Multilevel examination of diabetes in modernising China: what elements of urbanisation are most associated with diabetes?

Aims/hypothesis: The purpose of this study was to examine the association between urbanisation-related factors and diabetes prevalence in China. Methods: Anthropometry, fasting blood glucose (FBG) and community-level data were collected for 7,741 adults (18–90 years) across 217 communities and nine provinces in the 2009 China Health and Nutrition Survey to examine diabetes (FBG ≥7.0 mmol/l or doctor diagnosis). Sex-stratified multilevel models, clustered at the community and province levels and controlling for individual-level age and household income were used to examine the association between diabetes and: (1) a multicomponent urbanisation measure reflecting overall modernisation and (2) 12 separate components of urbanisation (e.g., population density, employment, markets, infrastructure and social factors). Results: Prevalent diabetes was higher in more-urbanised (men 12%; women 9%) vs less-urbanised (men 6%; women 5%) areas. In sex-stratified multilevel models adjusting for residential community and province, age and household income, there was a twofold higher diabetes prevalence in urban vs rural areas (men OR 2.02, 95% CI 1.47, 2.78; women, OR 1.94, 95% CI 1.35, 2.79). All urbanisation components were positively associated with diabetes, with variation across components (e.g. men, economic and income diversity, OR 1.42, 95% CI 1.20, 1.66; women, transportation infrastructure, OR 1.18, 95% CI 1.06, 1.32). Community-level variation in diabetes was comparatively greater for women (intraclass correlation [ICC] 0.03–0.05) vs men (ICC ≤0.01); province-level variation was greater for men (men 0.03–0.04; women 0.02). Conclusions/interpretation: Diabetes prevention and treatment efforts are needed particularly in urbanised areas of China. Community economic factors, modern markets, communications and transportation infrastructure might present opportunities for such efforts. Electronic supplementary material The online version of this article (doi:10.1007/s00125-012-2697-8) contains peer-reviewed but unedited supplementary material, which is available to authorised users

Long-term, treatment-free survival in select patients with distant metastatic papillary thyroid cancer

Well-differentiated thyroid carcinoma (WDTC) generally has a favorable prognosis. However, patients with distant metastatic disease experience progression of disease with a higher mortality. A subset of patients not previously described may challenge the conventional dogma regarding the progressive nature of all metastatic WDTC. Through analysis of our database, we identified patients with distant metastatic WDTC and persistent, minimally progressive disease. In all patients, persistent metastatic disease was confirmed via tissue biopsy, abnormal PET scan, and/or biochemical elevations in thyroglobulin or antibody levels. Progression of disease was monitored clinically and with repeat imaging. We describe five patients with WDTC and pulmonary metastases, aged 8–43 years at diagnosis. All patients underwent initial surgery and radioactive iodine (RAI) ablation, with some receiving multiple treatments. Persistent pulmonary metastatic disease was confirmed over decades (mean 22 years, range 8–42 years) with minimal progression despite no further treatment beyond thyroid hormone suppression. Persistent disease was biopsy-proven in all patients at a mean of 9.6 years from last RAI treatment. All patients had elevated thyroglobulin or anti-thyroglobulin antibody levels, while three demonstrated metabolically active disease with positive FDG uptake on PET scan, and one patient with persistent radioactive iodine avid pulmonary metastasis 36 years after her last RAI treatment. This case series demonstrates that some patients with distant metastases, even if metabolically active and radioactive iodine resistant, remain stable for decades without further treatment. Clinical awareness of such patients and continual reassessment of disease risk following initial therapy are crucial as aggressive treatment may not be necessary

Access to recreational physical activities by car and bus : an assessment of socio-spatial inequalities in mainland Scotland

Obesity and other chronic conditions linked with low levels of physical activity (PA) are associated with deprivation. One reason for this could be that it is more difficult for low-income groups to access recreational PA facilities such as swimming pools and sports centres than high-income groups. In this paper, we explore the distribution of access to PA facilities by car and bus across mainland Scotland by income deprivation at datazone level. GIS car and bus networks were created to determine the number of PA facilities accessible within travel times of 10, 20 and 30 minutes. Multilevel negative binomial regression models were then used to investigate the distribution of the number of accessible facilities, adjusting for datazone population size and local authority. Access to PA facilities by car was significantly (p<0.01) higher for the most affluent quintile of area-based income deprivation than for most other quintiles in small towns and all other quintiles in rural areas. Accessibility by bus was significantly lower for the most affluent quintile than for other quintiles in urban areas and small towns, but not in rural areas. Overall, we found that the most disadvantaged groups were those without access to a car and living in the most affluent areas or in rural areas

Localization of nonlinear excitations in curved waveguides

Motivated by the example of a curved waveguide embedded in a photonic crystal, we examine the effects of geometry in a ``quantum channel'' of parabolic form. We study the linear case and derive exact as well as approximate expressions for the eigenvalues and eigenfunctions of the linear problem. We then proceed to the nonlinear setting and its stationary states in a number of limiting cases that allow for analytical treatment. The results of our analysis are used as initial conditions in direct numerical simulations of the nonlinear problem and localized excitations are found to persist, as well as to have interesting relaxational dynamics. Analogies of the present problem in contexts related to atomic physics and particularly to Bose-Einstein condensation are discussed.Comment: 14 pages, 4 figure

Young star clusters in M31

In our study of M31's globular cluster system with MMT/Hectospec, we have obtained high-quality spectra of 85 clusters with ages less than 1 Gyr. With the exception of Hubble V, the young cluster in NGC 205, we find that these young clusters have kinematics and spatial distribution consistent with membership in M31's young disk. Preliminary estimates of the cluster masses and structural parameters, using spectroscopically derived ages and HST imaging, confirms earlier suggestions that M31 has clusters similar to the LMC's young populous clusters.Comment: 4 pages, 1 figure, contributed talk at "Galaxies in the Local Volume" conference in Sydney, July 200

Fermion Representation Of The Rolling Tachyon Boundary Conformal Field Theory

A free fermion representation of the rolling tachyon boundary conformal field theory is constructed. The representation is used to obtain an explicit, compact, exact expression for the boundary state. We use the boundary state to compute the disc and cylinder amplitudes for the half-S-brane.Comment: 27 page

The Anatomy of Star Formation in NGC 300

The Spitzer Space Telescope was used to study the mid-infrared to far-infrared properties of NGC 300, and to compare dust emission to Halpha to elucidate the heating of the ISM and the star formation cycle at scales < 100 pc. The new data allow us to discern clear differences in the spatial distribution of 8 micron dust emission with respect to 24 micron dust and to HII regions traced by the Halpha light. The 8 micron emission highlights the rims of HII regions, and the 24 micron emission is more strongly peaked in star forming regions than at 8 microns. We confirm the existence and approximate amplitude of interstellar dust emission at 4.5 microns, detected statistically in Infrared Space Observatory (ISO) data, and conclude it arises in star forming regions. When averaging over regions larger than ~ 1 kpc, the ratio of Halpha to Aromatic Feature emission in NGC 300 is consistent with the values observed in disks of spiral galaxies. The mid-to-far-infrared spectral energy distribution of dust emission is generally consistent with pre-Spitzer models.Comment: to appear in the ApJS Spitzer special issue (September 2004

Proximity to Sports Facilities and Sports Participation for Adolescents in Germany

Objectives - To assess the relationship between proximity to specific sports facilities and participation in the corresponding sports activities for adolescents in Germany. Methods - A sample of 1,768 adolescents aged 11–17 years old and living in 161 German communities was examined. Distances to the nearest sports facilities were calculated as an indicator of proximity to sports facilities using Geographic Information Systems (GIS). Participation in specific leisure-time sports activities in sports clubs was assessed using a self-report questionnaire and individual-level socio-demographic variables were derived from a parent questionnaire. Community-level socio-demographics as covariates were selected from the INKAR database, in particular from indicators and maps on land development. Logistic regression analyses were conducted to examine associations between proximity to the nearest sports facilities and participation in the corresponding sports activities. Results - The logisitic regression analyses showed that girls residing longer distances from the nearest gym were less likely to engage in indoor sports activities; a significant interaction between distances to gyms and level of urbanization was identified. Decomposition of the interaction term showed that for adolescent girls living in rural areas participation in indoor sports activities was positively associated with gym proximity. Proximity to tennis courts and indoor pools was not associated with participation in tennis or water sports, respectively. Conclusions - Improved proximity to gyms is likely to be more important for female adolescents living in rural areas

Thyroid Hormone Promotes Postnatal Rat Pancreatic β-Cell Development and Glucose-Responsive Insulin Secretion Through MAFA

Neonatal β cells do not secrete glucose-responsive insulin and are considered immature. We previously showed the transcription factor MAFA is key for the functional maturation of β cells, but the physiological regulators of this process are unknown. Here we show that postnatal rat β cells express thyroid hormone (TH) receptor isoforms and deiodinases in an age-dependent pattern as glucose responsiveness develops. In vivo neonatal triiodothyronine supplementation and TH inhibition, respectively, accelerated and delayed metabolic development. In vitro exposure of immature islets to triiodothyronine enhanced the expression of Mafa, the secretion of glucose-responsive insulin, and the proportion of responsive cells, all of which are effects that were abolished in the presence of dominant-negative Mafa. Using chromatin immunoprecipitation and electrophoretic mobility shift assay, we show that TH has a direct receptor-ligand interaction with the Mafa promoter and, using a luciferase reporter, that this interaction was functional. Thus, TH can be considered a physiological regulator of functional maturation of β cells via its induction of Mafa

Hubble Tarantula Treasury Project. III. Photometric Catalog and Resulting Constraints on the Progression of Star Formation in the 30 Doradus Region

We present and describe the astro-photometric catalog of more than 800,000 sources found in the Hubble Tarantula Treasury Project (HTTP). HTTP is a Hubble Space Telescope (HST) Treasury program designed to image the entire 30 Doradus region down to the sub-solar (~0.5 solar masses) mass regime using the Wide Field Camera 3 (WFC3) and the Advanced Camera for Surveys (ACS). We observed 30 Doradus in the near ultraviolet (F275W, F336W), optical (F555W, F658N, F775W), and near infrared (F110W, F160W) wavelengths. The stellar photometry was measured using point-spread function (PSF) fitting across all the bands simultaneously. The relative astrometric accuracy of the catalog is 0.4 mas. The astro-photometric catalog, results from artificial star experiments and the mosaics for all the filters are available for download. Color-magnitude diagrams are presented showing the spatial distributions and ages of stars within 30 Dor as well as in the surrounding fields. HTTP provides the first rich and statistically significant sample of intermediate and low mass pre-main sequence candidates and allows us to trace how star formation has been developing through the region. The depth and high spatial resolution of our analysis highlight the dual role of stellar feedback in quenching and triggering star formation on the giant HII region scale. Our results are consistent with stellar sub-clustering in a partially filled gaseous nebula that is offset towards our side of the Large Magellanic Cloud.Comment: 20 pages, 22 Figures, 3 Tables, Photometric Catalogs and Mosaiced images will be available for download upon publication, accepted for publication on ApJ