Does undiagnosed diabetes mitigate the association between diabetes and cognitive impairment? Findings from the ELSI‐Brazil study

Background: Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment. However, most of the evidence has been based on self‐reported T2DM, and undiagnosed diabetes has not been considered as a separate category. We aimed to examine the extent to which undiagnosed diabetes modifies the association between diabetes and cognitive impairment in a representative sample of Brazilian adults aged 50 years and older. / Methods: We analyzed baseline data from 1944 participants of the Brazilian Longitudinal Study of Aging (ELSI‐Brazil) conducted from 2015 to 2016. Diabetes was evaluated based on self‐reported doctor diagnosis and glycosylated hemoglobin levels. Participants were classified as diabetics (D), undiagnosed diabetics (UDD), or nondiabetics (ND). Cognitive function was assessed by word list learning and verbal fluency tests. Three multiple logistic regression models were used to evaluate the changes in the strength of the associations. / Results: Participants with diabetes had 49% greater odds of exhibiting impaired memory than nondiabetics (odds ratio [OR] = 1.49; 95% CI: 1.01‐2.20). By combining UDD and ND, the association between diabetes and impaired memory was attenuated by 2.0%, losing its statistical significance (OR = 1.46; 95% CI: 0.98‐2.17). By combining UDD and D, the association was attenuated by 7.4% (OR = 1.38; 95% CI: 1.01‐1.90). No significant association was found between T2DM and impaired verbal fluency. / Conclusion: This study found an association between T2DM and impaired memory but not with impaired verbal fluency. When UDD individuals are considered diabetics, this association is attenuated; when UDD individuals are considered as ND, this association is attenuated to the extent that it loses its statistical significance, affecting thus the clinical interpretation

Augmented plasma microparticles during acute Plasmodium vivax infection

Background: In the last few years, the study of microparticles (MPs) - submicron vesicles released from cells upon activation or apoptosis - has gained growing interest in the field of inflammation and in infectious diseases. Their role in the human malaria parasite Plasmodium vivax remains unexplored. Because acute vivax malaria has been related to pro-inflammatory responses, the main hypothesis investigated in this study was that Plasmodium vivax infection is associated with elevated levels of circulating MPs, which may play a role during acute disease in nonimmune patients. Methods: Plasma MPs were analysed among thirty-seven uncomplicated P. vivax infections from an area of unstable malaria transmission in the Brazilian Amazon. The MP phenotype was analysed by flow cytometry using the classical MP marker, annexin, and fluorochrome-labeled monoclonal antibodies against specific cell surface markers. The frequencies of plasma MPs in P. vivax patients (n = 37) were further compared to malaria-unexposed controls (n = 15) and ovarian carcinoma patients (n = 12), a known MPs-inducing disease non-related to malaria. Results: The frequencies of plasma circulating MPs were markedly increased in P. vivax patients, as compared to healthy age-matched malaria-unexposed controls. Although platelets, erythrocytes and leukocytes were the main cellular sources of MPs during vivax malaria, platelet derived-MPs (PMPs) increased in a linear fashion with the presence of fever at the time of blood collection (b = 0.06, p < 0.0001) and length of acute symptoms (b = 0.36, p < 0.0001). Finally, the results suggest that plasma levels of PMPs diminish as patient experience more episodes of clinical malaria (b = 0.07, p < 0.003). Conclusions: Abundant circulating MPs are present during acute P. vivax infection, and platelet derived-MPs may play a role on the acute inflammatory symptoms of malaria vivax

A Factorization Law for Entanglement Decay

We present a simple and general factorization law for quantum systems shared by two parties, which describes the time evolution of entanglement upon passage of either component through an arbitrary noisy channel. The robustness of entanglement-based quantum information processing protocols is thus easily and fully characterized by a single quantity.Comment: 4 pages, 5 figure

Survival of extremophilic yeasts to the stratospheric environment on balloon flights and laboratory simulations

The high-altitude atmosphere is a harsh environment with extremely low temperatures, low pressure, and high UV irradiation. For this reason, it has been proposed as an analogue for Mars, presenting deleterious factors similar to those on the surface of that planet. We evaluated the survival of extremophilic UV-resistant yeasts isolated from a high-elevation area in the Atacama Desert under stratospheric conditions. As biological controls, intrinsically resistant Bacillus subtilis spores were used. Experiments were performed in two independent stratospheric balloon flights and with an environmental simulation chamber. The three following different conditions were evaluated: (i) desiccation, (ii) desiccation plus exposure to stratospheric low pressure and temperature, and (3) desiccation plus exposure to the full stratospheric environment (UV, low pressure, and temperature). Two strains, Naganishia (Cryptococcus) friedmannii 16LV2 and Exophiala sp. strain 15LV1, survived full exposures to the stratosphere in larger numbers than did B. subtilis spores. Holtermanniella watticus (also known as Holtermanniella wattica) 16LV1, however, suffered a substantial loss in viability upon desiccation and did not survive the stratospheric UV exposure. The remarkable resilience of N. friedmannii and Exophiala sp. 15LV1 under the extreme Mars-like conditions of the stratosphere confirms its potential as a eukaryotic model for astrobiology. Additionally, our results with N. friedmannii strengthen the recent hypothesis that yeasts belonging to the Naganishia genus are fit for aerial dispersion, which might account for the observed abundance of this species in high-elevation soils

Dietary Habits And Functional Limitation Of Older Brazilian Adults: Evidence From The Brazilian National Health Survey (2013)

OBJECTIVE: To compare the consumption of selected healthy and unhealthy food groups among elderly Brazilians with daily living activity limitations relative to those with no limitations. DESIGN: Cross-sectional analyses of a nationally representative survey. Setting: The Brazilian National Health Survey, conducted in 2013. SUBJECTS: 11,177 Brazilians aged 60 and over. RESULTS: The prevalence of daily living limitations was 29% (95% CI 27.6,30.5). The consumption of daily meat, beans on a regular basis, and recommended fruit and vegetables intake were 67.1% (95% CI 66.5,68.7), 71.3% (95% CI 69.9,72.8) and 37.3% (95% CI 35.6,39.9), respectively. Compared to those without functional limitation, the consumption of these three food groups was significantly lower among those older adults with functional limitation (Prevalence Ratio = 0.89, 95% CI 0.80,0.98; 0.90, 95% CI 0.82,0.99 and PR 0.86, 95% CI, 0.76,0.96, respectively), independently of age, sex, marital status, living arrangements and education. Level of education showed a strong positive association with fruit and vegetable consumption, and a negative association with bean consumption, a staple diet in Brazil. CONCLUSIONS: Our findings highlight the need for public health policies to increase consumption healthy food consumption among those older adults with functional limitations, especially fruit and vegetable intake among those who have low education levels

Predictive value of multiple cytokines and chemokines for mortality in an admixed population: 15-year follow-up of the Bambui-Epigen (Brazil) cohort study of aging

Inflammation, particularly elevated IL-6 serum levels, has been associated with increased mortality risk, mostly in Caucasians. The influence of genetic ethno-racial background on this association is unknown. We examined associations between baseline serum levels of Interleukin-6 (IL-6) and other cytokines (IL1-2, TNF, IL-10, and IL1β) and chemokines (CCL2, CCL5, CXCL8, CXCL9 and CXCL10) with 15-year mortality in 1,191 admixed Brazilians aged 60 years and over. Elevated IL6 level (but not other biomarkers) was associated with increased risk of deaths with fully adjusted hazard ratios of 1.51 (95% CI = 1.15, 1.97), 1.54 (95% CI = 1.20, 1.96) and 1.79 (95% CI = 1.40, 2.29) for the 2nd, 3rd and the highest quartiles, respectively. Genomic African and Native American proportions did not modify the association (p > 0.05). The discriminatory ability to predict death of a model based on IL-6 alone was similar as that of a comprehensive morbidity score (C statistics = 0.59 and 0.60, respectively). The abilities of IL-6 and the morbidity score models to predict death remained stable for very long term after the baseline measurement. Our results indicate that genome-based African and Native American ancestries have no impact on the prognostic value of IL-6 for mortality

Measuring access to medicines: a review of quantitative methods used in household surveys

<p>Abstract</p> <p>Background</p> <p>Medicine access is an important goal of medicine policy; however the evaluation of medicine access is a subject under conceptual and methodological development. The aim of this study was to describe quantitative methodologies to measure medicine access on household level, access expressed as paid or unpaid medicine acquisition.</p> <p>Methods</p> <p>Searches were carried out in electronic databases and health institutional sites; within references from retrieved papers and by contacting authors.</p> <p>Results</p> <p>Nine papers were located. The methodologies of the studies presented differences in the recall period, recruitment of subjects and medicine access characterization.</p> <p>Conclusions</p> <p>The standardization of medicine access indicators and the definition of appropriate recall periods are required to evaluate different medicines and access dimensions, improving studies comparison. Besides, specific keywords must be established to allow future literature reviews about this topic.</p