Association of low fasting C-peptide levels with cardiovascular risk, visit-to-visit glucose variation and severe hypoglycemia in the Veterans Affairs Diabetes Trial (VADT)

Aims Low C-peptide levels, indicating beta-cell dysfunction, are associated with increased within-day glucose variation and hypoglycemia. In advanced type 2 diabetes, severe hypoglycemia and increased glucose variation predict cardiovascular (CVD) risk. The present study examined the association between C-peptide levels and CVD risk and whether it can be explained by visit-to-visit glucose variation and severe hypoglycemia. Materials and methods Fasting C-peptide levels at baseline, composite CVD outcome, severe hypoglycemia, and visit-to-visit fasting glucose coefficient of variation (CV) and average real variability (ARV) were assessed in 1565 Veterans Affairs Diabetes Trial participants. Results There was a U-shaped relationship between C-peptide and CVD risk with increased risk with declining levels in the low range (< 0.50 nmol/l, HR 1.30 [95%CI 1.05–1.60], p = 0.02) and with rising levels in the high range (> 1.23 nmol/l, 1.27 [1.00–1.63], p = 0.05). C-peptide levels were inversely associated with the risk of severe hypoglycemia (OR 0.68 [0.60–0.77]) and visit-to-visit glucose variation (CV, standardized beta-estimate − 0.12 [SE 0.01]; ARV, − 0.10 [0.01]) (p < 0.0001 all). The association of low C-peptide levels with CVD risk was independent of cardiometabolic risk factors (1.48 [1.17–1.87, p = 0.001) and remained associated with CVD when tested in the same model with severe hypoglycemia and glucose CV. Conclusions Low C-peptide levels were associated with increased CVD risk in advanced type 2 diabetes. The association was independent of increases in glucose variation or severe hypoglycemia. C-peptide levels may predict future glucose control patterns and CVD risk, and identify phenotypes influencing clinical decision making in advanced type 2 diabetes.

PATTERNS OF CHEMICAL CONTROL OF WEEDS ON DISC ON PRODUCTION AND RAINFALL AND RAIN DAYS AT KUALA PESILAM GARDEN GARDEN ELEPHANT HALL DIVISION I PT. BAHRUNY

This final project research was conducted at the Kuala Pesilam Balai Gajah estate, Division I, PT. Bahruny, North Sumatra Province. This study took place from July to July 2021. This study aims to determine the pattern of weed control in the circle on production as well as rainfall and rainy days. This study uses a descriptive method by collecting secondary data from the garden: rainfall and production data. The results of this study can indicate that Indonesia's unstable palm oil production is caused by several factors, namely genetic factors, biotic factors (weeds) and abiotic factors (rainfall and rainy days). Production in 2020 is the highest production of oil palm for 4 years (2017-2020) with a total production of 5,971,760 Kilograms with an area of 336.96 hectares. The amount of rainfall is 2371 mm and rainy days is 117 days with weed control patterns on the disk carried out 4 times a year. Production in 2018 was the lowest production of oil palm for 4 years (2016-2020) with a total production of 4,032,338 kg, with an area of 267.96 Ha. The amount of rainfall is 1854 mm and rainy days is 112 rainy days with weed control patterns on the disc 2 times a year. The optimal rainfall for the growth and production of oil palm plants is 2,000 mm, but with 1846 mm of rainfall it does not mean it is not good for the growth and production of oil palm plants as long as there is no water deficit, so this rainfall is still included in the criteria for growing oil palm. Production in 2018 was the lowest production of oil palm for 4 years (2016-2020) with a total production of 4,032,338 kg, with an area of 267.96 Ha. The amount of rainfall is 1854 mm and rainy days is 112 rainy days with weed control patterns on the disc 2 times a year. The optimal rainfall for the growth and production of oil palm plants is 2,000 mm, but with 1846 mm of rainfall it does not mean it is not good for the growth and production of oil palm plants as long as there is no water deficit, so this rainfall is still included in the criteria for growing oil palm. Production in 2018 was the lowest production of oil palm for 4 years (2016-2020) with a total production of 4,032,338 kg, with an area of 267.96 Ha. The amount of rainfall is 1854 mm and rainy days is 112 rainy days with weed control patterns on the disc 2 times a year. The optimal rainfall for the growth and production of oil palm plants is 2,000 mm, but with 1846 mm of rainfall it does not mean it is not good for the growth and production of oil palm plants as long as there is no water deficit, so this rainfall is still included in the criteria for growing oil palm.

Association of Low Fasting C-Peptide Levels With Cardiovascular Risk, Visit-To-Visit Glucose Variation and Severe Hypoglycemia in The Veterans Affairs Diabetes Trial (VADT)

Aims Low C-peptide levels, indicating beta-cell dysfunction, are associated with increased within-day glucose variation and hypoglycemia. In advanced type 2 diabetes, severe hypoglycemia and increased glucose variation predict cardiovascular (CVD) risk. The present study examined the association between C-peptide levels and CVD risk and whether it can be explained by visit-to-visit glucose variation and severe hypoglycemia. Materials and Methods Fasting C-peptide levels at baseline, composite CVD outcome, severe hypoglycemia, and visit-to-visit fasting glucose coefficient of variation (CV) and average real variability (ARV) were assessed in 1565 Veterans Affairs Diabetes Trial participants. Results There was a U-shaped relationship between C-peptide and CVD risk with increased risk with declining levels in the low range (<0.50 nmol/l, HR 1.30 [95%CI 1.05-1.60], p=0.02) and with rising levels in the high range (>1.23 nmol/l, 1.27 [1.00-1.63], p=0.05). C-peptide levels were inversely associated with the risk of severe hypoglycemia (OR 0.68 [0.60-0.77]) and visit-to-visit glucose variation (CV, standardized beta-estimate -0.12 [SE 0.01]; ARV, -0.10 [0.01]) (p<0.0001 all). The association of low C-peptide levels with CVD risk was independent of cardiometabolic risk factors (1.48 [1.17-1.87, p=0.001) and remained associated with CVD when tested in the same model with severe hypoglycemia and glucose CV. Conclusions Low C-peptide levels were associated with increased CVD risk in advanced type 2 diabetes. The association was independent of increases in glucose variation or severe hypoglycemia. C-peptide levels may predict future glucose control patterns and CVD risk, and identify phenotypes influencing clinical decision making in advanced type 2 diabetes.

Using mastoid vibration can detect the uni/bilateral vestibular deterioration by aging during standing

BACKGROUND: The mastoid vibration (MV) has been used to investigate unilateral vestibular dysfunction by inducing nystagmus. Additionally, this MV can be used to quantify the effect of deterioration by aging on the vestibular system during walking. Could such MV be used to assess the uni/bilateral vestibular deterioration by aging during standing? OBJECTIVE: This study attempted to determine the feasibility of using MV for identifying the uni/bilateral vestibular deterioration by aging during standing. METHODS: Fifteen young and ten old adults’ balance control patterns were assessed by three random MV conditions: 1) No MV; 2) Unilateral MV; 3) Bilateral MV. The dependent variables were the 95% confidence ellipse areas and the sample entropy values, which were calculated based on the center of gravity displacement within each condition. RESULTS: Significant main effects of MV and aging were found on all outcome variables. A significant interaction between aging and different MV types was observed in the 95% confidence ellipse area (p = 0.002) and the length of the short axis (anterior-posterior direction, p = 0.001). CONCLUSIONS: We concluded that the MV could be used to identify different vestibular dysfunctions, specifically in old adults.

Coercive control: Patterns in crimes, arrests and outcomes for a new domestic abuse offence

Critics of the criminalisation of coercive control warned that the criminal justice system was ill-prepared for a conceptualisation of domestic abuse that relies on victim accounts of fear and manipulation rather than on evidence of violence. Using data obtained through freedom of information requests to police forces and aggregated police records, this paper presents police force-level and nationwide patterns in recorded crimes, police arrests and crime outcomes for this new crime and shows that, nationally, the number of recorded crimes and arrests rose steadily, but there was significant variation in these patterns between police forces. Analysing police outcomes, we demonstrate that coercive control crimes face greater evidential challenges and are far less likely to result in prosecution than domestic abuse crimes in general. We discuss their implications of these trends and findings for the policing and criminalisation of coercive control.

Changes in Spatiotemporal Measures and Variability During User-Driven Treadmill, Fixed-Speed Treadmill, and Overground Walking in Young Adults: A Pilot Study

Walking is an integral indicator of human health commonly investigated while walking overground and with the use of a treadmill. Unlike fixed-speed treadmills, overground walking is dependent on the preferred walking speed under the individuals’ control. Thus, user-driven treadmills may have the ability to better simulate the characteristics of overground walking. This pilot study is the first investigation to compare a user-driven treadmill, a fixed-speed treadmill, and overground walking to understand differences in variability and mean spatiotemporal measures across walking environments. Participants walked fastest overground compared to both fixed and user-driven treadmill conditions. However, gait cycle speed variability in the fixed-speed treadmill condition was significantly lower than the user-driven and overground conditions, with no significant differences present between overground and user-driven treadmill walking. The lack of differences in variability between the user-driven treadmill and overground walking may indicate that the user-driven treadmill can better simulate the variability of overground walking, potentially leading to more natural adaptation and motor control patterns of walking.