Lifetime Accumulation Research Articles

Early sexual activity lowers the incidence of intracranial aneurysm: a Mendelian randomization investigation.

Investigate the potential correlation between the age of initial sexual contact, the lifetime accumulation of sexual partners, and the occurrence of intracranial aneurysm (IA) employing a two-sample Mendelian randomization approach. This research aims to elucidate the causal relationship between intracranial aneurysm (IA) and sexual variables. Two distinct sexual variables, specifically the age had first sexual intercourse (n = 406,457) and the lifetime number of sexual partners (n = 378,882), were employed as representative parameters in a two-sample Mendelian randomization (MR) study. Outcome data from 23 cohorts, comprising 5,140 cases and 71,934 controls, were gathered through genome-wide association studies (GWAS). To bolster analytical rigor, five distinct methodologies were applied, encompassing MR-Egger technique, weighted median, inverse variance weighted, simple modeling, and weighted modeling. Our investigation unveiled a causal relationship between the age first had sexual intercourse and the occurrence of intracranial aneurysm (IA), employing the Inverse Variance Weighted (IVW) approach [Odds Ratio (OR): 0.609, p-value: 5.684E-04, 95% Confidence Interval (CI): 0.459-0.807]. This association was notably significant in the context of unruptured intracranial aneurysms (uIA) using the IVW approach (OR: 0.392, p-value: 6.414E-05, 95% CI: 0.248-0.621). Conversely, our findings did not reveal any discernible link between the lifetime number of sexual partners and the occurrence of IA (IA group: OR: 1.346, p-value: 0.415, 95% CI: 0.659-2.749; SAH group: OR: 1.042, p-value: 0.943, 95% CI: 0.338-3.209; uIA group: OR: 1.990, p-value: 0.273, 95% CI: 0.581-6.814). The two-sample Mendelian Randomization (MR) study presented herein provides evidence supporting a correlation between the age of initial engagement in sexual activity and the occurrence of intracranial aneurysm (IA), with a noteworthy emphasis on unruptured intracranial aneurysms (uIA). Nevertheless, our investigation failed to establish a definitive association between IA and the cumulative lifetime number of sexual partners.

Preventing Childhood Obesity in Diabetes: A Critical Imperative

: Diabetes mellitus (DM) encompasses a range of chronic metabolic conditions characterized by hyperglycemia, stemming from either insulin deficiency due to pancreatic β-cell damage (T1DM) or peripheral tissue insulin resistance (T2DM). Given the importance of DM and obesity, this narrative review aimed to address the optimal screening and control of childhood obesity as the main strategies for dealing with the comorbidities of T2DM. This review underscores the critical importance of optimal screening and management of childhood obesity as primary strategies for addressing comorbidities associated with T2DM. In many cases, T2DM may remain asymptomatic for several years, leaving patients unaware of their condition or experiencing few symptoms despite having poorly controlled prediabetes or DM. Hence, it is imperative to recognize that screening for prediabetes and childhood obesity presents a crucial opportunity for intervention to avert the future development of DM and its lifelong health repercussions. Moreover, lifestyle modifications stand out as the most effective approach for preventing or delaying the onset of T2DM comorbidities and complications. It is noteworthy that reductions in mortality among people with DM, associated with current antidiabetic medications, will increase the lifetime accumulation of T2DM complications and morbidities worldwide.

Association between cumulative metabolic risk exposure and cardiovascular disease: a nationwide cohort of over 3.6 million young adults.

As lifetime accumulation of cardiovascular risk factors is gaining importance, early identification and management of risk factors are being emphasized. The global prevalence of metabolic syndrome (MetS), a constellation of these risk factors, is increasing, particularly among young adults. In this study, we aim to investigate the association between cumulative exposure to metabolic risk and cardiovascular disease (CVD) in young adults. In this nationwide population-based cohort, we analysed 3 688 787 young adults (<40 years) with 2 biennial National Health Screening examinations from 2009 to 2012. Participants were categorized into MetS-free, MetS-developed, MetS-recovered, or MetS-persistent group, based on MetS presence at each examination. The endpoint was new CVD development, including myocardial infarction (MI) and ischaemic stroke. During follow-up (median, 7.7 years), CVD occurred in 19 219 individuals (0.5%). The incidence rates of CVD were 0.58, 1.17, 1.20, and 1.83 (1000 person-years) in the MetS-free, MetS-developed, MetS-recovered, and MetS-persistent groups, respectively. The CVD risk was proportionally associated with cumulative metabolic risk exposure, with a maximum two-fold increase in the MetS-persistent group [adjusted hazard ratio (aHR) 1.94, 95% confidence interval (CI) 1.84-2.04], followed by the MetS-recovered and the MetS-developed groups with similar risks. Among the MetS components, persistent exposure to elevated blood pressure (BP) had the greatest association with CVD risk (aHR 1.69, 95% CI 1.63-1.76). This tendency was consistent in the separate analyses of the risk of MI and ischaemic stroke. The risk of CVD increased in an exposure-dependent manner among young adults. Efforts to optimize the cardiometabolic profile, particularly BP, even after the establishment of MetS, might help promote long-term cardiovascular prognosis.

SOCIAL SUPPORT, MENTAL HEALTH, AND SEXUAL ORIENTATION: A STUDY OF THREE TIME POINTS IN THE CLSA

Abstract Lesbian, gay, and bisexual (LGB) older adults exhibit mental health disparities stemming from a lifetime accumulation of minority stress experiences. Psychological resources like social support may buffer against these poor mental health outcomes. The purpose of this study was to examine indicators of depression and social support by sexual orientation over time in a sample of Canadian adults ages 45-85. We used data collected at three time points in the Canadian Longitudinal Study on Aging (CLSA; baseline, 2011-2015; follow-up 1, 2015-2018; and follow-up 2, 2018-2021). Depression was measured using the Center for Epidemiologic Studies Depression scale (CESD-10) and social support was measured using the Medical Outcomes Study Social Support Survey (MOS-SSS). For depression symptoms (n=38,244; 830 LGB), results indicated a significant effect of sexual orientation (F(2, 38242)=35.93, p&amp;lt;.001) such that LGB participants had more depression symptoms than heterosexual participants. There was also a significant effect of time on depression symptoms (F(2, 38242)=26.07, p&amp;lt;.001); mean depression scores decreased over time. For social support (n=35,795; 770 LGB), results indicated a significant effect of sexual orientation (F(2, 35794)=45.31, p&amp;lt;.001) such that LGB participants reported lower levels of social support than heterosexual participants. There was also a significant effect of time (F(2, 35794)=5.98, p=.003); the mean scores for social support increased over time. The potential role of social support in moderating depression symptoms will be discussed. This study adds to our understanding of potential protective factors influencing the mental health of older LGB people.

Prediction of continuous amyloid PET values by CSF tau measures

AbstractBackgroundAlzheimer disease (AD) is a slowly progressive neurodegenerative disorder characterized by the presence of amyloid plaques that can be measured in vivo with positron emission tomography (PET). PET quantifies the lifetime accumulation of amyloid plaques, while cerebrospinal fluid (CSF) biomarkers reflect the production and clearance of Aβ and tau peptides at time of CSF collection. Previous work has demonstrated a relative plateau of CSF values at higher levels of amyloid burden. Our objective was to identify the range of amyloid PET values predicted by CSF measures of tau phosphorylation, which have been found to be strongly associated with amyloid PET burden.MethodCSF was collected within two years of an amyloid PET scan from 417 (63 cognitively impaired) participants enrolled in studies of memory and aging at the Knight Alzheimer Disease Research Center (mean age 69.8 years, standard deviation 8.9 years). PET imaging was performed with Pittsburgh Compound B (PiB). CSF Aβ42, p‐tau181 and Aβ40 were measured with Lumipulse automated immunoassays. The CSF tau phosphorylation occupancies (percent of tau phosphorylated) at T111, T153, T175, T181, S199, S202, T205, S208, T217, and T231 were evaluated with an immunoprecipitation‐mass spectrometry (IPMS) assay. We applied a neural network to generate a simulated PET‐PiB scan and cortical summary estimates using the fluid biomarkers as modeled inputs. We used asymptotic regression to evaluate the range of amyloid PET values predicted by each CSF measure (Figure 1).ResultCombining fluid biomarkers generated a cortical amyloid burden estimate within 12.6% mean average percent error (MAPE). Four of the assessed fluid biomarkers individually generated estimates within 20% MAPE (Figure 2). Of these, CSF Lumipulse p‐tau181/Aβ42, pS208/S208 (%), and pT231/T231 (%) predicted amyloid PET burden up until a high level (3.08 SUVR/91.1 Centiloids; 3.01 SUVR/88.0 Centiloids; 2.79 SUVR/78.1 Centiloids, respectively) (Figure 3). CSF pT217/217 (%) also had high accuracy but a slightly lower prediction threshold (2.65 SUVR/71.8 Centiloids).ConclusionCSF measures including phosphorylated tau predict amyloid PET over different ranges. Combining different measures of CSF tau phosphorylation can generate estimates of cortical amyloid burden. Future work will evaluate the prediction of tau PET by CSF measures.

The amyotrophic lateral sclerosis exposome: recent advances and future directions.

Amyotrophic lateral sclerosis (ALS) is a fatal disease of motor neuron degeneration with typical survival of only 2-5 years from diagnosis. The causes of ALS are multifactorial: known genetic mutations account for only around 70% of cases of familial ALS and 15% of sporadic cases, and heritability estimates range from 8% to 61%, indicating additional causes beyond genetics. Consequently, interest has grown in environmental contributions to ALS risk and progression. The gene-time-environment hypothesis posits that ALS onset occurs through an interaction of genes with environmental exposures during ageing. An alternative hypothesis, the multistep model of ALS, suggests that several hits, at least some of which could be environmental, are required to trigger disease onset, even in the presence of highly penetrant ALS-associated mutations. Studies have sought to characterize the ALS exposome - the lifetime accumulation of environmental exposures that increase disease risk and affect progression. Identifying the full scope of environmental toxicants that enhance ALS risk raises the prospect of preventingdisease by eliminating or mitigating exposures. In this Review, we summarize the evidence for an ALS exposome, discussing the strengths and limitations of epidemiological studies that have identified contributions from various sources. We also consider potential mechanisms of exposure-mediated toxicity and suggest future directions for ALS exposome research.

Abundance and characteristics of microplastic in some commercial species from the Persian Gulf, Iran

Global production of plastics has increased dramatically in recent decades and is considered a major threat to marine life and human health due to their stability, persistence, and potential to move through food chains. The study was conducted to detect, identify and quantify microplastics (MP) in the gastrointestinal tract (GI) of some commercial fish species in the North Persian Gulf in Bushehr Province: Psettodes erumei, Sphyraena jello, Sillago sihama, Metapenaeus affinis and Portunus segnis. A total of 216 plastic particles were collected from 102 individuals (72.68% of all sampled individuals; MP prevalence of 85.1% for M. affinis, 80% for P. segnis, 70% for P.erumei, 60.3% for S.sihama, 45.2% for S.jello). The average number of microplastics per organism was 2.26 ± 0.38 MP/ind (considering only species that ingested plastic, n = 102) and 1.51 ± 0.40 pieces/ind (considering all species studied, n = 140). Microfibers accounted for 58.49% of the total microplastics, followed by fragments (33.02%) and pellets (8.49%). The most common color of microplastic was black (52.83%), followed by blue (22.64%) and transparent (15.09%). The length of microplastic ranged from 100 to 5000 μm with an average of 854 ± 312 μm. Microplastics were significantly (p < 0.05) abundant in two shrimp studied: M. affinis and P. segnis (plastic in 80% of individuals studied) and to a lesser extent in the pelagic barracuda fish S. jello (plastic in 45% of individuals studied). The main synthetic polymers identified by Fourier transform infrared spectroscopy (FTIR) were polyethylene (38%), polypropylene (24%), polystyrene (17%), polyethylene terephthalate (11%) and polyamide (10%). The pollutant load index and lifetime accumulation index were calculated to identify the most polluted species and their toxicity to human health. The white shrimp M. affinis was identified as the most polluted and toxic species for MP based on PLI. The present study can provide valuable data for further research and a background for the control and monitoring of this pollutant in the coastal environment of Bushehr province.

Unique behavioral strategies in visuomotor learning: Hope for the non-learner

The existence of individual differences in motor learning capability is well known but the behaviors or strategies that contribute to this variability have been vastly understudied. What performance characteristics distinguish an expert level performer from individuals who experience little to no success, those labeled non-learners? We designed a rule-based visuomotor task which requires identification (discovery) and then exploitation of specific explicit and implicit task components that requires a specific movement pattern, the task rule, for goal achievement. When participants first attempt the task, they are informed about the goal, but are naïve to the task rule. Therefore, the purpose of this experiment is to determine how acquisition of both implicit and explicit task components, the inherent elements of the task rule, reveals differing strategies associated with performance and task success. We test the hypothesis that an examination of performance will reveal sub-groups with varying levels of success. Further, for each subgroup, we expect to find a unique relationship between visual Time-in-Target feedback (a measure of success) and subsequent updating of each task component. Out of 32 non-disabled adults, we identified three distinct sub-groups: (Low Performer/Non-Learner (LP, N=9), Moderate Performer (MP, N=12) and High Performer (HP, N=11)). A quantitative analysis of behavioral patterns reveals three findings: First, the LP sub-group demonstrated significantly lower task success which was associated with difficulty identifying the explicit component of the task. Second, the HP sub-group acquired the two task components in parallel over practice. Third, when both explicit and implicit component performance is plotted across sub-groups, a task component continuum emerges that seamlessly progresses from low to moderate to high performer groups. An exploratory analysis reveals that self-reported level of prior lifetime accumulation of video game and physical activity experience is a significant predictor of individual task performance (R2=0.50). In summary, what appears to be a key distinction between varying levels of human rule-based motor learning is the process by which feedback is used to update performance of inherent elements of the task rule. Evidence of a performance continuum and limited prior experience suggests that Low Performer/Non-Learners are generally inexperienced with these kinds of tasks, although the role of genetics and other innate learning capabilities in visuomotor learning is still largely unknown. These findings provoke new research directions toward probing the differential performance strategies associated with expertise and the development of interventions aimed to convert non-learners into learners.

Occupational Solar Exposure at Summer Camp: The Failure to Protect from a Known Hazard

Summer camps are an $18 billion industry while providing over 14,000 individual programs in the United States in 2015. Camp counselors, like other outdoor workers, are at risk of occupational solar exposure. Occupational solar exposure increases an individual’s lifetime accumulation of solar radiation, leading to skin damage and higher rates of skin cancer. This study fills a gap in the research about the sun protection behaviors of camp counselors and their attitude towards protecting themselves and the campers in their care. Overall, counselors did not achieve experts’ recommendations for sun protection. The findings suggest that summer camps are not taking adequate steps to protect their staff from a known workplace hazard. The Occupational Safety and Health Administration appears to currently not be holding summer camps accountable. The findings have implications for hiring, training, and risk management practices for the summer camp industry. Subscribe to JOREL

Lifetime Accumulation of Microplastic in Children and Adults.

Human exposure to microplastic is recognized as a global problem, but the uncertainty, variability, and lifetime accumulation are unresolved. We provide a probabilistic lifetime exposure model for children and adults, which accounts for intake via eight food types and inhalation, intestinal absorption, biliary excretion, and plastic-associated chemical exposure via a physiologically based pharmacokinetic submodel. The model probabilistically simulates microplastic concentrations in the gut, body tissue, and stool, the latter allowing validation against empirical data. Rescaling methods were used to ensure comparability between microplastic abundance data. Microplastic (1–5000 μm) median intake rates are 553 particles/capita/day (184 ng/capita/day) and 883 particles/capita/day (583 ng/capita/day) for children and adults, respectively. This intake can irreversibly accumulate to 8.32 × 103 (90% CI, 7.08 × 102–1.91 × 106) particles/capita or 6.4 (90% CI, 0.1–2.31 × 103) ng/capita for children until age 18, and up to 5.01 × 104 (90% CI, 5.25 × 103–9.33 × 106) particles/capita or 40.7 (90% CI, 0.8–9.85 × 103) ng/capita for adults until age 70 in the body tissue for 1–10 μm particles. Simulated microplastic concentrations in stool agree with empirical data. Chemical absorption from food and ingested microplastic of the nine intake media based on biphasic, reversible, and size-specific sorption kinetics, reveals that the contribution of microplastics to total chemical intake is small. The as-yet-unknown contributions of other food types are discussed in light of future research needs.

Enhanced risk of cancer in companion animals as a response to the longevity

Cancer is caused by the lifetime accumulation of multiple somatic deformations of the genome and epigenome. At a very low rate, mistakes occur during genomic replication (e.g., mutations or modified epigenetic marks). Long-lived species, such as elephants, are suggested to have evolved mechanisms to slow down the cancer progression. Recently, the life span of companion dogs has increased considerably than before, owing to the improvement of their environment, which has led to an increase in the fraction of companion dogs developing cancer. These findings suggest that short-term responses of cancer risk to longevity differ from long-term responses. In this study, to clarify the situation, we used a simple multi-step model for cancer. The rates of events leading to malignant cancer are assumed to be proportional to those of genomic replication error. Perfect removal of replication error requires a large cost, resulting in the evolution of a positive rate of genomic replication error. The analysis of the model revealed: that, when the environment suddenly becomes benign, the relative importance of cancer enhances, although the age-dependent cancer risk remains unchanged. However, in the long run, the genomic error rate evolves to become smaller and mitigates the cancer risk.

Association Between Lifetime Affective Symptoms and Premature Mortality

Associations between affective symptoms and mortality have been evaluated, but studies have not examined timing or cumulative exposure to affective symptoms over the life course. To examine how lifetime accumulation and timing of affective symptoms are associated with mortality and identify potential explanatory factors. Data were obtained from the MRC National Survey of Health and Development (1946 British birth cohort), a socially stratified, population-based sample originally consisting of 5362 singleton births in England, Wales, and Scotland during March 1946. The cohort has been followed up 24 times, most recently in 2014-2015. Eligible participants included those flagged for mortality with affective symptom data available at a minimum of 3 time points (n = 3001). Data analysis was conducted from July 2016 to January 2019. Affective symptoms were assessed at ages 13 to 15 years (teacher-rated questionnaire), 36 years (Present State Examination clinical semistructured interview), 43 years (Psychiatric Symptom Frequency questionnaire), and 53 years (General Health Questionnaire-28). Case-level affective symptoms were determined by those scoring in the top 16th percentile (ie, suggestive of a clinical diagnosis). Mortality data were obtained from the UK National Health Service Central Register from age 53 to 68 years. Of 3001 study members (1509 [50.3%] female, 1492 [49.7%] male), 235 individuals (7.8%) died over a 15-year follow-up. After adjustment for sex, those who experienced case-level affective symptoms 1, 2, and 3 to 4 times had 76%, 87%, and 134% higher rates of premature mortality, respectively, compared with those who never experienced case-level symptoms. Case-level symptoms in adolescence only (ages 13-15 years) were associated with a 94% increased rate of mortality, which was unexplained after full adjustment for covariates (hazard ratio, 1.73; 95% CI, 1.10-2.72). Associations between participants with case-level symptoms multiple (2-4) times and mortality were predominately explained by adult health indicators and behaviors. For example, associations for those with case-level symptoms 3 to 4 times were most strongly attenuated by number of health conditions (32.1%), anxiolytic use (28.4%), lung function (24.6%), physical activity (23.9%), smoking (24.6%), antidepressant use (20.1%), diet (16.4%), pulse rate (12.7%), and adult social class (11.2%). Lifetime accumulation of affective symptoms may be associated with an increased rate of mortality, with explanatory pathways dependent on the duration and timing of symptoms. Future research into causal pathways and potential points of intervention should consider affective symptom history.

Extrachromosomal Circular DNA: Current Knowledge and Implications for CNS Aging and Neurodegeneration.

Still unresolved is the question of how a lifetime accumulation of somatic gene copy number alterations impact organ functionality and aging and age-related pathologies. Such an issue appears particularly relevant in the broadly post-mitotic central nervous system (CNS), where non-replicative neurons are restricted in DNA-repair choices and are prone to accumulate DNA damage, as they remain unreplaced over a lifetime. Both DNA injuries and consecutive DNA-repair strategies are processes that can evoke extrachromosomal circular DNA species, apparently from either part of the genome. Due to their capacity to amplify gene copies and related transcripts, the individual cellular load of extrachromosomal circular DNAs will contribute to a dynamic pool of additional coding and regulatory chromatin elements. Analogous to tumor tissues, where the mosaicism of circular DNAs plays a well-characterized role in oncogene plasticity and drug resistance, we suggest involvement of the “circulome” also in the CNS. Accordingly, we summarize current knowledge on the molecular biogenesis, homeostasis and gene regulatory impacts of circular extrachromosomal DNA and propose, in light of recent discoveries, a critical role in CNS aging and neurodegeneration. Future studies will elucidate the influence of individual extrachromosomal DNA species according to their sequence complexity and regional distribution or cell-type-specific abundance.

A survey of trace metal burdens in increment cores from eastern cottonwood (Populus deltoides) across a childhood cancer cluster, Sandusky County, OH, USA

A dendrochemical study of cottonwood trees (Populus deltoides) was conducted across a childhood cancer cluster in eastern Sandusky County (Ohio, USA). The justification for this study was that no satisfactory explanation has yet been put forward, despite extensive local surveys of aerosols, groundwater, and soil. Concentrations of eight trace metals were measured by ICP-MS in microwave-digested 5-year sections of increment cores, collected during 2012 and 2013. To determine whether the onset of the first cancer cases could be connected to an emergence of any of these contaminants, cores spanning the period 1970–2009 were taken from 51 trees of similar age, inside the cluster and in a control area to the west. The abundance of metals in cottonwood tree annual rings served as a proxy for their long-term, low-level accumulation from the same sources whereby exposure of the children may have occurred. A spatial analysis of cumulative metal burdens (lifetime accumulation in the tree) was performed to search for significant 'hotspots', employing a scan statistic with a mask of variable radius and center. For Cd, Cr, and Ni, circular hotspots were found that nearly coincide with the cancer cluster and are similar in size. No hotspots were found for Co, Cu, and Pb, while As and V were largely below method detection limits. Whereas our results do not implicate exposure to metals as a causative factor, we conclude that, after 1970, cottonwood trees have accumulated more Cd, Cr, and Ni, inside the childhood cancer cluster than elsewhere in Sandusky County.

Species-Specific Characteristics Influence Contaminant Accumulation Trajectories and Signatures Across Ontogeny in Three Pelagic Shark Species.

Factors influencing organic contaminant accumulation in sharks, especially across ontogeny, are not well-known. Contaminant concentrations were measured in three species of sharks (Blue, Shortfin Mako, and Common Thresher) across a range of size classes (neonatal to adult) that vary in their ecological and physiological characteristics. Empirical data was compared to a theoretical framework that predicted the shape of lifetime accumulation curves. We found that a one-size-fits-all accumulation model was not appropriate as species-specific characteristics had a significant effect on contaminant accumulation trajectories. Maternal offloading likely has an important effect on determining neonatal shark contaminant starting points, and trophic ecology and physiology may interact to affect the shape of species' contaminant accumulation curves. Makos were found to have the highest accumulation potential and Blues the lowest, with Threshers being intermediate in accumulation potential. Changes in species' ecology and/or physiology were also reflected in contaminant signature changes over ontogeny. If contaminant concentrations are to be used as a proxy for risk, species-specific characteristics need to be taken into account when estimating contaminant exposure and its potential negative effects on shark health and human consumption safety.

Late life disability and experienced wellbeing: Are economic resources a buffer?

BackgroundDisablement has been linked to compromised wellbeing in later life, but whether material resources buffer these negative effects is unclear. ObjectiveDrawing upon conceptual models of stress and coping, we analyze experienced wellbeing data from time diary interviews with adults ages 60 and older. We expect that experienced wellbeing will be influenced by each stage of the disablement process and that higher income and wealth will buffer the negative effects of disability on experienced wellbeing. Because income is a better reflection of one's liquid resources while assets reflect lifetime accumulation, we expect income to be a more substantial buffer than assets. MethodsWe use the Disability and Use of Time Supplement to the Panel Study of Income Dynamics (N = 1607). We consider several measures of the disablement process (activity limitations, impairment severity, duration of limiting condition) and history of work limitation and evaluate both pre-tax income and net worth quartiles. We estimate a series of multi-level regression models that account for clustering of individuals within couples. We calculate the marginal effects of disability on wellbeing at different quartiles of economic resources. ResultsWe find that impairment severity is associated with worse experienced wellbeing before and after adjusting for covariates, and income buffers these negative effects for those in the middle-income quartiles. ConclusionsFuture research should further explore the mechanisms through which income buffers the negative effects of impairment severity and specify the accommodations that enable economically disadvantaged and advantaged older adults alike to withstand physical declines while maintaining wellbeing.

Exploring Lifetime Accumulation of Criminal Justice Involvement and Associated Health and Social Outcomes in a Community-Based Sample of Women who Use Drugs.

Among people who use illegal drugs, engagement with the criminal justice (CJ) system often involves an ongoing, intermittent series of arrests, incarcerations, and periods of community supervision. The potential associations between the lifetime accumulation of CJ involvement and social and health outcomes is largely unexplored. In a cross-sectional sample of women who use crack, heroin, and/ or methamphetamine recruited from communities in Oakland, CA (N=624), we developed an approach to characterize CJ accumulation. We used latent class analysis (LCA), a multivariate person-centered method that assumes an unobserved categorical variable that divides a population into a small number of mutually exclusive and exhaustive classes. Using observed measures of incarceration and community supervision as indicator variables, we developed a model of CJ accumulation that elucidates patterns of involvement as lived by the women in the sample. Based on model fit statistics, we selected a three-class model and labeled the classes "low," "medium," and "high." We then explored associations between the classes of CJ accumulation and health and health-related outcomes using logistic regression. The odds of homelessness (p for trend=0.004), transience (p for trend=0.017), and recent victimization (p for trend=0.023) were higher among women in higher accumulation classes. Higher class of CJ accumulation was associated with higher odds of reporting unmet need for physical health care (p for trend <0.001) and mental health care (p for trend=0.002). The odds of physical health conditions, such as hepatitis C infection (p for trend<0.001) and mental health conditions, such as depression (p for trend=0.003), also increased with higher class of accumulation. While the findings described here are limited by the cross-sectional nature of the study, they suggest that CJ accumulation is a potentially meaningful concept for assessing associations between the CJ system and health-related issues.

An Ornithologist Shares His Passion and a Lifetime Accumulation of Great Bird Stories

An Ornithologist Shares His Passion and a Lifetime Accumulation of Great Bird Stories

Off Target: Assessing the Fairness of Ottawa's Proposed Tax Reforms for 'Passive' Investments in CCPCs

In July 2017, the Department of Finance launched consultations on a series of tax proposals affecting owners of Canadian-Controlled Private Corporations (CCPCs). The proposals on the treatment of “passive income,” from investments such as equities and government bonds, have attracted particular controversy. The proposed regime would end passive investment income-tax refundability for CCPCs – ie., taxes paid on investment income in a CCPC would no longer be tracked and refunded upon dividend payments. Although there are other versions of proposed changes, this is seemingly the one the government favours. Private corporations – and by extension their owners – would be taxed on their passive investment income on the same basis as if they were individual investors in fully taxable accounts. There would be diminished incentives to defer business consumption, and less income and business saving available for spending on capital equipment. The same is true of small business income retained for personal purposes – there will be greater incentives for immediate personal consumption of business income rather than saving it for retirement or other purposes. But is the current system inequitable? Our tax simulations show, overall, it is not – when benchmarked against the tax treatment afforded to personal retirement savings. Saving for retirement in tax-assisted plans – on a “consumption-equivalent” tax basis with a steeply graduated tax rate structure – is widely accepted in principle and in practice, because such treatment does not discourage saving as a pure income tax would do. Considering that additional administration, accounting, and tax compliance costs need to be incurred in corporate accounts, one could reasonably conclude that passively reinvested small business earnings receive a tax treatment similar to that of RRSP/TFSAs in a variety of possible portfolio compositions. Besides, successful businesses earning income above the small-business threshold enjoy no significant tax “advantages” on passively reinvested earnings. As laid out, these proposals risk delivering a blow to the retirement planning of many small business owners, not to mention their potential negative impacts on entrepreneurship and risk taking. Further, the playing field with respect to tax-assisted saving opportunities is already largely unequal. Outdated current tax rules allow career defined-benefit (DB) pension plan participants, particularly in the public sector, to end their careers with tax-assisted retirement wealth worth multiples of that practically achievable in RRSPs. If the government proceeds with changes along the lines it has outlined, fairness suggests that it should level the playing field so business owners have tax-assisted retirement saving opportunities comparable to those available to most public-sector employees in DB plans and Members of Parliament. The most ambitious reform would establish a lifetime accumulation limit of personal tax-assisted savings, in lieu of the current system of annual limits. A lifetime accumulation limit would ease the transition to the new proposed regime, and provide needed contribution flexibility and room to everyone, including small business owners, to accumulate sufficient retirement wealth.

High prevalence of anti-hepatitis E virus antibodies in outpatients with chronic liver disease in a university medical center in Germany.

Hepatitis E virus (HEV) is an emerging disease in developed countries. HEV seroprevalence ranges from 3.2 to 10% in Europe, but is higher in endemic areas such as southern France. In Germany, an increasing incidence of HEV infections has been reported recently. Risk factors for the acquisition of HEV are incompletely understood. We screened 295 consecutive patients with chronic liver disease attending the outpatient department at Charité University Hospital for HEV seroprevalence. Epidemiological characteristics were analyzed and patients were questioned for risk factors using a standardized questionnaire. A total of 78 patients without known liver disease were also tested for HEV IgG. Out of 295 screened patients, 62 tested positive for HEV-IgG. Overall, 50% of the HEV-positive patients were women and 23.8% had underlying liver cirrhosis. HEV-positive patients were older than HEV-negative patients (mean age 56 vs. 48.6 years). Seroprevalence increased with age from 13% in patients 30-39 years of age to 36.4% in patients 70-79 years of age. Of the total, 46.7% of HEV-IgG-positive patients had contact with domestic animals and 38.3% had received blood transfusions. A total of 50% of the HEV-IgG-positive patients had regularly consumed uncooked meat and 45% had regularly consumed wild game or wild boar, which was significantly more frequent than in HEV-IgG-negative patients. HEV-IgG seroprevalence was 21% in a cohort of patients with chronic liver disease and 24.4% in a cohort of patients without known liver disease. The higher seroprevalence found among elderly patients suggests a lifetime accumulation of risk of exposure to HEV. The results from this study imply that regular testing should be performed for HEV in developed countries in case of liver disease of unknown etiology.