN AND METHODS

A total of 24 T1D patients (median age 5.1 years) received a single intravenous infusion of autologous UCB cells and underwent metabolic and immunologic assessments.

RESULTS

No infusion-related adverse events were observed. β-Cell function declined after UCB infusion. Area under the curve C-peptide was 24.3% of baseline 1 year postinfusion (P < 0.001) and 2% of baseline 2 years after infusion (P < 0.001). Flow cytometry revealed increased regulatory T cells (Tregs) (P = 0.04) and naive Tregs (P = 0.001) 6 and 9 months after infusion, respectively.

CONCLUSIONS

Autologous UCB infusion in children with T1D is safe and induces changes in Treg frequency but fails to preserve C-peptide.




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The Digital Transformation Playbook: Rethink Your Business for the Digital Age

Every business begun before the Internet now faces the same challenge: How to transform to compete in a digital economy? This is the leadership challenge examined by BRITE founder and Columbia Business School faculty member David Rogers in his newest book, The Digital Transformation Playbook (April 5, 2016; Columbia Business School Publishing). In the book, […]




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Algorhythms for Marketing Transformation

We all understand that digital media, data, and analytics are driving transformations in society and business. Most marketers are now armed with case studies of what can be done differently, but many are still challenged with how to truly develop new ideas and execute new strategies to grow their business. Mitch Joel, President of Mirum […]




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Health Care Transition in Adolescents and Young Adults With Diabetes

Michael E. Bowen
Jun 1, 2010; 28:99-106
Feature Articles






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I’m a Cisgender Woman and My Husband Watches Trans Porn: Does That Mean He’s Not Into Me?

A reader submitted the following question: “I recently discovered that my husband is attracted to transsexuals (MTF - non op). This is the only type of porn that he looks at. He also role plays online with men for sexual play and chat. I discovered this after I started snooping because I had some red flags. He is very embarrassed and uncomfortable discussing it. He has apologized for the online chatting (as we had agreed this was out of bounds for our relationship). He says he likes them because they are feminine but his primary attraction is to women (with female parts). However, I just am not sure I believe him. I am terrified that when we are intimate (which I have to pretty much beg for), he can only do it when its dark and I am fearful he is fantasizing that I have a penis. This bothers me deeply on a number of different levels. Are there men who are only interested in transsexuals? Is it possible he is no longer turned on by my female genitalia?” There’s a lot to unpack in this question, but let’s start here: over the years, I’ve received several emails from women describing similar stories and concerns, so you’re not alone in feeling the way that you do.



  • Sex Question Friday
  • Sexual Problems and Solutions

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5 Common Myths About Sexually Transmitted Infections

April is STD Awareness Month, so let’s take a little time to set the record straight on some popular myths about sexually transmitted infections and diseases. In this post, we’ll explore five of the most common misconceptions.




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How repaying loans with social service transforms communities | Angie Murimirwa

What if you could repay loans through volunteering and mentorship instead of money? Activist Angie Murimirwa shares how a game-changing economic tool known as "social interest" is reinvigorating sub-Saharan communities once trapped in cycles of poverty. Join her as she explains how this approach to lending is creating opportunities for thousands of African women and girls -- and shows why this model can be replicated anywhere with lasting effects.




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Groups seek injunction to stop Idaho transgender sports ban




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New York Leap-Frogs ESSA With Its Own Financial Transparency Rule

New York will require some districts next year to have their school-by-school spending amounts approved by the state, an effort to assure that state funds are being distributed as intended.




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Groups seek injunction to stop Idaho transgender sports ban




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Connecticut Provides Resources to Ease Transition to Kindergarten

These tools encourage school administrators to gather as much information as possible about the students who will be entering kindergarten and the early-learning offerings in their communities.




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Trump Administration Weighs In On Lawsuit Against State's Transgender-Athlete Policy

The Trump administration weighed into a lawsuit, arguing that a state's transgender-athlete policy forces "biological girls to compete against biological boys who publicly identify with the female gender and want to compete on sex-specific athletic teams."




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Federal Appeals Court Upholds Oregon District's Pro-Transgender 'Safety Plan'

A federal appeals court rejected a multi-pronged challenge to a school district plan allowing transgender students to use restrooms and other facilities that match their gender identity.




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Transfer wide receivers bolster Sam Houston State

Sam Houston State has announced the addition of two transfer wide receivers, former Howard standout Jequez Ezzard and Harvard grad transfer Cody Chrest, for their final seasons of eligibility this year. The 5-foot-9, 190-pound Ezzard, from College Park, Georgia, gives the Southland Conference program one of the top big-play pass catchers in the FCS. The 6-foot, 190-pound Chrest, from Houston, broke out last season with 45 receptions and 706 receiving yards, Harvard's team highs.




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Transition Update: Washington

DeVos slammed for remarks on HBCU's, a new Senate measure could overturn Obama-era ESSA rules on accountability, and more.




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Restorative justice : an adjunct to the current punitive justice system / presented by Leigh Garrett, CEO OARS Community Transitions, including the Centre for Restorative Justice.




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Forum 2019 : 4A Transform your business culture with a 'meta' skill... : one that improves all other skills : slides / presented by Tomas Jajesnica, Mr Meditate.




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What Would Love Do? : Parenting a child through the first year of gender transition.




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Award of funding under the Regional Jobs and Investment Packages : Department of infrastructure, Transport, Cities and Regional Development, Department of Industry, Inovation and Science / The Auditor General.

"The objective of the audit was to assess whether the award of funding under the RJIP program was informed by appropriate departmental advice and that processes complied with the grants administration framework."--Page 8.




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National transport regulatory reform : Productivity Commission draft report / Australian Government Productivity Commission.

The Productivity Commission is to investigate the long-run economic impacts of transport regulatory reforms agreed by COAG in 2008-09 relating to heavy vehicle safety and productivity, rail safety and maritime safety and to make recommendations for further reforms towards a more integrated national market for transport services.




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Regional recycling transport assistance package : program guidelines / prepared by: Waste Avoidance and Recovery Programs, Office of Resource Recovery, Department of Environment and Science.

The Regional Recycling Transport Assistance Package provides funding to support resource recovery and recycling in regional Queensland, helping fund the costs of transporting recyclable material from regional Queensland to facilities where it can be recovered or processed and turned into new products. Details regarding eligible applicants, projects and costs are provided in these guidelines.




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Transition to Work Interim Evaluation Report.




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Data cities : how satellites are transforming architecture and design / Davina Jackson.

City planning -- Remote sensing.




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Science and religion : an impossible dialogue / Yves Gingras ; translated by Peter Keating.

Religion and science -- History.




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In the closet of The Vatican : power, homosexuality, hypocrisy / Frédéric Martel ; translated by Shaun Whiteside.

Catholic Church -- Clergy -- Sexual behavior.




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Biodiversity and climate change : transforming the biosphere / edited by Thomas E. Lovejoy & Lee Hannah ; foreword by Edward O. Wilson.

Biodiversity -- Climatic factors.




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Transcribing oral history / Teresa Bergen.

Oral history -- Methodology.




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Celestial bodies = Sayyidat al-qamar / Jokha Alharti ; translated by Marilyn Booth.

Sisters -- Fiction.




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First, they erased our name : a Rohingya speaks / Habiburahman with Sophie Ansel ; translated by Andrea Reece.

Habiburahman, 1979-




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Indiana Using Data to Build Better Transcripts, College Transitions

Indiana's efforts to give students more control over their academic transcripts may prove a boon for researchers and school reformers, too.




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A description of the arteries of the human body. Reduced to tables / by Adolphus Murray ; Translated from the original by Archd. Scott.

Edinburgh : And Bell and Bradfute, and E. Balfour, 1801.