Sex, Diabetes Status and Cognition: Findings from the Study of Longevity in Diabetes

INTRODUCTION: Women comprise two-thirds of people with dementia, making female sex a significant dementia risk factor. Both type 1 diabetes (T1D) and type 2 diabetes (T2D) are known dementia risk factors with an increasing global incidence. Understanding whether subtle sex differences persist in cognitive function prior to dementia in the context of diabetes may help elucidate the magnitude of sex effects on dementia risk. RESEARCH DESIGN AND METHODS: We examined cross-sectional data from the Study of Longevity in Diabetes (SOLID), a prospective cohort study of members of Kaiser Permanente Northern California aged 60 years and older with T1D (n=758), T2D (n=232) and without either T1D or T2D (n=247). We used factor analysis to generate summary scores of cognitive domains and used regression analyses to examine the associations between sex and cognition adjusting for sociodemographic and cardiovascular confounders. RESULTS: We included 1237 participants (630 women and 607 men) with mean age 68 years. By design, the distribution of men and women in T1D, T2D and no diabetes was similar. Women had better cognitive performance than men in global cognition (β=0.21, 95% CI 0.16 to 0.26), language (β=0.08, 95% CI 0.004 to 0.15), executive function (β=0.13, 95% CI 0.05 to 0.20), episodic verbal memory (β=0.68, 95% CI 0.59 to 0.77) and attention (β=0.20, 95% CI 0.11 to 0.28) but not in episodic visual memory (β=0.006, 95% CI -0.07 to 0.09) adjusting for age and education independent of diabetes status. We did not find an interaction between sex and diabetes status for any of the cognitive outcomes. CONCLUSIONS: Women in late mid-life have better cognitive performance than men in many cognitive domains independent of the presence of T1D or T2D. Further work is required to understand whether these differences change over time or in older cohorts and to understand their relationship to subsequent dementia

Habitat continuity and geographic distance predict population genetic differentiation in giant kelp

Isolation by distance (IBD) models are widely used to predict levels of genetic connectivity as a function of Euclidean distance, and although recent studies have used GIS-landscape ecological approaches to improve the predictability of spatial genetic structure, few if any have addressed the effect of habitat continuity on gene flow. Landscape effects on genetic connectivity are even less understood in marine populations, where habitat mapping is particularly challenging. In this study, we model spatial genetic structure of a habitat-structuring species, the giant kelp Macrocystis pyrifera, using highly variable microsatellite markers. GIS mapping was used to characterize habitat continuity and distance between sampling sites along the mainland coast of the Santa Barbara Channel, and their roles as predictors of genetic differentiation were evaluated. Mean dispersal distance (σ) and effective population size (Ne) were estimated by comparing our IBD slope with those from simulations incorporating habitat continuity and spore dispersal characteristics of the study area. We found an allelic richness of 7–50 alleles/locus, which to our knowledge is the highest reported for macroalgae. The best regression model relating genetic distance to habitat variables included both geographic distance and habitat continuity, which were respectively, positively and negatively related to genetic distance. Our results provide strong support for a dependence of gene flow on both distance and habitat continuity and elucidate the combination of Ne and σ that explained genetic differentiation

Association Between Lifetime Marijuana Use and Cognitive Function in Middle Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Marijuana use is increasingly common in the United States. It is unclear whether it has long-term effects on memory and other domains of cognitive function. To study the association between cumulative lifetime exposure to marijuana use and cognitive performance in middle age. We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of 5115 black and white men and women aged 18 to 30 years at baseline from March 25, 1985, to June 7, 1986 (year 0), and followed up over 25 years from June 7, 1986, to August 31, 2011, to estimate cumulative years of exposure to marijuana (1 year = 365 days of marijuana use) using repeated measures and to assess associations with cognitive function at year 25. Linear regression was used to adjust for demographic factors, cardiovascular risk factors, tobacco smoking, use of alcohol and illicit drugs, physical activity, depression, and results of the mirror star tracing test (a measure of cognitive function) at year 2. Data analysis was conducted from June 7, 1986, to August 31, 2011. Three domains of cognitive function were assessed at year 25 using the Rey Auditory Verbal Learning Test (verbal memory), the Digit Symbol Substitution Test (processing speed), and the Stroop Interference Test (executive function). Among 3385 participants with cognitive function measurements at the year 25 visit, 2852 (84.3%) reported past marijuana use, but only 392 (11.6%) continued to use marijuana into middle age. Current use of marijuana was associated with worse verbal memory and processing speed; cumulative lifetime exposure was associated with worse performance in all 3 domains of cognitive function. After excluding current users and adjusting for potential confounders, cumulative lifetime exposure to marijuana remained significantly associated with worse verbal memory. For each 5 years of past exposure, verbal memory was 0.13 standardized units lower (95% CI, -0.24 to -0.02; P = .02), corresponding to a mean of 1 of 2 participants remembering 1 word fewer from a list of 15 words for every 5 years of use. After adjustment, we found no associations with lower executive function (-0.03 [95% CI, -0.12 to 0.07]; P = .56) or processing speed (-0.04 [95% CI, -0.16 to 0.08]; P = .51). Past exposure to marijuana is associated with worse verbal memory but does not appear to affect other domains of cognitive function

Free energy for parameterized Polyakov loops in SU(2) and SU(3) lattice gauge theory

We present a study of the free energy of parameterized Polyakov loops P in SU(2) and SU(3) lattice gauge theory as a function of the parameters that characterize P. We explore temperatures below and above the deconfinement transition, and for our highest temperatures T > 5 T_c we compare the free energy to perturbative results.Comment: Minor changes. Final version to appear in JHE

Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk

Introduction Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual's risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the public and general practitioners. Methods and analysis Ten high-quality cohort studies from multiple countries were identified, which met eligibility criteria, including large representative samples, long-term follow-up, data on clinical diagnoses of dementia and NCDs, recognised modifiable risk factors for the four NCDs and mortality data. Pooled harmonised data from the cohorts will be used, with 65% randomly allocated for development of the predictive model and 35% for testing. Predictors include sociodemographic characteristics, general health risk factors and lifestyle/behavioural risk factors. A subdistribution hazard model will assess the risk factors' contribution to the outcome, adjusting for competing mortality risks. Point-based scoring algorithms will be built using predictor weights, internally validated and the discriminative ability and calibration of the model will be assessed for the outcomes. Sensitivity analyses will include recalculating risk scores using logistic regression. Ethics and dissemination Ethics approval is provided by the University of New South Wales Human Research Ethics Committee (UNSW HREC; protocol numbers HC200515, HC3413). All data are deidentified and securely stored on servers at Neuroscience Research Australia. Study findings will be presented at conferences and published in peer-reviewed journals. The tool will be accessible as a public health resource. Knowledge translation and implementation work will explore strategies to apply the tool in clinical practice

From Program to Policy: Expanding the Role of Community Coalitions

Background Diabetes mortality at the United States–Mexico border is twice the national average. Type 2 diabetes mellitus is increasingly diagnosed among children and adolescents. Fragmented services and scarce resources further restrict access to health care. Increased awareness of the incidence of disease and poor health outcomes became a catalyst for creating community-based coalitions and partnerships with the University of Arizona that focused on diabetes. Context Five partnerships between the communities and the University of Arizona were formed to address these health issues. They began with health promotion as their goal and were challenged to add policy and environmental change to their objectives. Understanding the meaning of policy in the community context is the first step in the transition from program to policy. Policy participation brings different groups together, strengthening ties and building trust among community members and community organizations. Methods Data on progress and outcomes were collected from multiple sources. We used the Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health (REACH) 2010 Community Change Model as the capacity-building and analytic framework for supporting and documenting the transition of coalitions from program to policy. Consequences Over 5 years, the coalitions made the transition, in varying degrees, from a programmatic focus to a policy planning and advocacy focus. The coalitions raised community awareness, built community capacity, encouraged a process of “change in change agents,” and advocated for community environmental and policy shifts to improve health behaviors. Interpretation The five coalitions made environmental and policy impacts by engaging in policy advocacy. These outcomes indicate the successful, if not consistently sustained, transition from program to policy. Whether and how these “changes in change agents” are transferable to the larger community over the long term remains to be seen

Area-wide eradication of the invasive European grapevine moth Lobesia botrana in California, USA

17openBothIn the fall of 2009, the first confirmed North American detection of the European grapevine moth (EGVM) Lobesia botrana (Denis & Schiffermüller) occurred in Napa County, California, USA. Based on its status as a significant grape pest in other parts of the world, the establishment of EGVM in California presented significant production and export issues for grapes, as well as for other fresh market agricultural commodities. Over the following seven years, an intensive California state-wide survey and area-wide eradication campaign was undertaken in partnership with agricultural officials at local, state and federal levels, university scientists and the wine, table grape and raisin industries. These efforts resulted in a dramatic decline in moth captures in pheromone traps from over 100 000 moths in 2010, to one in 2014, and none in 2015. In August of 2016, eradication was declared for all previously infested areas in California. The decision to pursue the eradication effort was based on the limited host range and geographic area of the EGVM infestation, the availability of effective tools for monitoring and control, and the strong support of the affected grape production and export industries. The eradication campaign employed coordinated logistical, regulatory, and technical efforts that included: 1) state-wide-monitoring using a network of pheromone-baited traps and in field monitoring; these findings were recorded in a geographic information system that was used to regularly communicate survey results to programme officials; 2) an area-wide application of mating disruption dispensers to infested vineyards, including use in urban environments within infested zones; 3) implementation by coordinators of area-wide insecticide treatments with application timing determined by degree-day modelling for each infested region; 4) a robust regulatory programme that initiated and maintained a quarantine of infested areas that regulated movement of fruit, farming equipment and winery processing waste; 5) an extensive outreach programme to grape growers, wineries, pest control specialists and the public; 6) formation of a technical working group that provided recommendations to the operational programme. An extensive methods development effort supported the programme. This included developing enhanced detection methods for vineyards under mating disruption, testing efficacy and residual control of insecticides, testing mating disruption formulations, evaluating the impacts of winery processing methods on EGVM mortality, developing methods to determine the timing of the development of successive EGVM generations (or biofix) under California conditions to improve degree-day models, developing EGVM rearing methods, testing the quality of pheromone lures and trap monitoring; and a spatial analysis of trapping data to determine programme effectiveness and to analyse invasion pathwaysopenSimmons, G.S.; Varela, L.; Daugherty, M.; Cooper, M.; Lance, D.; Mastro, V.; Carde, R.T.; Lucchi, A.; Ioriatti, C.; Bagnoli, B.; Steinhauer, R.; Broadway, R.; Stone Smith, B.; Hoffman, K.; Clark, G.; Whitmer, D.; Johnson, R.Simmons, G.S.; Varela, L.; Daugherty, M.; Cooper, M.; Lance, D.; Mastro, V.; Carde, R.T.; Lucchi, A.; Ioriatti, C.; Bagnoli, B.; Steinhauer, R.; Broadway, R.; Stone Smith, B.; Hoffman, K.; Clark, G.; Whitmer, D.; Johnson, R

The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population

BACKGROUND: Fatty liver (FL) is the most frequent liver disease in Western countries. We used data from the Dionysos Nutrition & Liver Study to develop a simple algorithm for the prediction of FL in the general population. METHODS: 216 subjects with and 280 without suspected liver disease were studied. FL was diagnosed by ultrasonography and alcohol intake was assessed using a 7-day diary. Bootstrapped stepwise logistic regression was used to identify potential predictors of FL among 13 variables of interest [gender, age, ethanol intake, alanine transaminase, aspartate transaminase, gamma-glutamyl-transferase (GGT), body mass index (BMI), waist circumference, sum of 4 skinfolds, glucose, insulin, triglycerides, and cholesterol]. Potential predictors were entered into stepwise logistic regression models with the aim of obtaining the most simple and accurate algorithm for the prediction of FL. RESULTS: An algorithm based on BMI, waist circumference, triglycerides and GGT had an accuracy of 0.84 (95%CI 0.81–0.87) in detecting FL. We used this algorithm to develop the "fatty liver index" (FLI), which varies between 0 and 100. A FLI < 30 (negative likelihood ratio = 0.2) rules out and a FLI ≥ 60 (positive likelihood ratio = 4.3) rules in fatty liver. CONCLUSION: FLI is simple to obtain and may help physicians select subjects for liver ultrasonography and intensified lifestyle counseling, and researchers to select patients for epidemiologic studies. Validation of FLI in external populations is needed before it can be employed for these purposes