Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes

<p>Background: Type 2 diabetes mellitus is associated with risk of congestive heart failure (CHF), cognitive dysfunction and depression. CHF itself is linked both to poor cognition and depression. The ventricular N-terminal pro-brain natriuretic peptide (NT-proBNP) is a marker of CHF, suggesting potential as a marker for cognitive impairment and/or depression. This was tested in the Edinburgh Type 2 Diabetes Study (ET2DS).</p> <p>Methodology and Principal Findings: Cross-sectional analysis of 1066 men and women aged 60–75 with type 2 diabetes. Results from seven neuropsychological tests were combined in a standardised general cognitive ability factor, ‘g’. A vocabulary-based test estimated pre-morbid cognitive ability. The Hospital Anxiety and Depression Scale (HADS) assessed possible depression. After adjustment for age and sex, raised plasma NT-proBNP was weakly associated with lower ‘g’ and higher depression scores (ß −0.09, 95% CI −0.13 to −0.03, p = 0.004 and ß 0.08, 95% CI 0.04 to 0.12, p<0.001, respectively). Comparing extreme quintiles of NT-proBNP, subjects in the highest quintile were more likely to have reduced cognitive ability (within the lowest tertile of ‘g’) and ‘possible’ depression (HADS depression ≥8) (OR 1.80; 95% CI: 1.20, 2.70; p = 0.005 and OR 2.18; 95% CI: 1.28, 3.71; p = 0.004, respectively). Associations persisted when pre-morbid ability was adjusted for, but as expected were no longer statistically significant following the adjustment for diabetes-related and vascular co-variates (β −0.02, 95% CI −0.07 to 0.03, p>0.05 for ‘g’; β 0.03, 95% CI −0.02 to 0.07, p>0.05 for depression scores).</p> <p>Conclusion: Raised plasma NT-proBNP was weakly but statistically significantly associated with poorer cognitive function and depression. The prospective phases of the ET2DS will help determine whether or not NT-proBNP can be considered a risk marker for subsequent cognitive impairment and incident depression and whether it provides additional information over and above traditional risk factors for these conditions.</p&gt

Cardiovascular disease biomarkers are associated with declining renal function in type 2 diabetes

Aims/hypothesis: We investigated whether biochemical cardiovascular risk factors and/or markers of subclinical cardiovascular disease were associated with the development of reduced renal function in people with type 2 diabetes. Methods: A cohort of 1066 Scottish men and women aged 60–74 years with type 2 diabetes from the Edinburgh Type 2 Diabetes Study were followed up for a median of 6.7 years. New-onset reduced renal function was defined as two eGFRs <60 ml−1 min−1 (1.73 m)−2 at least 3 months apart with a > 25% decline from baseline eGFR. Ankle brachial pressure index (ABI), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hsTnT) were measured at baseline. Pulse wave velocity (PWV) and carotid intima media thickness were measured 1 year into follow-up. Data were analysed using Cox proportional hazards models. Results: A total of 119 participants developed reduced renal function during follow-up. ABI, PWV, NT-proBNP and hsTnT were all associated with onset of decline in renal function following adjustment for age and sex. These associations were attenuated after adjustment for additional diabetes renal disease risk factors (systolic BP, baseline eGFR, albumin:creatinine ratio and smoking pack-years), with the exception of hsTnT which remained independently associated (HR 1.51 [95% CI 1.22, 1.87]). Inclusion of hsTnT in a predictive model improved the continuous net reclassification index by 0.165 (0.008, 0.286). Conclusions/interpretation: Our findings demonstrate an association between hsTnT, a marker of subclinical cardiac ischaemia, and subsequent renal function decline. Further research is required to establish the predictive value of hsTnT and response to intervention

A rigid body model for the assessment of glenohumeral joint mechanics: Influence of osseous defects on range of motion and dislocation

© 2016. The purpose of this study was to employ subject-specific computer models to evaluate the interaction of glenohumeral range-of-motion and Hill-Sachs humeral head bone defect size on engagement and shoulder dislocation. We hypothesized that the rate of engagement would increase as defect size increased, and that greater shoulder ROM would engage smaller defects. Three dimensional computer models of 12 shoulders were created. For each shoulder, additional models were created with simulated Hill-Sachs defects of varying severities (XS=15%, S=22.5%, M=30%, L=37.5%, XL=45% and XXL=52.5% of the humeral head diameter, respectively). Rotational motion simulations without translation were conducted. The simulations ended if the defect engaged the anterior glenoid rim with resultant dislocation. The results showed that the rate of engagement was significantly different between defect sizes (0.00

Dietary fat and total energy intake modifies the association of genetic profile risk score on obesity: evidence from 48 170 UK Biobank participants

Background: Obesity is a multifactorial condition influenced by both genetics and lifestyle. The aim of this study was to investigate whether the association between a validated genetic profile risk score for obesity (GPRS-obesity) and body mass index (BMI) or waist circumference (WC) was modified by macronutrient intake in a large general population study. Methods: This study included cross-sectional data from 48 170 white European adults, aged 37–73 years, participating on the UK Biobank. Interactions between GPRS-obesity, and macronutrient intake (including total energy, protein, fat, carbohydrate and dietary fibre intake) and its effects on BMI and WC were investigated. Results: The 93-SNPs genetic profile risk score was associated with a higher BMI (β:0.57 kg.m−2 per standard deviation (s.d.) increase in GPRS, [95%CI:0.53–0.60]; P=1.9 × 10−183) independent of major confounding factors. There was a significant interaction between GPRS and total fat intake (P[interaction]=0.007). Among high fat intake individuals, BMI was higher by 0.60 [0.52, 0.67] kg.m−2 per s.d. increase in GPRS-obesity; the change in BMI with GPRS was lower among low fat intake individuals (β:0.50 [0.44, 0.57] kg.m-2). Significant interactions with similar patterns were observed for saturated fat intake (High β:0.66 [0.59, 0.73] versus Low β:0.49 [0.42, 0.55] kg.m-2, P-interaction=2 × 10-4), and total energy intake (High β:0.58 [0.51, 0.64] versus Low β:0.49 [0.42, 0.56] kg.m−2, P-interaction=0.019), but not for protein intake, carbohydrate intake and fiber intake (P-interaction >0.05). The findings were broadly similar using WC as the outcome. Conclusions: These data suggest that the benefits of reducing the intake of fats and total energy intake, may be more important in individuals with high genetic risk for obesity

Definition of medical event is to be based on the total source strength for evaluation of permanent prostate brachytherapy: A report from the American Society for Radiation Oncology

AbstractPurposeThe Nuclear Regulatory Commission deems it to be a medical event (ME) if the total dose delivered differs from the prescribed dose by 20% or more. A dose-based definition of ME is not appropriate for permanent prostate brachytherapy as it generates too many spurious MEs and thereby creates unnecessary apprehension in patients, and ties up regulatory bodies and the licensees in unnecessary and burdensome investigations. A more suitable definition of ME is required for permanent prostate brachytherapy.Methods and MaterialsThe American Society for Radiation Oncology (ASTRO) formed a working group of experienced clinicians to review the literature, assess the validity of current regulations, and make specific recommendations about the definition of an ME in permanent prostate brachytherapy.ResultsThe working group found that the current definition of ME in §35.3045 as “the total dose delivered differs from the prescribed dose by 20 percent or more” was not suitable for permanent prostate brachytherapy since the prostate volume (and hence the resultant calculated prostate dose) is dependent on the timing of the imaging, the imaging modality used, the observer variability in prostate contouring, the planning margins used, inadequacies of brachytherapy treatment planning systems to calculate tissue doses, and seed migration within and outside the prostate. If a dose-based definition for permanent implants is applied strictly, many properly executed implants would be improperly classified as an ME leading to a detrimental effect on brachytherapy. The working group found that a source strength-based criterion, of >20% of source strength prescribed in the post-procedure written directive being implanted outside the planning target volume is more appropriate for defining ME in permanent prostate brachytherapy.ConclusionsASTRO recommends that the definition of ME for permanent prostate brachytherapy should not be dose based but should be based upon the source strength (air-kerma strength) administered

The Star Formation Rate Function of the Local Universe

We have derived the bivariate luminosity function for the far ultraviolet (1530Angstroms) and far infrared (60 microns). We used matched GALEX and IRAS data, and redshifts from NED and PSC-z. We have derived a total star formation luminosity function phi(L_{tot}), with L_{tot} = L_{FUV}+L_{FIR}. Using these, we determined the cosmic ``star formation rate'' function and density for the local universe. The total SFR function is fit very well by a log-normal distribution over five decades of luminosity. We find that the bivariate luminosity function phi(L_{FUV},L_{FIR}) shows a bimodal behavior, with L_{FIR} tracking L_{FUV} for L_{TOT}< 10^10 L_sun, and L_{FUV} saturating at 10^10 L_sun, while L_{TOT} L_{FIR} for higher luminosities. We also calculate the SFR density and compare it to other measurements.Comment: This paper will be published as part of the Galaxy Evolution Explorer (GALEX) Astrophysical Journal Letters Special Issue. Links to the full set of papers will be available at http:/www.galex.caltech.edu/PUBLICATIONS/ after November 22, 200

The UV-Optical Galaxy Color-Magnitude Diagram. I. Basic Properties

We have analyzed the bivariate distribution of galaxies as a function of ultraviolet-optical colors and absolute magnitudes in the local universe. The sample consists of galaxies with redshifts and optical photometry from the Sloan Digital Sky Survey (SDSS) main galaxy sample matched with detections in the near-ultraviolet (NUV) and far-ultraviolet (FUV) bands in the Medium Imaging Survey being carried out by the Galaxy Evolution Explorer (GALEX) satellite. In the (NUV − r)_(0.1) versus M_(r,0.1) galaxy color-magnitude diagram, the galaxies separate into two well-defined blue and red sequences. The (NUV − r)_(0.1) color distribution at each M_(r,0.1) is not well fit by the sum of two Gaussians due to an excess of galaxies in between the two sequences. The peaks of both sequences become redder with increasing luminosity, with a distinct blue peak visible up to M_(r,0.1) ~ − 23. The r_(0.1)-band luminosity functions vary systematically with color, with the faint-end slope and characteristic luminosity gradually increasing with color. After correcting for attenuation due to dust, we find that approximately one-quarter of the color variation along the blue sequence is due to dust, with the remainder due to star formation history and metallicity. Finally, we present the distribution of galaxies as a function of specific star formation rate and stellar mass. The specific star formation rates imply that galaxies along the blue sequence progress from low-mass galaxies with star formation rates that increase somewhat with time to more massive galaxies with a more or less constant star formation rate. Above a stellar mass of ~10^(10.5) M_☉, galaxies with low ratios of current to past averaged star formation rate begin to dominate

The Calibration and Data Products of the Galaxy Evolution Explorer

We describe the calibration status and data products pertaining to the GR2 and GR3 data releases of the Galaxy Evolution Explorer (GALEX). These releases have identical pipeline calibrations that are significantly improved over the GR1 data release. GALEX continues to survey the sky in the Far Ultraviolet (FUV, ~154 nm) and Near Ultraviolet (NUV, ~232 nm) bands, providing simultaneous imaging with a pair of photon counting, microchannel plate, delay line readout detectors. These 1.25 degree field-of-view detectors are well-suited to ultraviolet observations because of their excellent red rejection and negligible background. A dithered mode of observing and photon list output pose complex requirements on the data processing pipeline, entangling detector calibrations and aspect reconstruction algorithms. Recent improvements have achieved photometric repeatability of 0.05 and 0.03 mAB in the FUV and NUV, respectively. We have detected a long term drift of order 1% FUV and 6% NUV over the mission. Astrometric precision is of order 0.5" RMS in both bands. In this paper we provide the GALEX user with a broad overview of the calibration issues likely to be confronted in the current release. Improvements are likely as the GALEX mission continues into an extended phase with a healthy instrument, no consumables, and increased opportunities for guest investigations.Comment: Accepted to the ApJS (a special GALEX issue

Ly alpha-emitting galaxies at 0.2 < z < 0.35 from GALEX spectroscopy

We have used the GALEX (Galaxy Evolution Explorer) spectroscopic survey mode, with a resolution of similar to 8 angstrom in the far-ultraviolet (FUV; 1350-1750 angstrom) and similar to 20 angstrom in the near-ultraviolet (NUV; 1950-2750 angstrom) for a systematic search of Ly alpha-emitting galaxies at low redshift. Our aim is to fill a gap between high-redshift surveys and a small set of objects studied in detail in the nearby universe. A blind search of 7018 spectra extracted in five deep exposures (5.65 deg(2)) has resulted in 96 Ly alpha-emitting galaxy candidates in the FUV domain after accounting for broad-line AGNs. The Ly alpha equivalent widths (EWs) are consistent with stellar population model predictions and show no trends as a function of UV color or UV luminosity, with the exception of a possible decrease in the most luminous objects that may be due to small-number statistics. The objects' distribution in EW is similar to that at z similar to 3, but their fraction among star-forming galaxies is smaller. Avoiding uncertain candidates, a subsample of 66 objects in the range 0.2 < z < 0.35 has been used to build a Ly alpha luminosity function (LF). The incompleteness due to objects with significant Ly alpha emission but a UV continuum too low for spectral extraction has been evaluated. A comparison with H alpha LFs in the same redshift domain is consistent with an average Ly alpha/H alpha of similar to 1 in about 15% of the star-forming galaxies. A comparison with high-redshift Ly alpha LFs implies an increase of the Ly alpha luminosity density by a factor of about 16 from z similar to 0.3 to z similar to 3. By comparison with the factor of 5 increase in the UV luminosity density in the same redshift range, this suggests an increase of the average Ly alpha escape fraction with redshift