Diabetes and the Risk of Multi-System Aging Phenotypes: A Systematic Review and Meta-Analysis

[[abstract]]Background: Observational studies suggested an association between diabetes and the risk of various geriatric conditions (i.e., cognitive impairment, dementia, depression, mobility impairment, disability, falls, and urinary incontinence). However, the magnitude and impact of diabetes on older adults have not been reviewed. Methodology/Principal Findings: MEDLINE and PSYCINFO databases were searched through November 2007 for published studies, supplemented by manual searches of bibliographies of key articles. Population-based, prospective cohort studies that reported risk of geriatric outcomes in relation to diabetes status at baseline were selected. Two authors independently extracted the data, including study population and follow-up duration, ascertainment of diabetes status at baseline, outcomes of interest and their ascertainment, adjusted covariates, measures of association, and brief results. Fifteen studies examined the association of DM with cognitive dysfunction. DM was associated with a faster decline in cognitive function among older adults. The pooled adjusted risk ratio (RR) for all dementia when persons with DM were compared to those without was 1.47 (95% CI, 1.25 to 1.73). Summary RRs for Alzheimer's disease and vascular dementia comparing persons with DM to those without were 1.39 (CI, 1.16 to 1.66) and 2.38 (CI, 1.79 to 3.18), respectively. Four of 5 studies found significant association of DM with faster mobility decline and incident disability. Two studies examined the association of diabetes with falls in older women. Both found statistically significant associations. Insulin users had higher RR for recurrent falls. One study for urinary incontinence in older women found statistically significant associations. Two studies for depression did not suggest that DM was an independent predictor of incident depression. Conclusions/Significance: Current evidence supports that DM is associated with increased risk for selected geriatric conditions. Clinicians should increase their awareness and provide appropriate care. Future research is required to elucidate the underlying pathological pathway. 2009 Lu et al

Transition from high- to low-NOx control of night-time oxidation in the southeastern US

The influence of nitrogen oxides (NOx) on daytime atmospheric oxidation cycles is well known, with clearly defined high- and low-NOx regimes. During the day, oxidation reactions—which contribute to the formation of secondary pollutants such as ozone—are proportional to NOx at low levels, and inversely proportional to NOx at high levels. Night-time oxidation of volatile organic compounds also influences secondary pollutants but lacks a similar clear definition of high- and low-NOx regimes, even though such regimes exist. Decreases in anthropogenic NOx emissions in the US and Europe coincided with increases in Asia over the last 10 to 20 years, and have altered both daytime and nocturnal oxidation cycles. Here we present measurements of chemical species in the lower atmosphere from day- and night-time research flights over the southeast US in 1999 and 2013, supplemented by atmospheric chemistry simulations. We find that night-time oxidation of biogenic volatile organic compounds (BVOC) is NOx-limited when the ratio of NOx to BVOC is below approximately 0.5, and becomes independent of NOx at higher ratios. The night-time ratio of NOx to BVOC in 2013 averaged 0.6 aloft. We suggest that night-time oxidation in the southeast US is in transition between NOx-dominated and ozone-dominated

Predicting survival of patients with idiopathic pulmonary fibrosis using GAP score: a nationwide cohort study

BACKGROUND: The clinical course of idiopathic pulmonary fibrosis (IPF) varies widely. Although the GAP model is useful for predicting mortality, survivals have not yet been validated for each GAP score. We aimed to elucidate how prognosis is related to GAP score and GAP stage in IPF patients. METHODS: The Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate various characteristics in IPF patients from 2003 to 2007. Patients were diagnosed according to the 2002 criteria of the ATS/ERS. We enrolled 1,685 patients with IPF; 1,262 had undergone DL(CO) measurement. Patients were stratified based on GAP score (0–7): GAP score Group 0 (n = 26), Group 1 (n = 150), Group 2 (n = 208), Group 3 (n = 376), Group 4 (n = 317), Group 5 (n = 138), Group 6 (n = 39), and Group 7 (n = 8). RESULTS: Higher GAP score and GAP stage were associated with a poorer prognosis (p < 0.001, respectively). Survival time in Group 3 was lower than those in Groups 1 and 2 (p = 0.043 and p = 0.039, respectively), and higher than those in groups 4, 5, and 6 (p = 0.043, p = 0.032, and p = 0.003, respectively). Gender, age, and DL(CO) (%) differed significantly between Groups 2 and 3. All four variables in the GAP model differed significantly between Groups 3 and 4. CONCLUSION: The GAP system showed significant predictive ability for mortality in IPF patients. However, prognosis in IPF patients with a GAP score of 3 were significantly different from those in the other stage I groups and stage II groups of Asian patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12931-016-0454-0) contains supplementary material, which is available to authorized users