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Fatty acid biomarkers of dairy fat consumption and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies

PLoS Medicine - Me, 10/10/2018 - 23:00

by Fumiaki Imamura, Amanda Fretts, Matti Marklund, Andres V. Ardisson Korat, Wei-Sin Yang, Maria Lankinen, Waqas Qureshi, Catherine Helmer, Tzu-An Chen, Kerry Wong, Julie K. Bassett, Rachel Murphy, Nathan Tintle, Chaoyu Ian Yu, Ingeborg A. Brouwer, Kuo-Liong Chien, Alexis C. Frazier-Wood, Liana C. del Gobbo, Luc Djoussé, Johanna M. Geleijnse, Graham G. Giles, Janette de Goede, Vilmundur Gudnason, William S. Harris, Allison Hodge, Frank Hu, InterAct Consortium , Albert Koulman, Markku Laakso, Lars Lind, Hung-Ju Lin, Barbara McKnight, Kalina Rajaobelina, Ulf Risérus, Jennifer G. Robinson, Cécilia Samieri, David S. Siscovick, Sabita S. Soedamah-Muthu, Nona Sotoodehnia, Qi Sun, Michael Y. Tsai, Matti Uusitupa, Lynne E. Wagenknecht, Nick J. Wareham, Jason HY Wu, Renata Micha, Nita G. Forouhi, Rozenn N. Lemaitre, Dariush Mozaffarian, Fatty Acids and Outcomes Research Consortium (FORCE)

Background

We aimed to investigate prospective associations of circulating or adipose tissue odd-chain fatty acids 15:0 and 17:0 and trans-palmitoleic acid, t16:1n-7, as potential biomarkers of dairy fat intake, with incident type 2 diabetes (T2D).

Methods and findings

Sixteen prospective cohorts from 12 countries (7 from the United States, 7 from Europe, 1 from Australia, 1 from Taiwan) performed new harmonised individual-level analysis for the prospective associations according to a standardised plan. In total, 63,682 participants with a broad range of baseline ages and BMIs and 15,180 incident cases of T2D over the average of 9 years of follow-up were evaluated. Study-specific results were pooled using inverse-variance–weighted meta-analysis. Prespecified interactions by age, sex, BMI, and race/ethnicity were explored in each cohort and were meta-analysed. Potential heterogeneity by cohort-specific characteristics (regions, lipid compartments used for fatty acid assays) was assessed with metaregression. After adjustment for potential confounders, including measures of adiposity (BMI, waist circumference) and lipogenesis (levels of palmitate, triglycerides), higher levels of 15:0, 17:0, and t16:1n-7 were associated with lower incidence of T2D. In the most adjusted model, the hazard ratio (95% CI) for incident T2D per cohort-specific 10th to 90th percentile range of 15:0 was 0.80 (0.73–0.87); of 17:0, 0.65 (0.59–0.72); of t16:1n7, 0.82 (0.70–0.96); and of their sum, 0.71 (0.63–0.79). In exploratory analyses, similar associations for 15:0, 17:0, and the sum of all three fatty acids were present in both genders but stronger in women than in men (pinteraction < 0.001). Whereas studying associations with biomarkers has several advantages, as limitations, the biomarkers do not distinguish between different food sources of dairy fat (e.g., cheese, yogurt, milk), and residual confounding by unmeasured or imprecisely measured confounders may exist.

Conclusions

In a large meta-analysis that pooled the findings from 16 prospective cohort studies, higher levels of 15:0, 17:0, and t16:1n-7 were associated with a lower risk of T2D.

Great Ormond Street launches hospital of the future with AI and robots

New Scientist - Me, 10/10/2018 - 19:00
Step inside the hospital of the future, where face recognition tracks everyone who enters and robots roam the corridors

We need to get better at supporting people who lose a pregnancy

New Scientist - Me, 10/10/2018 - 17:37
This week is Baby Loss Awareness Week, but more must be done to help those who, like me, have suffered a loss, says Petra Boynton

AI’s dirty secret: Energy-guzzling machines may fuel global warming

New Scientist - Me, 10/10/2018 - 17:00
Advances in artificial intelligence could lead to massive growth in energy use as smart machines push into every corner of our lives

Bees suddenly stopped buzzing in the US during the 2017 solar eclipse

New Scientist - Me, 10/10/2018 - 16:00
When the moon hid the sun in the 2017 total solar eclipse, bees across the US suddenly stopped buzzing around - only one bee aross 16 locations buzzed

Potentially catastrophic Hurricane Michael is about to hit Florida

New Scientist - Me, 10/10/2018 - 15:50
Hurricane Michael intensified faster than expected overnight and is now headed for Florida. It was fuelled by abnormally warm waters in the Gulf of Mexico

Moons can have moons and they are called moonmoons

New Scientist - Me, 10/10/2018 - 12:53
If a moon is big enough and far enough from its planet, it can host its own smaller moon, called a ‘moonmoon’ - and four worlds in our solar system fit the bill

Are Virgin Galactic and Richard Branson really going to space soon?

New Scientist - Me, 10/10/2018 - 12:50
Richard Branson has said that his space flight company, Virgin Galactic, will go to space “within weeks”. Here’s what you need to know about his claims

Rabbits flee when they smell dead relatives in predators’ droppings

New Scientist - Me, 10/10/2018 - 12:20
Rabbits avoid nibbling grass in areas scattered with predator droppings – particularly if those predators have been fed on bunnies

You can recognise around 5000 faces, from family to celebrities

New Scientist - Me, 10/10/2018 - 01:01
For much of human evolution our ancestors may have encountered only a few hundred people in their lives – but we can each recall about 5000 distinct faces

Patient-centered primary care and self-rated health in 6 Latin American and Caribbean countries: Analysis of a public opinion cross-sectional survey

PLoS Medicine - Ma, 09/10/2018 - 23:00

by Frederico Guanais, Svetlana V. Doubova, Hannah H. Leslie, Ricardo Perez-Cuevas, Ezequiel García-Elorrio, Margaret E. Kruk

Background

Despite the substantial attention to primary care (PC), few studies have addressed the relationship between patients’ experience with PC and their health status in low-and middle-income countries. This study aimed to (1) test the association between overall patient-centered PC experience (OPCE) and self-rated health (SRH) and (2) identify specific features of patient-centered PC associated with better SRH (i.e., excellent or very good SRH) in 6 Latin American and Caribbean countries.

Methods and findings

We conducted a secondary analysis of a 2013 public opinion cross-sectional survey on perceptions and experiences with healthcare systems in Brazil, Colombia, El Salvador, Jamaica, Mexico, and Panama; the data were nationally representative for urban populations. We analyzed 9 features of patient-centered PC. We calculated OPCE score as the arithmetic mean of the PC features. OPCE score ranged from 0 to 1, where 0 meant that the participant did not have any of the 9 patient-centered PC experiences, while 1 meant that he/she reported having all these experiences. After testing for interaction on the additive scale, we analyzed countries pooled for aim 1, with an interaction term for Mexico, and each country separately for aim 2. We used multiple Poisson regression models double-weighted by survey and inverse probability weights to deal with the survey design and missing data. The study included 6,100 participants. The percentage of participants with excellent or very good SRH ranged from 29.5% in Mexico to 52.4% in Jamaica. OPCE was associated with reporting excellent or very good SRH in all countries: adjusting for socio-demographic and health covariates, patients with an OPCE score of 1 in Brazil, Colombia, El Salvador, Jamaica, and Panama were more likely to report excellent or very good SRH than those with a score of 0 (adjusted prevalence ratio [aPR] 1.61, 95% CI 1.37–1.90, p < 0.001); in Mexico, this association was even stronger (aPR 4.27, 95% CI 2.34–7.81, p < 0.001). The specific features of patient-centered PC associated with better SRH differed by country. The perception that PC providers solve most health problems was associated with excellent or very good SRH in Colombia (aPR 1.38, 95% CI 1.01–1.91, p = 0.046) and Jamaica (aPR 1.21, 95% CI 1.02–1.43, p = 0.030). Having a provider who knows relevant medical history was positively associated with better SRH in Mexico (aPR 1.47, 95% CI 1.03–2.12, p = 0.036) but was negatively associated with better SRH in Brazil (aPR 0.71, 95% CI 0.56–0.89, p = 0.003). Finally, easy contact with PC facility (Mexico: aPR 1.35, 95% CI 1.04–1.74, p = 0.023), coordination of care (Mexico: aPR 1.53, 95% CI 1.19–1.98, p = 0.001), and opportunity to ask questions (Brazil: aPR 1.42, 95% CI 1.11–1.83, p = 0.006) were each associated with better SRH. The main study limitation consists in the analysis being of cross-sectional data, which does not allow making causal inferences or identifying the direction of the association between the variables.

Conclusions

Overall, a higher OPCE score was associated with better SRH in these 6 Latin American and Caribbean countries; associations between specific characteristics of patient-centered PC and SRH differed by country. The findings underscore the importance of high-quality, patient-centered PC as a path to improved population health.

Retention in HIV care during the 3 years following release from incarceration: A cohort study

PLoS Medicine - Ma, 09/10/2018 - 23:00

by Kelsey B. Loeliger, Jaimie P. Meyer, Mayur M. Desai, Maria M. Ciarleglio, Colleen Gallagher, Frederick L. Altice

Background

Sustained retention in HIV care (RIC) and viral suppression (VS) are central to US national HIV prevention strategies, but have not been comprehensively assessed in criminal justice (CJ) populations with known health disparities. The purpose of this study is to identify predictors of RIC and VS following release from prison or jail.

Methods and findings

This is a retrospective cohort study of all adult people living with HIV (PLWH) incarcerated in Connecticut, US, during the period January 1, 2007, to December 31, 2011, and observed through December 31, 2014 (n = 1,094). Most cohort participants were unmarried (83.7%) men (77.0%) who were black or Hispanic (78.1%) and acquired HIV from injection drug use (72.6%). Prison-based pharmacy and custody databases were linked with community HIV surveillance monitoring and case management databases. Post-release RIC declined steadily over 3 years of follow-up (67.2% retained for year 1, 51.3% retained for years 1–2, and 42.5% retained for years 1–3). Compared with individuals who were not re-incarcerated, individuals who were re-incarcerated were more likely to meet RIC criteria (48% versus 34%; p < 0.001) but less likely to have VS (72% versus 81%; p = 0.048). Using multivariable logistic regression models (individual-level analysis for 1,001 individuals after excluding 93 deaths), both sustained RIC and VS at 3 years post-release were independently associated with older age (RIC: adjusted odds ratio [AOR] = 1.61, 95% CI = 1.22–2.12; VS: AOR = 1.37, 95% CI = 1.06–1.78), having health insurance (RIC: AOR = 2.15, 95% CI = 1.60–2.89; VS: AOR = 2.01, 95% CI = 1.53–2.64), and receiving an increased number of transitional case management visits. The same factors were significant when we assessed RIC and VS outcomes in each 6-month period using generalized estimating equations (for 1,094 individuals contributing 6,227 6-month periods prior to death or censoring). Additionally, receipt of antiretroviral therapy during incarceration (RIC: AOR = 1.33, 95% CI 1.07–1.65; VS: AOR = 1.91, 95% CI = 1.56–2.34), early linkage to care post-release (RIC: AOR = 2.64, 95% CI = 2.03–3.43; VS: AOR = 1.79; 95% CI = 1.45–2.21), and absolute time and proportion of follow-up time spent re-incarcerated were highly correlated with better treatment outcomes. Limited data were available on changes over time in injection drug use or other substance use disorders, psychiatric disorders, or housing status.

Conclusions

In a large cohort of CJ-involved PLWH with a 3-year post-release evaluation, RIC diminished significantly over time, but was associated with HIV care during incarceration, health insurance, case management services, and early linkage to care post-release. While re-incarceration and conditional release provide opportunities to engage in care, reducing recidivism and supporting community-based RIC efforts are key to improving longitudinal treatment outcomes among CJ-involved PLWH.

Falling rocks can explode so hard that only nuclear weapons beat them

New Scientist - Ma, 09/10/2018 - 17:00
If big rocks fall far enough they can explode with more energy than any non-nuclear bomb – and the ensuing shockwave can snap large trees half a kilometre away

Ancient ‘living fossil’ fish has scales that act as adaptable armour

New Scientist - Ma, 09/10/2018 - 13:30
The coelacanth fish has scales that can change their internal structure if they are pierced by a predator to stop cracks spreading

Home of the gentle giants: How humans live with Galapagos tortoises

New Scientist - Ma, 09/10/2018 - 12:25
The Galapagos archipelago is a growing tourist attraction, which is adding to the problems faced by the islands’ famous giant residents

Three people had their brains wired together so they could play Tetris

New Scientist - Ma, 09/10/2018 - 12:00
Three people played a game of Tetris using brain-reading caps. This is the first time several people have collaborated through brain-to-brain communication

Google+ to shut down after 500,000 people’s personal details exposed

New Scientist - Ma, 09/10/2018 - 11:45
The social network Google+ is shutting down for regular users, after it discovered a flaw in March that exposed personal information of up to 500,000 people

What is ‘problem internet use’ and is it really a problem?

New Scientist - Ma, 09/10/2018 - 01:01
Researchers are calling for recognition of mental health problems caused by excessive gaming, gambling and social media, but lumping these together may not be right

Jupiter’s moon Europa may have a belt of 15-metre-tall ice spikes

New Scientist - Lu, 08/10/2018 - 17:00
Landing on Jupiter’s moon Europa will be even harder than we thought due to a forbidding belt of huge ice spikes that could trap or incapacitate a spacecraft

Naysayers rise to the top because we naturally treat them as leaders

New Scientist - Lu, 08/10/2018 - 16:39
Openly negative and critical people are often elected leaders, perhaps because we perceive their disregard for social niceties as a sign of power and independence
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