Genetic modifiers of cognitive maintenance among older adults.

ObjectiveIdentify genetic factors associated with cognitive maintenance in late life and assess their association with gray matter (GM) volume in brain networks affected in aging.MethodsWe conducted a genome-wide association study of ∼2.4 M markers to identify modifiers of cognitive trajectories in Caucasian participants (N = 7,328) from two population-based cohorts of non-demented elderly. Standardized measures of global cognitive function (z-scores) over 10 and 6 years were calculated among participants and mixed model regression was used to determine subject-specific cognitive slopes. "Cognitive maintenance" was defined as a change in slope of ≥ 0 and was compared with all cognitive decliners (slope < 0). In an independent cohort of cognitively normal older Caucasians adults (N = 122), top association findings were then used to create genetic scores to assess whether carrying more cognitive maintenance alleles was associated with greater GM volume in specific brain networks using voxel-based morphometry.ResultsThe most significant association was on chromosome 11 (rs7109806, P = 7.8 × 10(-8)) near RIC3. RIC3 modulates activity of α7 nicotinic acetylcholine receptors, which have been implicated in synaptic plasticity and beta-amyloid binding. In the neuroimaging cohort, carrying more cognitive maintenance alleles was associated with greater volume in the right executive control network (RECN; PFWE  = 0.01).ConclusionsThese findings suggest that there may be genetic loci that promote healthy cognitive aging and that they may do so by conferring robustness to GM in the RECN. Future work is required to validate top candidate genes such as RIC3 for involvement in cognitive maintenance

Land Use Planning and Zoning in Ohio Townships

The study reported here examined the use of zoning for growth management in Ohio townships. Data were obtained from a survey of 252 township officials. The results showed that 59% of townships are using zoning, primarily due to citizen support. Zoned townships are using a variety of zoning techniques to assist in managing land use change and growth. Those townships without zoning cite a lack of growth and citizen interest as reasons for not using zoning

Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

BACKGROUND: Age-related cataract is the opacification of the lens, which occurs as a result of denaturation of lens proteins. Age-related cataract remains the leading cause of blindness globally, except in the most developed countries. A key question is what is the best way of removing the lens, especially in lower income settings. OBJECTIVES: To compare two different techniques of lens removal in cataract surgery: manual small incision surgery (MSICS) and extracapsular cataract extraction (ECCE). SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 8), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to September 2014), EMBASE (January 1980 to September 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to September 2014), Web of Science Conference Proceedings Citation Index- Science (CPCI-S), (January 1990 to September 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 23 September 2014. SELECTION CRITERIA: We included randomised controlled trials (RCTs) only. Participants in the trials were people with age-related cataract. We included trials where MSICS with a posterior chamber intraocular lens (IOL) implant was compared to ECCE with a posterior chamber IOL implant. DATA COLLECTION AND ANALYSIS: Data were collected independently by two authors. We aimed to collect data on presenting visual acuity 6/12 or better and best-corrected visual acuity of less than 6/60 at three months and one year after surgery. Other outcomes included intraoperative complications, long-term complications (one year or more after surgery), quality of life, and cost-effectiveness. There were not enough data available from the included trials to perform a meta-analysis. MAIN RESULTS: Three trials randomly allocating people with age-related cataract to MSICS or ECCE were included in this review (n = 953 participants). Two trials were conducted in India and one in Nepal. Trial methods, such as random allocation and allocation concealment, were not clearly described; in only one trial was an effort made to mask outcome assessors. The three studies reported follow-up six to eight weeks after surgery. In two studies, more participants in the MSICS groups achieved unaided visual acuity of 6/12 or 6/18 or better compared to the ECCE group, but overall not more than 50% of people achieved good functional vision in the two studies. 10/806 (1.2%) of people enrolled in two trials had a poor outcome after surgery (best-corrected vision less than 6/60) with no evidence of difference in risk between the two techniques (risk ratio (RR) 1.58, 95% confidence interval (CI) 0.45 to 5.55). Surgically induced astigmatism was more common with the ECCE procedure than MSICS in the two trials that reported this outcome. In one study there were more intra- and postoperative complications in the MSICS group. One study reported that the costs of the two procedures were similar. AUTHORS' CONCLUSIONS: There are no other studies from other countries other than India and Nepal and there are insufficient data on cost-effectiveness of each procedure. Better evidence is needed before any change may be implemented. Future studies need to have longer-term follow-up and be conducted to minimize biases revealed in this review with a larger sample size to allow examination of adverse events

Vitamin D in obesity

Purpose of review: Vitamin D is essential for bone health, and may also have important functions in immunity and other systems. Vitamin D deficiency is common, and testing and supplementation is increasing. Serum vitamin D is lower in obese people; it is important to understand the mechanism of this effect and whether it indicates clinically significant deficiency. Recent findings: Vitamin D is fat soluble, and distributed into fat, muscle, liver, and serum. All of these compartments are increased in volume in obesity, so the lower vitamin D likely reflects a volumetric dilution effect and whole body stores of vitamin D may be adequate. Despite lower serum vitamin D, obese adults do not have higher bone turnover or lower bone mineral density. Patients undergoing bariatric surgery do have bone loss, and ensuring vitamin D sufficiency in these patients may help to attenuate bone loss. Summary: Lower vitamin D in obese people is a consistent finding across age, ethnicity, and geography. This may not always reflect a clinical problem. Obese people need higher loading doses of vitamin D to achieve the same serum 25-hydroxyvitamin D as normal weight

Planning in the age of Facebook: the role of social networking in planning processes

Abstract There has been rapid growth in the use of online social networking sites, such as Facebook. The public is increasingly using these sites for organizing around place-based issues. This research examines the extent to which the public and planners are using social networking sites to organize the public around place-based planning issues. Using content analysis of social networking sites, place-based planning groups are identified and analyzed. The administrators for the groups were contacted to determine their goals and satisfaction with their groups' work. Planning departments in the same communities were then contacted to determine the degree to which the social networking groups influenced the planning process. The results of this study found that the public primarily organizes to oppose development projects. While on average these groups attract hundreds of people, planners and group administrators report that there is minimal influence on the planning process

Investigating the antigenicity of the lyssavirus glycoprotein

Rabies, the archetypal lyssavirus, is one of the most feared viruses known to man and globally, is the cause of more than 55,000 deaths per year. Alongside rabies virus, numerous related lyssaviruses exist that are also capable of causing fatal disease, clinically indistinguishable from rabies. Whilst the human burden of these non-rabies lyssaviruses remains unknown, fatalities have been reported. The lyssavirus glycoprotein is the sole target for virus neutralising antibodies and several amino acid epitopes have been linked to virus neutralisation. Lyssaviruses are genetically and antigenically categorised into phylogroups that indicate the level of protection afforded by current vaccines. It is generally accepted that an antibody response to the currently available rabies vaccines affords protection against all viruses that are categorised into phylogroup I. However, this antibody response does not protect against lyssavirus species within phylogroups II and III. Indeed, experimental data has shown that the antibody repertoire induced by rabies virus vaccines is unable to neutralise viruses in these phylogroups. In this study we have generated lentivirus pseudotypes representing all currently defined lyssaviruses as well as including chimeric lyssavirus glycoproteins that have had their antigenic sites swapped between phylogroup I and II viruses. Using the wildtype lyssavirus pseudotypes we have confirmed a strong level of intra-phylogroup neutralisation in addition to very limited inter-phylogroup neutralisation. The antigenic site swap constructs have shown an alteration in both glycoprotein functionality alongside altered neutralisation profiles using a variety of vaccine induced and divergent lyssavirus specific sera. Promising cross protective candidates have been cloned into a vaccine strain full length backbone and reverse genetics has enabled rescue of these viruses. The growth kinetics of recombinant viruses have been studied in vitro and an investigation into the pathogenicity and degree of vaccine induced protection against these viruses in vivo has been conducted